Becker's Spine Review asked Farzin Kabaei, MD, of DOCS Spine + Orthopedics in Los Angeles to share how his practice has adapted during the pandemic, what he is watching most closely in terms of COVID-19 developments, and what's top-of-mind for orthopedic surgeons today.
Note: Responses were lightly edited for style and length.
Question: What innovative strategies has your practice implemented to weather the COVID-19 pandemic?
FK: We implemented a makeshift orthopedic urgent care in our office. Our team made ourselves available for urgent and emergency phone calls to divert orthopedic and spine ailments from the emergency room to our offices. Since DOCS Spine + Orthopedics owns and operates our own orthopedic hospital, it allows us to take any surgical trauma cases there regardless of age and comorbidities. Our hospital does not treat COVID-19 patients and provides a safe alternative to going to a general emergency room. This also provides relief to our local hospitals by diverting orthopedic care patients; it allows them to conserve their personal protective equipment, have more available beds and mitigate the spread of COVID-19.
Q: There's a lot we still don't know about COVID-19, or how it will affect life in the next year or so. Which developments are you following most closely?
FK: One, understanding how herd immunity works and its potential impact against COVID-19. This is when a substantial amount of the population becomes immune to the virus, either through previous infection or by vaccination, reducing the likelihood of infecting those who are not. Two, maintaining our strict protocols of handwashing, temperature monitoring and routine testing of our staff with the possibly a rapid saliva test.
Q: Other than recovery from COVID-19, what are the top concerns for orthopedic surgeons today?
FK: Today, physicians have less control over patient care than they did yesterday, and that trend is steadily increasing. There are two main reasons; first, insurance companies and the government (Medicare) have created a medical coding system that makes the tax code look like homework for a second grader. This has made it extremely difficult for a physician to efficiently bill and get paid without a team of billers constantly following up on payments. Second, since reimbursements for services have been on a decline, more and more recently graduated physicians are joining the "big box" hospital system as an employee. The hospital provides a stable salary, insurance and benefits for a physician's family and paid time off, however, they have now become part of the problem.
The bureaucratic beast that is our hospital system will continue to grow and swallow young physicians. It wastes taxpayer dollars on hiring more bureaucrats to put up red tape. This will inevitably make it more and more difficult for physicians to have private practices and have control over the care they provide — it discourages innovation. It is increasingly difficult for a hospital system to implement a new technology due to the bevy of red tape. This delays quality care to our population, especially in the spine and orthopedic surgery field, where there have been key technological advancements made in robotic surgery. DOCS Spine + Orthopedics surgery center has purchased two robots, costing well over $1 million in a matter of 12 months, where the same purchase would take a "big box" hospital three to five years. We need to go back to a simpler and more efficient model. You'll always be treated better at a speciality boutique (DOCS) than a big-box (large, bureaucratic hospital).
Want to share your thoughts on this topic? Email Angie Stewart: astewart@beckershealthcare.com.