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Spine & Neck Service Line Requires Planned Growth

Joe Cantlupe, for HealthLeaders Media, November 15, 2010
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Since the program was established several months ago, it has increased patient load, with dozens of surgeries anticipated by the end of the year. "We're getting referrals for more patients, and with marketing, the hospital has adopted and accepted this as a unique new program," Lieberman says. "It puts the hospital on the map. There is a lot of competition in the Dallas area for spine surgery, and this is attracting patients."

Indeed, a Millennium study noted that with an increasing number of companies and devices entering the market, aggressive marketing is prompting patients "to actively seek out these treatments."

"I must admit that I agree with some of the critics that a proportion of spine fusion surgery is over prescribed," says Lieberman. "I do, however, qualify that statement with the fact that historically we did not have all the tools available to us today so the pool of patients is in fact larger; we can treat more varied pathology and therefore, in absolute numbers, more surgeries are done, but by proportion the increase is not as substantial."

"I do feel technologies like robotic assistance will further facilitate appropriate spine surgery fusion procedures by virtue of the precision, efficiency, limited morbidity, and optimized outcomes," he says.
Lieberman, who had worked at Cleveland Clinic, was attracted to the Texas hospital when it agreed to use the SpineAssist robot. Lieberman says he has been involved in the robot program for 10 years, worked on grant applications and has a financial interest in it. He noted that for the robotic surgeries, federal reimbursements are still considerable compared to other orthopedic programs. 

"I think this type of technology is going to shine in the future," he says. "We are now in the infant stage of development, just moving to the toddler stage."

To broaden the potential base for the robot, the Texas hospital has become the exclusive training center for physicians learning to use the SpineAssist.

Canose, the hospital's CEO, says the hospital wants to establish "our footprint in being the leader providing national expertise" in spine care with the robot, which improves name recognition for the hospital as it pursues other programs.

"We still have a growing population and a lot of other competitors to look into this market," Canose says. "The volumes are going to shift; we wanted to be proactive about forecasting what the needs of our population are going to be."

Success Key No. 3:  Avoid overtreatment

Swedish Covenant Hospital's Chicago Back Pain Institute is specializing in a conservative approach and complementary therapies for patients with neck and back pain, with a focus on avoiding "overtreatment," according to hospital President and CEO Mark Newton.

The hospital is pinning its success on its approach, with its various possibilities for treatment.
Osteopathic techniques, as well as clinical massage, physical therapy, pain management, and acupuncture specialties are part of the noninvasive procedures the Chicago Back Institute employs. The approach puts the hospital in a position to "strategically grow this service line and become a destination  provider in the region," Newton says.

"Surgery is not the answer for most back pain patients, and many other therapies have proven highly effective. Patients embrace this approach, and many find relief with nonsurgical therapies," Newton says.
That's not to say surgery, which is a traditional moneymaker for hospitals, is ignored. It's just that the evolution of surgery combined with potential patient outcomes offers more potential business for the center, Newton says, noting that "the success of the Chicago Back Institute is anticipated to be achieved through providing all the services a patient may need—from conservative approaches through advanced minimally invasive surgeries—under the comprehensive program."

The Chicago Back Institute has been open for several months, and already hospital officials are seeing the potential of their investment. "If projected volumes are achieved, strategic analyses point to a modest return on investment during fiscal year 2013 and steady growth thereafter," says Newton. "Investing in minimally invasive and motion-preservation surgical treatments is evidence of the hospital's commitment to the success of this service line.

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