This is Carly Beam with the Becker Spine
and Orthopedics podcast, and I'm thrilled to be
joined today by doctor William Kemp, spine surgeon
with Neurosurgical
Associates.
Doctor Kemp, thank you so much for joining
us today.
Thanks for having me, Carly. Happy to be
here.
So, doctor Kemp, can you before we dive
to our questions, can you introduce yourself, share
a bit more about your background?
Sure. I'm a board certified fellowship trained, spine
neurosurgeon,
with a specific focus on delivering high quality
patient centered care
with an emphasis on spine surgery outcomes,
efficiency, and innovation.
I recently transferred to a new role, down
in Richmond at Virginia at, Neurosurgical Associates.
That's awesome. And, you know, when you think
about spine innovations,
what excites you the most right now?
Sure. There are a few areas that, that
I think are are really up and coming
in the field,
maybe even already here. One of them is
motion preservation
biologics.
It's a huge part of my practice,
trying to expand
the, the indications and the utility of disc
replacement surgery.
It's an old adage in this field that
it only takes 10 patients to have a
spine practice
because patients keep coming back for the next
level. And we have good data to suggest
that disc replacement arthroplasty patients in the cervical
and lumbar spine,
can hopefully avoid those very things from happening.
I think, the utility of minimally invasive endoscopic
surgery is
is not just a marketing,
fad. I think that it's actually improving patient
outcomes, particularly in the short term, immediate postoperative
recoveries.
Mhmm. And when you think about just patient
outcomes, what would you say is the most
important
metric that all spine surgeons should be monitoring?
So I think, you know, I oftentimes,
the metric that's maybe can't even be count
can't even be measured
is just having a conversation with the patient.
How are you doing? Are you back to
your life
the way you wanna be living it? And
that's a really hard metric to measure.
But I actually think that, you know, from
a standpoint of, you know, how how quickly
can we get the patient back into,
physical therapy,
after their surgery? How quickly can we get
them back to their normal lifestyle? And my
goal all after every surgery is that it's
happening within six weeks to three months after
surgery. That's always my goal.
So the best quality of life improvement you
can have in that,
three to six week window, it sounds like.
Correct.
Awesome.
And can you talk about some of the
biggest headwinds that you're
anticipating
this year and how you're planning to get
ahead of it?
Yeah. So I, you know, health, there are
there are extraordinary,
forces in health care that are changing the
landscape,
and it's something that's fine surgeons in particular
have to be
able to adapt and, you know, dodge and
block and and and evolve and adapt.
One of them is, you know, reimbursement pressures
versus rising costs. You know, how does that
how does that manifest in a private practice
situation?
The administrative burden and prior authorization with insurance
companies, that's always
an ever changing,
obstacle, particularly in the setting of,
AI being more and more utilized by the
insurance companies.
And, also, where are we operating? Is it
the ASC or the hospital? The biggest challenge
today isn't really surgery. It's the environment around
the surgery.
Getting ahead means really building efficient systems,
proving our value,
not only as a not only as a
surgeon, but also as the as the actual
surgeries with outcomes data and protecting sustainability
of our workforce.
Yeah. Can you dive into a bit more
talk about, you know,
proving the value of your work. How has
that process
changed for you
over the last five, ten years?
So I think, you know, ever since I've
I think just generally in medicine,
physicians are becoming
less relied upon. You know, we have the
the,
the increasing utilization of advanced practice professionals with
nurse practitioners
and, physician,
associates.
The question is what, you know, what happens
to the training of a of a of
a surgeon, of a spine surgeon? And I
think that is invaluable.
I think that there's always gonna be a
role for the spine surgeon, not only to
take care of patients surgically,
but also as a spine specialist
to take care of patients
nonoperatively and operatively. One thing that I always
utilize
is a lot of I do a lot
of my own injections.
It builds trust with patients.
It also gives us diagnostic criteria to say,
hey. If we do an injection at this
specific spot and you don't get long term
benefit from this injection, but we prove that
you got some relief for a certain amount
of time, it gives us greater input to
say, hey. If we operate this level, we're
gonna do you some good. I do think
that spine surgery or the spine field is
changing the sense that more and more nonsurgeons
are doing spine surgery. And this is a
new thing in the last probably five years
that wasn't around when I was in my
training, and that gives me a lot of
pause.
