'A busy physician is a happy physician': What we heard in October

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Spine and orthopedic experts in October spoke with Becker's about topics from healthcare disruptors to staff retention.

"The most innovative way spine practices can increase revenue is to transition more surgical care into an ambulatory setting. To do this successfully, it is important to avoid prolonged hospital stays and optimize each patient's presurgical health with a standardized checklist that helps with smoking cessation, blood glucose management, nutrition and medical clearance." — Hao-Hua Wu, MD, UCI Health in Orange, Calif., on opportunities to boost revenue.

"For the physicians, we spend a lot of time looking at metrics and looking at where we can put a body and have that person be busy from the beginning. A busy physician is typically a happy physician. We also let everyone know that the future is bright for TCO from the standpoint of growth. It has been a hard couple of years from an overhead standpoint, but I do think that the growth in the number of physicians that we have, the growth in regards to our newer contracts are really going to offset that. " — Christopher Meyer, MD, president of Edina, Minn.-based Twin Cities Orthopedics, on physician retention.

"As an orthopedic surgeon, many things keep me up at night. Within any surgical specialty, fear of complications is a major cause of lost sleep. While every effort is made to minimize risk, there is no such thing as a guaranteed outcome. I lose more sleep before an OR day than an office day for certain. Other things that worry me are patient non-compliance and re-injury. My initial surgical job is done, but I cannot be with the patient monitoring their compliance and efforts in the recovery process. I try to put significant effort into ensuring the patient understands the clinical scenario before and after the surgical procedure, as well as the full recovery timeline." — Adam Bitterman, DO, Huntington (N.Y.) Hospital, on what keeps him up at night.

"We will continue to see insurance companies adjusting reimbursements towards outcome-based care. As healthcare costs continue to rise, we cannot continue practicing as usual as there is not an endless supply of healthcare dollars. Insurance companies will begin dropping surgical coverage of procedures that do not have strong evidence in terms of research driven outcomes. In addition to this, insurance companies will continue bundling reimbursement for disease-specific conditions. We have already seen this change in adult reconstruction and arthroplasty. This will begin to make its way into the sports medicine and spine surgery world as well. So for surgeons to become more cost conscientious when treating certain pathologies." — Vishal Khatri, MD, Alliance Orthopedics (Fair Lawn, N.J.), on what orthopedics will look like in 10 years.

"The more healthcare becomes transactional, the less patients will have the warm and fuzzy feelings about their treating provider. The less power MDs will have in the system, the human touch will be replaced by episodic algorithmic care. The outliers, contraindications and reliable transfer of information will take a back seat to overarching standards. I worry that the ability to innovate will be stifled by the one-size-fits-all mentality based on older data because its proven, and newer treatments will not be approved. The constant scrutiny of the pre-approval process will cross the line for deciding treatments or indirectly, and de facto, become practicing medicine without a license." — Alan Reznik, MD, Connecticut Orthopaedics (Hamden), on healthcare disruptors.

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