Patient accessibility to healthcare is a persistent challenge, and spine surgeons are using multiple strategies to manage it.
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 question: What would Medicaid cuts at the federal level mean for spine surgery access? Would it force more independent spine surgeons to stop taking Medicaid patients?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Tuesday, April 1.
Editor’s note: Responses were lightly edited for clarity and length.
Question: What’s the top barrier to patient access in your market? How are you addressing that?
Michael Briseño, MD. North Texas Orthopedics & Spine Center (Grapevine): We have found that completing the puzzle of patient access is multi-factorial and requires multiple solutions to be deployed together specifically in private practice where the economics of the labor force are highly influential, having sufficient staff to be available to our patients that are desiring access to the clinic while still having sufficient staff to operate the clinic at the most efficient level possible is one of the most significant barriers.
When looking at the nuances of the issue, patients are often hesitant to receive care as a result of the disinformation that the public gets access to through misleading advertising, misrepresentative online research and/or exposure to non-evidence-based modalities. This can lead to delayed presentations to our clinic or to patients receiving musculoskeletal services with the incorrect providers prior to seeing us, thus delaying their care and often further complicating their condition.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: An access barrier in our market is the sheer amount of time it takes to see a surgeon is increasing. What we do at our office is make sure patients that need to be seen are not given an appointment six weeks out. We see patients in a timely fashion and make sure that they don’t wait hours to be seen. We are chipping away at access to care issues by being available and timely, and giving patients adequate time in their appointments to get their questions answered.
Brian Fiani, DO. Spine Surgeon. (Birmingham, Mich.): One of the top barriers to patient access in many markets is often related to technology and digital literacy. Giving patients different access options helps. Ensuring that there are non-digital ways to access care, such as phone-based appointments or in-person visits, can help bridge the gap for those less comfortable with technology. I also continue to perform community outreach. Engaging with the community through outreach programs can help identify barriers and educate patients about available resources.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Patient access to our market is limited to referral patterns, insurers and approvals. There are no barriers to the highest acuity and complex patients entering the system, which reflects the ineptitudes, complex service-line representation and stratification of insurance coverage of some surgery centers. Risk assessment should be part of the formula with limited services, and the solution is using the best of nomenclature and modality submission.
