Becker's Spine Review

9 THOUGHT LEADERSHIP in the ASC can help ease the transition and ensure efficiency. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): e answer to this paradoxical question is the level of care for acuity-based diagnosis and the comparable specialty of deliverable care these institutions do not provide. Most surgery centers are not equipped with complex post-operative care from a physician nor advanced nursing standpoint, (ICU and step-down units). Not having this level of care should deter most presupposing surgeons from performing complex surgeries based on safety issues and true patient-centric concerns. e other ramp up would include multiplex anesthesia services, with both capability and willingness to manage these complex patients intra/post operative. n 'Hospitals are scared to death': Why ASCs have the advantage in recruiting spine surgeons By Carly Behm A llowing physicians to have ownership in the places they work can make ASCs more attractive in recruiting, spine surgeon Stephen Hochschuler, MD, said. Dr. Hochschuler, of Texas Back Institute in Plano, spoke with Becker's about his outlook for ASCs and the essential nonsurgical skills physicians should have. Note: This conversation was edited for clarity and length. Question: How can ASCs gain an edge in surgeon recruiting? Dr. Stephen Hochschuler: Hospitals are scared to death right now because they're wondering where their future is. Most hospitals are owned by hospital companies or not for profits. From a surgeon standpoint, why shouldn't they own part of the facility that does the production? Unlike chiropractors, and unlike dentists who help each other, surgeons are always competing to be at the top. Not all of them, but the majority. That's ingrained. And if it wasn't, the surgeons would be more in charge than they are today. Right now, hospital companies, insurance companies, attorneys, you name it, they run medicine. At least 60% of orthopedic surgeons and maybe even higher, the neurosurgeons are now working for somebody either a hospital or a company like United Healthcare. So doctors are looking to simplify their life. The more modern people all want what the older guys have, but they want it yesterday. It's just a totally different philosophy. So how can you get physicians on the same page? So we started with surgery centers years ago. The way you do it, you give them a commonality. The commonality is if myself and my main competitors in the marketplace all own part of the surgery center instead of being jealous of how much work they are doing, I'm thrilled because they're feeding the surgery center, which I own a big part of. Q: Would you say having some knowledge in business is essential for early-career spine surgeons? SH: Without a doubt. I went to medical school at Harvard and I kept saying, "Why don't we send our guys six to eight weeks to Harvard Business School?" That was 50 years ago. I was 50 years too soon. We need to know business, and the smart physicians will take the time and get an MBA and work in the business/medical realm. I was criticized years ago for trying to marry the best of business with the best of medicine. But you gotta play the game, and you got to be involved. You have to look at what's next. And every industry does that. Medicine has not done it, and we've been hamstrung. So now when you bring business knowledge into the medical realm, tie it in with logic, and the number one criterion, we've always stressed this is not how much money the doctor makes. It's not how famous the guy is. It's not how much the insurance makes or doesn't make. It's not the attorney, it's the patient. The only one that people should focus on is the patient. Next to the patient should be the doctor, and all the rest is ancillary. n How emerging spine surgeons, value-based care can win By Carly Behm H yun Bae, MD, has his eyes on the evolution of outpatient spine surgery and value-based care. And one key element to their trajectories will be physician control. Dr. Bae is one of the leaders for Los Angeles-based Commons Clinic's new Center for Spine Economics, Outcomes & Research. e center is investing $100 million over the next decade and will introduce a center of excellence program for spinal restoration. He spoke with Becker's about why spine surgery is best fit for the outpatient center and his outlook for value-based care in the industry. Note: is conversation was edited for clarity and length. Question: What are your top goals with the new center? Dr. Hyun Bae: Improving patient care is our biggest goal. It's really

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