Five spine and neurosurgeons share changes in their patient population and provide insight into how it may evolve in the future.
Question: How has your patient population changed over the past five years? How do you expect it to evolve in the future?
Gerald Rodts, MD. Emory University School of Medicine (Atlanta): The number of elderly (Medicare age) patients continues to rise in my practice over the past five years. Not only is that segment of the population growing nationwide, but the number of neurosurgery colleagues in Atlanta who no longer accept Medicare is increasing.
Khoi Than, MD. Duke Spine Center (Durham, N.C.): I spent the past four years at Oregon Health & Science University, where I developed a strong referral network of patients who had undergone previous spine surgery elsewhere but did not heal appropriately or still had residual symptoms. During my time there I saw more and more of those types of cases, and fewer primary or virgin cases. Patients would come not only from Oregon but also Washington, Idaho, California, Montana, Alaska and Pennsylvania. The furthest patient I saw and operated on came from the United Arab Emirates.
I'm about to join the fantastic spine program at Duke University in Durham, N.C., where I know patients will come from all over the region, nation and world. My focus at Duke will be on patients with spinal pathologies that can be treated minimally invasively, which these days includes basically all spinal pathologies except for the most severe deformities.
Richard Chua, MD. Northwest NeuroSpecialists (Tucson, Ariz.): The patient population where I practice in Tucson, Ariz., has become much more fit with more active lifestyles and is more prepared to discuss surgical and non-surgical treatments for their condition. With the access to information on the internet, including YouTube videos of surgical procedures and patient-centered blogs, many patients are prepared to ask questions, compare treatment options, and make an informed decision. I anticipate that this will continue in the future.
Camden Burns, MD. Indiana University School of Medicine (Indianapolis): As the baby boomer generation continues to age, we see an older population with an increased incidence of osteopenia and osteoporosis. This is significant to all areas of spine surgery and to orthopedics in general. It is becoming more essential that spine surgeons and orthopedic surgeons initiate treatment for osteoporosis to improve bone quality in patients needing surgery and decrease their risk of osteoporotic fractures.
We have also seen increased incidences of patients seeking minimally invasive options. These treatments have certainly evolved in recent years and are very attractive for patients looking for smaller incisions, less pain and shorter hospital stays. We expect this aspect of our practices to continue to grow.
Robert Gewirtz, MD. Stanford University Medical Center (Palo Alto, Calif.): My patients continue to get older and less healthy. BMIs continue to go up, but smoking is trending down. It seems everyone is on an anti-platelet or anticoagulant therapy.