Patient referrals and maintaining volumes is crucial for any strong spine practice. And as the healthcare landscape and technologies evolve, spine surgeons need to adapt.
Five spine surgeons discuss their strategies for patient referrals.
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. Becker's invites all spine surgeon and specialist responses.
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Editor's note: Responses were lightly edited for clarity and length.
Question: As healthcare changes, what pivots are you making to grow patient volume and referrals?
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: Patient volume and referrals are not necessarily a package deal. Referral sources may come and go, sometimes which insurance the practice takes pushes the latter more than almost anything. Growing patient volume is the sole supporting source for many overgrown and bloated practices dependent on 'making the nut' each year. Smarter practices will focus on patient experience and satisfaction throughout the process — from intake to graduation. Referral sources can be capricious and you can do an amazing job with a difficult patient or case and the referring physician may not even register your efforts. It is best to keep on grinding and spreading the gospel through happy patients and honest reviews.
Jason Liauw, MD. Hoag Orthopedic Institute (Laguna Hills, Calif.): I am a big believer that the patient is the ultimate customer. And patient education is a driving choice. I have seen this play a larger role in the interest for cervical and lumbar artificial discs. Increasingly I have become a big believer in cervical and even lumbar arthroplasties as I have seen great results with my own eyes in both cohorts. In fact, with the advent of the Simplify disc which is semi-constrained, I rarely do anterior cervical fusions. I only do ACDFs when I see patients who have significant facet arthropathy or other indications of instability. With future pivots, I think patients will continue to drive innovation and adoption of technology. I think there is still significant momentum to drive spine surgery even more minimally invasive and endoscopic. I think less invasive surgery will be the way I pivot in the future to grow volume so long as I believe the technology doesn't compromise biomechanical integrity. I think a pivot towards more minimally invasive surgeries will be driven by patients. This wouldn't be dissimilar to the shift we have seen from open neurovascular and open cardiovascular surgeries to endovascular platforms.
Krishna Satyan, MD. Dallas Neurosurgical & Spine (Plano, Texas): As healthcare continues to change, technology also advances rapidly. There are many new avenues of reaching patients and referring providers. One of the important things right now is to have a digital presence. Many physicians stay active on social media, but it's not my preference. I prefer a robust website that patients can access, providing information about various symptoms, pathologies and treatment options.
I prioritize relationships above all else. I try to stay in constant contact with referring providers to keep them up to date on their patients. I also maintain good, honest, factual relationships with my patients. This is vital, as they are one of our biggest referral sources. Despite changing technology, you really can't beat word-of-mouth. At the end of the day, we are providing a service to our patients, and the backbone of this service should be honesty, integrity, and dedication to improving their lives. By following those values, the referrals and volume should come naturally.
Hao-Hua Wu, MD. UCI Health (Orange, Calif.): Overall, I am adapting to changes in healthcare by embracing technology, collaborating with other professionals, focusing on patient education and empowerment, and implementing innovative approaches to care delivery. Embracing these changes has allowed me to expand my professional network and receive more patient referrals in cases I specialize in, such as surgical care for complex spine tumor patients.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Our state is currently a desirable transferable location as many continue to leave for the tiresome reasons which need no mention. The influx of retirees seeking maintenance healthcare has been quite tragicomic of late, where regions of expansive housing, facilities and politics have changed.
That being said, dramatic pivotal changes are not in the forecast as the local two-tiered system of patient care remains: Those employed physicians who continue administering care to all patients (larger hospital systems) and those restricting one's care to surety coverage and personal investment. Recently a patient with a symptomatic cauda equina tumor was dismissed by two insouciant surgeons who conveniently disapproved of his insurance profile defaulting to the health system where spinal neurosurgery was available. Fortunately, the system has in place a backstop to care for those especially in proper need.