The COVID-19 pandemic has highlighted some of the benefits of performing spine surgery at ASCs, but hospitals are still struggling with patients' reluctance to have inpatient procedures.
During Becker's 18th Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, Frank Phillips, MD, director of spine surgery at Rush University Medical Center in Chicago, discussed outpatient migration and consolidation in orthopedics and what his practice will look like one year from now.
Below is an excerpt from the conversation, slightly edited for clarity. To view the full session on demand, click here.
Question: How has the pandemic changed your outlook on the spine field?
Dr. Frank Phillips: It's been an interesting time for all stakeholders in spine. The next year is going to be challenging for all of us. There's no doubt spine surgery in my mind is going to slow down to some extent. I think patients are afraid of being in hospitals with all the fears of COVID-19. I think hospitals are struggling. In the days when they were primarily filled with COVID-19 patients and not doing elective surgery, they lost millions of dollars every week, and that's hard to come back from. At the same time, device manufacturers have had a tough go — they've lost a quarter of revenue.
And hospitals are pulling back: They're not spending on capital equipment now because they got to conserve capital. I'm optimistic, ultimately, but I think it's going to be a difficult year. We'll get through it; I don't think fundamentals around spine have changed, but I think it's going to be a challenging year regardless of your type of practice or where you practice, although there's certainly some geographic variation we've seen in the effects of COVID-19 on spine practices.
Q: Where is your practice today? Are you starting to ramp back up again?
FP: In March and April, our practice pretty much totally shut down other than care. Now, I think we are pretty much back to normal, certainly in terms of how the operating room functions. For me personally, when we came back in May, I did all my cases in the surgery center for a number of reasons. As of June, I've been pretty much back to full speed at the hospital, as well as obviously the surgery center. What we're seeing in our practice now is this ramp-up of cases, because there's been this pent up demand. I have patients that were originally scheduled in early March and we were rescheduling them every two weeks through this period. So, they are very frustrated and they just want to get it done. I think by the end of the year, we'll probably be back to baseline.
Q: Where do you see your practice one year from now? What do you think will be different? What will be the same?
FP: I think we're all very adaptable. Certainly, I was freaked out about going back to work, and three weeks later it feels like it's back to normal, even though it's not. A year from now practices will look the same. I think hospitals will look similar. For my practice, I believe there will be more surgery in the ASC. Across the board, in terms of practices, I suspect there'll be more consolidation. I think a lot of these small three-, four-, five-person practices have had a tough go of it during the shutdown and they're looking for partners and bigger groups to potentially share some of their downside or risk with. For our practice, which is obviously an established busy practice, a year from now it'll look pretty similar. I think maybe more ASC surgery, but other than that, nothing drastically different to what it was three or four months ago.