What is Your Number One Concern for Spine Surgery in 2012?


Six spine surgeons discuss their number one concerns for spine care in 2012.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question is: Where are you focusing your research and development in 2012? Please send responses to Laura Miller at laura@beckershealthcare.com by Tuesday, Jan. 3 at 5pm CST. Limit responses to five sentences or less.

Dennis Crandall, MD (Medical Director, Sonoran Spine Center, Mesa, Ariz.):
I worry most about the catastrophe looming over American healthcare if Obama is re-elected.

Ara Deukmedjian, MD (Founder, Deuk Spine Institute, Melbourne, Fla.):
Spine care in America is being destroyed by insurers at an unimaginable and unprecedented rate. Every day spine surgeons are discovering insurance company created roadblocks to their ability to care and provide for their patients. Spine care is very complex and involves many conditions that are difficult to treat. The most common spinal conditions are those causing debilitating pain from the spine. The most common causes of this pain include muscle pain, facet joint pain and pain originating in the spinal disc (discogenic pain). The only treatments available for these types of conditions are medication, therapy, needle procedures and surgery. Every one of these avenues of treatment is currently (and has been for some time) under heavy attack by the insurance industry. Insurers simply don't want to pay for spine care so I predict we will see a dramatic reduction in elective spine care in the near future. Patients will be forced to make a choice: either demand more coverage for spine care from their insurer or pay more out of pocket themselves. The shift of cost for spine care to the patient will result in fewer spinal procedures and this in turn will create tremendous stress on spine care providers to survive in independent practice.

J. Brian Gill, MD (Spine Surgeon, Nebraska Spine Center, Omaha):
The ability to perform procedures due to insurance approval. I have had more denials in the past four months than I had total for the prior two years. Unfortunately, it puts the patients in the middle with nowhere to turn. Another issue is the continuing declining reimbursements while trying to maintain a practice where expenses continue to increase.

Michael Gleiber, MD (Founder, Michael A. Glieber, MD, PA, Jupiter, Fla.):
Making sure those patients who require surgical procedures and osteobiologics are covered by their insurance plans so they can receive the appropriate, gold standard care.

Paul Slosar, MD (President, SpineCare Medical Group, San Francisco Spine Institute):
I have too many to list here.  Spine surgery can be an easy budget target because we provide a discreet care episode (surgery) that is "expensive" but in the large picture of healthcare costs we are miniscule. 

Brian Subach, MD (Director of Research and Spine Surgeon, Virginia Spine Institute, Reston):
Patient access to spinal healthcare. I am concerned that the healthcare reform combined with private insurers denying medically necessary procedures will lead to patients suffering unnecessarily when there are effective and proven technologies available to help them.

Related Articles on Spine Surgery:

10 Cost Benchmarks for Outpatient Cervical Spine Surgery
Where Spine Research is Headed: 5 Points From Dr. Frank Phillips

Building a Foundation for Scoliosis Treatment: 3 Important Studies

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