Top of mind concerns for 4 spine surgeons amid practice growth

Written by Laura Dyrda | November 02, 2018 | Print  |

Four spine surgeons who are on the front ends of their careers discuss their biggest practice concerns.

Question: What are the biggest concerns for your practice today? What keeps you up at night?

Andrew Schoenfeld, MD. Brigham and Women's Hospital (Boston): In my practice as a clinician scientist, I have concerns that span both patient care and the research realm. Some of these involve the ways in which healthcare reform efforts may impact patient access to certain types of spine surgical interventions or the way external pressures might alter the delivery of care in the context of spinal disorders. For example, how does the implementation of ACOs alter the availability of spine surgical care, affect the types of interventions offered or restrict access to spinal healthcare? This also happens to be one of the particular areas of interest for my research.

Samuel Joseph Jr., MD. Spine Surgeon (Tampa, Fla.): It will be extremely important to consider creative ways to make services more appealing to insurance carriers, such as outpatient procedures. We will need to incorporate technology into the care of patients that reduce overall costs. Perhaps utilizing wearables, augmented reality and artificial intelligence in the practice for more efficiencies [will] lower overall costs of certain procedures. Two other concerns are the increasing control insurance companies have on delivering care to patients as well as malpractice premiums.

Kris Radcliff, MD. Rothman Institute (Philadelphia): One of my biggest concerns is the rising cost of spine care and the absence of good literature about the value of spine care. Although I believe that spine surgery has a significant financial and functional value to patients' lives, there is a misperception about the outcomes of spine surgery that we have not yet overcome with research. I am concerned that the preponderance of misinformation available to patients on the internet may result in unfortunate delays in care and poor outcomes of spine care.

Tobias Mattei, MD. SLUCare Physician Group (St. Louis): The mission of providing excellent care in complex spine surgery certainly involves many challenging aspects, ultimately requiring utmost dedication from the whole multidisciplinary team involved in the integrated care of such patients. Such efforts are not exclusively related to the technical aspect of performing complex spinal operations, but involve a constant strive for efficiency and cost-effectiveness at every step of the care of patients with spinal disorders, from the referral process to initial evaluation, ordering of ancillary tests, proper coordination of initial conservative care with other healthcare members such as physical therapists and pain management, timely processing of authorizations for tests and surgeries as well as postoperative rehabilitation and coordination of follow-up in a multidisciplinary fashion. The responsibility of playing a central leadership role in such a complex and integrated process unquestionably involves a significant amount of time as well as personal efforts and concerns.

Learn more about the latest trends in spine technology at the Becker's 17th Annual Future of Spine + The Spine, Orthopedic & Pain Management-Driven ASC Conference, June 13-15, 2019. Click here for more information. To learn more about exhibiting and sponsorship opportunities, contact Maura Jodoin at

More articles on spine surgery:
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