This is Carly Beam with the Becker Spine
and Orthopedics podcast, and I'm thrilled to be
joined today by doctor Eric Anderer,
a neurosurgeon with NYU Langone Health. Doctor Anderer,
thank you so much for being here today.
I appreciate you having me on. So before
we dive into our questions, could you just
introduce yourself and tell us a bit about
your background?
Sure.
As mentioned, my name is, Eric Anderer. I'm
the chief of neurosurgery at NYU Langone Hospital,
Brooklyn.
I'm also the, the co director of a
perioperative services,
sort of a title that used to be
known as surgeon in chief. So help run
the ORs in Brooklyn.
I was born in Japan, grew up in
New York, have been in Brooklyn for the
past twenty some odd years.
So, it really, was sort of an honor
when, you know, I was asked to sort
of head up the the neurosurgery effort in
Brooklyn,
at the former Lutheran Medical Center. So I've
been there since the NYU merger in 2016,
and it's been, you know, almost ten great
years there. That's great. And can you talk
about just what are the top three trends
that you're following in health care today?
Sure. I mean, there's so much to talk
about. I mean, obviously, the landscape is constantly
changing, but I would say that the things
that are,
sort of top of mind for me, number
one would be sort of access to information.
I mean, it's something that, you know, with
the Internet, with, you know, influencer culture, with,
you know, sort of inundation
of information out there, from various sources.
You know, I think in a lot of
ways, it's it's had a positive influence on
the way that,
I think people, experience health care. And what
I mean by that is
this sort of democratization
of of information,
I think has been helpful for people to
be
informed, let's say, about their conditions and such.
So I don't think it's ever gonna replace
going to a doctor, and I think that,
really the best thing to do, when you
have questions about your health, about,
you know, something going on with you, one
of your loved ones is to maybe take
some of that information that you digest from
other sources,
and really sort of, help,
you know, sort of, formulate questions, I think,
that, that you can kinda go in with
and be that much more informed when you
go to your visit and get that much
more out of your visit with your physicians.
But I generally see it as a positive.
I mean, clearly, there's, you know, some negatives
and, you know, just obviously the the access
to sort of voluminous amounts of information that
is sometimes hard to to verify, can be
somewhat problematic. But I think on balance,
it's been a good thing, generally.
So that would be one,
you know, as a surgeon, it's hard not
to talk about tech. Right? And so, that's
another thing I think that I'm super excited
about,
robotics specifically in spine,
but even sort of AI, applications, to
sort of help us understand who are the
right patients for surgery, how, you know, to
predict, you know, how patients are gonna do
afterwards,
where to send them to recover the best,
you know, that's rehab facility at home, that
kind of thing. You know, so I think
it's really revolutionized the way that we,
we look at, at surgery and who should
be having surgery and how how best to
apply that.
And then, you know, the other thing I
think that's sort of out there,
and this is, you know, at the government
level, but all the way down to, you
know, to sort of this the information sources
that I was talking to talking about earlier.
I think there's a lot of sort of
focus on, the root cause of disease.
And, you know, again, I mean, sort of
a lot of chatter out there,
you know, about that. But I would say
that a focus on that specifically,
sort of divorced from, you know, all the
other
kind of, you know, either political, social, cultural
things that can be sometimes associated with that
discourse. I think, that's also on balance,
a a positive thing for patients and and
physicians because I think that, you know, the
reality is,
who doesn't wanna get at? What is it
that's making us sick? And how do we
stay healthy? And, you know, even as a
surgeon,
how do we keep people from having spine
surgery?
You know, there's always gonna be a need
for people to have have surgery, to have,
you know, some sort of structural problem fixed.
But the hope is that, we're really gonna
be,
applying that,
you know, in sort
of very focused cases,
and for the vast majority of people that
experience the very, very common symptom of back
pain. Right? I mean, who hasn't had back
pain out there?
Right. Hope is that it's only the small
minority of people that have that are gonna
that are gonna really need surgery. So, again,
sort of looking at the root cause of
this, how to get people out of, you
know, sort of a sedentary lifestyle, how to
get people eating better, how to get people
moving again,
I think those are all, again, on balance
sort of net positives. So those are the
three things I'm looking at. Yeah. And I
wanna follow-up you on your what you're just
talking about, these root causes of
disease and,
spine
pain, etcetera.
