Spine and orthopedic experts in July spoke with Becker's about topics from CMS policy to outdated industry trends.
"I am still surprised to encounter patients who have been treated by other spine surgeons who do not believe in sacro-iliac joint pain. While that was more common ten years or more ago, there is such a wealth of literature today that it is hard to justify that thought. To those surgeons, the SIJ must be that one magical joint in the body that cannot cause pain. While treatment recommendations may differ, on face value, it makes no sense to deny the diagnosis exists," Richard Kube II, MD, of Prairie Spine & Pain Institute in Peoria, Ill., on outdated ideas in spine care.
"I think the Medicare reductions are shortsighted. Coming out of the pandemic orthopedic practices have been subjected to unprecedented increases in overhead. We've seen large numbers of licensed professionals, nurses, therapists, etc., leave their jobs. Wages for those who continue to work in their profession have gone up dramatically. At the same time the cost of supplies has increased at rates we haven't seen in the past. Now Medicare is cutting reimbursements by 3.34 percent. Some practices will have to consider limiting Medicare patient access in favor of higher paying patients. Others will consider this the last straw that pushes them to sell out to the local health system or to private equity. We know that as the health systems become more vertically integrated competition diminishes and costs to the entire system rise," Ed Hellman, MD, of Indianapolis-based OrthoIndy, on CMS' proposed 2024 physician fee rule.
"More spine surgeons should be using their hospital's old-school dictation system. I believe using speech recognition for your reports is unnecessary tech bloat. It eats up a ton of your time, and using templates in general is a no-no from a medical legal standpoint. I find that dictating your operative report captures the nuances of every surgery that templates steamroll over and open you up to questions in litigation. Also, it really paints a vivid picture and lets you 'tell the story' as you go," Brian Gantwerker, MD, of The Craniospinal Center of Los Angeles, on one thing more spine surgeons should do.
"Overall, orthobiologics are not overhyped. This type of treatment has been established as being safe and effective in the well-selected patient. The proper use of leukocyte-rich or leukocyte-poor PRP formulations, minimally manipulated adipose, or bone marrow concentrate has shown benefit in many common orthopedic injuries. On the other hand, "regenerative medicine" is not a proper description of these treatments. Advertisements that suggest cartilage, tendon or spinal discs can "regrow" are extremely misleading and medically false. Patients should consult with their doctors to ensure they pursue the treatment best for them rather than the treatment receiving the most hype," — Gurtej Singh, MD, on the state of orthobiologics.
"The best advice I could give the next generation of orthopedic surgeons is to be constantly looking for opportunities to innovate. We have made great strides in orthopedic care in recent decades, both through surgical techniques and in the philosophy of how we approach and treat different medical problems. Although we always want to build upon the techniques and practices that have come before, I am constantly challenging the next generation to come up with newer and better ways to help patients recover and regain mobility as quickly as possible," Frank Liporace, MD, on the best advice for early-career surgeons.