Becker's Spine Review

25 PRACTICE MANAGEMENT How to grow a successful independent spine practice: 4 key questions By Laura Dyrda F our spine surgeons answered tough questions on how to build and sustain a successful practice in today's chang- ing healthcare environment. Question: If a practice is established and relatively successful, what can be done to shake things up and promote growth? Adam Bruggeman, MD. Texas Spine Care Center (San Antonio): Each market is dif- ferent, so a detailed Strengths, Weaknesses, Opportunities and reats analysis is neces- sary to evaluate the individual market. at being said, healthcare is increasingly becom- ing local, and as such, patients are frequently going to the nearest spine surgeon as opposed to driving. Providing a closer, more conve- nient location for patients, even if once per week, can open up new referral patterns from physicians as well as increase the likelihood of patients coming to see you on a self-referral. Q: Where do you see the biggest opportu- nities for independent physicians to build their businesses? Stephen Hochschuler, MD. Texas Back Institute (Plano): Tele- health is an expandable area that allows you to cover your patients more efficiently. All the rules of telehealth are changing, so you have to learn what they are. Another area I'm look- ing at is pain management for spine surgeons; you need a multimodal approach to prepare the patient for preoperative and then what to expect without opioids. Finally, I'm looking at regenerative medicine for spinal procedures to address anti-inflammatory issues. Q: Do you think independent physicians will be able to remain so as competition es- calates in the industry? Vladimir Sinkov, MD. New Hampshire Or- thopaedic Center (Manchester): Innovative and entrepreneurial physicians who value their independence will continue to thrive and adapt to the ever-changing landscape of medicine in the U.S. If things continue as they are, however, and if the government passes more laws that are aimed at destroying private practices, such as Obamacare, less and less physicians are going to be willing to keep up the fight. Ironically, the demise of private practice will not be due to competition; it will be due to the reasons listed above. Competi- tion is actually good and makes everyone try harder and be better at what they do. e current system is anti-competitive. It provides an unfair legal and financial ad- vantage for non-profit tax-exempt large hospital systems and insurance companies. Q: How do you expect the value equation to change the practice of spine surgery over the next decade? Frank Phillips, MD. Mid- west Orthopaedics at Rush (Chicago): Bun- dled payments will continue to evolve with the inevitable march away from a fee-for-ser- vice model. Bundles are readily managed for spinal procedures with reproducible and pre- dictable outcomes, such as anterior cervical discectomy and fusion. More complex treat- ments, such as surgery for advanced spinal deformity, will remain a challenge in a val- ue-based purchasing system. With increased emphasis on value and transparency, practic- es' and practitioners' outcomes will become increasingly available to the public who will become much more sophisticated healthcare shoppers. n Memorial Health lays off 85 employees with push toward spine, joint focus: 3 takeaways By Mackenzie Garrity D uring the first week of May, Savannah, Ga.-based Memorial Uni- versity Medical Center laid off 85 employees, WTVM reports. Here are three takeaways: 1. Along with the 85-person layoff, the hospital is shifting other team members into new roles focused on direct care delivery. 2. A spokesperson with the hospital's parent Nashville, Tenn.-based Hos- pital Corporation of America said Memorial Health is looking to hire 200 employees for patient care roles. 3. The hospital is currently making a push to focus on its centers of excel- lence for children, cancer, heart, joint, spine, minimally invasive surgery and emergency care. n

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