Becker's ASC Review

6 THOUGHT LEADERSHIP right and too much when it comes to pain medication. I am excited about the potential of AI to help pinpoint the right spot on the pain management continuum so that my patients can recover well without future risks of harm from pain medication. While we might be a way off from harnessing the most potent potential of AI in all of the above areas of spine surgery, I am confident we will get there. Spine surgery research as it relates to AI is more proliferated than it was even five years ago, and if I know one thing about the history of spine surgery and the tenacious researchers behind it – where there is a will, there is a way. Choll Kim, MD, PhD. Excel Spine Center (San Diego): Patients considering spine surgery are hungry for information. I imagine a day soon when there is an AI version of myself that has studied everything I have ever said and written, along with a selective body of information pertinent to my practice, that my patients, and their loved ones, have access to 24 hours a day, seven days a week, 365 days a year. ey can ask me any question they want, for as long as they want, and the same question in as many ways as they want, without me getting tired or impatient. I hope and pray that this will free up my time to focus on higher level activities that I enjoy more. Just like the convenience of the internet and the apps on our mobile devices, AI will make life easier in many ways. But of course, there is no such thing as a free lunch. e tradeoff is that my office will be a lot lonelier, as the need for ancillary staff will be greatly diminished, and there will be many people that might prefer interacting with my AI more than me. For an extrovert, not having real people to spend time with is terrifying. Philip Schneider, MD. e Centers for Advanced Orthopaedics (Bethesda, Md.): AI and machine learning have demonstrated the ability to assist in surgical decision-making, patient selection, and predicting functional outcomes – which can all result in improved patient care. However, I am concerned that surgeons may become overly dependent on AI over time. All technology is prone to failure at some point, and my trust in AI is not yet fully established. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): ere certainly seems to be a societal press in medicine (like every other facet of our professional lives) to meld AI beyond our perspectives to a point of newfound dependence, should elevate nervousness amongst actual and proper practicing clinicians. Some aspects of discernable AI techniques such as risk stratification, image analysis and intraoperative navigation may be useful to some, the variability of patient symptoms and diversity of anatomic presentation requires more individualistic prescience. My fears of further dehumanizing the art and science of medicine will only be furthered and justified with added dilution of separation as this reliance and dependence grows. e goals of mitigating doubt and errors in medicine and its delivery is paramount. Methods to do so are supported. n What ASCs want hospitals to know By Patsy Newitt A SCs and hospitals in many markets have a complicated relationship, with some hospitals opposing surgery centers despite looking to invest in their own centers. Shakeel Ahmed, MD, CEO of Atlas Surgical Group in St. Louis, joined Becker's to discuss what he wishes hospitals knew about ASCs and changes he would like to see to improve the relationship between the two. Editor's note: This interview was lightly edited lightly for clarity and length. Question: What's one thing you wish hospitals knew about ASCs? Dr. Shakeel Ahmed: One of my favorite quotes is "Do the right thing, because that's the right thing to do," by Immanuel Kant. Hospitals will have to realize they have to do the right thing. Their bonuses are good because they managed to do it the way they always have, but allowing for ASCs to grow in their markets is the right thing to do. have. Now, some hospital systems are already jumping into the ASC game for sort of ulterior reasons.They will have to accept the fact that ASCs are what is needed to save healthcare money. Q: What needs to change to fix the "adversarial" relationship between ASCs and hospitals? SA: There's multiple points from personal practice that apply here. The insurance contracts are swayed in favor of the hospitals. Hospitals are the big dogs in the area. They command the interest and fear of the insurance companies. I routinely see private insurance companies give us contracts that are 90% of Medicare, and some hospitals have contracts that are 200% of Medicare. Hospital-affiliated physicians need to be free from noncompetes. When the Federal Trade Commission's noncompete ban is enacted — taking that pressure off of the physicians and surgeons — the playing field will become level. The hospitals have this monopoly on specialized services, the high-end procedures, the more expensive ones, and they fight tooth and nail to keep them in house. The hospitals will have to realize this is just something that is not the right thing to do. n "AI is paving the way for the type of innovation in spine surgery that will help our patients get the exact care they need, delivered with incredible precision, to the specific area of the spine where they need it, all while allowing for minimal invasion and faster recovery. It remains in the infancy stage, but the power and promise of AI in spine surgery are right here in front of us." — Neel Anand, MD

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