Issue link: https://beckershealthcare.uberflip.com/i/772947
10 SPINE LEADERSHIP How 10 Spine Surgeons are Preparing Their Practice for a Donald Trump Presidency By Laura Dyrda T en spine surgeons talk about what they expect from President Donald Trump over the next four years and how their practices are preparing for the future. Scott Blumenthal, MD, Texas Back Institute (Pla- no): He has promised to repeal Obamacare and has the Congress to get it done. My question is what will it be replaced with. What happens to the millions on the exchanges? Will they be uninsured? Will there be a public option? My opinion is that we need to reform and more tightly regulate the private insurers. And how soon will we build "the wall!" Stephen Hochschuler, MD, Texas Back Institute (Plano): Personally, I believe change in every level was and is needed. Value-based medicine is here to stay!! Obamacare, despite promises, cost the average American a huge increase in deductibles and one was not able in most cases to keep their doctor or health plan. Delivery of spine care will be influenced by MIS, outpatient surgery, global fees and episodes of care; direct patient marketing, coalition of various groups locally, regionally, nationally and internationally; the growth and importance of IT; mergers/affiliations aggregations of pharma/implant companies/insurance companies/ spine surgeons/hospital systems; growth of consults, rehab, pre-hab, coalition through telemedicine, etc. John Dietz, MD, OrthoIndy (Indianapolis): I watched Tuesday evening's election coverage stunned — flabbergasted — just like everyone else in our great country. Now I'm busy trying to understand what it means for healthcare. I've talked to surgeons who are deeply saddened by our country's decision to elect Mr. Trump. Others are frightened, even ones who support- ed the Republican nominee. Still others in our group are elated beyond be- lief, feeling the Affordable Care Act would be immediately repealed and our economy saved. I say the same thing to all: Take a deep breath. We live in the greatest country this earth has ever known. e political system that created this country has taken its course. e le and right will still be there tomorrow as they were yesterday. Now we need to get to work. One possibility is that Mr. Trump rolls up his sleeves, calls the far right and the le into the room and says "Now we get to work." If all voices are in the room. Personally I don't want to see another 2008 to 2010 where Mr. Obama's team acted unilaterally, alienating the center ever since. If Mr. Trump pushes too hard in one direction there may be a backlash and the pendulum will swing back to the detriment of the country. If Mr. Trump sets the stage to solve problems then the naysay- ers in both parties will be too busy counting their accomplishments to gridlock the government. What happens to healthcare? First, filling the Supreme Court vacant seat is an immediate and lasting accomplishment. at alone is worth all the misery of the last four months. I am encouraged and I think the country will be well served. Healthcare needs competition, not consolidation. Competition im- proves quality and reduces costs. Applying that maxim to the Afford- able Care Act would be a great next step. e anti-competitive portions of the bill could be eliminated immediately including the provision which bans physicians from any owning a portion of a hospital. Fol- low the data and reward programs that improve quality at a lower cost. Aer that, inject competition and transparency into every healthcare experience and we will get more work done for fewer dollars. at's the goal isn't it? Competition is key. Regulatory agencies which operate largely outside public oversight have become a bludgeon beating our economy — and specifically the health- care economy — to death. Regulation without demonstrated improve- ment of outcomes drags down every patient and every physician. e regulatory burden needs to be reduced. Equally important is to build checks and balances, which control the regulators and take government agencies from the CMS, to the FBI and the IRS, out of the business of achieving political goals. People cynically call these regulatory agencies the "fourth arm of government." at needs to change. Congress and the White House can work together to make a better system. Robert Masson, MD, NeuroSpine Institute (Or- lando): e election of 2016 has finished and the American people have very clearly spoken. I personally supported the beginning of the ACA, not because I agreed with its final product but because I was grateful that people were talking, debating and imagining a post-modern healthcare system. I am clear that this election suggests that the American people want a differ- ent Washington and a better healthcare system. I remain optimistic that this seismic election will continue to change our healthcare system forward and my particular expectation is holding health insurance companies account- able. I also believe that the industry supporting technology in healthcare needs to be proactive and innovative again. Careerism in the major compa- nies has stagnated our innovative capacity. Relative to our practice we will continue to focus on optimization of spine health and solutions. e changing landscape has demanded that we change our processes and I expect that to continue. Kern Singh, MD, Midwest Orthopaedics at Rush (Chicago): I think the next four years may be even more interesting than the last eight. With a Republican President and Congress we may actually see a repeal of the Affordable Care Act. Unquestionably, President Trump campaigned on that very premise. For the average patient, hopefully that means lower deductibles and premiums. For me as a physician, it really will depend upon what the ACA is replaced with. My sense is that the onerous requirements of medical records and documentation will still be there but that the health exchanges will be removed. is may open up a window for patients who are currently working and receiving employer-based health insurance to get access to the spine surgery they may need and require. John Finkenberg, MD, Alvarado Orthopedic Med- ical Group/Helix Orthopedics & Sports Medicine (San Diego): It will be important for the spine care specialists to pay very close attention to our current MACRA and MIPS requirements as these rules that are