Six spine surgeons discuss how spine surgeons can partner with other surgeons to benefit patient care.
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 will be the keys to reducing healthcare costs without compromising care?
Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, April 24, at 5 p.m. CST.
![Dr. Jeffrey Goldstein of NYU Langone Medical Center's Hospital for Joint Diseases]( "Dr. Jeffrey Goldstein of NYU Langone Medical Center's Hospital for Joint Diseases")
Jeffrey Goldstein, MD, Director of Spine Service, NYU Langone Medical Center's Hospital for Joint Diseases: Spine surgery has become quite subspecialized. Even within our own area of expertise there is subspecialization such as deformity, degenerative, trauma, pediatrics, cervical, etc. We each have our own skills. Some may still feel comfortable doing it all. It is not uncommon that a degenerative surgeon may call upon a deformity surgeon to collaborate and vice versa. At NYU Langone Medical Center Hospital for Joint Diseases, we have found that for patients undergoing large revision surgery that the skills of a plastic surgeon are often valuable and lead to diminished post-op infection rates and wound problems. We occasionally rely on vascular, thoracic or ENT surgeons to provide anterior spinal exposure.
Walter Eckman, MD, owner of Aurora Spine Center, Tupelo, Miss.: Spine surgeons can work with each other for education and improved communication about new trends and concepts of care, including teaching and helping each other to expand the role of minimally invasive surgery. In hospitals, they can work together to provide better and less expensive equipment, implants, supplies, bone substitutes, etc. Mergers would be most helpful to develop joint imaging, surgery centers and exercise and therapy centers.
![Dr. J. Brian Gill of Nebraska Spine Center in Omaha]( "Dr. J. Brian Gill of Nebraska Spine Center in Omaha")
J. Brian Gill, MD, Orthopedic Spine Surgeon, Nebraska Spine Center, Omaha: I think that there are a couple of examples in which patients can benefit from spine surgeons partnering with other surgeons. First, orthopaedic surgeons and neurosurgeons partnering together can provide a complement and comprehensive list of services to patients. While both specialties perform spine surgery, each has their own unique abilities that will provide a synergistic effect for patients. Another example would be the use of approach surgeons such as general surgeons or vascular surgeons. Using select individuals as an approach surgeon will allow those individual physicians to become more proficient in their skills to access the anterior spine. This will allow greater efficiencies such as time while reducing potential complications.
![Dr. Jeffrey Wang of UCLA Spine]( "Dr. Jeffrey Wang of UCLA Spine")
Jeffrey Wang, MD, UCLA Spine Center: I do think it is important to work as a team, both with other physicians in your spine center and with the staff in the hospital. Making things more efficient and patient-friendly will improve patient satisfaction. Certainly, as we track our outcomes, re-admission and the quality of our work, we do want to demonstrate improvements in our patients, better patient care and results. I think by raising awareness, making things more efficient and streamlining the processes for our patients, we can make things better. Communicating with your colleagues is very important. I also think surgeons can work together and input their data in registries, so that we can pool our clinical experiences and gather better information on certain procedures, instruments, and outcomes of treatments. We need to show that what we do makes our patients better and improves our lives. For some unanswered clinical questions, it will require surgeons working together to compile the data and having definitive results. I see many societies, professional medical organizations, and physician groups moving in this direction.
Kern Singh, MD, Rush University Medical Center, Chicago: Surgeons and physicians are the keys to delivering efficient and cost-effective healthcare. Unfortunately, physicians tend to be divisive and autonomous leading to large healthcare reforms without physician input. Hospital-physician and physician-physician partnerships through joint ventures in the hospital and surgicenter environment will allow doctors to deliver cost effective and expeditious healthcare.
Ali Araghi, DO, Orthopedic Spine Surgeon, The CORE Institute, Phoenix: Surgeons can collaborate with each other to collect outcomes data. Outcomes based data, which is derived from the collaboration, can lead, define and identify best practice algorithms, which in turn if it is followed will ultimately improve patient care. A large part of this depends on the ability to include standardization of practices amongst the physicians. This is necessary for collection of meaningful outcomes data. Standardization is also of paramount importance for implementation of best practices based on the outcomes data.
