Three spine surgeons weigh in on the regulatory environment.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.
Next week's question: What are your best strategies for ensuring comprehensive clinical documentation, especially in the current era of increasing regulatory burdens?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Dec. 5, at 5 p.m. CST.
Question: What healthcare policies concern you the most?
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: The current rollout of opioid restrictions is emblematic of the misguided and clunky conceptions of chronic pain rampant in the current administration. Whoever is whispering into the Attorney General's ear is not only clueless, but dangerous. Again, they are not attacking the main current driver of prescription addiction — the companies and the distributors.
For most of my postoperative patients, I can only give five days' worth of reasonably strong opiates. Patients with chronic pain cannot function and "suck it up." The pharmacies have also come off the rails and drafted their own misguided restrictions, essentially practicing medicine. I think as physicians, we all would like to work with the DOJ, OIG, DEA and FDA. But if their solution is to crank down on the doctors (again), I urge patients with chronic pain being denied legitimate medications to vote their conscience.
Rob D. Dickerman, DO, PhD. Director of Neurosurgery at Presbyterian Hospital of Plano (Texas) and Director of Spine Surgery at Medical Center Frisco (Texas): Continued restrictions and denials by insurance.
Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): The burden of ever increasing and constantly changing government regulations that create more expense, uncertainty and inefficiency while not benefiting patient care is getting worse every year. The deliberate decline in reimbursements for spine surgery by government agencies and private payers makes it more difficult to run a stable and successful private practice and to provide best possible care for my patients.
The lack of comprehensive overhaul of the medical liability policies in the country continues to add to further wasteful spending of "defensive medicine" and over-treatment, which only harms patients. If these concerns are not addressed, the healthcare industry as a whole will continue to become more expensive, less efficient and lower in quality.