The spine landscape has transformed significantly for William Kemp, MD, especially with the rise of advanced practitioners and non-operative spine physicians. However he affirms there’s still important value for trained surgeons.
Dr. Kemp, a spine surgeon in Richmond, Va., discussed what’s changed in the spine landscape and a disadvantage with AI on the “Becker’s Spine and Orthopedic Podcast.”
Note: This is an edited excerpt.
Question: What are some of the biggest headwinds that you’re anticipating this year? How are you planning to get ahead of them?
Dr. William Kemp: There are extraordinary forces in healthcare that are changing the landscape, and something that spine surgeons in particular have to adapt to is reimbursement pressures versus rising costs. How does that manifest in a private practice situation? The administrative burden and prior authorization with insurance companies has always been an ever changing obstacle, particularly with AI being more and more and more utilized by the insurance companies.
The biggest challenge today isn’t really surgery, it’s the environment around the surgery. Getting ahead means really building efficient systems, proving our value, not only as a surgeon but also as the actual surgeries with outcomes data and protecting the sustainability of our workforce.
Q: Can you dive more into proving the value of your work? How has that process changed for you over the last five to 10 years?
WK: Generally in medicine, physicians are becoming less and less relied upon. We have the increasing utilization of advanced practice professionals with nurse practitioners and physician associates. The question is: What happens to the training of a spine surgeon?
I think that there’s always going to be a role for the spine surgeon, not only to take care of patients surgically, but also as a spine specialist to take care of patients non operatively. One thing that I utilize is my own injections. It builds trust with patients. And it gives us diagnostic criteria to say that if we do an injection at a specific spot, and a patient gets some relief for a certain amount of time, it gives us greater input to say that operating at the level will do some good.
The spine field is changing in the sense that more and more non-surgeons are doing spine surgery. This is a thing in the last five years that wasn’t around when I was in my training, and that gives me a lot of pause. I really do believe that spine surgery should be designated purely in the hands of fellowship-trained spine surgeons.
Q: On AI, how are you using it in your practice? And how are you navigating the landscape, especially as insurers are also using these tools?
WK: One thing the payers are doing is they’re actually using AI to make sure that we have the appropriate physical therapy documentation that we have the “correct reads on imaging.” I think that’s going to be an obstacle, because I’ve often found that actually AI is not reliable enough to be making those types of decisions. With the increasing frequency of peer to peers, which we were able to explain the situation, and just talking to another human versus a computer, I think it’s actually slowing down patient care, which is the exact opposite of what AI should be doing. It’s not exactly helping us, from that standpoint.
The way I’m using AI, particularly in the deformity realm is really trying to figure out if a patient has a certain deformity, what type of implant I’ll use to correct it, whether it’s a simple spondylolisthesis or an overall sagittal or coronal deformity.
