The next 5 years: Where Dr. Todd Chapman sees the biggest challenges & opportunities for spine surgeons just starting out


Todd Chapman, MD, of Charlotte, N.C.-based OrthoCarolina Spine Center, discusses the philosophies and technologies that will shape his practice for many years to come.

Question: What are the biggest concerns for your practice today? What keeps you up at night?

Dr. Todd Chapman: The biggest concerns of my practice are the potential volatility of the healthcare market. Those of us who have started a practice as spine surgeons within the last five years started in the midst of the implementation of the ACA. This is currently in the process of being dismantled, or altered, by the government. There are undoubtedly changes coming in the healthcare landscape, but accurately predicting where these changes are heading is exceedingly challenging.

Additionally, with new metrics surrounding "value-based care," there are pressures to deliver care with specific, but poorly defined, outcome goals. This new emphasis with pending impacts on clinical care and delivery of care are issues that I struggle with as I try to figure out how to shape and grow my practice in order to be successful going forward.

Q: What are you most excited about in terms of technology advancement in the spine space? Where do you see the best opportunity for growth?

TC: I am most excited about the current understandings that we have of spine alignment and how it can affect clinical outcomes for patients. As our understanding of the drivers of outcomes improves, we will be able to better determine the areas where technological advancements can help achieve these radiographic views. Combining this new knowledge with the basic and infallible tenets of spine surgery is where we can continue to further advance and develop technologies that will offer our patients better outcomes. As we decrease the negative impacts of our procedures while maximizing our positive impacts, we can deliver more meaningful and impactful care.

I see the most opportunity for growth to be focused around fusionless surgery. Decreasing spine motion through fusions to correct underlying spine conditions is a sacrifice that our patients make to have their current ailments alleviated. And while we can continue to perform fusions that offer better outcomes with less disruptive impacts on our patients, targeting non-fusion technologies is an area that has not been adequately explored.

Q: Where do you see your practice growing or evolving in the next 5 years? What is the next step or evolution in your career?

TC: I see my practice growing to include more minimally invasive techniques without sacrificing the surgical tenets that I have been taught through my training. Combining these tenets and techniques is where I feel I can continue to seek to improve patient outcomes. Furthermore, seeking the non-fusion technologies and working to develop and implement them is an area I am eager to explore.

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