The best investments made at 9 spine practices


Strategies to cut costs are top of mind for many spine physicians. Where to invest money for the most value is just as important.

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.

Next week's question: What's one thing not enough spine surgeons are doing today?

Please send responses to Carly Behm at by 5 p.m. CDT Wednesday, July 26.

Editor's note: Responses were lightly edited for clarity and length.

Question: What's the best investment you've made at your practice?

Chester Donnally, MD. Texas Spine Consultants (Dallas): Human scribes. It's definitely a big overhead cost, but it allows me more time with the patient, I am not typing at all when with the patient, and I can really focus on the exam and MRI, as opposed to charting. But this is not cheap!

Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (West Bloomfield, Mich.): The best investment one can make is in oneself. Particularly, marketing will be a wise way to help one's practice become visible.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: Believe it or not, internet bandwidth. We recently started seeing a lot of lag at the office. I contacted my provider and they were offering faster speeds at a lower price. So we not only cut expenses but also got faster access. We are also getting new internet appliances with a faster speed that are to be installed very soon. The ones I have had before lasted me 10 years and have been rock solid, but expensive initially. I must say, paying extra for GOOD hardware initially is very worth it, and may last a decade or more if you get a good IT person and ask them for recommendations, rather than what's cheapest at Best Buy.

Anthony Giuffrida, MD. Cantor Spine Center at the Paley Orthopedic & Spine Institute (Fort Lauderdale, Fla.): The most valuable investment I've incorporated into my medical practice at Cantor Spine Center is assembling a team of exceptional medical professionals. It's common for physicians to prioritize minimizing overhead costs, especially those associated with staff salaries. However, I perceive these expenditures, notably wages, as strategic investments towards the future growth of my practice and ensuring exceptional patient care is provided.

In a climate where significant employee turnover is the norm, the costs associated with interviewing, training and onboarding new team members often exceeds the cost of providing competitive compensation to existing employees. A proficient, trustworthy and loyal team forms a robust backbone required to expand a multisite practice successfully.

Allocating extra funds towards employee retention and team development can yield substantial long-term returns. Additionally and even more important, maintaining a consistent team helps foster familiarity with patients, thereby enhancing the quality of patient care.

Richard Kube II, MD. Prairie Spine & Pain Institute (Peoria, Ill.): The best investment I've made at my practice has by far been the buildout of our surgical suite. Patients love outpatient procedures, and I certainly do not miss going to the hospital. There is also the benefit of an added revenue stream without having to increase surgical volume.

Ali Mesiwala, MD. DISC Sports & Spine Center (Newport Beach, Calif.): The best investment we have made in our practice relates to the hiring of exceptionally qualified personnel. In this day and age, customer service is critical, and having staff understand this can make or break your practice. While there are certainly economic challenges for every practice, and the current economic environment does not shield medical providers, we have paid our employees very well and given them appropriate raises and bonuses when deserving.

Ultimately, minimizing staff turnover and building a brand that patients trust is critical. In my view, there is no better investment than in our staff.

Vladimir Sinkov, MD. Sinkov Spine (Las Vegas): I invested my time and money to build a successful independent solo practice. It has been three years so far. We are busy and I am able to provide excellent care to my patients exactly how I want without any internal bureaucracy. It is amazing and I cannot imagine being an employee anymore. 

Issada Thongtrangan, MD. MicroSpine (Scottsdale, Ariz.): In my opinion, the best investment is to teach and train my staff on how to deal with patients and their significant others in a professional manner in person and on the phone. I also invest my time to teach them the critical questions to ask when they call with problems.

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): What continues to be the "best investment" for this practitioner are the hard-working and longevity-based personnel and staff. Inclusive to advanced providers are also nursing, managerial and office support staff. Granted, administrative costs have reached record levels across all boards, patient flow mechanics through the continuum remain a challenge. Proper personnel are invaluable and seemingly irreplaceable as past work ethos wanes. Fortuitously for our institution, pre-pandemic staffing numbers and productivity are correcting. 

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.