Becker's Spine Review

14 SPINE SURGEONS Dr. Kris Radcliff: How early-career spine surgeons view private practice vs. employment opportunities By Alan Condon K ris Radcliff, MD, is a fellowship-trained spine surgeon with 10 years of experience in private practice with Philadel- phia-based Rothman Institute. Here, Dr. Radcliff recalls how his practice began at Rothman and dis- cusses how emerging spine surgeons are viewing private practice ver- sus employment opportunities. Question: You began practicing in 2009. What was your mindset in terms of seeking employment opportunities versus private practice after you completed your fellow- ship? Where do you think the next generation of spine surgeons' heads are at now? Dr. Kris Radcliff: I did a fellowship at the Rothman Institute at om- as Jefferson in 2009. I was offered a job with my fellowship mentors and have had one job ever since I started my practice. Before I got offered the job, I considered going back to where I did my residency in Houston at Baylor College of Medicine and taking a hybrid academic/ private practice job. I love working in this hybrid private practice/academic model. My part- ners are international experts in orthopedic surgery who have made a significant academic contribution to the literature and to our societies. Consequently, they are absolutely supportive of my own academic en- deavors, and they continually open doors for me. I have an academic appointment at a university. I'm very involved in research and teaching. However, I also really enjoy working in a private practice, physician-run group. Our president and board are physicians who are very sensitive to our needs, perspectives and training. Our group is very nimble. Because we only do musculoskeletal care, we're very good at being a center of excellence. us, it's easy for me to get the clinical resources that I need to advocate for myself and my patients. Certainly, being private practice carries some financial risk, which is more present than if I were em- ployed by an organization with a bit more of a guaranteed salary. But it's interesting, it even changes your perception of the office, the building and so forth. You own part of it, so you take more care in it. I was at a meeting recently where someone spoke about trends in em- ployment among physicians. According to a recent American Medical Association survey, the majority of physicians are employed. With- in orthopedics, there are way more people taking employed jobs now than when I was a fellow 10 years ago. at is probably a reflection of consolidation in the job market as well as the growth of hospitals and healthcare organizations. I think it's probably hard to negotiate as an independent eight-to-10-person group from an insurance and contract- ing perspective. e generation of surgeons who are coming out now have seen significant changes in healthcare in the last two years with the ACA and potential repeals. I think that it's probably appealing to work for a big organization that will buffer you a little bit from potential future changes to the way healthcare is practiced. e problem is when you're employed you do lose some leverage, and you probably lose some degree of autonomy over various aspects of your practice. n AAOS, AANS partner for new spine registry By Laura Dyrda A new partnership between two professional specialty organizations will yield a spine registry that will allow all spine surgeons in North America to collect and share quality data. The American Association of Neurological Surgeons, which has supported the Quality Outcomes Database, part- nered with the American Academy of Orthopaedic Surgeons to enhance the registry so it can reach more surgeons and specialists across North America. The American Spine Registry will be jointly owned by both associations and include the data science capabilities of AANS. AAOS will bring its operational expertise to the registry, which aims to engage multiple stakeholders. The organizations hope their new registry will lead to more informed decision-making and better spine care. "This is an appropriate, timely and potentially paradigm-shifting partnership," said Anthony Asher, MD, of Carolina Neu- rosurgery & Spine Associates. He serves as co-chair of the American Spine Registry along with Steve Glassman, MD, of Louisville, Ky.-based Norton Leatherman Spine Center. "It is significant that these two organizations ultimately chose to embrace the greater potential of what we could accomplish together." Ideally, the registry will be able to inform both organizations about care guidelines and establish benchmarks for testing clinical performance. It will also provide surgeons with feedback to continue improving their practices and outcomes while lowering the burden of data reporting for regulatory requirements. n

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