'Do we invest in more, or do we retire?': What we heard this week

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Physicians spoke with Becker's about several topics this week, including physician shortages and growth opportunities for anesthesiology.

What we heard this week:

How will the impending physician shortage affect ASCs?
Christine Blackburn, BSN. Administrator at the South Kansas City SurgiCenter (Overland Park): I think the next three years will be pivotal for ASCs for multiple reasons in regard to aging surgeon owners. These surgeons see inconsistent payer practice from CMS and commercial with restrictive prior authorizations and then the removal of the 258 CPT codes from the ASC. It's so hard to decide where to go with this information. Do we invest in more, or do we retire? Additionally, COVID-19 and all of the variants and the expense and changes that come with this. If they are close to retirement, this might be the tipping point for the physician. Can the new surgeon afford to buy into a center?

What's the biggest opportunity for growth in anesthesiology?
Jonathan Beathe, MD. Assistant Clinical Director of the Department of Anesthesiology at the Hospital for Special Surgery (New York City): One of the biggest opportunities for growth in the field of anesthesiology is improving the experience of care post-discharge. With trends toward shorter length of stay and the disruptive innovation of telemedicine, there is tremendous opportunity for anesthesiologists to demonstrate our value. Modernized analgesic strategies that minimize or even eliminate the use of opioids, including the use of continuous peripheral nerve blocks, have the added potential benefit of reducing the incidence of chronic postsurgical pain. As the trend toward outpatient total joint replacements continues, it is not enough to be satisfied with acceptable patient safety metrics. At my institution, we continue to optimize enhanced recovery pathways to focus on outcomes that matter to our patients.

2 spine techniques shaping a Missouri ASC
Andrew Lovewell. Administrator of Surgical Center at Columbia (Mo.) Orthopedic Group: Cervical disc arthroplasty has seen a tremendous growth in recent years due to technological advances with implants that recreate the natural structure of the spine while preserving flexibility and relieving pain. Many patients that once had to have a fusion that may result in further future surgeries can now have the disc in their neck replaced. The procedure is minimally invasive, but also more cost-effective than a traditional fusion. On top of that, many of our patients have a same-day discharge, no complications, faster return-to-work and immediate relief.

Minimally invasive sacroiliac joint fusion is another procedure that has seen dramatic growth at our practice. SI joint pain was previously a nonoperative type of pain that many patients had to live with for years. However, with new technology, many patients that suffer from SI joint dysfunction or disruption may be candidates to have an SI joint fusion. The procedure has an extremely small incision that allows just enough room to implant the devices that are needed to fuse the SI joint together. All of our patients have a same-day discharge just a few hours after the surgery, and patients require significantly less recovery time than an open SI joint fusion.

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