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forward slash beckers podcast.
This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we are recording live at the
twenty second annual Spine Orthopedic and Pain Management
Conference.
I'm currently joined by doctor Izzy Lieberman, who
is an orthopedic surgeon at the Texas Back
Institute. So, doctor Lieberman, thanks for being here.
Let's start off by having you introduce yourself
a little bit further and share more about
your role and organization.
Thank you very much. It's a privilege and
a pleasure to be here and sharing this
information with you.
I do work at the Texas Back Institute.
I've been there for the last fifteen years.
Prior to that, I was at the Cleveland
Clinic for thirteen years. I,
trained and worked at the University of Toronto
in Toronto, Canada for five years before that.
I principally do orthopedics and spine surgery today.
The easiest way to describe my practice is
I do whatever
anyone else doesn't want to do.
And, I do a lot of revision, a
lot of deformity work. I'm also involved in
a lot of development work. I've got, relationships
with, multiple strategic companies
in terms of consulting, and I've got,
my own startup company also that's involved in
the spine space.
Wonderful. Well, thank you for being here. And
let's start our conversation
by talking about trends and shifts. So what
are you seeing right now in the industry
that you think is most important for leaders
to pay attention to?
There's there's two big trends that that I'm
seeing right now,
both of which personally are a little concerning
to me.
The first trend is the
use of social media
in spine surgery.
Now it's permeated in everything in society
today,
and absolutely there are benefits to it. But
there are also,
some
non benefits to it. It can be problematic.
As spine surgeons, we wanna make sure that
we're competitive. We stay in the in in
the practice. We can attract the right patients
to us, and the use of social media
for that is exceptionally important.
But I do see a trend
where social media
is embellishing
what's going on out there in spine surgery,
where individuals
are promoting themselves
inappropriately
to a certain extent.
I do a lot of revision surgery, and
unfortunately,
I see the guys on social media, and
then I see the patients coming to me.
They're on social media, and they're saying, oh,
I do this operation under forty five minutes,
mainly invasive skin to skin.
But then they're back with me six months
later because the surgery was not done appropriate.
So the use of social media has to
somehow
be regulated
and monitored.
And and likewise,
the ability
for ratings
online
has become problematic.
Now there's a lot
of fake ratings out there. There's a lot
of legitimate ratings out there. But when there
is a negative
unwarranted
rating
on somebody, that becomes very, very difficult
to correct.
So we need to figure all of that
out.
The second issue
that I see is problematic
now
in in spine surgery
is the amalgamation
of groups
and, essentially, a lot of physicians
moving towards an employee model
or the
PE firms that are coming up
and are starting to
gobble up
spine practices.
Now at Texas Back Institute, we're a big
group, and we were looking at ways
to maintain our relevance and sustainability.
And we met with a number of the
private equity groups, and it dawned on me
that if if these guys think
they can make money off of myself and
my partners,
we have to figure out how to make
money off ourselves. Why why are we giving
it away
to them?
And until the private equity group can actually
bring a benefit to the table
to the surgeons, and that benefit obviously is
some form of contracting
rather than just practice efficiency by rolling up.
Unless they can do that, I really don't
see
any role. And we see this pendulum
swinging towards the private equity and the roll
up of the groups,
but it's self limited. And that pendulum is
gonna swing right back and knock people over.
Absolutely.
And I'd also love to touch on staffing
and workforce challenges as these continue to be
a concern across health care.
So how is your organization
navigating these pressures, and what strategies have you
seen work well?
The reality today is that
the employment workforce is mobile. We're not getting
beyond that.
The post pandemic reality
is that people wanna work from home.
If we wanna
maintain
our
current
business profile, we have to be able to
adapt to that.
So we have taken steps to provide
our employees
with the ability to work from home, from
the
office,
combination things.
Working from home, you have to be able
to monitor the employees.
It's pretty clear that they are not as
productive at home as they are in the
office.
So that's been a challenge for us as
a group, but we've been
able to to work through that.
The transient
nature
of the employee
workforce, they they're just going after the the
higher paycheck. They'll go from our practice to
the practice next door to the practice next
door, and then eventually they come back to
our practice again because they see that it's
really not that much better. They're making any
difference there.
So we just have to accept that fact,
but we have to add something to the
mix. And what we've tried to add at
the Texas Back Institute is more of a
collegial
family
related type approach to this,
where we have events. We bring people together.
We do things on it. So you're building
some camaraderie in the team.
And over time, and we've started to see
this, but over time, we're seeing a drop
in that turnover rate.
And as outpatient care continues to grow, how
do you see the role of spine evolving
within the broader health care ecosystem?
The good news
about
spine care is that everyone has a spine.
The better news
is that over your lifetime, everyone with a
spine has got an eighty percent chance of
a problem. So we know we're always gonna
be in business. Okay. There is no doubt
that we can do more, and we can
do it better now
in a less invasive, potentially outpatient environment.
Our diagnostics
are so much better at this point. Our
treatment plans have improved substantially.
The execution of surgery has become more precise,
more efficient.
The understanding of physiology
has has improved where we can be more
predictive and avoid some of those complications.
So spine is here to stay in in
the global health care. I think spine is
going to be,
a much more important economic
driver
as well, especially with the aging population.
And I see exciting things ahead of us
with the technology
that's out there.
There's so much
technology
at hand right now. We just have to
figure out how to use it to the
advantage of our patients.
And that is a perfect segue actually into
my final question.
Many organizations are exploring new technologies, partnerships, or
care models to improve efficiency and outcomes. So
are there any innovations or initiatives you found
particularly promising?
Critical review
of how we do things is important.
Now we do have a lot of
data analysis
packages where we can look at our efficiency
in the clinic, our outcomes in the operating
room.
We can look at our patient flow, patient
satisfaction.
So looking at all that,
the ultimate though and and I'm kinda reluctant
to use that that term, but the AI
component. Everyone's using AI AI.
But the reality is
that data information that's gonna come back to
us is gonna help us do better for
for our patients in the future.
If I know that I do
operation x on patient y the same way
every time and I get this result,
the AI is gonna remind me,
this is patient x. Do operation wide. This
is what you're gonna get. So that's where
I think we're gonna see a lot of
benefit in spine surgery.
Wonderful. Well, as we wrap up, is there
anything else you'd like to share that we
didn't touch on today?
Just to reemphasize, despite all the rhetoric and
scrutiny on spine surgery, it is an exciting
time. There there's a lot that we can
do.
We can really
change our patients' lives now.
And the the myth
that having a bad back and undergoing spine
care is gonna be problematic
is all just a myth. We we can
we are doing better.
Wonderful. Well, doctor Lieberman, thanks so much for
being here today on the Becker's Healthcare Podcast.
Again, we're recording live at the twenty second
annual Spine Orthopedic and Pain Management Conference.