The healthcare environment is rapidly evolving, creating opportunities for some spine surgeons to succeed while others are left in the dust. Todd Albert, MD, spine surgeon and president of Rothman Institute in Philadelphia, talks about what it takes for spine surgeons to become agents of change in healthcare.1. Meet the challenges of the future head-on. New technology, regulations and business models are constantly sprouting up in today's healthcare world, and spine surgeons will have an advantage if they see where the future is headed. Stay informed on the regulatory and reimbursement climate to forecast coming trends and find a way to overcome these issues.
"The over-arching theme is trying to predict what healthcare will look like in two, three and four years from now and trying to make changes in your own group or practice," says Dr. Albert. "This sets the standard for other practices to follow. Today, you want to create a business model to collect patient outcomes and measure your quality or your value."
Collecting outcomes will make a difference in the future as payors move more towards pay-for-performance, accountable care organizations and other measures to reward cost and quality incentives instead of patient volume.
2. Invent a disruptive technology. Surgeons who are on the forefront of research and innovation are constantly looking for the next big development. These developments should go far beyond the current standard of care to really make an impact on how care is delivered. Participate in clinical trials and be among the first to adapt proven new technology into your practice.
"In the past decade, BMP was that technology," says Dr. Albert. "It disrupted the way we did surgery because it cut down on taking bone graft. It also came with complications when people went off the reservation and overused the technology. However, it has really been a disruptive technology."
Researchers are now studying how to improve upon bone morphogenic protein technology and other biologics to potentially regenerate discs in the distant future. Surgeons are also researching spinal biomechanics and motion preservation to develop a better procedure that would restore motion and avoid adjacent segment degeneration.
"We hoped artificial discs would do this, but they haven't shown they are better than fusions yet," says Dr. Albert. "Some of the cervical spine long term data may prove their effectiveness in the future."
3. Engage in research. It will be important for spine surgeons in all practice settings to engage in data collection, research and publication. Development in data collection is constantly improving to make this process easier for surgeons and their staff members.
"We are working on a program where patients, as part of their visit, answer standard questions electronically so we can get the outcomes measures we need," says Dr. Albert. "More people are doing so and we see that smaller groups are able to research; it's not just surgeons in a big university setting."
This research will support surgical and nonsurgical treatment pathways for future coverage, as well as lead the way in innovative technology. Dr. Albert sees the most important research will be done in areas yet undiscovered or unproven.
"The next wave of disruptive technology will prevent us from doing surgery on certain diseases," he says. "It will slow down the disease process like certain medications stop people from needing heart surgery. It will be an interventional technology that prevents a big procedure. I don't think we know what that is yet."
4. Work with other like-minded people. Spine surgeons can't strike out on their own in today's healthcare environment and expect to stay on the forefront of the field. Regulatory challenges have made it difficult for surgeons to even stay in a solo practice. However, if they are able to partner with like-minded individuals, they will be successful.
"You have to have a group of individuals who are willing to work together and believe in what they are doing," says Dr. Albert. "They should want to share and prove that what they are doing is correct. To lead that group is easy because they are all on the same page. You can't do it if they don't believe what they are doing is correct."
For example, in a large practice setting make sure all the surgeons are onboard for new partnership initiatives with other providers or adding services to the practice. Everyone should know why they are making the change and the potential benefits for the future.
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