Kristopher Kimmell, MD, is a neurosurgeon in Rochester, N.Y., with a practice focused on minimally invasive spine surgery, traumatic brain injury, brain tumors and other spinal procedures.
Here, Dr. Kimmell examines new technologies today, beyond the traditional implants and systems, and shares his thoughts on how the field is changing.
Question: What emerging technology are you most interested in today and why?
Dr. Kristopher Kimmell: Although there is a large amount of interest among surgeons in implant materials and biologics, I think that I am more interested in the emergence of computer systems and informatics for care delivery. The work we do as surgeons is increasingly in the digital realm. It behooves surgeons to become more facile in this space.
There are a wide-variety of applications for these technologies, including digital voice recognition for documentation and communication; wearables for tracking patient movement and progress in response to therapies; capturing of patient reported measures; genomics; and other pertinent data to drive practice improvement and outcomes and to convey these results efficiently to patients, payers, and other stakeholders.
Q: How do you think your practice will change in the next three years? What are you doing today to prepare?
KK: It is clear that the trend of the last few years has been driving physicians to do more with less. Reimbursement rates are falling, indications for surgeries are tightening, and many surgeons are finding themselves beholden to larger and larger institutions and stakeholders. Surgeons must find ways to work smarter, not harder, by familiarizing themselves with rapidly evolving healthcare policy as well as digital technologies.
I subscribe to a wide variety of outlets reporting on changes in healthcare technology and policy and am actively involved in my specialties societies in order to 'keep my ear to ground' on policies coming down the pipeline that affect my patients. The only way for physicians to combat policies that are unfriendly to our patients is to be informed and speak up.
Q: What is the most dangerous trend in healthcare, spine or orthopedics today and why?
KK: I think that, rather than working for positive reform and improvements in care delivery within their systems, many surgeons engage in 'bare minimum' activities, i.e. the least amount required to get their work done. Alternatively, there is a lot of gamesmanship practiced by surgeons. There have been surgeons that find loopholes in coding or reimbursement policies and deliberately alter their practice in order to maximize reimbursement. This is not always what is the best and right thing for the patient. Inevitably these loopholes are closed, and surgeons may move on to a new technology or procedure.
I think that we need to move away from a view of trying to extract maximum reimbursement from every patient and procedure and move toward demonstrating our value to healthcare systems and payers from a more holistic perspective. We do add value and contribute to our healthcare systems in multiple ways. But we have to be aware of these benefits and leverage them to our advantage while also delivering the best possible care to our patients.
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