Issue link: https://beckershealthcare.uberflip.com/i/759246
20 JUNE 2017 CONFERENCE PREVIEW How MIS has Transformed the Field — Dr. Andrew Kokkino on Hospital Employment & the Challenges That Remain By Mary Rechtoris A ndrew Kokkino, MD, of Springfield-based Oregon Neuro- surgery Specialists, speaks to the challenges neurosurgeons continue to face in a complex healthcare system. Question: How has neurosurgery transformed since you started practicing? Dr. Andrew Kokkino: Obviously, transformation has been ubiquitous. Technically, the greatest change has come from performing more minimally invasive procedures in both brain and spine surgery. e evolution of endovascular neurosurgery has been rather successfully managed as we neurosurgeons have remained a part of the solution and not become part of the problem or become obsolete. Within radiosurgery, we have demanded a spot at the table and have successfully led many scientific trials, as the brightest neurosurgeons continued to put out peer-reviewed scientific articles in the field of radiosurgery. e healthcare economics of neurosurgery have drastically changed as we have lost the vast majority of independent private practices in a model that dates back 50 years and is never coming back. From the perspective of your organization, this last point is probably the most interesting. I do not believe that the hospital employment model is the ideal model as most hospital organizations are actually healthcare organizations that are struggling between how they pro- vide inpatient and outpatient services. When they employ specialists, those two different components of the healthcare organization fight over the best utilization of physician services. Finally, I very much wonder about the evolution of the corporate hiring of physicians to provide clinical medicine. We see this as a major corporation purchas- es one of the nation's largest cancer networks. It may only be a matter of time before the largest healthcare corporations begin purchasing large blocks of orthopedic or spine surgeons. Q: What are the key opportunities & challenges neurolog- ical surgeons face today? AK: Many of these are mentioned above. Opportunities and challenges depend on the phase of your career. If you are at the beginning of your career and are heavily in debt, many surgeons choose the best financial opportunity over the better long-term organization within which they can grow. On the flip side, independent private practices have a very hard time competing with revenue-rich employers who can offer top dollar on the front-end of an employment contract. e issues for the surgeons in the middle of their careers involve ba- sically how to navigate an ever-complex system as we fight with a re- volving door of hospital administrators to get our jobs done, balance more burdensome call schedules and try and learn negotiating tactics with third-party payers or employers on the fly. e other major chal- lenge is the evolution to electronic health records and incorporating them comprehensively into the entire spectrum of our patients' care. Q: How will MIS for spine care continue to evolve in the coming years? AK: Technically, the evolution has been rather dramatic. e issue now will come down to providing scientific evidence. Ultimately, we want minimally invasive surgery to translate into shorter patient stays, diminished complication rates, and a faster return to work. If MIS does not meet those standards, it needs to be reevaluated and restructured. n Dr. Andrew Kokkino will be speaking on "Minimally Inva- sive Spine in ASCs—Key Advice" at the conference Friday, June 23 at 2:40 p.m. 141 PHYSICIANS SPEAKING, PRIMARILY SPINE SURGEONS 235+ SPEAKERS TOTAL REGISTER HERE www.beckersasc.com/june-conference Registration@BeckersHealthcare.com OR 800.417.2035. 15TH ANNUAL SPINE, ORTHOPEDIC AND PAIN MANAGEMENT-DRIVEN ASC CONFERENCE + THE FUTURE OF SPINE JUNE 22-24, 2017 | SWISSÔTEL | CHICAGO, ILLINOIS BECKER'S ASC REVIEW Marcus Allen Former NFL Running Back, Los Angeles Raiders and the Kansas City Chiefs and Analyst, CBS Lou Dobbs Business and Financial News Legend and Host, Fox Business News' Lou Dobbs Tonight Andrew Hayek Chairman and Chief Executive Of ficer, Surgical Care Af filiates Michael A. Kasper Chief Executive Of ficer, DuPage Medical Group KEYNOTES BY