Here are five ways spine surgeons and practices can stay on the cutting edge.
1. Participate in research, development and FDA trials. Leaders are often chosen from those who are willing to share their expertise. Regardless of age or experience, spine surgeons at the top — or on the rise — should be willing to share their technique with others and learn from their colleagues. This could be through research, surgical training or advocacy efforts.
"It takes a huge amount of time to be involved in politics and develop relationships with others, but it builds the field," says Robert S. Bray, MD, founder of DISC Sports & Spine Center in Marina del Rey, Calif. "Research isn't only for academic institutions anymore; you can participate in FDA studies, clinical outcomes studies and basic science research. Leaders show dedication to passing on their knowledge base."
It takes time and energy to cultivate these efforts, but spine surgeons who do give back to their colleagues and innovate in the field will become natural leaders.
"You are looking for the person who gives a lot back," says Dr. Bray. "You are trying to develop spine as a field. It's not just performing surgery; it's integrating all of the multidisciplinary specialties. These people have to have passion. They must love what they do and give a lot of time and effort to it."
2. Engage in 21st century marketing techniques. Before social media, health information flow came only from physicians and healthcare groups. Physicians could, to an extent, dictate disease and treatment perceptions, says John Caruso, MD, a neurosurgeon with Parkway Neuroscience & Spine Institute, a private multi-specialty group in Hagerstown, Md. Social media offers a wide-open arena and it is giving patients a voice in the healthcare information flow — they can engage in a dialogue about their aliments with other patients, with physicians and with healthcare organizations. According to Dr. Caruso, social media will push physicians towards better outcomes and more transparency, not just for the cost but the quality of the care.
Additionally, the social media community can help patients assuage their concern about diagnoses. For instance, breast cancer is a diagnosis that has seen a lot of social media activity. Jay Harness, MD, a breast cancer surgeon in California, launched a website to answer questions from breast cancer patients. The
website now features over 200 YouTube videos from physicians who answer questions to frequently asked questions as well as questions patients submit online. The website now launches content via YouTube, Facebook, Twitter and Google+.
Although different from spine related diagnoses, physicians can still apply some of the techniques. Spine surgeons, neurosurgeons and orthopedic surgeons could maintain a social media presence and answer patient questions.
Social media is going to revolutionize how medicine is viewed in the country so spine centers need to be involved, says Dr. Caruso. Both physicians and spine centers should have social media outlets. A spine center will need to hire someone to coordinate the flow of information, says Dr. Caruso. "It is important for physicians to be a part of the information dissemination," says Dr. Caruso.
There are many strategies for improving spine center profitability. Overall, increasing patient flow and reducing costs are pillars in the best practice arena for profitability. Utilizing new technology, embracing different healthcare perspectives and hiring individuals that have the mindset and drive for success among healthcare reform are best practices that may guide a spine center to a better tomorrow.
3. Focus on education to further the field. Richard Guyer, MD, founded the Texas Back Institute Spine Surgery Fellowship program in 1986, which has trained nearly 100 Orthopaedic and Neurological Surgeons to date. Dr. Guyer and Jack Zigler, MD, are current directors of the fellowship, which provides a broad base of exposure to all aspects of spine reconstruction for degenerative conditions, deformity, tumor, and trauma, with a concentration on spine arthroplasty.
"The creation of the fellowship sparked the development of our weekly neuroscience conference, which is CME accredited," wrote Stephen Hochschler, MD, former president of Texas Back Institute and chairman of Texas Back Holdings Corp. "The fellowship program also includes weekly interesting case conferences, biweekly M&M conferences, and a monthly journal club."
Fellows are also required to engage in research with the Research Foundation and present their findings before successfully completing the fellowship. The practice also welcomes surgeons from around the world to observe their technique. Education is an important part of furthering the field of spine surgery, and Texas Back Institute has spread its network far and wide throughout the process.
4. Innovate in patient coverage and payment models. Consider new ways to partner with patients, insurance companies and other providers to drive patient volume and ensure coverage for care. When patients receive coverage denials, especially if the technology or procedure is considered "experimental," some will search for a way to have the procedure regardless. "We were noticing many patients were considering going to Germany or India where they could pay cash for an ADR," says Kenneth Pettine, MD, a fellowship-trained spine surgeon and co-owner of the Loveland (Colo.) Surgery Center. "We felt we could offer these patients a cash price similar to what they would pay overseas but allow them to have their surgery close to home by a surgeon they know and trust," he says. "Follow up is easier and more efficacious." By offering cash payments at a lower price, the center is providing patients "an alternative to obtain quality spine care otherwise denied by their insurance and avoid a trip overseas," he says.
Loveland has set cash prices for these surgeries that represent a 60 percent reduction from the hospital charges. The cash price includes the implants, surgeon, facility and anesthesiologist fees. "All this can be provided to patients at an affordable rate, still allowing ample profit margins," he says. Following the procedure, Loveland Surgery Center bills all cash-paid surgeries to the insurance company. In a few cases, insurers have paid for the surgery even though they initially denied it, in which case the surgery center then reimburses the patient.
"Once the precedent has been set, our experience is insurance companies continue to pay for the procedure even after an initial denial," Dr. Pettine says.
5. Participate in academics. Success for your business in a competitive market depends upon differentiating you product from others on the shelf. The same rings true for orthopedic practices. When launching their practice, the original Rothman partners were keenly aware of this concept. "In order to be a sustained leader in our market, we had to differentiate ourselves," says Alexander Vaccaro, MD, PhD, a spine surgeon and one of the founding partners of Rothman Institute in Philadelphia. "Instead of just being the best surgeons clinically, we had three additional criteria our partners strove to meet: we had to be clinically productive, a good citizen and active in academic work."
Maintaining clinical productivity meant the surgeons were seeing an appropriate patient volume and optimizing their time; being a good citizen meant respecting all employees, being a team player and contributing to the positive culture at the practice; having a focus on academics meant the surgeons were also required to research and write papers, deliver lectures at professional meetings and participate in community events such as sitting on the sidelines at youth sporting activities.
"You can't just be a productive orthopedic surgeon because everyone does that, and their practices can still fail," says Dr. Vaccaro. "If you give back to the community and participate academically, that's different."
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