Q: How can spine surgeons become more involved in shaping healthcare and spine care policy in the United States?
Jaideep Chunduri, MD, Spine Surgeon, Beacon Orthopaedics & Sports Medicine, Cincinnati: This is quite difficult due to practice and family requirements. Several f the societies (ie NASS) are made up of individuals that perform non-operative care as well as operative care so there can be a clash of cultures.
Dennis Crandall, MD, Founder and Medical Director of Sonoran Spine Center, Mesa, Ariz.: Docs4patientcare is my favorite political effort, since it brings together physicians from all specialties in medicine toward ensuring patients retain access to quality care and choice of providers. Check out http://docs4patientcare.org/. As a spine surgeon, donating to spine political action committees seems reasonable. I am not optimistic about our spine lobbying efforts, since surgeons are viewed as part of the vilified 1 percent, where politicians expect us to work harder for less reimbursement, in addition to donating more of our earnings to the tax man.
Richard Kube, MD, Founder & CEO, Prairie Spine and Pain Institute, Peoria, Ill.: Physicians really need to take the time to become involved politically. This spans from locally to nationally. Most professional societies have advocacy branches that do a lot of work to preserve physician rights and reimbursements. There is usually opportunity to join these. An example would be the Coding and Reimbursement Task Force for the International Society for the Advancement of Spine Surgery. Another opportunity is to become acquainted with state and federal politicians on a personal level.
Do not be afraid to contribute financially to campaigns and advocacy groups who support your interests. Physicians tend to have a mentality that they work hard taking care of patients and there is not time to do these types of things or that it is too expensive to contribute. If physicians do not advocate for themselves, there will not be anyone to do it for them. It's time to take a page for the attorney playbook and become involved in politics. If we as physicians do not take up this challenge, we can only expect time and wages to both be further diminished.
Isador Lieberman, MD, Spine Surgeon, Texas Back Institute, Plano:
1) Be vigilant with their hospital partners in working towards cost containment.
2) Be vocal and involved with their respective societies' advocacy committees.
3) Seek out and discuss issues with your federal and state government elected officials.
4) Engage your patients in making an effort to get involved.
5) Speak at community events to educate the public about the virtues of spine surgery.
6) Raise awareness of healthcare issues by attending and speaking at any town hall or local political events.
Nick Shamie, MD, Co-Director of UCLA Comprehensive Spine Center: First and foremost we have to make sure we take great care of our patients and also being model citizens. We also have to make sure that we work with our hospitals, implant companies and patients to deliver the best care and efficiency for our patients. Then we have to get involved…gone are the days that we could just focus on patient care. We need to be involved locally and nationally and speak up about the benefits our profession provides our communities (improving patients' quality of life, etc.) and economies (getting patients back to work so they can remain productive). We should also ask our patients to speak up and become our advocates.
Jennifer K. Sohal, MD, Orthopedic Surgeon, St. Vincent Spine Institute, Los Angeles: We have to better communicate with the community we serve, both patients and other physicians. By setting realistic expectations and educating others, we can debunk the misconception that spine surgery is something to avoid...that it does not help. When performed for the right indications, spine surgery can greatly improve a patient's quality of life and increase their independence, placing less of a burden on society.
Scott Tromanhauser, MD, Spine Surgeon, Boston Spine Group: The best thing that any spine surgeon can do is support clinical research that defines what works and what doesn’t. Right now there is a dearth of evidence that supports what we do which has allowed non-surgeons and others to shape perceptions and policy regarding spine surgery. On the other hand, there are a number of interventions that really have no evidence support at all or have evidence that doesn’t support them, but are commonly performed with poor results and chew up valuable healthcare resources. The best way to provide this support is to become involved in meaningful clinical research, if at all possible. Alternatively, donate to professional society research funds such as the NASS Annual Research Fund. Go one step further and reach out to society leadership and express your opinion about how these funds are used.
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