This month, four experts have spoken to Becker's Spine Review's about outpatient spine cases.
Here are their insights:
James Chappuis, MD, Spine Center Atlanta. The most relevant way to make spinal fusions more cost-effective without sacrificing quality is to perform them in an outpatient surgery setting. There is no doubt that you can save money in this type of setting. Overall, your quality can improve because you have control over what you can use, in addition to the choice of who you're working with. I maintain consistency amongst my staff with the same standards of excellence for each case.
Benjamin Burkett, MD, Newark, Ohio-based Orthopedic Specialists & Sports Medicine. Any time the discussion turns to outpatient spine surgery, safety and novel approaches for pain control must be the foremost challenges to solve. The more effectively we can address patients' postoperative pain, the more effective we will be at delivering patients with successful spine surgery in the outpatient setting.
Timothy Kremchek, MD, Cincinnati-based Beacon Orthopaedics & Sports Medicine. We started doing outpatient total hip and knee replacements years ago at our ASC. Now, we must recognize that the whole approach is the opposite of how I was trained in the early 1990s in Boston. The old way centered around the patient as a "sick person." We [must now] shift our view of total knee and hip replacement patients from [being] "sick" to simply injured, no different than someone who may have an ACL or shoulder injury — they just might happen to be a little bit older.
Mark Liker, MD, Santa Clarita-based California Neurological Institute. There are three overall factors that will reduce the cost of spinal fusions: implant cost, surgical expediency and the increased use of outpatient facilities. Of the three, the use of outpatient facilities is the most impactful in the near-term. Increased comfort with outpatient fusions for the right patient population will be advantageous to cost, both in terms of the overall lower cost of surgical centers and the better pricing leverage in surgeon-owned facilities.