Are non-trained specialists performing spine procedures?


Today, spine surgeons and their patients face several threats from new industry trends, including prior authorization denials, artificial intelligence and increased care provided by non-physician providers. 

While spine surgeries and procedures have historically been performed by surgeons with specialty training, three physicians told Becker's that they fear more non-trained individuals may be performing spine procedures, causing issues of safety and compliance:

Alfonso Garcia, MD. Spine Surgeon at Espalda Saludable (Tijuana, Mexico): In México, there's been a recent surge toward incorporating endoscopic spine surgery by many undertrained surgeons. This trend as it has always been happening throughout the evolution of better and less invasive spine surgical procedures, will experience a short rise in early adopters complications. With time and improvements in training programs we will see more stable and predictable results. 

Brian Gantwerker, MD. Neurosurgeon at The Craniospinal Center of Los Angeles: There are two dangerous trends in spine currently. First is the continued push of device manufacturers to put pedicle screw-type devices into the hands of non-spine surgeons. Multiple organizations, including the Congress of Neurological Surgeons, American Association of Neurological Surgeons and American Academy of Orthopedic Surgeons put out a joint position statement stating, unequivocally, that spine surgery and specifically fusions should only be done by surgeons. There have been several concerning posts on LinkedIn and some other social media sites with non-surgeons showcasing them placing interspinous devices and devices supported by pedicle screws. It is beyond the pale. If you want to put in pedicle screws, do the appropriate residency and fellowship. There are no shortcuts, and patients should not suffer aspirational greed and clinical gaslighting. 

Tan Chen, MD. Assistant Professor of Orthopedic Surgery at Geisinger Commonwealth School of Medicine (Scranton, Pa.): There is an increasing number of non-surgical and pain management physicians who have started performing spinal instrumentation. Without formal spine surgery training and understanding the indications and management of complications, this is extremely dangerous for patients, physicians and the public perception of spine surgery. 

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