Bryan Oh, MD, a spine surgeon with BASIC Spine in Orange, Calif., discusses leadership among young spine surgeons and how they can propel themselves to success in the future.Q: What does it take for young spine surgeons to be successful in today's healthcare environment?
Dr. Bryan Oh: Spine surgery and healthcare are undergoing a lot of changes with ObamaCare and not a lot of people know what is really going to happen within the next few years. For successful young spine surgeons, the first thing they need to do is be informed about what is going on. It's more than just practicing medicine, more than what we were taught during our residencies and fellowships; they have to understand the bigger healthcare picture.
They must understand healthcare in a broader sense, which includes who is going to be in charge and what the new rules will be for treating patients. They also have to know their reimbursement levels and changes. Finally, they must understand that it will take people with an entrepreneurial spirit to succeed with changes in spine surgery.
Q: What resources do young spine surgeons have to help them through their first few years of practice?
BO: There are a few resources: first, talk with other successful spine surgeons who are out there in private practice. These days, talk to colleagues who finished training a few years ahead of you. Young spine surgeons may think working for a hospital is the only way to go, but there are still a lot of surgeons who have been successful in private practice endeavors.
Number two, it might be difficult in the beginning starting out in private practice, but the rewards will outstrip the potential drawbacks. Remember, hospitals don't have the best interest of spine surgeons at heart — they have the best interest of the hospital at heart. What might seem like a good contract out front — attractive because you don't have to set up an office staff or drive patient volume — might not be so great because you are giving up control of your practice to someone who doesn't have you or your patients' best interests in mind.
When surgeons try to renegotiate their contracts, they will find the rates aren't as attractive as they are for the new surgeons coming in. By that point, the spine surgeon will have a wife and children, which makes it really hard to move and set up a new private practice environment. All of these are huge challenges that spine surgeons face.
I would advocate on an organizational level, experienced spine surgeons should work with young surgeons to look at private practice and show them how to get that done. It will serve our interests and patients' interest in the long run.
Q: How can spine surgeons make sure their practice is successful without the elements that make hospital employment so attractive?
BO: I think it's still really important for any young spine surgeons coming out of training to seek their own referral sources — not just sticking with ones from their own practice. There is no substitute for going out there and shaking hands with other physicians in the community. Have dinner and office visits with referring physicians and give lectures within the community to people who have an interest in spine surgery and spine-related issues.
Spine surgeons must also understand that the internet is a really powerful tool and whether we like it or not, data about us is on the internet. Understand what information is out there and find a way to control it. You have to be able to use the internet to your advantage. I think that's something that's not taught in residency or fellowship but it's very important.
Finally, young spine surgeons should understand what is going on at a national level with professional medical organizations. I'm not advocating a huge leadership role in these organizations, but young spine surgeons should have a familiarity with them and consider membership.
Q: Over the next several years, which spine surgeons will rise to the front of the pack as industry leaders?
BO: I think folks who ultimately want to seek out what will happen with ObamaCare and become the first adapters will understand the system very well and they'll do very well. They are the surgeons who understand how these changes came about. I think it's important for young surgeons to know their results and how much patient care matters. They must find a reputable way to track their own results, produce these results to their carriers and accountable care organizations. If they can demonstrate they provide good quality care, they will do very well in this model.
There is a different mindset today than just getting the work done. Quality of care really matters. There are some hospitals now that want surgeons to produce patient care data for the past few years. This is a rapidly approaching reality for spine surgeons at all levels.
Q: What are the biggest opportunities for young spine surgeons to grasp hold of going forward?
BO: To be successful in the future, I think we have to go back to being able to demonstrate that we are providing high quality care at a reasonable cost. With the potential increase in the number of insured patients with ObamaCare that will be really important. It will be all about quality of care.
Number two will be looking at how they can be involved in ancillary services because reimbursements are going down and they will continue to decrease. People don't learn about investing in ancillary services or running ambulatory surgery centers in training. Involvement in these other areas could potentially bring another source of income and allow them to stay independent.
The third point is having a good marketing presence both with the traditional methods as well as new methods such as the internet and electronic media marketing.
Dr. Bryan Oh is board certified in neurosurgery and received his undergraduate degree in 1996 and his medical degree in 2001 from Stanford University. He did his residency and spine surgery fellowship at the University of Southern California.
Dr. Oh was a faculty member at the University of Texas at Houston Medical School and was Director of Neurotrauma for the busiest Level One Trauma Center in the United States.
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