Outpatient spine surgery's rise 'encouraging and concerning': Dr. Sigurd Berven


Sigurd Berven, MD, professor in residence and chief of spine service at UCSF Health sees spine surgery moving outpatient as technology develops and surgeons become more precise with their approach to care.

He also experienced several professional accomplishments in the last year and sees exciting times ahead. Dr. Berven shared with Becker's about some of the big successes he's had in the last year and where he sees spine technology and the field headed.

Question: What are the biggest trends you're following in healthcare right now?

Dr. Sigurd Berven: The healthcare trends that I am following most closely include the introduction of new technologies to spine care, reimbursement reform, and the rise in outpatient surgery for spine care. I am enthusiastic about new technologies that include predictive models and precision health. The application of principles of precision medicine to spine care offers great promise to direct the right patient to the right treatment, and to improve the appropriate use of care in managing spinal disorders.

Applying machine learning to large and comprehensive datasets is a new technology that will significantly redirect our healthcare resources. Identifying the data elements that are predictive and significant is the work that needs to be prioritized. Reimbursement reform to transition a fee for service healthcare economy to a value-based economy remains a significant challenge. I have confidence that risk sharing programs, and accountable care healthcare organizations, hold promise to provide a financial incentive for evidence-based and appropriate care.

The rise of outpatient surgery is both encouraging and concerning. Ambulatory surgical centers have demonstrated significant ability to deliver cost-effective and efficient care for our patients. The development of techniques and technologies for minimally invasive care, including endoscopic surgery, is revolutionizing how we manage common spinal disorders. However, it is imperative that surgeons and healthcare policy leaders direct patients to appropriate care, and that when more extensive reconstructive surgery and higher risk and higher cost surgery is appropriate, that we support those interventions with appropriate reimbursement and risk stratification.

Q: What are you most proud of from the last year?

SB: I identify distinct achievements that are personal and professional when reflecting on the things of which I am most proud in the past year. Professionally, I am proud of the work that our spine division at UCSF has done in building and sustaining a workplace that is compassionate and inclusive in providing the highest level of evidence based, interdisciplinary care for a remarkably diverse population of patients.

Our research team has been recognized with best paper awards at international conferences, and our work on creating predictive models using machine learning algorithms has been rewarding and innovative. Our recent research efforts in identifying predictors of health status beyond the traditional metrics of x-rays and labs, including the social determinants of health, is exciting regarding the potential to better characterize our patients, and study characteristics that matter.

I am proud to be the recipient of the David Selby Award from the North American Spine Society. The award recognizes contributions to the art and science of spinal disorder management through service to NASS, and I credit my clinical team and research associates for their partnership in earning that recognition.

Personally, I am most proud of my family, and the accomplishments of my three sons over the past year. My eldest, Alistair, married Molly Maloney in September, and we celebrated with a beautiful ceremony in London. My middle son, Kipper, is completing is final year at Harvard Law School, and he has earned recognition for his contributions to environmental policy and justice. My youngest son, Benjamin, is completing his undergraduate engineering degree at Lehigh, and he has excelled in scholarship and service.

Q: What are you excited about for 2024?

SB: My excitement for the next year includes both professional and personal goals. Professionally, I am considering a change from the only job that I have ever had in an academic practice to another practice setting, and I am considering opportunities that will combine my passion for teaching and research with opportunity to have ownership in a surgical practice and to contribute to innovative product and procedure development. Personally, I am excited about plans in 2024 that include time with my family in celebrating more achievements together, including graduation ceremonies for Kipper and Benjamin.

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