What's next for spine care? Notes from an expert


Long Island, N.Y.-based orthopedic spine surgeon Daniel Choi, MD, believes that the future of spine care not only lies in new technology, but in ASCs. 

Dr. Choi owns his own practice in New York, and is trained in minimally invasive surgical procedures. He completed his spine surgery fellowship at Harvard Medical School in Boston after receiving his doctorate at Chicago-based Northwestern University. 

While he believes that interbody fusion devices and robotics will take the spine field by storm in the next three to five years, the more efficient and cost effective care at ASCs will help them to stand out over traditional practices. 

"Migration of spine cases to outpatient ASCs is a definite thing that is happening everywhere. It's interesting if you look at the trends for this, a lot of it has to do with geography. If it's better for the patient and more efficient and cheaper for the healthcare system, it should be happening everywhere," Dr. Choi told Becker's. "In Texas, it's common, but in New York, nobody is doing spine procedures in ASCs. That has a lot to do with regulatory rules by healthcare entities that want to prevent migration of cases to outpatient settings due to losses in revenue." 

Dr. Choi also believes that moving forward, more practices will hire additional office staff to help reduce the burden on physicians who are increasingly facing burnout. 

"You see a lot of physician burnout right now, and when you ask 'what's burning you out,' it's a lot of things related to paperwork, electronic health records and being bogged down by the non-clinical work in medicine that's required of them," he said. "Most physicians love being with their patients, caring for them, performing surgeries. What they trained so long to do. Being stuck in a clinic and realizing you have three hours of charting at the end of the day makes physicians prone to burnout. I have tried to eliminate every part of that kind of paperwork and administrative burden by hiring support staff and training them to assist with that."

Besides changes in the way practices are run, new technologies are also advancing the spine surgery field. In the next three to five years, Dr. Choi is excited about the evolution of navigation, robotics and 3D printing. 

"The rapid evolution of various techniques and technologies to optimize interbody fusion is really exciting to me. Various techniques like utilization of navigation, robotics, 3D printing, have all been utilized to improve outcomes. When I was in training, the gold standard was to utilize a tlif approach, but now there are a lot of other options that have been popularized," he said. "I have witnessed how it is a struggle learning to use these new techniques, but utilization has really improved patient outcomes. I am looking forward to seeing more inventions in this area. I think the hope is to decrease operative times and complication rates with these techniques." 

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