Becker's Spine Review

11 THOUGHT LEADERSHIP and appropriate care. Sometimes delaying medically necessary surgery by trying additional physical therapy or injections only delays the "inevitable," increases the overall cost of care for this diagnosis and prolongs the duration of time the patient is not back to full function or work. Hao-Hua Wu, MD. UCI Health (Orange, Calif.): As someone who has been involved in multiple cost-effectiveness studies, including one that won the NASS Value Abstract Award in 2021, I have found that one of the biggest drivers of healthcare cost is the inpatient stay. Every night spent in the hospital is costly, and certain spine procedures require patients to stay in the hospital longer. Patients who undergo minimally invasive surgery for their spine, however, have the potential to recover faster. In my practice, when possible, I perform MIS procedures, such as motion- preserving cervical laminoplasty and tubular decompression, to minimize recovery time needed in a hospital setting. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Cost reduction (per unit case) is best managed for all complex spinal practices by negotiating implant costs and orthobiologic usage. Our health system has a corporate-wide committee that works closely with physicians and the private sector to manage, regulate and intercede when contracts become due. Conservative mindsets and applied measures can also serve this cause. Reimbursements continue to falter, and this will indirectly affect surgeons nationally. n The essential investments for spine practices By Carly Behm W hile it's important for spine surgeons to strategize on cost savings and revenue boosts, it's just as vital to know where to invest money when it comes to running a strong practice. Four spine surgeons share the areas they're investing in at their practices. Editor's note: Responses were lightly edited for clarity and length. Question: What is an investment all spine practices should make? Joel Beckett, MD. UCLA Health/DISC Sports and Spine Center in Marina del Rey, Calif.: In the swiftly evolving landscape of spine care, an investment all spine practices should make is in state-of-the-art imaging and surgical technology. Advanced imaging techniques can improve diagnostic accuracy, while modern surgery systems enhance precision in complex spinal procedures, allowing for more minimally invasive approaches. Not only does this technology improve clinical outcomes, but it also sets a practice apart as a leader in the field. Furthermore, investing in telemedicine infrastructure can expand a practice's reach and provide convenient, ongoing care, which has become increasingly important to patients in the current healthcare environment. Another often-overlooked investment that can yield substantial dividends for spine practices is patient education and engagement. Providing patients with accessible, engaging, and informative resources can empower them to participate actively in their care. Interactive tools, digital platforms for tracking symptoms and progress, and educational seminars can lead to better compliance, improved outcomes and higher patient satisfaction. In an era where healthcare is becoming increasingly patient-centered, this investment can significantly enhance a practice's reputation and success. Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: Durable investments in a spine practice should be three things: Updating and refining coding skills — With new capricious guidelines from payers, we all need to be sharp, accurate and erudite in our knowledge. Invest in good computers — I do not want to give out any kudos to certain companies, but throw-away PCs are a terrible idea, and your tax deductions are better served with other things; it is not worth the sacrifice of your staff's sanity and productivity. Invest in your abilities — Stay current on your technical knowledge and outcomes data, but also be open to learning new things and adopt them at a speed that feels comfortable to you. Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: The biggest investment we can make is in our staff. The patient experience doesn't solely depend on the physician. The patient experience starts with that phone call that they first make to schedule an appointment, the way they are greeted when they check in, whether or not they are escorted to the exam room and also at the end of the visit, how quickly their questions are answered. The investment we make in our staff comes in many forms. Of course, making sure that our staff feel fairly compensated for their efforts is an essential part of the equation. As important is making sure they truly feel they are part of the team. An engaged staff performs better. In lean methodology, involving every staff member in process improvement work that pertains to their role leads to the development of better processes that they are truly invested in. This sense of purpose and sense that everyone is essential to taking care of the patient is a key component of the culture that we have to build. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): As best one can, the investments in staff, health and mechanisms of efficiency are dividends for a successful long-term practice. Reliable and accountable staff members are paramount to the ebbs more often than flows of healthcare in its present state. Current economic woes should lean professional and personal goals toward debt reduction, higher-yield savings accounts and a "rainy day" outlook as hiring inabilities, Medicare cuts and insurance drawdowns slow the pace of surgical production. n

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