Nonsurgical procedures, mediocre care & COVID-19: 3 spine surgeons on the biggest threat to their practice


Three spine surgeons provide their insight on the biggest potential threats to their practice.


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 was your most recent payer struggle? How did you navigate it?

Please send responses to Alan Condon at by 5 p.m. CDT Wednesday, April 8.

Note: The following responses were lightly edited for style and clarity.

Question: What do you see as the biggest potential threat to your spine practice?

Christian Zimmerman, MD. Saint Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Presently, idleness and social complacency for our current health situation. Like everyone else, the sheer number of postponements and delays will keep our practices busy for months. Social responsibility and awareness will get us through these trying moments, with some sooner than others. 

My thoughts are duly directed to the healthcare workers on the front lines locally and nationally in our hardest hit areas. They risk themselves and their families for all of us. They deserve our support and gratitude. Optimism is a virtue in difficult times. 

Guy Lee, MD. Rothman Orthopaedic Institute (Philadelphia): There continues to an abundance of procedures that are being marketed to non-spine surgeons and non-spine specialists. I routinely see patients who have had these newer procedures, which in my opinion, are not clinically indicated. For example, percutaneous decompressions done for back pain as well as spinal interspinous implants being performed for back pain. 

As spinal specialists, we know that getting rid of leg pain is generally the primary goal when treating these patients. However, it is unfortunate that some patients are looking for the newest and latest innovations to avoid surgery. I tell my patients it is always better to get a second opinion before you have any procedure done to your back.

Brian Gantwerker, MD. Craniospinal Center of Los Angeles: I think the acceptance of the public writ large of mediocre care. If patients are happy waiting three hours to see their doctors and to spend five minutes discussing a potentially life-altering surgery, then I think the whole system is going down the proverbial tubes. I believe my practice may actually thrive, once people wake up and realize that it is not acceptable.  

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