Issue link: https://beckershealthcare.uberflip.com/i/1468175
23 THOUGHT LEADERSHIP from other surgeons, such as new approaches to spine surgery or recent studies to check out. I use LinkedIn as less of a marketing tool to patients and more as an education tool for myself as well as my peers, physical therapists, chiropractors, hospital executives, OR nurses, etc. Everyone has social media these days, so we might as well try to make it somewhat educational. Q: What trends and technologies most excite you in spine surgery? CD: Not to sound like a broken record, but I really like robotic-navi- gated technology. It's definitely not all there yet — the elephant in the room is the price, around $1 million for the robot and if also an O-arm, that's another huge expense. So, it's very difficult to get this technology in an ASC at the moment. Robots are super expensive now, but there are smaller companies that are making more cost-efficient technolo- gies. I think as the technology develops and more companies launch their own devices, the prices will come down. irty years from now, every operating room could have a robot in it. Fluoroscopy was super expensive when that first came out, and I'm sure there were those who wanted to just stick with the anatomy and intra-op single shot X-rays. From a surgeon's standpoint, we're all concerned about our health and the longevity of our careers and robots decrease radiation exposure for us. Unfortunately, I think every spine surgeon knows at least three other spine surgeons who have had some type of cancer. Is that because of all the fluoro or X-ray we're using? Possibly. Robotic technology greatly reduces the radiation exposure to the surgeon and OR staff, which is hugely important. Q: Outside of the size and cost, what other draw- backs do you see with robots? How do you see the technology developing 10 years from now? CD: To use a spine robot today, you are kind of committing to doing a fusion. If we're all saying we should do less fusions, why are we making more technology to perform fusions? I think there's a thought that at some point robots will help with decompressions and perhaps when that happens, surgeons will lose jobs or have their prices slashed as the robots will be able to do them faster and more efficiently! But I think what we should be focusing on is determining who needs fusions and if there are other motion-sparing technologies we can use instead. Q: What do you hope to achieve professionally and personally in the next five years? CD: For me, I focus on my three pillars: Spine, local community and family. I want to be a leader in my specialty. I'm not aiming to be Alex Vaccaro, MD, PhD, the best-looking and most famous spine surgeon in the world, ever. But it'd be nice to be recognized as a leader in my field and for my friends to believe that I'm doing great things for spine surgery. From a nonsurgical standpoint, I also want to be a leader in my com- munity. I practice in the same area I went to elementary school, middle school, high school and college in (Dallas). I know these people I operate on. Many of my patients are my parents' friends, so I'm already a figure- head in the community as one of the spine surgeons they know and trust. e third is being a great role model for my family. at means not going to every speaking engagement, not going to every spine course, not doing every consulting agreement and flying all across the country. Missing those definitely take a hit on your ancillary life, but family life is also very important to me. So I focus on those three things and hope- fully take little steps each week to make an impact. n 'It has never been better to be independent': Why 4 surgeons are sticking to private practice By Alan Condon D espite the challenges for surgeons in private prac- tice — including rising costs, declining reimburse- ments and administrative hurdles — the autonomy, work-life balance and close patient relationships are some of the benefits that can make it worthwhile. Four spine surgeons shared with Becker's why they will not be leaving private practice anytime soon. Question: What would it take for you to sell your spine practice? Brian Gantwerker, MD. The Craniospinal Center of Los An- geles: It would take an apocalyptic event. This journey has been one we all have worked so hard to get to where we are that I am not sure anyone could care for our patients in the same way. Regardless, I feel we can do a better job and take better care of our patients in a way that they are accustomed to and what they have come to expect. Richard Kube, MD. Prairie Spine & Pain Institute (Peoria, Ill.): It would take an act of God. It has never been better to be independent. I have no plans to sell in the future. Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): Absolutely nothing. This is my second year in solo prac- tice. I love the independence and the ability to take care of my patients the best way I can. I only wonder why I didn't start this earlier. Issada Thongtrangan, MD. Microspine (Scottsdale, Ariz.): For me, it is a time when the practice no longer is the autonomy-providing blessing it once was. Sometimes physician-owners continue to work the medical practice until they grow tired of the grind (i.e. declining reim- bursements, burdensome government regulations, etc.) and finally reach that point when they say, "It's time." An- other important consideration is burnout. This can have very negative impacts on productivity and the medical practice value. Running a practice requires a significant investment by a physician-owner, and this is generally more by way of their time than actual capital. Physician-owners are gen- erally passionate, driven individuals who love what they are trying to achieve. If they do not reach the "I'm over it" stage mentioned above, a physician-owner will generally stick with it until they can no longer physically keep up. This happens when it is finally time for them to retire or sell the practice. n