Issue link: https://beckershealthcare.uberflip.com/i/1198635
30 PRACTICE MANAGEMENT How awake endoscopic spine surgery reinvigorated Dr. Raymond Gardocki's practice By Alan Condon R aymond Gardocki, MD, is a spine sur- geon specializing in endoscopic spine surgery at Memphis, Tenn.-based Campbell Clinic Orthopaedics. Ten years ago, Dr. Gardocki tried his hand at endoscopic spine surgery before turning to focus on outpatient lumbar fusions. Aer continuously refining his approach to outpa- tient lumbar fusions with no new technology or variation to the procedure on the horizon, he recalled the early stages of burnout start- ing to set in. Dr. Gardocki returned to endoscopic spine surgery, completed his training and began incorporating it into his practice in 2017. In February, he completed his 100th endoscopic spine surgery using joimax technology. Here, Dr. Gardocki discusses the evolution of patient education and avoiding burnout. Question: How has the evolution of the internet and patient self-educa- tion affected your practice? Have you experienced patients requesting specific spine procedures they've re- searched? Dr. Raymond Gardocki: Actually, yes. ere's one gentleman who had a transforaminal dis- cectomy awake and he did a very good job of articulating what it was like. I think that's one of the most common questions patients ask me — 'what is it like to be awake when you're pulling stuff out of my spine?' I always send people to this video because he articulated it very well. at patient came to me in clinic, said he's got a problem with pain down his leg and saw I was doing this surgery. He said, 'I don't know if I'm a candidate, but I want you to do it anyway.' I told him it doesn't work that way, but he actually turned out to be an excel- lent candidate. ere's a moment where I pull the herniation out and he explains how the pain relief came on and how he literally passed out from joy and relief of pain. For a while I was getting burnt out, I didn't think I could do spine surgery much longer and now I look forward to going into the OR. When I had the difficulty with endoscopic surgery a decade ago, and kind of gave up on it, I really focused on outpatient lumbar fusions. I got pretty good at it and I felt like I had it refined about as much as I could. When you start doing a surgery like that it takes you four hours, and I got it down to 90 minutes. You don't knock 90 minutes off a surgery by finding one thing that saves you 90 minutes; you find 90 things that save you a minute each. You don't do it by rushing, you do it by doing things efficiently and only do- ing the essential steps. I was at the point where unless there was some sort of technological change, I didn't see my- self being able to do this much differently or better than I am doing it now. en the en- doscope came along. It's very enjoyable to of- fer patients a procedure you think is best and there's nobody else offering it in your commu- nity. I truly believe I'm doing the best I can and the best that's possible with the technol- ogy that's available, which is very fulfilling. n Walmart pilot program to identify quality physicians will include orthopedics By Laura Dyrda W almart plans to launch new services for multiple specialties, including orthopedics, to connect patients with local physicians that the retail giant deems quality providers, according to an article written by Elizabeth Walker of Walmart Corporate Affairs. Four things to know: 1. Walmart worked with Embold Health to develop a data- base of "Featured Providers" that it will make available to patients looking for services in primary care, cardiology, gastroenterology, endocrinology, obstetrics, oncology, orthopedics and pulmonology. 2. The Featured Providers will include those with a reputa- tion for consistent quality care, based on data from public and private insurance programs. Walmart plans to provide its list of Featured Providers to associates as they make de- cisions about where to seek care. 3. Walmart plans to launch the Featured Providers pro- gram in North Arkansas, Orlando, Fla., Tampa, Fla., and Dallas-Fort Worth as part of its 2020 medical plan. 4. The company will also expand telehealth in Colorado, Minnesota and Wisconsin with additional offerings, in- cluding chronic care management. The visits will cost $4 and guarantee an appointment with a primary care physi- cian within one hour. n