Dr. Adam Bruggeman: The trends shaping the next evolution in spine practice

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Adam Bruggeman, MD, a spine surgeon with Texas Spine Care Center in San Antonio, outlines his goals for the coming year and how he prepares for uncertainty with the evolving payment models.

Question: If 2020 is a successful year for you, what will it look like?

Dr. Adam Bruggeman: There are several factors. Our goals for 2020 are to continue to see our year-over-year growth in serving the greater San Antonio community. This includes opening a new office, and likely surgery center, on the outskirts of the city limits in an area seeing tremendous growth. Concurrently, I am proud to be the founder of NuHope, an outpatient facility where we work to deliver individualized treatment paths for those dealing with pain and opiate dependency. I believe that our evidence-based treatment combined with a holistic approach makes NuHope the best treatment option available in the U.S. today, and it’s right here in San Antonio.

Q: Where will you focus most of your time and energy next year?

AB: This year my focus has narrowed in on improving our already outstanding outcomes. I have seen a significant worsening of symptoms in certain subsets of patients and have created a new evaluation service geared towards identifying nontraditional measures of preoperative factors that influence cost of care and outcomes. We have partnered with NuHope in our community and termed this our PREOP evaluation. We hope to publish on the results as they are obtained and are optimistic about their potential.

Q: What do you consider the biggest potential threat to your spine practice?

AB: It depends, the changes to payment models both statewide and nationally continue to change our practice. I will be closely watching the national laws on balanced billing and surprise billing. We achieved great bipartisan and across-the-board stakeholder buy-in for our Texas legislation and hope to see similar billing at the national level. The decisions made in state and federal legislation could significantly impact spine practices and push them away from independent practice and towards employed models. These models have the potential to dramatically impact our practices and the way care is delivered. We continue to keep a close eye on any developments and will be prepared to adapt and continue to deliver high-quality care.

Q: What do you plan to start doing next year, and what will you stop doing?

AB: As mentioned above, we are going to start preoperatively testing and treating non-traditional factors that impact spine surgery outcomes, such as anxiety, depression, opiate use and pain catastrophizing. This will lead to earlier intervention and the ability to treat the entire patient, not just the biological problem that brought them to our office. I think this will lead to more predictable outcomes and lower costs of care with an increase in satisfaction rates.

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