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This is Carly Beam with the Becker Spine

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and Orthopedics podcast, and I'm thrilled to be

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joined today by doctor William Kemp, spine surgeon

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with Neurosurgical

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Associates.

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Doctor Kemp, thank you so much for joining

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us today.

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Thanks for having me, Carly. Happy to be

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here.

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So, doctor Kemp, can you before we dive

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to our questions, can you introduce yourself, share

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a bit more about your background?

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Sure. I'm a board certified fellowship trained, spine

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neurosurgeon,

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with a specific focus on delivering high quality

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patient centered care

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with an emphasis on spine surgery outcomes,

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efficiency, and innovation.

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I recently transferred to a new role, down

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in Richmond at Virginia at, Neurosurgical Associates.

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That's awesome. And, you know, when you think

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about spine innovations,

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what excites you the most right now?

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Sure. There are a few areas that, that

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I think are are really up and coming

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in the field,

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maybe even already here. One of them is

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motion preservation

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biologics.

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It's a huge part of my practice,

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trying to expand

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the, the indications and the utility of disc

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replacement surgery.

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It's an old adage in this field that

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it only takes 10 patients to have a

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spine practice

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because patients keep coming back for the next

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level. And we have good data to suggest

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that disc replacement arthroplasty patients in the cervical

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and lumbar spine,

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can hopefully avoid those very things from happening.

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I think, the utility of minimally invasive endoscopic

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surgery is

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is not just a marketing,

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fad. I think that it's actually improving patient

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outcomes, particularly in the short term, immediate postoperative

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recoveries.

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Mhmm. And when you think about just patient

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outcomes, what would you say is the most

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important

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metric that all spine surgeons should be monitoring?

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So I think, you know, I oftentimes,

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the metric that's maybe can't even be count

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can't even be measured

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is just having a conversation with the patient.

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How are you doing? Are you back to

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your life

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the way you wanna be living it? And

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that's a really hard metric to measure.

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But I actually think that, you know, from

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a standpoint of, you know, how how quickly

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can we get the patient back into,

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physical therapy,

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after their surgery? How quickly can we get

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them back to their normal lifestyle? And my

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goal all after every surgery is that it's

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happening within six weeks to three months after

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surgery. That's always my goal.

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So the best quality of life improvement you

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can have in that,

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three to six week window, it sounds like.

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Correct.

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Awesome.

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And can you talk about some of the

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biggest headwinds that you're

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anticipating

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this year and how you're planning to get

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ahead of it?

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Yeah. So I, you know, health, there are

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there are extraordinary,

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forces in health care that are changing the

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landscape,

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and it's something that's fine surgeons in particular

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have to be

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able to adapt and, you know, dodge and

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block and and and evolve and adapt.

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One of them is, you know, reimbursement pressures

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versus rising costs. You know, how does that

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how does that manifest in a private practice

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situation?

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The administrative burden and prior authorization with insurance

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companies, that's always

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an ever changing,

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obstacle, particularly in the setting of,

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AI being more and more utilized by the

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insurance companies.

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And, also, where are we operating? Is it

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the ASC or the hospital? The biggest challenge

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today isn't really surgery. It's the environment around

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the surgery.

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Getting ahead means really building efficient systems,

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proving our value,

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not only as a not only as a

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surgeon, but also as the as the actual

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surgeries with outcomes data and protecting sustainability

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of our workforce.

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Yeah. Can you dive into a bit more

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talk about, you know,

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proving the value of your work. How has

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that process

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changed for you

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over the last five, ten years?

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So I think, you know, ever since I've

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I think just generally in medicine,

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physicians are becoming

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less relied upon. You know, we have the

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the,

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the increasing utilization of advanced practice professionals with

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nurse practitioners

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and, physician,

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associates.

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The question is what, you know, what happens

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to the training of a of a of

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a surgeon, of a spine surgeon? And I

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think that is invaluable.

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I think that there's always gonna be a

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role for the spine surgeon, not only to

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take care of patients surgically,

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but also as a spine specialist

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to take care of patients

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nonoperatively and operatively. One thing that I always

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utilize

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is a lot of I do a lot

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of my own injections.

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It builds trust with patients.

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It also gives us diagnostic criteria to say,

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hey. If we do an injection at this

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specific spot and you don't get long term

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benefit from this injection, but we prove that

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you got some relief for a certain amount

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of time, it gives us greater input to

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say, hey. If we operate this level, we're

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gonna do you some good. I do think

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that spine surgery or the spine field is

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changing the sense that more and more nonsurgeons

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are doing spine surgery. And this is a

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new thing in the last probably five years

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that wasn't around when I was in my

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training, and that gives me a lot of

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pause.