Can you talk about just any initiatives or
findings that you've been involved in,
with NYU
to address those head on in the community?
Sure. I mean, you know,
obviously, anything involving spine surgery and the way
we do spine surgery,
you know, is gonna be, I'd say, a
a good thing with respect to the field
and how we're gonna treat patients that have
this disease. And there's so much of that
going on. You know, there's a lot of
stuff going on with, you know, the ways
to do surgeries, the ways to leverage robotics
to do, surgeries in ways that are,
you know, less invasive. And, you know, let's
say, for example,
doing a two part surgery in one sitting
using,
robotic technology,
in ways that we weren't weren't able to
do before.
You know, that's that a lot of that
research is being done here, by, you know,
by our colleagues.
And so that's that's certainly, I think, something
that is, you know,
you know, a positive in terms of how
to how to treat and how to, you
know, kind of move forward with, with treatment
algorithms.
But on the other hand, again, kinda getting
back to the idea of
who is it that needs surgery.
You know, I think that the goal really
is in general
for people with back pain to avoid surgery.
And how do we do that? Well, you
know, there are ways of looking at,
you know, other types of treatments, other types
of modalities
to help with this.
And, again, if it's, like, you know, looking
at returning to activities, returning back into, you
know, sort of functional movement,
there are, you know, modalities, I think, that
we can look at that are that have
been beneficial. So yoga would be one, for
example.
You know, anyone that knows me and that's
talked to me knows that I'm sort of
a fan of yoga, sent my patients into
it.
And, again, not necessarily you know, I don't
want them jumping into, like, hot yoga or
doing handstands or anything like that. But, you
know, I think,
do going into, like, a, a beginner type
of program that's modified for people with back
pain, I think, can be very, very beneficial.
I actually,
you know, wrote a paper with this yoga
teacher named Eddie Stern who,
actually is the one that brought Ashtanga yoga
as a practice to America from India.
And, he is, very interested, I think, in
in this dialogue
between sort of more conventional,
intervention based, medicine and how to use these
other modalities that have been really in place
for, you know, centuries,
to help, kind of be adjuncts, to help,
you know, to I'd say together
formulate this kind of unified way of treating,
treating back pain and spine disease.
That's fascinating. And then I also want to
circle back to what you're saying about this
information
culture we have now. It's I've actually wrote,
an article
recently,
I guess,
this week as of,
you know, November 21 or in this this
week. And, you know, hearing from sponsors and
how they have conversations,
how they
address patients who come in with their own
research,
their own,
ideas, perhaps maybe misconceptions,
you know, after consulting
influencers,
doctor Google, quote, unquote.
I'd love to hear your advice on
how spine surgeons should, you
know, base or address approach these conversations
with, you know,
with this information culture.
Yeah. No. And I I think that's a
good question. And I think that, you know,
truthfully,
a lot of surgeons, I'd say initially,
and a lot of, you know, doctors in
general initially,
can be a little bit, apprehensive or dismissive.
Like I'd I'd say, when those things kind
of things come up. But I I I
honestly look at it as an opportunity,
because anybody that comes in that's informed,
that know that, you know, knows how to
speak the language, knows,
you know, the terms,
knows,
you know, a little bit about the way
this disease process works,
you know, from and getting this from from
various sources, I think,
is not necessarily
a bad thing. And I think that what
you can do is it kinda sets the
groundwork for conversation.
And in some ways, it means I think
you're just that much farther ahead when you
really have the conversation. So I would say,
don't necessarily look at it as an annoyance
or as a hindrance to a discussion like,
oh, yeah. Well, that was doctor Google. It's
not that you know, there is information out
there, and I think what you're really looking
to do is provide the context for it.
And so, I usually look at it as
as an opportunity. It's like, oh, well, tell
me about what you read. Tell me about
what you you know, the the different approaches
that you have, read about to treat your
your disease,
or your issue. And, and I'm happy to
kind of give you my take on it
and why it is that I think, you
know, x, y, or z is the way
to go. So, honestly, I I sort of
see it as an opportunity,
rather than a hindrance to sort of a
a burgeoning doctor patient relationship.
Absolutely. And it sounds like it's a very
it opens the door for more collaboration between
what the patient comes in knowing and then
what you know in terms of the best
course for treatment.
Absolutely.
And then I wanted to ask you, how
are you thinking about growth over the next
twelve to twenty four months?
