What spine surgeons should expect in 2019 from Dr. Benjamin Bjerke

Written by Mackenzie Garrity | December 21, 2018 | Print  |

Benjamin Bjerke, MD, is a board-certified, fellowship-trained spine surgeon at the Boulder (Colo.) Centre for Orthopedics. Here he discusses upcoming trends for spine surgeons and how to tackle the opioid epidemic.

Question: What is the No. 1 thing spine surgeons should expect in 2019? What, if anything, are spine surgeons leaving behind in 2018?

Dr. Benjamin Bjerke: This is a very exciting time to be in spine surgery. I think the trend toward outpatient and more minimally invasive interventions will continue into 2019 and beyond. I think that bundled payment groups will continue to show savings for health insurance companies while providing incentives for surgeons to decrease costs.

Q: Private equity continues to funnel into spine and orthopedic practices. How does this affect the industry?

BB: As surgical sub-specialists, we are some of the last practitioners to enjoy independence from outside influence, and most of us value that highly. In a time where most of our independent decision-making is being taken over by hospital administration and private equity, there is a great risk that medical decisions will become increasingly influenced by financial bias. I believe strongly that the best interest of the patient is the only interest to be considered, and this is at risk as private equity becomes more involved in healthcare.

Q: What strategies are you implementing to limit opioid prescriptions? Are there initiatives and actions spine surgeons can take to fight the epidemic?

BB: Multi-modal analgesia, use of minimally invasive procedures when appropriate, decreasing pre-surgical narcotic use, avoiding long-acting narcotic agents, and use of liposomal bupivacaine and are all steps in the right direction. Fortunately, the public has become aware of the extent of this problem and has become more understanding. Unfortunately, many of those harmed by narcotics aren't the people we prescribe for. Prescription drug sharing or theft is a major problem, and I greatly limit the quantity of medications per prescription; many of my patients who have undergone a minimally invasive procedure will not use any of their prescription medication. I feel it's important for me to prescribe in small quantities and be in close communication with those patients who are currently taking prescription narcotics.

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