Three spine surgeons from across the country discuss the big trends in spine today and how their practices will likely change next year.
Question: If 2020 is a successful year for you, what will it look like?
Scott Boden, MD. Director, The Emory Orthopaedics & Spine Center (Atlanta): Success next year would be continued growth in spine practice at our institution.
Nick Shamie, MD. Professor and Chief of Spine Surgery at the David Geffen School of Medicine at UCLA: The past few years have been challenging in getting some of the newer treatments approved by the payers but I believe we will stabilize in 2020 so we can focus on our patients and the best treatment we can provide them.
Richard Wohns, MD, JD. Founder of NeoSpine (Puyallup, Wash.): As of January 2020, we will be incorporating the Globus Excelsius Robot into our inpatient spine surgery regimen. In 2020, we are going to move more TLIFs and extreme lateral lumbar interbody fusions into the outpatient spine surgery center.
Q: Where will you focus most of your time and energy next year?
Dr. Boden: Working to improve quality, decreasing complications, and decreasing cost of spine care.
Dr. Shamie: Our spine division and our department at UCLA are going through major expansion and our focus will be on quality and how we can maintain our highest standards with controlled growth. We are excited to be ranked No. 1 in California, which comes with great opportunities, but also tremendous responsibilities to the communities we serve.
Dr. Wohns: Becoming proficient with robotic spine surgery.
Q: What do you consider the biggest potential threat to your spine practice?
Dr. Boden: The biggest potential threat is the inability to easily measure improved clinical outcomes for certain types of spine procedures.
Dr. Shamie: The biggest threat to any surgical specialty is the irresponsible growth of unproven treatments and surgeries. As physicians, we need to better define the best indications for the various treatments we have available in our armamentarium, taking into account our patients' needs, financial burden to our systems while maintaining our responsibilities to our patients, our profession and our society.
Q: What do you plan to start doing next year, and what will you stop?
Dr. Boden: I plan to increase our outcomes data collection efforts.
Dr. Shamie: I will stop worrying about the future and try and do the best I can, every day.
Dr. Wohns: I plan to figure out how to continue to care for patients in need, providing the best possible care in a timely fashion, despite escalating numbers of denials. Also, after mastering robotic spine surgery in the hospital, consider robotic applications in the outpatient setting.