Becker's Spine Review

15 SPINE SURGEONS Dr. Mark Malone on founding his own practice, filling the need for pain management By Carly Behm M ark Malone, MD, founded Austin, Texas-based Advanced Pain Care. A former back pain patient himself, Dr. Malone turned to a spinal stimulator to resolve pain. He spoke with Becker's Spine Review about how his practice approached the COVID-19 pandemic and his outlook on pain management. Note: Responses were edited for length and clarity. Question: What has been your philosophy in founding and growing Advanced Pain Care? Dr. Mark Malone: So starting 18 years ago, I le a busy anesthesiology practice to go into the pain management field because I saw a big need in the world of pain management. I was overseeing a lot of surgery, especially back surgery, that didn't have great results. A lot of patients were in chronic pain both before and aer surgery, and we had a lot of repeat surgeries. I gathered from talking to patients and other doctors that there wasn't a lot of advanced pain management out there. So I did a fellowship with pain management and then opened my clinic to fill a need. Q: How have you seen this practice grow over the last 18 years? MM: [It's] growing pretty rapidly. A lot of new techniques have be- come available, especially in the last four to five years. at is fueling an explosion in the field. Q: How has the pandemic affected your practice and how are you managing any obstacles? MM: We're doing well. I was worried, of course back in February and March when all of this was taking place and coming down … but we are front-line workers. We didn't close down, not for a single day, and we've had a great experience. One thing I learned is that patients re- ally do need us. We have very few cancellations. We didn't suffer any decreased volume, even though many of our patients had lost their jobs and some had lost their insurance. e demand was unchanged, in fact, gradually increasing through the pandemic over the last seven months. We did close down the surgery centers for a six-week period, which was mandatory in the state of Texas … so that affected our practice, but we were confident that we would reopen soon. We didn't lay off any employees, and on May 5, we reopened, and our volume quickly caught up and surpassed the pre-COVID-19 volume. Q: By how much did volume surpass compared to pre- COVID-19? MM: Twenty percent. Q: How did your experience there compare to other spine practices in the area? MM: I can give one statistic that summarizes our COVID-19 experi- ence. We have 360 employees across 11 clinics in central and northern Texas in the seven months since the COVID-19 crisis came out. We've only had seven or eight people test positive, and none of them became seriously ill. So this tells us that wearing a mask and washing your hands and keeping some social distance is effective. n 'Separating science from hope': AAOS' biologic initiative to inform surgeons of approval status By Alan Condon T he American Academy of Orthopaedic Surgeons on Oct. 15 introduced the AAOS Biologics Dashboard to help physicians keep up to date with the approval status of biologic innovations. As regenerative medicine and stem cell therapies be- come increasingly popular in orthopedics, the society has emphasized the need to provide credible sources for evi- dence-based information. "These new tools further validate AAOS' leadership in sep- arating science from hope with the goal of helping patients receive the highest quality of evidence-based care," said David Jevsevar, MD, chair of the AAOS committee on devic- es, biologics and technology. The online platform combines the most recent clinical evi- dence with FDA guidance. Users enter four characteristics of a particular product, in- cluding the tissue type it's derived from and whether it's autograft or xenograft, and the dashboard produces a red, yellow or green color to indicate the regulatory status of the product. Stem cell-based products, platelet-rich plasma and bone marrow aspirate concentrate have demonstrated potential to regenerate tissue, accelerate bone healing and reduce pain. However, there is a significant lack of clinical data for these recent innovations. While rising in popularity, the FDA has not approved PRP or BMA for any indications in the treatment of any pathology, including osteoarthritis and spinal fusion. n

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