1 2 7
D E C E M B E R 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T
Surgeons on board?
It's more than likely that your physicians will be the ones leading the
way toward minimally invasive spine. If hosting the cases is the
administration's idea, however, one of the biggest challenges you
might encounter is recruiting and convincing surgeons to take on out-
patient spine.
Orthopedic spine surgeons and neurosurgeons cover the same
anatomical territory. Even though neuro docs seem about 10 times
more conservative in their techniques and treatment, the regimenta-
tion of both specialties may affect their practitioners' comfort with
same-day discharges.
The first step toward adding the procedures is determining the level
of physicians' discomfort. In one-on-one conversations, discuss the
achievability of expanding patient care and developing a new revenue
stream. Does their discomfort stem from the procedure itself, or from
the ambulatory environment? Are their objections based on personal
philosophy ("This procedure should not be done outpatient."), clinical
trends ("We should wait until Medicare covers this, and everyone else
$7,842 for the procedure. For lumbar fusion, compare the $6,000 to $9,000 for
implants with a reimbursement of about $12,922.
Clearly you'll want to keep a close eye on your implant deals. The key here is to
remember that your surgeons and your center are on the same team. This is a con-
versation you have to hold in order to stay profitable. Sometimes you'll see hospitals
cutting implant deals with specific vendors, or vendors reaching out to surgeons
directly. That runs counter to your business's interests. Discuss implant preferences
with your surgeons and present a unified front when you negotiate with your
implant vendors. They should provide a service and a product, and they should work
for your business.
— Laurie LaPenotiere, MSN, RN