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I really do believe that spine surgery should

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be designated purely

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in the hands of spine of of fellowship

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of of fellowship trained spine surgeons.

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Got it. And, you know, you also mentioned

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AI. I'd love to hear how you're using

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it in your practice and then

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also how you're kind of, you know, navigating.

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You mentioned the insurers using AI as well.

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I'd love to hear how you're just kinda

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navigating all of that. So I think one

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thing that the insure one thing that the

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payers are doing is that they're actually using

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AI to make sure that we have, you

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know, appropriate physical therapy documentation,

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that we have, you know, the well, the

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quote unquote,

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correct reads on imaging.

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And I think that's gonna be an obstacle

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because I've often found that actually AI is

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not reliable to be making those types of

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decisions. So we often with more and more

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with increasing frequency of peer to peers, which

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we were able to explain the situation and

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just in talking to another human versus a

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computer, I think it's actually, it's slowing down

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patient care, which is the exact opposite of

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what AI should be doing. It's not exactly

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helping us in that standpoint.

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It's slowing down patient care and possibly delaying

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it. Yeah. I do think from a standpoint

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of how I would be utilizing AI. I'm

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using utilizing AI, particularly in the in the

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deformity realm. Mhmm. Mhmm. We're trying to figure

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out, you know, in terms of if a

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patient has this deformity,

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if we would do, you know, posterior column

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osteotomies, a PSO,

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what type or or a or even a,

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an ALR release,

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what type of implant am I doing to

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overall correct,

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whether it's

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a a a simple spondylolisthesis

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or an overall,

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sagittal

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or coronal deformity.

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Got it. And then can you talk about

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how you're thinking about growth over the next

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twelve, twenty four months?

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Yeah. So I think particularly since I just,

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transitioned to this new role at, NeuroSearch Associates,

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growth is the name of the game for

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the next, one to two years, particularly in

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my mark particularly in the Richmond market.

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We are doing great new things down here.

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We just did the first, lumbar disc replacement

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at Chippenham Hospital about a month ago. Congratulations.

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And awesome. And we just did the first

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three level surgical disc replacements,

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two weeks ago, and that patient's also doing

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well. This is going to expand,

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quite quickly

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over the next two years. We are offering

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patients

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better options

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to get back their life and also to

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prevent for future surgery down the road.

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We're gonna be expanding MIS, motion preservation, obviously,

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but also end endoscopic

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approaches, also, you know, stem cells. We're doing

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regenerative medicine, things that don't exist currently in

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the Richmond market. We're hoping to, you know,

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really,

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solidify our base there and also, hopefully, be

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attracting patients from, frankly, all over the East

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Coast to come down to Richmond to see

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us. So I think there's a tremendous opportunity

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for for very rapid,

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growth that's gonna be, affecting,

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frankly, the entire state of Virginia,

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for many decades to come.

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That's incredible.

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And then, doctor doctor Kemp, last question I

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had for you is, what are three health

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care trends that you're following closest this year?

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I guess, besides, you know, what we've been

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talking about already. Yeah. I so I think,

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you know, one thing that's that's big in

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health care is, you know, are we are

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we gonna be making more of a migration

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to the outpatient

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arena

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or even to the ambulatory surgery centers, particularly

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from a spine standpoint?

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Mhmm. Obviously, the economics,

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you know, are always a factor in, you

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know, how we're doing something or what we're

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doing. But, also, there there has to be,

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as always,

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a patient centered

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patient safety decision making happening. Right?

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And there has to be a specific, patient

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preference, whether it be a smaller surgery versus

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a complex

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deformity, that would be,

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favorable for an ASC scenario.

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We have to we have to generate proper

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selection protocols, and that will be an obvious,

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really good segue for AI to really make

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its mark,

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on the physician selection side of things. We

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also have to have value based care driven

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by our outcomes, whether it's with, patient registries,

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analytics.

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Pay the surgeon's

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skill

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should be measured on the durability

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of their outcomes,

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not necessarily

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how much volume they have. If the if

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the surgeon is doing tons of volume, but

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the outcomes are not good, who are they

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helping?

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Addition third thing is that we have to

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have good technology integration, whether it's, obviously, with

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AI, but also with robotics and navigation. There

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has to be good planning, safety, and efficiency

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in the surgical arena, and we only have

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to prove the value there to the hospital

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systems

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that they are actually improving patients' care, but

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also patient safety.

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Very well said. Well, doctor Kemp, thank you

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again for joining us on today's podcast.

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Had a great conversation, and I look forward

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to connecting again. Thank you, Carly. Great great

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to be here. Thank you.