Chris Zorn: What I’m seeing in the United Kingdom, throughout Europe, Mexico and South America are a similar dynamic as happening there as in the United States — the strong growth of spine care in privately and independently-owned surgery centers. In these regions I am seeing acceleration, based on satisfying a basic patient-market need, the same phenomenon as in the United States where ambitious and forward-thinking surgeons and administrators are creating parallel practices in the private sector.
The United States, with the robust debate and healthcare policy developments now, is slowly stepping toward some of the other global models. Meanwhile, some providers that are in these heavily social and universal type healthcare systems are doing what we’re doing in the states — they’re developing private clinics and they’re doing it to give quicker access, better technology options and comprehensive care options. They’re providing and marketing valuable alternatives to the local patient community. They are satisfying a need for access outside the strongly controlled and politically dominated traditional systems. It’s almost like a reversal — as we evolve their way, they’re evolving our way.
There are some other dynamics I think are interesting. Germany, for instance, which in many ways has healthcare delivery systems closest (relatively) to ours here in the United States, has recently instituted mandates that require patients, who previously were referred directly to a surgeon for a spine procedure, to go through and fail extensive conservative physical therapy and pain management therapies before surgery. This has had a short-term negative effect on surgical procedure volume, but the responsive private centers have integrated upstream and downstream to surround the patient with total integrated care, with surgery being a step in the path. Patients in that country also have mandated intensive post surgery physical therapy and rehab so it becomes a system approach. Why not, if you are an entrepreneur and forward thinking, organize and optimize and control the system? I think a lesson here is consider building stronger affiliations upstream and downstream in the care path. It not only intuitively makes great patient care sense, but will help develop efficiencies and relationships that someday should be a valuable and marketable practice differentiator.
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