Becker's Spine Review

Spine Surgeon Leadership 14 John Seitz. CEO of MMX Holdings (Sparta, N.J.). Amy Sinder. Administrator of CBC Surgery Center (Crown Point, Ind.). Natalie Soule, RN. Premier Orthopedic Surgery Center (Nashville, Tenn.). Thomas Stallings. Partner with McGuireWoods (Richmond, Va.). Jim Stilley. Director of Clinical Workflow Consulting for Versus Technology (Traverse City, Mich.). Angela Talton. Senior Vice President of Coding for National Medical Billing Services (St. Louis). Barry Tanner. President and CEO of Physicians Endoscopy (Doylestown, Pa.). Larry Taylor. President and CEO of Practice Partners in Healthcare (Birmingham, Ala.). Jill Thrasher. Administrator of Precision Surgery Center of Dallas. Anna Timmerman, JD. Associate with McGuireWoods (Chicago). Debra Stinchcomb, RN. Consultant for Progressive Surgical Solutions (Poway, Calif.). Gretchen Heinze Townshend, JD. Partner with McGuireWoods (Chicago). Michael Stroup. Senior Vice President of Acquisitions for United Surgical Partners International (Addison, Texas). John Venetos, MD. Gastroenterologist, John Venetos Ltd. (LincolnWood, Ill.). Chris Swing. CFO of Vantage Outsourcing (Effingham, Ill.). Melissa Szabad, JD. Partner with McGuireWoods (Chicago). Pedro Vergne. CEO of Physicians' Capital Investment (Dallas). Barton Walker, JD. Partner with McGuireWoods (Charlotte, N.C.). Marsha Wallander, RN. Associate Director of Accreditation Services for The Accreditation Association for Ambulatory Health Care (Skokie). Kelly Webb. Vice President and General Manager of ASC Billing Division for MediGain (Plano, Texas). Robert Westergard, CPA. CFO of Ambulatory Surgical Centers of America (Hanover, Mass.). Richard Wohns, MD, JD. Founder of NeoSpine (Puyallup, Wash.). Bob Woodward. Pulitzer Prize-Winning Journalist, Author and Associate Editor with The Washington Post (Washington, D.C.). Bob Zasa. Managing Partner and Co-Founder of ASD Management (Dana Point, Calif.). Joseph Zasa. Managing Partner and Co-Founder of ASD Management (Dallas). Greg Zoch. Partner and Managing Director of Kaye/Bassman International (Dallas). n What Medicare Cuts Mean for Spine Surgeons: Q&A With Dr. Terrence Crowder of Sonoran Spine Center By Laura Miller T errence Crowder, MD, a spine surgeon with Sonoran Spine Center in Mesa, Ariz., discusses the recent Medicare payment cuts as a result of the sequester and how these cuts will impact spine surgeons going forward. Question: How do you feel about the recent Medicare payment cuts? What do they mean for spine surgeons? Dr. Terrence Crowder: It's extremely disheartening that the government has completely forgotten about physicians. Every year we take a pay cut from Medicare because of bad Congressional politics. This additional cut will only serve to discourage more of our country's brightest and best from becoming physicians. We don't have socialized medicine, but because Medicare is the leader they set the rules for everyone else. Unfortunately, it's becoming harder and harder to actually deliver care. Q: How will the cuts impact spine surgeons in particular? TC: Unlike other physicians, surgeons are generally performing surgery by necessity. We are correcting problems that are significantly affecting peoples' lives. Sometimes spine procedures are called elective, but it isn't a choice to the suffering patient. Spine problems are very expensive to society. The company loses productivity and the patient loses income. For some, if they aren't at work their job can't be done. There are multiple procedures that are extremely beneficial for patients, which we know through many studies. However, with the cuts that are arriving in Medicare, these kinds of surgeries may not be funded anymore. Additionally, surgeons will receive less payment for procedures that are proven to benefit patients.  What are surgeons suppose to do?    Dr. Terrence Crowder Q: How are spine groups reacting to these cuts? Is there anything they can do to soften the blow? TC: In general, practices are now limiting the number of Medicare patients they are willing to see because of the recent changes from the sequester. Medicare patients generally require the most attention, the most time, yet we as physicians are paid a low amount to see them. Q: Will these payment cuts impact how the field is evolving right now? TC: We've seen a boom in spine technology and technique development, but the cuts mean there will be very little innovation in spine over the next several years. The amount of time and money necessary to provide proper research is high; therefore most surgeons will no longer have the time to conduct these projects. Instead, they will spend their time trying to recover lost reimbursement. Additionally, spine companies won't see an innovative strategy as profitable because they aren't paid for their innovations. The motivating factor among companies is more capitalistic than altruistic. I foresee most spine innovation moving to Europe and Asia, and out of the United States, because it's cheaper to develop it there and easier to deal with their regulatory systems.   Q: What trends do you expect for spine surgeons in the future as a result of these cuts? TC: I see a shift in doctors becoming employees instead of entrepreneurs. Private practice in medicine could easily disappear in this country and essentially we will have a system for socialized medical care. n

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