This is Carly Beam with the Becker Spine
and Orthopedics podcast. And today, I'm thrilled to
be joined by doctor Michael Virden, a spine
surgeon at Transcendent Care.
Doctor Virden, thank you so much for being
here today.
Appreciate it. Thanks for the opportunity to talk.
Absolutely. Before we dive into our questions, could
you introduce yourself and tell us more about
your background?
Yeah.
My name is Mike Verdin. I'm a neurosurgeon
in Dayton, Ohio. I've been in practice for,
going on sixteen years,
this year.
Been in basically,
spine surgery is is kinda what I do.
Community community spine surgeon in in Dayton.
I've been in a private practice setting essentially
or community setting my whole career.
Started a couple of practices.
I've been involved with startup projects with service
line development as well as
hospital service line development as well. So,
that's about it.
Great. And it sounds like, you know, so
you said you've been in community,
care and private practice for sixteen years. I'd
love to just kind of hear
what are some of the biggest changes that
you've seen in that landscape in your career.
I think over time, it's,
really COVID, in my opinion, gutted the workforce.
So a lot of people who were
late career and not real or mid to
late career not really wanting to to dig
into what was going on has left. So
there's been
a huge experience strain out of the entire
health care system from nursing to administration
to lab, PT,
really all across the board. So it's it's
now much more do it yourself kind of
situation.
So we've had to try to use or
develop
technology technique to make it better for us
to evaluate patients, be more efficient. So I
think what's happened post COVID is there's this
push for efficiency and
the there's not a human,
workflow to help help with that, and you
have to
provide the same level of care with less
human resources. So more things need to be
processed oriented or,
instead of people oriented. And I think that's
gonna continue to go,
moving forward.
Got it. And can you talk about some
of the other
biggest health care trends that you're following today?
Well, kind of the rise of,
Ingenic
AI in the clinical space from an office
documentation standpoint. So there's quite a few technologies
out there that listen to the interaction between
the patient and physician and generate
notes or potentially orders off of that.
It's primarily, it seems to me, for the
primary care space or that's the ideal location
for it.
I'm kind of looking to see how that's
gonna
influence or eventually show up in in specialty
clinics like spine or orthopedics or cardiac,
because I think there's a huge need for
that those kind of technologies there.
Mhmm.
And how are you using AI in your
practice if at all?
We are. Actually, we we have been using
a tool that we developed,
to triage patients based on the referral type
so we know how to order or schedule
their appointments.
We've been using that in the clinic for
about three years now.
You know, patients call, get a referral.
My office staff calls a minute. They we
have
a kind of the software based package that
helps question the patients,
And then,
it's a
algorithmic way to triage patients based on,
their symptoms severity, and it's a validated tool
that we've used for a while, and it's
really helped. I mean, my throughput has increased
by a factor of two. In other clinics,
they're out there in their surgical output, this
increased by 10%. So it's really pretty neat.
You have a way to and the patients
get early treatment, right person, right time kind
of thing.
And, it's been good for the patients and
and of clinical efficiencies.
Yeah. That sounds especially useful too just in
terms
of getting patients
what they need quicker through the help of
AI.
And, like, besides,
you know, these listening tools and triage,
what other applications for AI and SpineCare do
you think will really take front and center
stage in the coming
I think,
so decision support tools kind of for people.
So the whole concept of,
you know, OpenAI,
really, as a technology scrapes the Internet for
knowledge to give you,
suggestions.
Well, I think there's gonna be a back
end where research tools are gonna feed those
kind of machines,
and you're gonna have fresh new research type
data to,
again,
fuel those large machines to
create outputs that are relevant to a patient
or to a patient population.
I was talking to a friend of mine
yesterday. It's like almost each individual,
hospital will be will be its own data
hub, which is, if you think about that,
pretty fascinating. Right? So you can treat the
patients in your community
with the disease states that they're presenting with
based on your own clinical data,
and help evolve care,
for your community, which is really what we
need. We need, like, the right treatment for
the community because,
you know, what is
a disease process that's very common in Detroit
is not the same as it is in
Dubai. They're just very different
based on the way people live and how
their the diseases are presenting. And we're gonna
have tools to be able to
help the people at the bedside get the
patient what they need as soon as they
can.
Absolutely. And really just kind of parsing through,
like, the nuance you said in, you know,
between different communities.
Correct.
And what are some other things that are
really exciting you right now in spine and
in health care?
