Brian Gantwerker, MD, FAANS, of The Craniospinal Center of Los Angeles, Charles D. Theofilos, MD, of The Spine Center in Palm Beach Gardens, Fla., and Jeffrey R. Carlson, MD, of Orthopaedic and Spine Center in Newport News, Va. describe the best things spine surgeons have done this year.
Question: What is the smartest thing you've seen spine surgeons do this year? Why?
Dr. Gantwerker: I think the smartest thing we have done in the past year has been advocating for repeal of the IPAB. The IPAB is an unelected, unaccountable cabal of people who do not practice, nor understand the mechanisms by which our practices operate and care for our patients. Their rulings are arbitrary and non-appealable. They are shrouded in mystery and there is no way of holding them responsible for their actions.
I feel they should be given a vote of no confidence by NASS, AANS, CNS, AAOS and the AMA and be jettisoned from the process. They do not help doctors do their jobs, only make it harder for us to make payroll and to keep our doors open.
Dr. Theofilos: The smartest thing would be branching out of just offering surgery to offering minimally invasive procedures and offering multidisciplinary spine, neck and pain care. Back in 2001, we started diversifying the practice by offering the most comfortable, innovative and effective surgical, minimally invasive, and non-surgical treatment options including artificial disc replacement, stem cells, platelet-rich plasma, specialized blood proteins and more.
We originally wanted to do this to establish a protocol for our patients and employ conservative treatment before directing patients toward interventional and invasive procedures.
Dr. Carlson: I have seen spine surgeons fight to remove the "Sustainable Growth Formula." This formula has been a huge disincentive to surgeons and non-surgeons alike. The cuts proposed in this ongoing legislation were always a threat to the ability to provide care to some of the most needy people in our society. Those patients that have paid into the Medicare formula over many years have had their healthcare used as a playing card in all sorts of political debates which put them in jeopardy of receiving the care they need.