by Elizabeth Hofheinz, M.P.H., M.Ed., October 1, 2019
Is the spine field being carved up? “Yes,” says one spine surgeon.
“The spine community is now experiencing an identity crisis similar to that which occurred in the plastic surgery/cosmetic surgery world over a decade ago. The lines between surgeons and non-surgical providers are increasingly blurred. Patients are often unclear whether the man or woman in scrubs who they are seeing an orthopedic or neurosurgery trained surgeon or an interventional pain specialist. Both groups of doctors offer patients discectomy, decompression (laminectomy or MILD), and even place implants. The recent Boston Scientific acquisition of Vertiflex is a sign that industry believes that non-surgeons should be placing implants in the spine.”
Specialty societies on “mute”…
“Ordinarily, it would fall upon the specialty societies and medical boards to clearly define the scope of practice and safety of various procedures. What is surgery? Who should be able to open and work on organs in the body? Should providers who perform surgical procedures on the spine also be able to handle common complications such as durotomy, hematomas, instrumentation malposition, fractures, and infections? However, the medical boards and specialty societies have been silent in this regard.”
“Having non-surgery trained providers perform surgical procedures could solve access problems and potentially offer patients access to innovative, non-traditional surgical procedures. However, there is also the potential that procedures done by non-traditional surgical providers could lead to more complications and potentially bad outcomes.”