More Articles on Spine:
Outlook on Spine Surgeon Relationships With Hospitals: Q&A With Dr. Bryan Oh of BASIC Spine
10 Tips for Spine Surgeons to Consider When Choosing a Practice
5 Tactics to Help Young Spine Surgeons Build Their Practices
Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, April 24, at 5 p.m. CST.
Jeffrey Goldstein, MD, Director of Spine Service, NYU Langone Medical Center's Hospital for Joint Diseases: Spine surgery has become quite subspecialized. Even within our own area of expertise there is subspecialization such as deformity, degenerative, trauma, pediatrics, cervical, etc. We each have our own skills. Some may still feel comfortable doing it all. It is not uncommon that a degenerative surgeon may call upon a deformity surgeon to collaborate and vice versa. At NYU Langone Medical Center Hospital for Joint Diseases, we have found that for patients undergoing large revision surgery that the skills of a plastic surgeon are often valuable and lead to diminished post-op infection rates and wound problems. We occasionally rely on vascular, thoracic or ENT surgeons to provide anterior spinal exposure. Walter Eckman, MD, owner of Aurora Spine Center, Tupelo, Miss.: Spine surgeons can work with each other for education and improved communication about new trends and concepts of care, including teaching and helping each other to expand the role of minimally invasive surgery. In hospitals, they can work together to provide better and less expensive equipment, implants, supplies, bone substitutes, etc. Mergers would be most helpful to develop joint imaging, surgery centers and exercise and therapy centers.
J. Brian Gill, MD, Orthopedic Spine Surgeon, Nebraska Spine Center, Omaha: I think that there are a couple of examples in which patients can benefit from spine surgeons partnering with other surgeons. First, orthopaedic surgeons and neurosurgeons partnering together can provide a complement and comprehensive list of services to patients. While both specialties perform spine surgery, each has their own unique abilities that will provide a synergistic effect for patients. Another example would be the use of approach surgeons such as general surgeons or vascular surgeons. Using select individuals as an approach surgeon will allow those individual physicians to become more proficient in their skills to access the anterior spine. This will allow greater efficiencies such as time while reducing potential complications. 
Jeffrey Wang, MD, UCLA Spine Center: I do think it is important to work as a team, both with other physicians in your spine center and with the staff in the hospital. Making things more efficient and patient-friendly will improve patient satisfaction. Certainly, as we track our outcomes, re-admission and the quality of our work, we do want to demonstrate improvements in our patients, better patient care and results. I think by raising awareness, making things more efficient and streamlining the processes for our patients, we can make things better. Communicating with your colleagues is very important. I also think surgeons can work together and input their data in registries, so that we can pool our clinical experiences and gather better information on certain procedures, instruments, and outcomes of treatments. We need to show that what we do makes our patients better and improves our lives. For some unanswered clinical questions, it will require surgeons working together to compile the data and having definitive results. I see many societies, professional medical organizations, and physician groups moving in this direction.Kern Singh, MD, Rush University Medical Center, Chicago: Surgeons and physicians are the keys to delivering efficient and cost-effective healthcare. Unfortunately, physicians tend to be divisive and autonomous leading to large healthcare reforms without physician input. Hospital-physician and physician-physician partnerships through joint ventures in the hospital and surgicenter environment will allow doctors to deliver cost effective and expeditious healthcare.
Ali Araghi, DO, Orthopedic Spine Surgeon, The CORE Institute, Phoenix: Surgeons can collaborate with each other to collect outcomes data. Outcomes based data, which is derived from the collaboration, can lead, define and identify best practice algorithms, which in turn if it is followed will ultimately improve patient care. A large part of this depends on the ability to include standardization of practices amongst the physicians. This is necessary for collection of meaningful outcomes data. Standardization is also of paramount importance for implementation of best practices based on the outcomes data.
More Articles on Spine:
Outlook on Spine Surgeon Relationships With Hospitals: Q&A With Dr. Bryan Oh of BASIC Spine
10 Tips for Spine Surgeons to Consider When Choosing a Practice
5 Tactics to Help Young Spine Surgeons Build Their Practices