How Cleveland Clinic is growing in spine: 3 Qs with Dr. Michael Steinmetz


In December 2018, Becker's Spine Review interviewed Michael Steinmetz, MD, chairman of the department of neurosurgery at Cleveland Clinic. He discussed a range of topics, including where the department is headed for spine over the next few years.

Here are three questions examining how the academic medical center is changing it's approach to spine care and where Dr. Steinmetz sees the field headed.

Read the full Q&A with Dr. Steinmetz here.

Question: What is the biggest challenge you are facing as head of the department and how are you overcoming that?

Dr. Michael Steinmetz: Due to the increased competition in the market, in 2019 we are looking at a strategic goal of expanding our business in regions where we do not have the greatest market share. We are focusing our strategy on areas where we haven't traditionally been the strongest. How do we go into those markets, understand the market and build in that market to provide the same care we do at Cleveland Clinic's central location there?

Cleveland is a flat market. It's shrinking, and most private practices are aligned with health systems already. If I want to grow market share by 5 percent, I have to get it somewhere else. We have to be strategic with our marketing, interaction with providers and relationships with primary care physicians to grow our business. For us, that's one of the biggest challenges for 2019. We are continuously working to innovate the care we deliver and broaden our outcomes-based care in the real world. That will allow us as a business to flourish to a greater extent because if we can provide the most appropriate care for the patient and get the best outcome, that's not only great for patient care but great for business.

Q: Are there any new expansion projects you can discuss at this time?

MS: We are continuously expanding [our] spinal oncology and deformity surgery brand; those are two areas where we are expanding clinical research, but what is new is endoscopic minimally invasive spine surgery. We are aggressively moving into the endoscopic space and offering a niche product for patients who want to fly in, stay at a hotel and undergo endoscopic spine surgery at a nice hospital off the main campus. It's near the airport and will offer a concierge-type service. We are trying to develop that as an aspect of our clinical armamentarium.

Q: When you are adding new surgeons and trainees to your team, and what qualities have changed over the past five years in the applicants? What is most attractive now?

MS: When we looked at recruits and trainees five years ago, we looked for people well-versed in basic science and clinical research. Now we look for people with backgrounds in data science and machine learning. Our research is now in big data. We have had a data registry since 2007, and we have to figure out what to do with all that data. We are using AI and machine-based learning to do data analysis of our outcomes and facilities to make that information more predictive. We consider which treatments will be best for each specific patient and whether there are factors that would affect the patient's outcome that we can mitigate. We can also see who the best surgeon would be to operate on each patient to achieve the best outcome.

That's the direction we are trying to go, and I think that's the direction of spine surgery. We've gone from a concept to data science, and we can do that because we're a large academic medical center. The data gathering capabilities will be a limiting factor for small groups. Now we are looking at how we can export the data we have at Cleveland Clinic to other practices and facilities; there are many challenges out there. We are just getting our feet wet in the whole arena.

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