Spine surgeons are facing a myriad of headwinds in 2023. Five of them shared the one thing the spine industry needs sooner than later.
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. Becker's invites all spine surgeon and specialist responses.
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Editor's note: Responses were lightly edited for clarity and length.
Question: What's one thing the spine industry needs now more than ever?
Chester Donnally, MD. Texas Spine Consultants (Dallas): There are many great tools we are using to keep incisions small and recover faster. Understandably, many of these tools/technologies have a capital requirement by the hospital system to allow their surgeons to use these tools. Hospitals don’t want to spend $300,000 to $1 million on a tool that maybe one surgeon might use. We surgeons need to do a better job providing data that proves why minimally invasive or enabling technology tools are worth the capital investment to help justify the costs.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: What we need more than ever is fair prior authorization practices to be put in place. Insurers have increasingly outsourced their authorization duties in order to save themselves money and to absolve them of arbitrary medical decisions by local and state rules. This has become customary and obstructionist and benefits only their shareholders. If Congress and HHS are serious about saving money, they need to stop letting insurers dictate the rules of engagement and stop blaming physicians who are fighting on behalf of their patients.
Luke Macyszyn, MD. DISC Sports & Spine Center (Newport Beach, Calif.): The spine industry currently is doing extremely well producing very high-quality implants and surgical technologies to aid the surgeon in the operating room. However, the industry requires more analytical and data-driven software tools to analyze and evaluate the impact that our surgeries are having on the patient population, and — importantly — the quality of life that patients experience after spinal surgery.
It is not possible to conduct a randomized, controlled trial for every implant and procedure that we have in spinal surgery. We need easy-to-use-and-manage software tools that allow us to track individuals as well as groups of patients so we are better equipped to ascertain and analyze the efficacy of our procedures. The use of these surgical implants and technologies in the operating room is rapidly rising, along with the cost and expenditure for spinal surgery in general. We need to be able to demonstrate to our patients and society that the procedures we are performing improve outcomes and are cost-effective.
Jeremy Smith, MD. Hoag Orthopedic Institute (Newport Beach, Calif.): Now more than ever, the spine industry needs increased involvement and collaboration with the insurance industry. This will promote affordable access to care, drive innovation, and ensure the best possible outcomes for patients. It is crucial for both industries to work together to establish effective reimbursement models, streamline processes, and address any barriers that hinder patients' access to quality spine treatments.
In addition, the spine industry needs a continuous focus on innovation in MIS surgery, regenerative medicine, and tissue engineering. By embracing new approaches, the industry can enhance treatments, improve safety, reduce costs and leverage new technologies to revolutionize spine care.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Cost and delivery are issues of present and future, and will only be solved by disintermediation at the industry level. An immediate innovation would be direct merchandising to both hospital system and end user eliminates a portion of conveyance cost with little effect to laid out efficiency and delivery. The current economy is unprecedented and unsettling, with growth stagnation, rising unemployment, high inflation, growing government debt and a populace reeling from a pandemic. Cost will remain an issue and reverberation will portend the future.