You know, I think it's not exciting, but
it's certainly a huge opportunity is this whole
care the access,
model that they're talking about for for,
Medicare patient population. So we're gonna be forced.
I think
organizations are gonna be forced to
treat for value. Meaning,
not everybody you're not gonna get paid per
per piece meal. You're gonna get paid per
patient population or per disease
state for the patient population.
It's kind of an old fashioned version of
capitated medicine under a certain disease state. And
so whoever owns that whole entire
system of care
is gonna
provide the best care usually,
have the whole patient population, quote, unquote, captive.
That would be surgical and nonsurgical, and then,
again, have the data to prove that their
model of care is most effective.
So it's a real opportunity. You know? I
I think as a physician, I am
I create a lot of data, and I
generate a lot of data, and I become
I become the tool that,
applies the data. I think that's how we're
gonna change. The medicine's gonna change. It's gonna
not you're not in the health care business
anymore. You're in the health care data business.
And I feel like
once people wake up to that, their whole
I think a lot of the relationships could
change.
Very well said. And can you talk about
how you're thinking about growth over the
next twelve to twenty four months, whether it's,
you know, expanding practice locations,
increasing your volume, or, you know, just kind
of expanding on this value based care that
you're talking about?
I think there's gonna be more of a
push, not it's gonna be effective
quality volume. Right? So we can't just so
a lot of times when we hear models
about it's gonna be quality based outcomes or
no volume is gonna stay the same.
There's gonna be a premium for quality volume.
And how I think that needs to be
built is by having a standard way to
just take a patient in,
And that's what essentially triage is. Right? A
standard way to evaluate a patient, a standard
way to work a patient up, a standard.
And there's so much variability,
across
the regions for, say, spine care. Right? What
what is the standard treatment in your community
for this mixed bundle as these set of
five s one on a healthy 45 year
old? It is wildly different, the places I've
lived.
So,
I think those nuances are not gonna go
away, but you're gonna they're gonna value the
outcome.
So,
you know,
I was watching the movie, The Founder. It's
about Ray Kroc up in your your neck
of the woods at the founder of McDonald's,
and he had a revelation when he was
told that he wasn't in the hamburger business,
that he was in the real estate business.
And I kinda feel like we're in the
data business.
So
we have to own what we're producing and
then look at what we're doing and and
and ask ourselves, is this really valuable? And
then can you market what you do?
Absolutely. And I'm wondering, you know, obviously, a
lot of opportunities, a lot of exciting things
going on. What are some of the biggest
headwinds that you're
preparing for going into 2026?
I think
in in my market, consolidation
and or
integration vertically. So there's not a lot of
room for independent practice to function.
I think you have we definitely are gonna
have to partner with hospital systems no matter
where you are from an economies of scale
standpoint. You know,
I think that there's
reimbursements declining to a point where it's punitive
to do cases to do clinic.
You can't do clinic because you'll lose money
in the clinic, which seems crazy, but the
reimbursement has gotten so low.
The amount of
volume you have to take on to make
it up or the cost that you have
to assume to attain the patient pool is
is not is counterproductive.
So I don't think that that
model is gonna be sustainable. I don't think
any of the older model that we're used
to fee for service
is sustainable in any way, shape, or form.
We're in we're definitely in a strange new
world where
the models are gonna be laid out there,
and we have to iterate way through it.
Got it. And, you know, just my last
question for you and might have touched on
it a bit already, but
if you can pinpoint a a single key
disruptor to spine surgery in the next next
year, what would it be?
Migration of of technologies out of the Operating
Room and into the clinic. I think that's
really where we don't we haven't thought about
it much yet. But how are
most surgeons that I know are neuro or
ortho spine are
not technophobes. We embrace technology development,
but that has not shown up in the
way
of
office or operations and or service line development.
And that migration now will
whoever embraces that and uses that information to
grow
and to handle
obstacles to care delivery will likely succeed.
And I think
those who refuse to acknowledge that,
will probably not won't be able to scale.
It's just a matter of the volume coming
in cannot be handled by a human anymore.
There needs to be some element of machine,
learning or
identification
to parse through
the silver tsunami that's coming at all of
us.
Got it. Well, thank you so much for
joining us today, doctor Verdin. It's been a
pleasure speaking with you, and I look forward
to connecting down the line.
Thank you very much. I appreciate the opportunity.
Have a good day. You. Have a good
day. Bye.