Becker's Spine Review

11 SPINE SURGEONS Where orthopedic surgeons work — breakdown by facility type By Jackie Drees Medpage Today unveiled its Salary Survey Orthopedics Specialty Fall 2018 report. Here is the breakdown of where orthopedic surgeons work by type of facility: Single-specialty group practice — 30 percent Hospital (non-government) — 24.8 percent Multispecialty group practice — 20.3 percent Solo private practice — 15.2 percent College of university (academic) — 3.4 percent VA hospital or other government facility — 1.7 percent Other — 1.7 percent College or university (clinical) — 1.4 percent Community healthcare center — 1 percent Walk-in or urgent care clinic — 0.3 percent n 5 big growth opportunities in spine By Laura Dyrda H ere are key thoughts from five spine surgeons as they discuss the biggest opportunities for practice growth in the coming year. Key themes the surgeons discussed include: • Taking more outpatient procedures into the ASC • Incorporating cutting-edge technology • Taking steps to engage in value creation and bundled payments • Partnering with multidisciplinary spine specialists for pa- tient-centered care • Using technology such as social media for marketing and tele- health for follow-up visits Q: What are the biggest growth opportunities for spine surgeons today? Kern Singh, MD. Co-Director of the Minimally Invasive Spine Institute at Rush and Partner at Midwest Orthopaedics at Rush (Chicago): 1. Increasing ancillary utilization will allow private prac- tices to maintain autonomy. Orthopedists are learning quickly that relying solely upon professional revenues is not sustainable. Rather, other avenues for revenues will need to be maximized, including du- rable medical equipment, MRI and physical therapy. 2. Bundled Payments Care Initiative will be an area of significant growth for those practices that specialize in high volume acuity of care — total hips, knees and spine — and can provide these treat- ments in a cost-contained, low complication fashion. Margins are still large in BPCI, and with the correct infrastructure, this can still be a source of significant revenue for the private practitioner. 3. Social media and online marketing will continue to grow. e ability to capture large audiences with a smaller cost can allow all practices the ability to increase patient flow. Real time social media — Facebook, Instagram and search engine optimization — is key to the evolving world of healthcare marketing. Alpesh Patel, MD. Co-Director of the Northwestern Spine Center (Chicago): In general, growth for businesses entering spine is go- ing to come from meaningful innovation that then creates product differentiation. Meaningful innovation will only occur if real clinical needs are met: safer, reliable and predictable spinal fusion as one ex- ample. Studies, like the upcoming Kuros study on Fibrin-Parathyroid hormone, will provide evidence as to whether or not these clinical needs are being met. ose facts, presented within a framework of improving patient outcomes, can be drivers of growth. Jocelyn Idema, DO. Orthopedic Spine Surgeon (Pittsburgh and Washington, Pa.): I see the best opportunities for growth are in the outpatient spine sector. I feel as though the surgical culture continues to move towards patient-centered healthcare, and thus we can really work out a lot of issues before and aer surgery in the comfort of the patient's own homes. By utilizing home health and therapy teams effectively in the patient-centered mindset, I am beginning to see a lot of opportunity in telehealth and reaching out to patients across the country, but also when you can't wait for an appointment in four to six weeks. With videotaped exams we can at least initiate treat- ment electronically with PT, medications and ordering of X-rays, and then bring you in for a face-to-face follow-up appointment later. I do know of a few companies that are starting to work towards providing these types of services for patients. Charles Gordon, MD. CEO of Precision Spine Center and Found- er of Texas Spine & Joint Hospital (Tyler, Texas): We believe that with interdisciplinary consolidation [there] is also an opportunity for value creation. Bringing like-minded physicians in complementary specialties together not only improves patient convenience, but [also] achieves some scaling efficiency and reduces overall costs. Finally, as readers of Becker's surely know, there appears to be contin- ued regulatory and consumer support in favor of ASC-based proce- dures over those done in a traditional hospital setting, when appro- priate. Technical improvements also are enabling this trend. We see this as a continued opportunity in select markets. Stephen Hochschuler, MD. Founding Physician of Texas Back In- stitute (Plano): Growth in spine: (1) Application of artificial intelligence using registries, information technology, predictive analytics. (2) Integration of telemedicine to streamline care and lower costs while increasing access. n

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