Financial issues are top-of-mind for most surgeons today. Three spine surgeons discuss the financial challenges worrying them the most and how they feel about the future.
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 of the reasons driving spine surgeons toward hospital employment?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, June 25, at 5 p.m. CST.
Question: What are the most pressing financial concerns keeping you up at night?
Christian G. Zimmerman, MD, Neurosurgeon, Idaho Neurological Institute at SARMC, Boise, Idaho: As a contracted worker within a mission-oriented health system, our burgeoning uninsured and under insured populace are cared for without much discussion. The worry for me is the next five years, with more disastrous reductions to hospitals, dissolution of rural care facilities and the dismissive nature of our political representatives [looking] to implement a "European model" of healthcare.
A. Nick Shamie, MD, Chief of Orthopedic Spine Surgery, David Geffen School of Medicine at University of California, Los Angeles: I don't loose sleep over financial concerns because being a physician continues to offer us a job security unmatched by most other professions. Moreover, I continue to cherish my interaction with my patients and feel blessed to have gained the expertise to be able to help them with my skills as a surgeon.
Our society and policy makers are misinformed about how the rising healthcare costs are mostly due to escalating administrative costs, etc., and not due to physicians' professional fees, which has in many cases declined compared to a decade ago. This has led to a downward pressure in reimbursement from the government and insurance companies specifically affecting our professional fees.
Despite the negative pressures facing us, I am optimistic about the future. We have a global epidemic of spinal disorders in the aging populations that need to be treated by the experts. Having the unique expertise of spine surgery offers me and my colleagues tremendous opportunities to continue doing what we love doing most, taking care of patients, and still remain financially secure with some creativity in our business models.
Richard A. Kube II, MD, CEO, Founder, Prairie Spine & Pain Institute, Peoria, Ill.: Probably the most pressing concern relates to the insurance industry in general. Insurance companies are disputing cases. Also, authorizations for procedures that used to be commonplace are increasingly difficult to obtain. Besides the obvious impact to our patients who are unable to obtain access to the medical care they need and desire, the overall case volume seen in spine practices has decreased. Or, in some cases the volume has remained, but the added staff required to sort through the less than transparent insurance authorization process is increasing overhead.
Given the decreases in reimbursements, the added overhead mixed with decreased revenues paints an undesirable picture of the financial landscape for medical practices. It begs the question of how long these two trends can remain on converging paths without rendering increasing numbers of medical practices insolvent.
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