Amid constant changes in the healthcare landscape, business and communication skills will become more important than ever for spine surgeons to master in 2025.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.
Next question: What will become a nonnegotiable utilization for AI in the next 5 years for spine surgeons?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CST Tuesday, Jan. 21.
Editor's note: Responses were lightly edited for clarity and length.
Question: What's one skill (clinical or administrative) that spine surgeons should master in 2025?
Jeffrey Carlson, MD. Orthopedic Spine Surgeon at Orthopaedic & Spine Center (Newport News, Va.): I have been struck by the number of surgeons who have very little grasp of coding and billing for their work. Most seem to depend on their hospital administration or computer algorithms to spit out the correct codes. As we know, insurance denials for payment are becoming more common and complex. The knowledge and skill to get the coding right will decrease those denials and decrease your personal overhead by saving your staff time fighting for reimbursements. Don't expect the hospital to support you or your patients in pursuing payment.
Brian Fiani, DO. Spine Surgeon. (Birmingham, Mich.): In 2025, one essential skill that spine surgeons should master is integrative digital health. This includes proficiency in telemedicine, remote patient monitoring, and the use of advanced data analytics to enhance patient care. As healthcare increasingly adopts digital tools, being adept at utilizing these technologies will improve communication with patients, streamline pre- and post-operative care, and facilitate better decision-making based on real-time data. Additionally, understanding how to interpret and use insights from patient data can lead to more personalized treatment plans and improved outcomes for spine surgery patients.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: If it is one thing that a spine surgeon should have and must definitely master is time management. Keeping on-time for clinic and being on-time for surgery shows respect for everyone else's time but also makes you a person of their word. Patients know you are busy, and know you as the surgeon are important. But it is also key to show everyone that they and their time are important to you, and that you moreover are organized.
Steven Girdler, MD. DISC Sports & Spine Center (Newport Beach and Marina del Rey, Calif.): Communication. Clear communication with patients, families, coworkers, staff and administrators is paramount for a successful practice. With the rise of the internet, patients have access to more information than ever before. Being able to communicate clearly and concisely can help surgeons participate in shared decision-making, set goals and expectations for care, and help build a successful practice in 2025.
Ehsan Jazini, MD. VSI (Virginia Spine Institute) in Reston: Spine surgeons in 2025 should focus on mastering and integrating advanced technologies like AI, robotics and biologics into their practice. These innovations can significantly enhance patient outcomes by improving precision, efficiency and personalized care. Surgeons can safely adopt these technologies to improve their patient's quality of life while reducing risks and avoiding unnecessary complications.
William Kemp, MD. VSI (Virginia Spine Institute) in Reston: Mastering endoscopic spine surgery will become increasingly crucial in 2025 as technological advancements expand its applications. Although the initial learning curve may be steep, this ultra-minimally invasive approach enables spine surgeons to significantly accelerate patient recovery and improve overall outcomes, making it an essential skill for the future of spine care.
Yu-Po Lee, MD. UCI Health (Orange, Calif.): One skill that spine surgeons will need to continue to master in 2025 is accurate documentation and record keeping. Federal regulations require the use of electronic medical records. This has many benefits for physicians, patients, and hospitals. For physicians, electronic medical records provide easy access to past records. Physicians have access not only to their own notes, but also to the notes from other clinicians. This has resulted in improved continuity of care and improved patient care because physicians are able to have more accurate information, and they can have that information readily available in most cases without having to contact another physician's office to have the note faxed to them. This has also benefited patients because electronic medical records have improved the accuracy of record keeping for patient medications and consultations. Patients can also review their own medical records and share their medical records with new providers and contact their providers to make changes if there are any inaccuracies in the medical records. Hospital systems benefit from electronic medical records for billing purposes.
However, the electronic medical records are only as good as the information that is put into the notes. If the records are inaccurate and incomplete, this will result in delays or improper medical care. The reliance on templates and copying and pasting notes without accurately modifying them could lead to inaccuracies in the medical records. So, physicians need to take advantage of new technology, such as artificial intelligence, to make sure that their notes are as accurate and complete as possible. Also, in terms of medical legal issues, the medical records are the best defense a physician must defend himself/herself. So, investing in methods or technologies to ensure accurate records will also help protect physicians in medical legal cases as well.
Philip Louie, MD. Virginia Mason Franciscan Health (Tacoma, Wash.): Collaborative Leadership. Make 1+1=3.
Spine surgeons need to better understand the administrative decisions that are being made on their behalf and educate themselves on the big picture that drives these decisions. Potentially to the point of being willing to take a seat at the table in order to provide the clinical knowledge necessary.
Administrators need to better understand the clinical impact of the decisions they make. They need to dedicate some time on the front lines, because the patient care that is observed in real life is very different from the patient care that appears on spreadsheets and graphs.
So yes, mastering the art of collaboration, with surgeons bringing their clinical expertise to the decision-making table and administrators grounding their strategies in the realities of frontline patient care. These synergistic solutions may far outproduce what each group can do individually.
Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: Communication is perhaps the most important skill that we can possess spine surgeons. I find myself working on my communication every day. Communication with our patients, communication with our staff, communication with hospital administration, communication with insurance companies, communication with the broader public through avenues like our websites, news, blogs, videos, and even social media. One size does not fit all when it comes to these very diverse arenas for communication. I do think it is a constant effort to optimize communication; I am not sure that it is truly a skill that we can ever completely master.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Accommodation.
Currently, the AMA, physicians and hospitals are extremely disappointed that Congress failed to prevent Medicare cuts next year, threatening their financial viability, physician practices and endangering already fragile access to care for Medicare beneficiaries. The 3% cut, following two decades of dwindling reimbursements and flat payment rates, will have consequences on health care access for older Americans.
Originally doctors had been staring down as much as 8.5% in 2023 Medicare pay cuts, but an advocacy campaign of over one million physicians and action groups helped stave off some of these reductions. Unfortunately, the inevitable occurred, but the number was less. Historically, these projected reductions will continue and resurface as the costs to do business in healthcare have only increased. Capital equipment replacements are scarce and scrutinized.
Definitely as time progresses, and financial stressors continue to plague healthcare systems, resetting ones' expectations and impositions will be required. This is an acquired skillset.