Five spine surgeons weigh in on the biggest areas for opportunity in spine care in the coming year.
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 key trends to expect in the biologics arena in the next five years?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Jan. 17, at 5 p.m. CST.
Question: What are some of the biggest opportunities for spine surgeons in 2018?
J. Brian Gill, MD. Spine Surgeon at Nebraska Spine Hospital (Omaha): There has been a push to do more procedures in an outpatient setting. Surgeons have to be more selective in their patient population. A greater emphasis is being placed on preoperative narcotic use, smoking status, obesity and general health. All of these components are extremely important. Surgeons are becoming more aware of these issues and their effect on procedures in an outpatient setting. Thus, many surgeons must address these issues preoperatively more so than they may have done in the past.
Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): MIS spine surgery techniques are becoming easier to learn and more effective. I would recommend every spine surgeon become familiar with them and offer them to their patients when appropriate. With less pain and quicker recovery after MIS surgery, more spine procedures will be moving from hospitals to ASCs. Spine surgery biologics for fusion and non-fusion procedures and robotic technology will continue to improve and evolve in 2018 as well.
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: I think as a group, we have the ability to use data from peer-reviewed studies to support the use of motion-preserving devices. Devices such as coflex as well as cervical and lumbar arthroplasty devices should be and will be covered by insurers. Quite simply, motion-preserving devices are not just equivalent, but are appearing in some circumstances to be superior to previously used devices. I think we as surgeons have the opportunity to leverage data, experience and expertise to get patients the right treatments, and not just the cheapest.
Richard Kube, MD. Founder and CEO of Prairie Spine & Pain Institute (Peoria, Ill.): I believe there will be more widespread bundled payment acceptance. In particular, as the self-insured market becomes educated regarding the free market and its potential impact on medical care and huge savings for the insured, we will see this sector grow. Those folks who embrace price transparency and deliver value-based care will have a leg up in this market. It is estimated that one-in-three insured individuals obtain coverage through a self-insured employer. That is a big opportunity.
Payam Farjoodi, MD. Orthopedic Spine Surgeon at Spine Health Center at MemorialCare Orange Coast Medical Center (Fountain Valley, Calif.): Continuing to collect data showing the value and efficacy of our treatments for the different types of spine pathology. Healthcare is becoming increasingly results-driven and in order to demonstrate the importance of what we do, we need to work hard on collecting outcomes and publishing this information in a concise way.