What Medicare Cuts Mean for Spine Surgeons: Q&A With Dr. Terrence Crowder of Sonoran Spine Center

Laura Miller -  
Terrence Crowder, MD, a spine surgeon with Sonoran Spine Center in Mesa, Ariz., discusses the recent Medicare payment cuts as a result of the sequester and how these cuts will impact spine surgeons going forward.Question: How do you feel about the recent Medicare payment cuts? What do they mean for spine surgeons?

Dr. Terrence Crowder: It's extremely disheartening that the government has completely forgotten about physicians. Every year we take a pay cut from Medicare because of bad Congressional politics. This additional cut will only serve to discourage more of our country's brightest and best from becoming doctors. We don't have socialized medicine, but because Medicare is the leader they set the rules for everyone else. Unfortunately, it's becoming harder and harder to actually deliver care.

Q: How will the cuts impact spine surgeons in particular?

TC: Unlike other doctors, surgeons are generally performing surgery by necessity. We are correcting problems that are significantly affecting peoples' lives. Sometimes spine procedures are called elective, but it isn't a choice to the suffering patient. Spine problems are very expensive to society. The company loses productivity and the patient loses income. For some, if they aren't at work their job can't be done.

There are multiple procedures that are extremely beneficial for patients, which we know through many studies. However, with the cuts that are arriving in Medicare, these kinds of surgeries may not be funded anymore. Additionally, surgeons will receive less payment for procedures that are proven to benefit patients.  What are surgeons suppose to do?   

Q: How are spine groups reacting to these cuts? Is there anything they can do to soften the blow?

TC: In general, practices are now limiting the number of Medicare patients they are willing to see because of the recent changes from the sequester. Medicare patients generally require the most attention, the most time, yet we as physicians are paid a low amount to see them.

Q: Will these payment cuts impact how the field is evolving right now?

TC: We've seen a boom in spine technology and technique development, but the cuts mean there will be very little innovation in spine over the next several years. The amount of time and money necessary to provide proper research is high; therefore most surgeons will no longer have the time to conduct these projects. Instead, they will spend their time trying to recover lost reimbursement.

Additionally, spine companies won't see an innovative strategy as profitable because they aren't paid for their innovations. The motivating factor among companies is more capitalistic than altruistic. I foresee most spine innovation moving to Europe and Asia, and out of the United States, because it's cheaper to develop in there and easier to deal with their regulatory system.  

Q: What trends do you expect for spine surgeons in the future as a result of these cuts?

TC: I see a shift in doctors becoming employees instead of entrepreneurs. Private practice in medicine could easily disappear in this country and essentially we will have a system for socialized medical care.

More Articles on Spine Surgeons:
5 Steps for Spine Surgeons to Run Top OR Teams
5 Steps to Translate Spine Innovations to the Operating Room
9 Surgeons on Adopting Minimally Invasive Spine Techniques

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