Although spine therapies — surgical and nonsurgical — have grown over the last decade, it’s overly simplistic and simply inaccurate to conclude that this phenomenon has been primarily fueled by a profit motive. Improvements in technologies have contributed substantially to this growth. Simply put, more patients with debilitating spine disorders are now eligible for therapies to help relieve pain and improve their well-being.
To this end, Brian R. Subach, MD, a practicing spine-neurosurgeon from northern Virginia, was recently invited to serve as a panelist on National Public Radio’s (NPR’s) Diane Rehm Show. The program, “Concerns About The Increase In Spinal Fusion Surgery,” featured a number of other panelists, including Richard Deyo, MD (a professor, physician and researcher from the Oregon Health and Science University), and Dan Keating (a reporter from The Washington Post). This program was an outgrowth of an article in The Washington Post and subsequent letter to the editor that Dr. Subach submitted.
Dr. Subach did an outstanding job highlighting the benefits of spinal fusion surgery for appropriate indications, while supporting continued outcome studies to refine those indications. He also firmly supported the benefits of appropriate conservative therapy.
Furthermore, neurosurgery, as a specialty, is working to better understand which patients will benefit from certain surgical interventions, which is why the American Association of Neurological Surgeons launched the National Neurosurgery Quality and Outcomes Database project — the largest prospective, longitudinal clinical data collection effort in spine care in the U.S.
Addressing the clinical registry topic, Becker’s SpineReview recently published an article, with Jonathan Slotkin, MD, and Matthew McGirt, MD, who share their thoughts on the most important benchmarking initiatives in spine care and how data will impact care delivery in the future.
As Dr. McGirt states, “Medical and surgical spine care is first and foremost designed to help improve patients’ health status and quality of life. Evolving our understanding of what works and what doesn’t in each setting for each individual patient is how we can begin evolve using intelligent analytics of outcomes data. We want to identify the right treatment, in the right patient, at the right time to optimize outcomes and reduce healthcare waste.”
This quote drives home the point that neurosurgeons share with the public a sense of urgency and responsibility to meet the challenges of creating a value-based, sustainable healthcare system. As such, we are committed to the creation of intelligent, long-term, strategies for achieving quality care using real world, patient-specific, objective information (not anecdote or data from narrowly focused controlled trials).