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26 PRACTICE MANAGEMENT Spine practices must 'understand and accept our interdependence,' Dr. Jeffrey Cantor says By Alan Condon J effrey Cantor, MD, of Cantor Spine Institute in Fort Lauderdale, Fla., outlined the biggest obstacle facing spine providers during COVID-19 and how practices can support each other during this challenging period. Q: What is the biggest obstacle facing spine providers at the moment? Dr. Jeffrey Cantor: e biggest obstacle facing spine surgeons is paradigm. 'e way things are done' and the arduous process of change. We have a tendency to do 'what we do,' even when there are better ways and techniques. It takes a long time and huge per- sonal effort to change. Robotics, image guidance, ultrasonics and biocompatible materials are just a few of the things that can change and improve the way we do things. Are we going to use them to make a different shape or color screw, or are we going to use them to figure out a way to not use screws at all? Q: How can spine practices help one another during this turbulent period? JC: Understand and accept our interdependence. Continue to col- laborate, share ideas and educate each other. Q: How has your practice navigated the challenges brought by the COVID-19 pandemic? What have been your keys to success? JC: COVID-19 gave one gi to spine surgeons that is desperately needed and never available — time. Time to think. Time to criti- cally look at our processes, both nonsurgical and surgical. Time to review our cases, digest data and understand what we are doing well, and more importantly, what we are not. Time to develop ways to better help our patients. Q: What will the spine field look like one year from now? What do you see being different and what will remain the same? JC: As in other industries, spine surgeons will interact with their patients and among themselves remotely. Virtual reality will take over our educational process, and possibly even work into our in- teraction with our patients. We have already seen a huge improve- ment in our ability to interact with, accurately evaluate and solve our patients' problems at a distance. Hopefully, that trend will con- tinue. n 4 spinal cord injury rehab hospitals planned, opened in 2020 By Alan Condon Here are four spinal cord injury rehabilitation hospitals opened or announced so far this year: Enola, Pa.-based Post Acute Medical announced plans in Au- gust to build a 42-bed rehab hospital in Dayton, Ohio. Allentown, Pa.-based Good Shepherd Rehabilitation Network seeks to build a 75-bed rehab hospital in Center Valley, Pa. Construction is expected to take two years. In June, University of Iowa Health Care in Iowa City and Bir- mingham, Ala.-based Encompass Health opened a rehab hos- pital in Coralville, Iowa, for patients with spinal cord injuries and complex orthopedic conditions. The Community Stroke and Rehabilitation Center, a $40 mil- lion facility, owned by Munster, Ind.-based Community Health- care System, opened in Crown Point, Ind., in March. n Spinal approach ranks among most expensive ASC procedures By Angie Stewart T otal disc arthroplasty using the anterior approach was the 23rd most expensive procedure done in ASCs in 2019, according to a Definitive Healthcare ranking. Definitive Healthcare compiled data on 2019 all-payer medical claims from multiple U.S. medical claims clearing- houses. The dataset is updated monthly. Three key insights: 1. The total charges for code 0375T were $648,868, with 15 of these procedures done in ASCs in 2019. 2. The average per-procedure charge for total disc arthro- plasty via the anterior approach was $43,258. 3. A breast reconstruction procedure was the most expen- sive one done at ASCs in 2019. Also making the list of most expensive ASC procedures were ones involving implant neurostimulator pulse generators, cochlear devices and defibrillator services. n