Predicting the unpredictable: 4 spine surgeons on challenges under Trump


Four spine surgeons discuss the potential disadvantages for providers under President Donald Trump.

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: What will MIS surgery look like five years from now in terms of innovation & adoption?


Please send responses to Anuja Vaidya at by Wednesday, March 8, at 5 p.m. CST.


Question: What are some disadvantages that spine surgeons may face under the new administration?


Richard Kube, MD. Founder and CEO of Prairie Spine & Pain Institute (Peoria, Ill.): It is hard to predict specific disadvantages. Frankly, that inability to predict is a major disadvantage in and of itself. The unknown can be costly. Anticipate too much and you can spend a lot of money going in the wrong direction. Anticipate too little and you can also spend money trying to catch up. It really means walking a fine line so that you can forecast and react as quickly as possible.  


That added attention to an evolving array of policies takes added time and resources to study and remain current. For the small group, that means a significant strain on internal resources, both capital and personnel. However, with a smaller size, there is a greater ability to be nimble and best optimize one's practice as the political currents shift.


Kern Singh, MD. Co-Director of Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush (Chicago): If the predictions are true and many Americans do lose their healthcare insurance under the new administration, we might see an increase in patients who allow their spine degeneration to progress without treatment or intervention. This can lead to more complex patients and worse outcomes overall than if these patients had been seen by a surgeon earlier on in the course of their disease.  


Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: Mostly the fear of lack of clarity with the changes. The new administration will hopefully partner with actual physicians when writing the new policies and understand that having an insurance company [help] write the ACA was one of many egregious errors and inexplicable oversights when the first set of laws came out. Furthermore, I think some surgeons are concerned how they will get paid if there is a gap between repeal and replace.


Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): As long as the new administration stays true to their campaign promises and enacts the reforms that will ease administrative burdens on physicians, I do not foresee any disadvantages.


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