4 spine surgeons on biggest challenges to running their business

Anuja Vaidya -   Print  |

Four spine surgeons weigh in on the non-patient issues that pose a challenge.

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. We invite all spine surgeon and specialist responses.

Next week's question: Who do you look to as a mentor in your professional career?


Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Oct. 4, at 5 p.m. CST.


Question: What are the most pressing non-patient issues facing spine surgeons today?


Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): Declining reimbursements is probably the biggest issue. Every year, as the costs of running a practice go up, we are getting paid less and less (not even accounting for inflation) for doing the same work and doing it better, with more experience and fewer invasive techniques. Unlike any other industry, most spine surgeons cannot set their own rates based on supply and demand. Instead we are forced to accept what the government and other payers choose to pay us — based on arbitrary decisions, not on value of our work — or risk losing access to most of our patients.

To add an insult to the injury, we are facing the ever-increasing burdens of mandatory government regulations that do not improve quality of care and do not control costs. The administrative burdens of surgery pre-approval requirements and unjustified denials by private payers are also getting more complex.

And of course there is the ever-present threat of a lawsuit. It has been shown multiple times that most medical liability lawsuits are not justified by any wrong-doing by a surgeon and they usually get dismissed. The process, however, is still arduous. The financial and emotional cost associated with going through a frivolous lawsuit is significant, even if it gets dismissed and no payment is made. The costs of taking time off from work and away from the family do not get reimbursed.   


Payam Farjoodi, MD. Spine Surgeon at Center for Spine Health at Orange Coast Memorial Medical Center (Fountain Valley, Calif.): The administrative roadblocks to patient care being placed by insurers. It is becoming an increasing burden on providers to prove the need for treatment for patients, and a leading cause of physician burnout. We need to urge our professional societies to continue to pressure insurers to provide outcomes-proven care for patients and place accountability on the insurers when they deny necessary treatments.


Kern Singh, MD. Co-Director of Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush (Chicago): Spine surgeons are constantly dealing with hospital administrations that aggressively increase the regulations for surgeons. The ability to manage the doctor-administrative relationship in order to continue to provide excellent patient care is the ultimate goal.


Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: Far and away, the most pressing is reimbursements. We need to work with regulators and show them what we go through and what they put the patients through with last-minute denials and unfounded medical decisions. We also need to have a voice in Medicare and need to mandate that CMS have an ombudsman's office within its system.


Copyright © 2021 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

Featured Webinars

Featured Whitepapers

Featured Podcast