Becker's Spine Review

Sign up for Becker's Orthopedic, Spine Business & Pain Management E-Weeklies at www.BeckersOrthopedicandSpine.com or call (800) 417-2035 How to Build & Manage Spine Groups in the 21st Century: Q&A With Dr. Richard Kube 47 Dr. Richard Kube By Laura Miller R ichard Kube, MD, CEO of Prairie Spine & Pain Institute and Prairie SurgiCare in Peoria, Ill., tackles some of the big issues facing spine surgeons in private practice today and how surgeons can be successful in the 21st century. Q: What are the biggest opportunities for spine surgeons to build and grow their practices today? Dr. Richard Kube: Creating an integrated care model remains a positive growth opportunity for spine practices. As accountable care organizations form, spine is specialized enough to be able to create an all-spine services ACO type of environment in a private practice setting. This is especially true if you have a surgical facility and utilize minimally invasive techniques to increase the number of potential cases for the facility. Care in this type of setting can be more comprehensive and efficient, thereby increasing patient satisfaction and controlling cost. This provides the practice the ability for a great variety of contracting options and access to patients not available to practices without such a model. Q: As the healthcare environment is changing around the country, what are the most beneficial relationships for spine surgeons to make? How can these relationships lead to practice success? RK: Surgeons should build relationships with their customer base. In an era when many of the traditional referral sources are employed by, and hence controlled by hospitals, insurance carriers, etc., one must form relationships outside those traditional models to assure practice growth. These relationships start when the patient enters the office and begins his or her experience with you, the physician. Tools such as internet, email, websites, and so forth can also interact with your patients. It also is a good idea to be involved in the community as a whole. You will have a more successful practice in a more successful community. Many if not most small businesses owners make an effort to support local community businesses and events. These activities should not be overlooked for their value in creating a positive perception with your customer base to further strengthen your practice growth. Q: Medicare reimbursements have undergone cuts this year, and the downward trend seems likely to continue. How can spine surgeons in private practice continue to see these patients and keep their businesses running? RK: I think that reimbursements as a whole are dropping whether it is Medicare or the standard PPO. I believe there's an opportunity for a winwin situation for the physician and society is to create an integrated spine care model. This moves most if not all of the spine-related services under one roof. The physician has the opportunity to offset reduced margins with more volume and more service lines. From society's standpoint, the care will be less costly, more efficient and more convenient, i.e. greater value. Given most physician offices are compensated at rates often less than half that of the hospital alternative, huge savings can be seen in this model for patients, PPOs and Medicare. Satisfaction scores are higher for patients given the convenience and the ability for the care team to work together to provide more favorable outcomes. MedPAC found in 2005 that PT integrated into physician groups posted a 38 percent savings over the independent models. We know this also holds true for procedures performed at ambulatory surgical facilities. For those physicians resisting hospital employment, the solution is to create an integrated care model and compete directly with the hospitals for spine care services. Q: What role do the internet and online forums play in medical decision-making today? How can spine surgeons optimize online resources to build their business? RK: Patients are increasingly savvy when shopping and assessing medical care. Our practice sees increasing numbers of patients finding us on the internet. In an age when hospitals are buying primary care practices and hiring specialists, the internet remains an opportunity to maintain control over a portion of your referral base. It continues in my opinion to be an all too often overlooked part of marketing your practice. It is usually at least, if not more, cost effective as the typical marketing and advertising options many practices engage in the newspaper, TV, billboards, etc. The added benefit to the internet and webpages is the direct control you have on a daily basis to keep the message current and fresh. n Advertising Index Note: Ad page number(s) given in parentheses Amedica. marketing@amedical.com / www.amedicacorp.com / (855) 839-3500 (p.48) Blue Chip Surgical Center Partners. jleland@bluechipsurgical.com / www.bluechipsurgical.com / (513) 561-8900 (p. 38) Esaote. info@esaoteusa.com / www.esaoteusa.com / (800) 428-4374 (p. 2) Paradigm Spine. information@paradigmspine.com / www.paradigmspine.com / (888) 273-9897 (p. 29, 30, 31, 32 33, 40, 41, 42, 43) Surgical Management Professionals. ktalcott@smpsd.com / www.smpsd.com / (605) 444-8297 (p. 7) Surgical Notes. sales@surgicalnotes.com / www.surgicalnotes.com / (800) 459-5616 (p. 4)

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