Becker's Spine Review

27 PRACTICE MANAGEMENT Dr. Greg Gullung: Commercial payers' approval process is biggest barrier to spine care By Alan Condon G reg Gullung, MD, an orthopedic spine surgeon at Birming- ham-based OrthoAlabama, discusses the biggest barrier for spine providers and how medical practices can help one another push through the COVID-19 crisis. Question: How has your practice navigated the challeng- es brought by the COVID-19 pandemic? What have been your keys to success? Dr. Greg Gullung: Like almost every industry we have been impact- ed by the pandemic. Many of our challenges relate to protecting the public while still providing the best possible care. Fortunately, we transitioned to social distancing, personal protective equipment and screening early in the process. We screened staff and patients prior to entering the clinic, used masks, provided hand sanitizer and lim- ited the number of patients seen per day. is created a bottleneck for patients, but almost everyone understood the need for increased caution given the uncertainties present during the early stages of the pandemic. is allowed us to continue providing patient care with the least amount of risk. Q: What is the biggest obstacle facing spine providers in the modern landscape? GG: From personal experience and discussions with colleagues, it seems to be the approval environment from commercial insurance. Many of the advancements in technology, techniques and training have produced competent and caring surgeons, but their decisions for care are oen guided by the local insurance providers. Fortunately, many of the treatment guidelines follow the guidelines of our pro- fessional societies, but not everyone fits neatly into a predetermined treatment algorithm — that is where the individual physician must provide detailed and research-backed explanations for their treatment plan. It has also been my experience that most companies are willing to provide approval for various treatment options given sound clinical decision-making. Q: How can spine practices help one another during this turbulent period? GG: Medicine in general has always had a tradition of cooperation and sharing of information, and I think this must continue now and in the future. Due to the current medical climate, many practices are forced to evaluate daily operations with a more business-minded ap- proach, but we must remember to continue sharing knowledge, tips and personal assistance to colleagues locally and internationally. is way the maximum number of patients can have access to the high- est quality of care. One must also be open to taking on extra patient care responsibility; be it clinical, emergency or consultations, given the probability that physician availability may be limited during the current crisis. Q: What will the spine field look like one year from now? What do you see being different and what will remain the same? GG: Given that one year is a relatively short period of time, I do not see any significant leaps forward in terms of technology or technique. I do not say this to mean there will be a standstill in advancement of these means of care. On the contrary, I fully expect the release of new helpful products, improvements in intraoperative imaging and continued modification of surgical techniques to improve patient out- comes. But I wonder if the most impactful change will be a decrease in infection rates. e reason behind this is the higher quality of sterilization proce- dures, more rigorous screening of patients and increased attention to sterile technique by all OR and clinical staff, as well as patients them- selves. While not all infections are preventable, there is a subset that can be avoided, and given the high cost of spine infections to the pa- tients themselves, as well as the overall monetary cost to the system, any decrease in infection rate provides a positive boost for the field. n 19-physician orthopedic group begins expansion — 3 things to know By Angie Stewart J ackson-based West Tennessee Bone & Joint Clinic broke ground on a new office building in Paris, Tenn., according to The Paris Post-Intelligencer. Three things to know: 1. West Tennessee Bone & Joint Clinic has 10 existing locations, as well as a surgery center in Jackson. Ortho- pedic surgeon Jason Hutchison, MD, serves as the clin- ic's president. 2. The new building will create more space for patients and staff of the 19-physician practice. Two physicians and two physical therapists have joined West Tennessee Bone & Joint Clinic in the past few years, according to orthopedic surgeon Blake Chandler, MD. 3. The expansion project will include new examination rooms, additional procedure rooms and conference space for community seminars. Construction is slated for completion in late 2021. n

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