Becker's Spine Review

4 SPINE SURGEONS 'We have to prepare for the future now': Dr. James Lynch on the importance of ASC partnerships in spine By Alan Condon J ames Lynch, MD, is founder of SpineNevada in Reno, where he is chairman and CEO, as well as partner and director of spine services at Westchester, Ill.-based Regent Surgical Health. A spinal neurosurgeon for more than 25 years, Dr. Lynch participat- ed in the closing keynote interview at the Becker's Spine, Orthope- dic and Pain Management-Driven ASC + the Future of Spine virtual event June 19, sharing his thoughts on innovations and opportunities in spine services. Click here to view the full interview and access several other chats, panels and workshops held during the event. In this excerpt, Dr. Lynch discusses spinal navigation, telemedicine and the importance of building a practice that provides the full spec- trum of patient care. Note: Responses have been lightly edited for clarity. Question: What innovations are you most excited about in spine in the next five years? Dr. James Lynch: Navigation is one of the most important develop- ments over the years and has really come to fruition as a baseline plat- form. Navigation is akin to what MRI did to imaging back in the 1980s. Advancements in navigation have allowed us to get to the next level in robotics. e next level that I'm excited about is augmented reali- ty and Augmedics' xvision Spine System. It's really X-ray vision that allows [surgeons] to look at a 3D image of the spine without looking at a screen. It's very hands-on and has all the advantages of a neuro- navigation platform, yet it's a lot more cost-effective, which is [ideal] for hospitals in this current climate. We're just starting to use it in our practice in Reno, and I'm really looking forward to it. Q: Where do you see the biggest opportunities for spine surgeons on the current landscape? JL: We have to prepare for the future now. I think building a muscu- loskeletal differentiated practice with the whole spectrum of patient care is important. I think the isolated silos of practice — whether it's surgery, pain management or PM&R — working individually is going to change, except if you're in remote areas. ere's a rapid transforma- tion occurring. at may not be in months, but certainly over the next three to five years. I think focusing on partnerships or investments in an ASC platform is a natural transition for this. Currently, about 10 percent to 15 percent of spine cases are being done in an ASC platform, which is far too low. Some projections have this at 35 percent to 40 percent over the next few years. Q: What technologies do you think will become more prominent as a result of the COVID-19 pandemic? JL: COVID-19 has really revolutionized telemedicine. If we look at telemedicine going forward, there are so many barriers to that in the past. Patients were not all that into it. ere were also concerns about data sharing, regulations, cost and payments. But CMS really came in and has changed [telemedicine] entirely. While there may be some re- strictions of the technology aer the pandemic, I believe it's front and center. Patient adoption has been huge. We did telemedicine over five years ago. It cost over $10,000 to reach out to the remote areas in Neva- da, and now you can do it on an iPhone or an iPad with no added cost. We've been working with TelePT for years. We also partnered with an Irish group, which offers customizable, remote physical therapy. We've been using it in our practice to good avail over the last four years, but the big issue was trying to get the insurance companies to adapt it and pay for it. e COVID-19 crisis has really fast-forwarded the technol- ogy, and I think telemedicine will continue to be huge. What would traditionally take years to change the mindset of providers, patients and the community occurred within a one-month period, and now it's standard accepted practice. n Former spine surgeon accidentally burns down mansion in evidence- destroying venture By Eric Oliver M ark Kuper, MD, and wife Melissa Kuper acci- dentally burned down their $1.6 million Fort Worth, Texas, house when Mrs. Kuper allegedly burned medical records in an attempt to hide evidence of fraudulent medical claims, state prosecutors alleged in an indictment filed against the couple June 17. The Dallas Morning News reported on the indictment which alleged Mrs. Kuper, who was the clinic's office manager, set fire to a number of medical records in their backyard in October 2017; that fire spread and ultimate- ly razed the couple's mansion. The indictment accused the Kupers and their clinic, Fort Worth-based Texas Center Orthopedic & Spinal Disor- ders, of defrauding Medicare and other government healthcare programs for around $5 million. Dr. Kuper and the clinic allegedly submitted more than 100,000 fraudulent claims for fake physical therapy, psychother- apy and pain management services from 2014 to 2017. Dr. Kuper started his career as a surgeon, but converted his practice to an unregistered pain management clinic in 2014 after settling a malpractice lawsuit against him. Dr. Kuper viewed pain management as "bottom feed- ing," the indictment said. The government alleged Dr. Kuper used opioids to get regular patients to return for treatments so he could bill the government for "worth- less services." Dr. and Mrs. Kuper appeared in federal court in Fort Worth June 22 and pleaded not guilty in a whistleblower lawsuit. n

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