4 spine, neurosurgeons on the best initiatives undertaken in their practices


Four spine and neurosurgeons describe initiatives implemented in their organizations and why they are most proud of them.

Question: Is there a single initiative your organization has undertaken recently that you are particularly proud of? 

Dr. David Antezana: Neurosurgeon at The Oregon Clinic and Co-Medical Director of the Spine Center at Providence Brain and Spine Institute (Portland, Ore.). The Complex Spine Roadmap. During the last few years, I have been intimately involved and the main driver of the Complex Spine Roadmap we have developed. It is an outstanding collaboration between Portland, Ore.-based The Oregon Clinic and the Providence Brain and Spine Institute. Initially, I got it off the ground with funding from the independent practice association.

The Roadmap has three arms: preoperative, intraoperative and postoperative. It essentially functions as a risk stratification tool to minimize complications and improve outcomes. It is far-reaching in the areas it covers. At its core is a multidisciplinary conference to discuss our more challenging patients. There we adjust or add to surgical plans. At times, we change them altogether. Everyone has an input.

While there are other such approaches to surgery in the spine world, there is a dearth of them published in the literature. All of them from academic centers. The Roadmap is very similar to other initiatives at Northwestern (Chicago), Seattle Spine and UPenn (Philadelphia) but we have strived to include more disciplines in our conference and encompass outcome measures. It is also adjustable to allow evaluation of less complex surgeries in more medically complex patients. To date, more than 80 patients have taken part. We hope to roll it out throughout Providence Portland Medical Center and Providence Saint Vincent’s Medical Center this fall. Private practice offers challenges different from academics. We have sought to recognize this in our work and look forward to the Complex Spine Roadmap helping patients in our community.

Emeka Nwodim, MD. Spine Surgeon at Centers for Advanced Orthopaedics, Bay Area Orthopaedics & Sports Medicine in Glen Burnie, Md. An initiative which my organization has taken and which I am very proud of is the unification of many private practice physicians and surgeons to optimize patient care and improve population health. By coming together, The Centers for Advanced Orthopaedics has helped balance the decision-making pendulum between patients, payers and providers.

Mark McLaughlin, MD. Neurosurgeon at Princeton (N.J.) Brain and Spine. My managing partner, Nirav Shah, initiated a clinical assistant and scribe system for improved patient traffic though the office. This helps our company, Princeton Brain and Spine, have better documentation and more efficient data entry into the patient’s chart. These clinical assistants and scribes are recruited from a pool of pre-med and post-baccalaureate students seeking experience and training before they head to medical school. They are superstars with a great attitude and eagerness to learn. Plus, we’re giving them patient interaction experience.  It’s a win-win!

Vivek Deshmukh, MD. Neurosurgeon at The Oregon Clinic in Portland and Chairman of the Department of Neurosurgery at Providence (Ore.) Brain and Spine Institute. Our spine care continuum program has allowed us to identify and treat surgical spine patients more expeditiously and has allowed us to direct non-surgical patients more quickly toward appropriate pain management avenues. This has been a win for our patients and surgeons and has helped us to reduce overall costs for this patient population.

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