As health systems and MSOs continue to consolidate spine practices across major metro markets, Los Angeles-based USC Spine Center is doubling down on a hub-and-spoke strategy that emphasizes proximity, academic depth and the ability to manage the region’s most complex cases, Jeffrey Wang, MD, said.
Dr. Wang, chief of orthopedic spine surgery and co-director of the USC Spine Center, spoke about where academic programs fit in the larger spine landscape.
Note: This conversation was lightly edited for clarity.
Question: How are you differentiating USC Spine Center from MSOs, competing health systems or other consolidation options for specialty practices?
Dr. Jeffrey Wang: It’s hard especially in Los Angeles because a lot of the major centers are buying up practices and buying up hospitals. I think we need to be strategic. We have acquired some community practices and community hospitals — things that just make sense for us given the size of our enterprise. We don’t want to go in an area that we can’t support. There has to be sort of a spoke and hub model. Even if you reach out to the community and you have outpatient surgery centers, if patients need a major surgery they’ll probably need to come to the big university hospital. We already get a lot of referrals being a university hospital when there are some cases that perhaps the community physicians can’t handle. But we also want to make sure that we stay in proximity to some of the practices we acquire so that we can not only reach people out geographically, but also make them comfortable knowing they can come to the university and it’s not too far for them.
Q: What are some of the advantages the academic spine setting has over private practices or non-academic health systems?
JW: There’s a couple ways to look at this. I think from a clinical expertise side, we’re seeing some of the bigger cases. Someone in the community that has a big case may not have the ICU facilities or the around the clock care that we have here. They’re just not going to take that on in the community hospitals, and they’re going to send it over to us. But what we get out of that not only being a teaching program, we get a collection of these highly complex cases so we can develop a real expertise in dealing with them. We have surgeons in our spine center that routinely deal with the most complex revision surgeries that a lot of people in the community just feel like they don’t really have an answer for. For me, I still think that’s a competitive advantage because even our competitors, when they have cases that are kind of too big or too complicated, we will get those referrals. And they will easily sell that to the patients because they’ll sit there and say ‘These guys at USC routinely see these types of cases.’ So I think that’s the main advantage that we have.
We also provide more around-the-clock care. Obviously, if you’re a small practice the actual attending surgeon has to be available 24/7, but they may not always be readily available. We have such a collection and a large number of clinicians of all different specialties that if a patient develops a problem and needs another specialty care, we don’t have to wait a long time to get that consultation. We have people in-house that are there that can service that and so we can get consults quickly. If the patient is medically complex, we can get those other problems taken care of quickly rather than trying to get a private practice physician to finish their clinic and come over and consult.
And when you think about it, depending on the level of the trauma center, what community hospitals have in-house overnight? At the university hospital, we have all the specialties in house overnight with residents and fellows in training. We can have that expertise seen if someone comes in and they need emergency care.
