Jeffrey A. Goldstein, MD, is a clinical professor and director of spine service, Department of Orthopaedic Surgery at NYU Langone Medical Center and sits on the Board of Directors for the International Society for the Advancement of Spine Surgery. Here, he discusses the biggest challenges for spine surgeons next year and where the field is headed in the future. 
Question: What will be the biggest challenges for spine surgery in 2013?
Dr. Jeffrey Goldstein: The biggest challenges in spine surgery continue to focus on providing the right treatment for the right patient based on appropriate guidelines and protocols. The onus is on the spine surgeon to maintain an open and honest relationship with the patient to include them in the decision process and develop the best treatment for that particular patient. These decisions need to be based on what we as surgeons know, and not on what we believe. While our knowledge comes from the sum total of our experience combined with the evidence, which includes understanding the lifestyle and goals of the patient as well. Surgeons continue to be challenged by limitations of resources which are real in addition to those limits placed by payors.
Q: How will healthcare reform affect the industry?
JG: Healthcare reform will affect the industry, but to what extent and how remains to be seen. An influx of patients into the system will put greater demands on practitioners and providers and potentially lead to increased utilization. Utilization will be directed by the Independent Payment Advisory Board. Demand may very well increase which would put greater strains on the healthcare providers, challenging our ability to continue to provide timely care.
Q: Do you expect the medical device tax to have a noticeable impact? If so, in what ways?
JG: As a surgeon and teacher, I would be concerned if any changes moved resources away from the industry and decreased their capacity for innovation. The specific implications of a medical device tax would be better addressed by industry.
Q: How will spine surgeons need to adapt to overcome these challenges?
JG: Regardless of any change, spine surgeons should stay focused on doing their best to treat and advocate for their patients. Surgeons should provide care based on recognized treatment guidelines. Societies such as ISASS will play an important role in educating their members and collaborating with industry to foster innovation and provide algorithms for patient care. Additionally, we should work with patients to help them become better advocates for themselves and participate in forums such as International Advocates for Spine Patients or the Better Way Back.
Q: What abilities must spine surgeons possess to deal with the future industry?
JG: The future industry remains unclear. While this may sound obvious, surgeons will do best if they continue to do what they know best. Be a good doctor and do the right thing. Take good care of your patients and practice good medicine. This is what we know best. Patients will continue to seek out good doctors who demonstrate skill, intelligence, compassion and empathy.
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Question: What will be the biggest challenges for spine surgery in 2013? Dr. Jeffrey Goldstein: The biggest challenges in spine surgery continue to focus on providing the right treatment for the right patient based on appropriate guidelines and protocols. The onus is on the spine surgeon to maintain an open and honest relationship with the patient to include them in the decision process and develop the best treatment for that particular patient. These decisions need to be based on what we as surgeons know, and not on what we believe. While our knowledge comes from the sum total of our experience combined with the evidence, which includes understanding the lifestyle and goals of the patient as well. Surgeons continue to be challenged by limitations of resources which are real in addition to those limits placed by payors.
Q: How will healthcare reform affect the industry?
JG: Healthcare reform will affect the industry, but to what extent and how remains to be seen. An influx of patients into the system will put greater demands on practitioners and providers and potentially lead to increased utilization. Utilization will be directed by the Independent Payment Advisory Board. Demand may very well increase which would put greater strains on the healthcare providers, challenging our ability to continue to provide timely care.
Q: Do you expect the medical device tax to have a noticeable impact? If so, in what ways?
JG: As a surgeon and teacher, I would be concerned if any changes moved resources away from the industry and decreased their capacity for innovation. The specific implications of a medical device tax would be better addressed by industry.
Q: How will spine surgeons need to adapt to overcome these challenges?
JG: Regardless of any change, spine surgeons should stay focused on doing their best to treat and advocate for their patients. Surgeons should provide care based on recognized treatment guidelines. Societies such as ISASS will play an important role in educating their members and collaborating with industry to foster innovation and provide algorithms for patient care. Additionally, we should work with patients to help them become better advocates for themselves and participate in forums such as International Advocates for Spine Patients or the Better Way Back.
Q: What abilities must spine surgeons possess to deal with the future industry?
JG: The future industry remains unclear. While this may sound obvious, surgeons will do best if they continue to do what they know best. Be a good doctor and do the right thing. Take good care of your patients and practice good medicine. This is what we know best. Patients will continue to seek out good doctors who demonstrate skill, intelligence, compassion and empathy.
More Articles on Spine Surgery:
The Arduous Path Toward Healthcare Reform: Is Unification of Ideals and Realities Possible?
St. Joseph's Hospital Surgeons Perform Spinal Surgery on Texas A&M Linebacker
Drs. Edward Zampella, Jonathan Baskin, Jay Young Chun Join Summit Medical Group