Issue link: https://beckershealthcare.uberflip.com/i/829284
6 SPINE SURGEONS Dr. Todd Albert: 5 Key Thoughts on the Future of Orthopedics By Laura Dyrda T odd Albert, MD, surgeon-in-chief and medical director for New York City- based Hospital for Special Surgery, re- cently discussed the future of orthopedics in an interview with Medscape. Here are the key trends: 1. Patient-reported outcomes are a huge topic of discussion, and gaining additional sophis- tication to better understand which outcomes measures are best for evaluating each specific disease will help clinicians provide better care. 2. Physicians and researchers are conducting studies based on value to prove which treatments have the best outcomes while using resources efficiently. ey are now able to take large datasets and population health data to examine many aspects of disease and treatment. 3. Studies show surgeons who perform a high volume of procedures typically achieve better outcomes. Dr. Albert's studies at the HSS Healthcare Research Institute examine how many procedures sur- geons must do to become competent, and whether they should be performing a procedure at all. 4. Physician burnout has been a big topic of discussion; to prevent burnout at HSS, Dr. Albert and his team try to keep physicians happy and create a pleasant environment. He also noted a good culture can lead to better outcomes for patients. 5. Dr. Albert is excited about robotic surgery, particularly in the knee, which may be able to deliver reproducible, guaranteed out- comes. e technology can make a difference in the era of person- alized medicine. n The Next 5 Years for Spine Surgery in ASCs: Key Thoughts from Dr. Frank Phillips By Laura Dyrda Frank Phillips, MD, co-founder of the Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush in Chicago discusses the future of spine in ambulatory surgery centers and where the biggest opportunities for outpatient spine will be in the next five years. Question: How do you see spine evolving in ASCs over the next five years? How will it change and how will it stay the same? Dr. Frank Phillips: There will be continued expansion of spine procedures in the ASC environment. With the advent of improved anesthesia and more reliable postoperative analgesic strategies, more complex spinal procedures will migrate to ASCs. Already we and others are routinely per- forming lumbar and cervical fusions as outpatients in an ASC setting. The efficiencies and cost-effectiveness when compared to traditional hospitals will continue to drive this. With this inevitable migration to outpatient surgery, hospi- tals/hospital systems and surgeons will be required to part- ner in creating ASC opportunities. When done appropriate- ly this creates aligned incentives for all stakeholders. Q: What opportunities are there for spine surgeons to expand their outpatient ASC and practice? FP: There are still many instances where spine surgeons do not have relationships, incentives or ready access to fo- cused ASCs. This is particularly the case in academic, uni- versity-based programs where large hospitals have been the backbone of the relationship. I would suggest that these practices need to explore ASC opportunities, often by necessity in partnership with their affiliated hospitals, to provide the most appropriate venue for spinal procedures. Spine surgeons interested in expanding procedures in the ASC, should work closely with the center to establish safe and reliable patient care pathways to ensure excellent pa- tient care. Q: What do spine surgeons need to know about payers and reimbursement for their procedures in ASCs? FP: This is an area where considerable effort is required. Complex spine procedures are expensive and resource in- tensive and without appropriate contract negotiations and developing carve-outs for implant and biologics, these procedures are not sustainable in the ASC. The demon- strable cost savings realized in the ASC environment will, however, bring payers to the negotiating table. n Dr. Todd Albert Dr. Frank Phillips