How Does Spine Surgeon Employment Compare to 10 Years Ago? 6 Spine Surgeons Respond


Here are six spine surgeons discussing out-of-network contracts for spine surgery. 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: Have you considered offering spine surgery for cash-pay patients?

Please send responses to Laura Miller at by Wednesday, August 29, at 5pm CST.

Dennis Crandall, MD, Founder and Medical Director of Sonoran Spine Center, Mesa, Ariz.:
There are more spine surgeons, especially neurosurgeons, employed or supporting our area hospitals than ever before. The motivation seems to be tied to call coverage.

Walter Eckman, MD, Founder, Aurora Spine Center, Tupelu, Miss.:

J. Brian Gill, MD, Spine Surgeon, Nebraska Spine Center, Omaha:
There is a slight increase of employed spine surgeons with only one to two new employed physicians at most. In the smaller communities several hours outside of my location, hospitals are aggressively pursuing spine surgeons as these are the only entities that lure a spine surgeon to the area and support him clinically and financially.

Richard Guyer, MD, Chairman, Texas Back Institute Research Foundation:
The simple answer is that I do not know any of my spine colleagues that are employed by hospitals. In our market it is very competitive and we have many groups that vary in size that have been able to maintain their independence. However, I have seen the trend increasing in other orthopedic specialties. I believe that we will begin to see this change in Dallas in the future as I have colleagues on the east coast that have become hospital employees. My obvious preference is that we at TBI maintain our independence and continue to meet the economic challenges and government inventions, both good and bad, while providing the best medical care to our patients. Our goal is to be leaders of the new era of medicine, not the followers.

Richard Kube, MD, Founder & CEO, Prairie Spine and Pain Institute, Peoria, Ill.
: When I started in practice six years ago, there were no spine surgeons employed by hospitals. Since that time, one of the local health systems bought the neurosurgery group, effectively moving half of the spine surgeons into the hospital employee category.  There are other orthopedic spine surgeons in the community, but there is no indication that any of them are leaving private practice any time soon.

Jeffrey Nees, MD, Spine & Neurosurgeon, Laser Spine Institute, Oklahoma City:
Spine surgeons choosing hospital employment is undoubtedly a growing trend and hospitals are aggressively pursuing this paradigm. However, I left private practice in Oklahoma City a few months ago and chose Laser Spine Institute because I'm able to do what I do best as a surgeon – focus exclusively on patient care and recovery.

More Articles on Spine Surgeons:

5 Spine Surgeons on Negotiating Out-of-Network Payor Contracts

What Percentage of Spine Surgery Could be Performed in ASCs? 7 Surgeons Respond

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