Becker's Spine Review

9 SPINE SURGEONS What price transparency will do to spine – key thoughts from 5 surgeons By Laura Dyrda V alue-based care and price transpar- ency is on the forefront of physicians' and healthcare executives' minds, es- pecially aer President Donald Trump issued an executive order to require healthcare price disclosure. Here, five spine surgeons discuss how both trends will affect spine care and what sur- geons can do to prepare for the future. Wellington Hsu, MD. Clifford C. Rainsbeck Distinguished Professor of Orthopaedic Surgery and Director of Research at North- western University Feinberg School of Med- icine (Chicago): I believe that price transpar- ency and value-based care will force surgeons to consider the value different parts of the surgery adds. is will make us consider all facets of new technology before we accept them for the vetting process. Price transpar- ency will allow comparisons of like surgeons to improve efficiency across-the-board. Jason Huang, MD. Chair of the Department of Neurosurgery at Baylor Scott & White Health (Dallas): Price transparency and value based care will allow surgeons to work more efficiently with primary care physicians and other non-surgical providers from differ- ent areas (such as physical therapists, chiro- practors and pain management doctors) to work collaboratively across the health system. Sometimes early surgical intervention is more cost-effective and can result in better outcome for spine patients; other times patients shall only be treated conservatively to allow for bet- ter outcome and less expenses. ese trends will force spine surgeons to consider all facets of care in a health system before major deci- sions are made for more complicated spine patients. Jesse Even, MD. Spine Surgeon at TMI Sports Medicine and Orthopedic Surgery (Arlington, Texas): e higher the deduct- ibles go on our patients the more we are going to have to push for price transparency. Now that people are paying a larger and larger por- tion of their costs for their healthcare, and are consumers, now, instead of just receivers. We are going to have to be much more transpar- ent in our pricing structures. e practices and hospitals that adapt to this will gain the confidence of the people they serve, and like other transparent organizations such as Ama- zon, Walmart, etc., they will gain a much larg- er market share. Jonathan Carmouche, MD. Section Chief of Scoliosis and Pediatric Orthopedics at Carilion Clinic (Roanoke, Va.): ere will be more drive towards minimally invasive procedures to shorten length of stay and de- crease cost. Aggressive implant negotiations will be necessary to decrease implant-related costs. I also see continued optimization of patient-specific case packs to minimize ster- ilization of many trays and decreased fusions for axial pain. Peter Passias, MD. Spine Surgeon at NYU Langone Health (New York City): While there is opportunity to improve our care in terms of price transparency and value-based care evaluations, unfortunately, there is also much potential for the level and availability of care to be negatively affected. Value-based care based on the current systems in place inherently implies cutting services. We need to be absolutely certain that we thoroughly assess the impact of such retractions on an in- dividual, as well as from a general population basis, prior to implementation. n Meet the head neurosurgeon for Elon Musk's Neuralink, Dr. Matthew MacDougall By Laura Dyrda T esla founder Elon Musk hired Matthew MacDougall, MD, a practicing neurosurgeon, to participate in a new project to develop a brain-computer interface technology and advance treatment for brain disorders, according to the Wall Street Journal. Neuralink is working on FDA clearance for its platform, which is designed to help treat patients with spinal cord injury and other neurological conditions. The company has around 100 employees and is currently recruiting. Mr. Musk unveiled the startup on July 17 in a presentation that indicated Dr. MacDougall was head neurosurgeon for the company. Dr. MacDougall joined the company in De- cember 2017 and maintains his practice as a San Francis- co-based neurosurgeon at Sutter Health. He also has expe- rience as a clinical instructor at Stanford Health Care. Dr. MacDougall earned his medical degree at the Universi- ty of Southern California in Los Angeles and completed his residency at the University of California, San Diego. He also underwent a fellowship at Stanford (Calif.) University. In addition to his clinical practice, Dr. MacDougall has con- ducted research in optical brain interfaces. During the pre- sentation, Dr. MacDougall said Neuralink implants "could be as seamless as Lasik in the future," according to TeslaRati. So far, surgeons have performed 19 procedures with Neu- ralink technology on animals and successfully placed its threads 87 percent of the time. The company hopes to begin implanting the device in humans next year, with the goal of allowing paralyzed people to control phones or computers with the implants. n

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