MDNews - Minnesota

because of changes in insurance coverage. Many of the national carriers now recognize disc replacement as a viable alternative to fusion, and it is often a covered procedure. In Minnesota, many of the major carriers now cover cervical total disc replacement, while we still have a long way to go on coverage for lumbar total disc replacements. This increase in patient coverage has allowed us, as a leading provider of motion-sparing surgery in the Twin Cities, to expand our research activities on total disc replacement and perform total disc replacements on patients who just a year ago would have undergone spinal fusion to correct their pathology. Q What single message do you wish to communicate to the Twin Cities healthcare community? A: Midwest Spine Institute is the only practice in the Twin Cities that has adopted a combined orthopedic and neurosurgery model, similar to the Cleveland Clinic and the Norton Leatherman Spine Center in Louisville. In my opinion, this combined spine approach is the most effective way to provide patients the full spectrum of coverage for spine conditions, including degenerative disorders, scoliosis, major trauma, infections, tumors of the spinal column, spinal cord tumors, tethered cord, Chiari malformations and syringomyelia. Hospitals and referring providers who rely on our physicians for care have a 'one-stop' group they can rely on to consult for any condition afflicting the spine. Our ability to treat any degree of spinal pathology complexity has given us a significant competitive advantage in the Twin Cities healthcare market. Q Would you describe your vision? A: I believe the single most important thing we have done and must continue to do is provide world-class, comprehensive care at the community level. Our providers extend clinical care to patients at nearly 20 locations throughout Minnesota and western Wisconsin. In addition, surgical procedures are performed at both small and large institutions throughout the state to bring expert spine treatment to these communities. Patients and referring providers in areas where there is often very limited spine care continue to be highly satisfied with our availability to them and have rewarded Midwest Spine with intense loyalty to our practice. Q What is the most significant change you have seen in the healthcare environment during the past decade? How do you see it changing in the next decade? A: The most significant change I have witnessed recently in the healthcare industry is the dramatic change in the way spine surgery is viewed by the major healthcare payers and how this has affected the treatment of patients. The preauthorization process has become much more rigorous during the past few years, not only for spine surgery but also for any interventional treatments we provide our patients. I support the assertion that a thorough workup of each patient must be done and any surgical treatment must have clear indications based on scientific criteria. However, I believe the pendulum may have swung too far, as delays and denials are now more common than ever. This has led to treatment delays for the patient, the need for peer-to-peer reviews, increased staffing to manage authorizations and reviews, as well as frustration for patients and their families. At Midwest Spine, providers are involved in clinical care on a daily basis and also have spent significant time on committees that establish guidelines for appropriate conservative, interventional and surgical care. It will be critical for our providers to continue to be involved at the local, state and national levels so treatment guidelines used by the insurance industry are in collaboration with treatment guidelines developed by clinical experts, such as spine surgeons and spine surgery societies. The challenge during the next decade will be to ensure the goal of timely and appropriate patient care continues. Q Today's patients are becoming increasingly involved in decisions about their medical care. How do physicians at your facility ensure Orthopedic and neurological spine surgeons and interventional pain physicians empowered patients receive the best possible care? A: The availability of information about spinal conditions, procedures and spine surgery has never been greater. Our providers believe that the better informed patients are about their treatment, the better they will be able to participate in shared decisions to receive the best possible care. Any patient who is considering treatment options is educated by the provider about associated outcomes of a particular procedure and is provided with detailed informational packets to review. These packets discuss the pre-procedure, procedure and postprocedure period. In my practice, I discuss reasonable expectations for outcomes as well as outline the literature outcomes for a procedure with patients, refer them to our website for more information, and often schedule them for a follow-up consultation to discuss the procedure once they have had an opportunity to digest the information. As a group, Midwest Spine has made the commitment to work within the framework of various system spine centers where shared decision making is the cornerstone of deciding which patients require surgical intervention. In this rapidly changing healthcare environment, patients who are knowledgeable and empowered will have the greatest opportunity to obtain the best possible care. Visit www.MidwestSpineInstitute.com or call 651-430-3800. ■ MdNewS.CoM ■ MD News Twin Cities | 29

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