I really do believe that spine surgery should
be designated purely
in the hands of spine of of fellowship
of of fellowship trained spine surgeons.
Got it. And, you know, you also mentioned
AI. I'd love to hear how you're using
it in your practice and then
also how you're kind of, you know, navigating.
You mentioned the insurers using AI as well.
I'd love to hear how you're just kinda
navigating all of that. So I think one
thing that the insure one thing that the
payers are doing is that they're actually using
AI to make sure that we have, you
know, appropriate physical therapy documentation,
that we have, you know, the well, the
quote unquote,
correct reads on imaging.
And I think that's gonna be an obstacle
because I've often found that actually AI is
not reliable to be making those types of
decisions. So we often with more and more
with increasing frequency of peer to peers, which
we were able to explain the situation and
just in talking to another human versus a
computer, I think it's actually, it's slowing down
patient care, which is the exact opposite of
what AI should be doing. It's not exactly
helping us in that standpoint.
It's slowing down patient care and possibly delaying
it. Yeah. I do think from a standpoint
of how I would be utilizing AI. I'm
using utilizing AI, particularly in the in the
deformity realm. Mhmm. Mhmm. We're trying to figure
out, you know, in terms of if a
patient has this deformity,
if we would do, you know, posterior column
osteotomies, a PSO,
what type or or a or even a,
an ALR release,
what type of implant am I doing to
overall correct,
whether it's
a a a simple spondylolisthesis
or an overall,
sagittal
or coronal deformity.
Got it. And then can you talk about
how you're thinking about growth over the next
twelve, twenty four months?
Yeah. So I think particularly since I just,
transitioned to this new role at, NeuroSearch Associates,
growth is the name of the game for
the next, one to two years, particularly in
my mark particularly in the Richmond market.
We are doing great new things down here.
We just did the first, lumbar disc replacement
at Chippenham Hospital about a month ago. Congratulations.
And awesome. And we just did the first
three level surgical disc replacements,
two weeks ago, and that patient's also doing
well. This is going to expand,
quite quickly
over the next two years. We are offering
patients
better options
to get back their life and also to
prevent for future surgery down the road.
We're gonna be expanding MIS, motion preservation, obviously,
but also end endoscopic
approaches, also, you know, stem cells. We're doing
regenerative medicine, things that don't exist currently in
the Richmond market. We're hoping to, you know,
really,
solidify our base there and also, hopefully, be
attracting patients from, frankly, all over the East
Coast to come down to Richmond to see
us. So I think there's a tremendous opportunity
for for very rapid,
growth that's gonna be, affecting,
frankly, the entire state of Virginia,
for many decades to come.
That's incredible.
And then, doctor doctor Kemp, last question I
had for you is, what are three health
care trends that you're following closest this year?
I guess, besides, you know, what we've been
talking about already. Yeah. I so I think,
you know, one thing that's that's big in
health care is, you know, are we are
we gonna be making more of a migration
to the outpatient
arena
or even to the ambulatory surgery centers, particularly
from a spine standpoint?
Mhmm. Obviously, the economics,
you know, are always a factor in, you
know, how we're doing something or what we're
doing. But, also, there there has to be,
as always,
a patient centered
patient safety decision making happening. Right?
And there has to be a specific, patient
preference, whether it be a smaller surgery versus
a complex
deformity, that would be,
favorable for an ASC scenario.
We have to we have to generate proper
selection protocols, and that will be an obvious,
really good segue for AI to really make
its mark,
on the physician selection side of things. We
also have to have value based care driven
by our outcomes, whether it's with, patient registries,
analytics.
Pay the surgeon's
skill
should be measured on the durability
of their outcomes,
not necessarily
how much volume they have. If the if
the surgeon is doing tons of volume, but
the outcomes are not good, who are they
helping?
Addition third thing is that we have to
have good technology integration, whether it's, obviously, with
AI, but also with robotics and navigation. There
has to be good planning, safety, and efficiency
in the surgical arena, and we only have
to prove the value there to the hospital
systems
that they are actually improving patients' care, but
also patient safety.
Very well said. Well, doctor Kemp, thank you
again for joining us on today's podcast.
Had a great conversation, and I look forward
to connecting again. Thank you, Carly. Great great
to be here. Thank you.