Five spine surgeons discuss how their practices are performing with the return to elective surgery and project when pre-pandemic patient volumes will return.
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: How can spine surgeons capitalize on the current state of the field?
Please send responses to Alan Condon at acondon@beckershealthcare.com by 5 p.m. CDT Wednesday, June 17.
Note: The following responses were lightly edited for style and clarity.
Question: When do you see your practice returning to pre-pandemic patient volumes?
Richard Kube, MD. Prairie Spine (Peoria, Ill.): I anticipate it will be in the fall before we approach normal volumes. Prior to quarantine, we were up about 10 percent in volume over last year. With the extended shut down in Illinois, however, it will take a long time to recover. Patient backlogs due to circumstances outside of our practice continue so slow our ability to get patients to the operative suite. Additionally, there are many patients who will unfortunately need to postpone treatment due to their personal financial situations.
Many have been out of work and without a paycheck for several weeks. It is now financially impossible for them to take time off just as they are returning to work (if they still have a job to return to) as elective procedures open, so this will contribute to slowed volume. Additionally, there will be those who decide to live with their problem given they have done so for weeks already. Finally, many people will not wish to pursue elective procedures immediately upon returning to their social lives. Once we get past this initial catch-up period, these aforementioned factors will keep volumes slower than usual for a few months.
Issada Thongtrangan, MD. Microspine (Phoenix): The pandemic is unprecedented and affects all industries, including healthcare. My practice is still following CDC guidelines and practicing social distancing guidelines. I have to adapt the way I run the practice to ensure the safety of our staff and patients. There are no more packed waiting rooms and telehealth is on the rise. My prediction is that our patient volume will gradually pick up. Effective vaccine and rapid tests will be key. In addition, I hope there will not be a second spike. I anticipate that it will be at least next year until we will see the volume return to pre-pandemic levels.
Brian Gantwerker, MD. Craniospinal Center of Los Angeles: If I were a glass half-full person, I would say the end of the year or beginning of 2021. There will be a lot of people who will be on COBRA, Medicaid or Medi-Cal, or change insurance carriers due to job losses. They may not be able to see local surgeons and the board will be shuffled. On the other hand, it will be interesting to see how employed surgeons are treated by their respective health systems. I foresee many changes coming as physicians come to realize who has their own best interests in mind.
Jeffrey Wang, MD. USC Spine Center (Los Angeles): This pandemic has allowed us to re-examine our workflows and utilize telemedicine moving forward for those conditions that are very conducive to telemedicine visits. By utilizing a combination of in-person and telemedicine visits, we can try to return to seeing and caring for our patients at pre-pandemic levels. The real barrier right now is OR time, and the lack of open rooms to perform our surgeries because of necessary coronavirus-related accommodations.
We reserve a certain number of ORs for COVID-19 patients to keep non-coronavirus areas and patients separate from COVID-19 spaces. Additionally, added decontamination procedures to allow for patients to have subsequent surgeries in the same room elongate turnaround times for ORs to be used. It will be some time before we are able to resume the surgical volume that we had prior to the pandemic.
Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): I am hoping to return to regular patient volumes in three months as social distancing rules relax, medical practices open and patients feel safer to visit physicians' offices.
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