Yeah. I mean, for me,
personally, I mean, you know, again, given my
background kinda working in a hospital in Brooklyn
that was, you know, truthfully a safety net
hospital,
had been doing great work, but, you know,
I'd say under resourced,
you know, in a community that is very
highly sort of, Medicaid population,
and that really probably didn't have the access
to the level of care they're getting now
in their borough.
I see growth as providing care for people
where they are, where they live.
There's a lot of opportunities out there for
that. And again, just to use our example,
it used to be that if you wanted
complex spine surgery with robotics and all the
bells and whistles, you had to cross the
river.
You had to go into Manhattan to do
that. And, you know, since, we've had this
relationship and basically have, have built,
you know, this,
NYU Langone Hospital Brooklyn, which is essentially,
you know, the same care. And we get
you whatever you're doing we're doing in Manhattan,
theoretically, we're gonna be trying to be doing
the exact same thing in Brooklyn.
And the goal really is to provide the
same level of care,
in in the context that, you know, where
you live, you know, with your families,
with your community without you having to actually
travel for it.
So Very well said. Yeah. I think that's
that's the biggest opportunity for growth. It's based
because there's so many places out there where
that's the case, where they just don't have
that, you know, access to the same level
of care. You have to be sent into
something like tertiary,
you know, academic medical center. And I think
that, the owner should be on these medical
centers,
to go out there and to and to
build the resources and the communities that people
live in.
Yeah. And how are you addressing how will
you tackle
any sort of major headwinds to these goals,
whether for the growth and community care?
Yeah. I mean, you know, I'd say that
that most of the headwinds,
are sort of
infrastructural. Right? I mean, the it's you're certainly
not gonna get a lot of, you know,
headwinds from people. You know, everywhere we've gone
in the community, we've get given talks in
the community, people are are, you know, generally
very, very happy about what's going on.
And oftentimes, they're surprised to hear kind of
the level of care that's, that's happening really
in their backyard.
The headwinds tend to be infrastructural. Right? So
it's all, like, kind of the the more
boring stuff, but the stuff that's vital, it's
like money, resources, allocation, you know, the, you
know, the changing
environment at the federal level, government reg regulatory,
changes. So these things all have an impact
on how you do things because, you know,
at the end of the day, these things
also can't, they have to be self sustaining
in some ways.
And, you know, there's, you know, the saying,
you know, sort of no margin, no mission.
So, you know, fiscal responsibility obviously has to
play a part in this because, you know,
if you don't, you know, you can't take
care of people if you can't keep the
lights on. And there are just many other
factors that go into that,
that may seem sort of boring or whatever,
but that you have to take into account.
So, honestly, I would say it's mostly sort
of the, you know, the regulatory financial environment,
that is probably the what's giving the most
headwinds to to this type of growth that
we're speaking of.
Got it. And my last question for you,
doctor Ander,
is what do you think will be a
key disruptor to spine surgery and neurosurgery
in 2026?
You know, I mean, I think that disruptor
is interesting.
So, I mean, that's clearly, the the obvious
answer to that in, at any, surgical field
is gonna be tech. Right? So, you know,
advanced robotics,
and and this kind of thing, I think.
But I, you know, I would say if
we're talking disruption and just sort of thinking
outside the box here, just there there's just
so much stuff going on,
with AI, predict predictive analytics, like, all this,
you know, where where I think that we're
actually gonna probably end up,
you know, basing,
some treatment on algorithms that were sort of
written,
via some kind of AI model. And a
lot of that's actually being done in the
neurosurgery world. And and, at NYU, it certainly
is,
you know, where we can sort of use
de identified data
to, like, you know if somebody comes in
with this complaint,
at this time of day with this, you
know, we can almost predict kind of where
they're gonna go, what, like, what kind of
problem they're gonna have, where they're gonna get
discharged,
to all these things, which I think is
gonna be sort of interesting, because clearly, it's
you know, you we're gonna have to have
some sort of human oversight into how this
is done.
But, you know, to sort of harness,
the the power of of AI and tech
in general, I think for these types of
things is really gonna change the way that
we, that we diagnose and treat disease.
Well,
doc doctor Andrew, thank you so much for
joining us today. It's been a pleasure speaking
with you, and I look forward to connecting
again down the line. Thank you so much
for having me.