Spine Industry Leadership: How Does it Need to Evolve?

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 some technology-based investments you are making to improve your practice?

Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, March 26, at 5 p.m. CST.

Question: In what ways does spine industry leadership need to evolve to meet the changing needs of the industry? Do you have advice for fellow spine surgeon leaders?

Neel Anand, MD, Clinical Professor of Surgery, Director, Spine Trauma, Cedars-Sinai Spine Center, Los Angeles: Spine surgeon leaders are going to be leading the way for appropriate surgery and developing new procedures that are also cost effective. Spine surgery has to result in better outcomes but must also have an aspect of cost containment. Minimally invasive approaches have a significant role to play if they are done safely and cost effectively.

Nader Dahdaleh, MD, Northwestern Medicine Neurosurgeon, Assistant Professor, Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago: The high cost of newer cutting edge technologies as they first emerge into the market impedes their initial use in many academic institutions where reimbursement is unpredictable due to the variability of payers and especially when other alternative implants exist. Industry leadership should find ways of cutting costs even if the technology is unique. Cost is almost always the limiting step in acquiring newer technologies in our and many other institutions.

Continued quality representation in the operating room and outside the OR is also important. In my view, most spine companies have excellent basic spinal implants that are not too different in utility and efficacy. What makes the difference is the quality and competency of the spine representatives. This is reflected in educating the operating room staff and residents, knowledge of the implant and of alternatives, and as importantly, availability, especially in cases of emergency surgeries.

Finally, it is important that industry will continue sponsoring courses, symposia and conferences, which are instrumental in spreading and sharing knowledge, innovation and technical skills nationwide.

Jeffrey Wang, MD, Chief, Orthopedic Spine Service, Co-Director, USC Spine Center, Keck Medical Center of USC, Los Angeles: Spine industry leadership needs to understand that surgeons are in this for the long-term and we want to treat our patients. Industry wants the spine arena and business to survive, but also needs to sell their products. These are not mutually exclusive, and there are areas where motives are aligned.

However, there are situations where the motives are not aligned. My advice to surgeon leaders is to take each issue separately, and not to judge the entire industry on specific viewpoints only on specific issues. A spine leader needs to look more globally at situations and be able to pick the right course of action. When leaders act, they need to consider the effects in all areas, not just the concerns of the moment.

Mark Spoonamore, MD, Assistant Professor of Clinical Orthopaedic Surgery, Keck Medicine of USC: I believe that spine industry leadership now understands the challenges that surgeons face and also understands all the issues involved in taking care of patients. They understand the need to show evidence for efficacy and the importance of patient outcomes when introducing new technologies as well as the need for well-designed studies.

The industry had to evolve with the new healthcare plans, and I believe they are responding appropriately with patient care as the priority. I think that fellow spine surgeon leaders need to work with the industry to look for ways to improve the ways in which we can care for our patients in an appropriate manner. If all is done appropriately, it will be better for our patients.

More Articles on Spine:

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Orthopedic, Neurosurgeon Roles: Medical Teaching, Administrative & Research
Growing Patient Volume in 2014 & Beyond: 4 Spine Surgeon Initiatives