Rethinking Spine Care

Some health systems are moving beyond surgery in serving back pain patients.

The rapid growth in spinal surgery volumes over the past 20 years has prompted payers, policy experts and some spine surgeon groups to call for a reappraisal of spine care in the U.S. That's partly why Legacy Health, a self-insured hospital system based in Portland, Ore., in 2012 began requiring its employees and their family members who were seeking elective spine surgery to go through a pre-surgical assessment including meetings with a physical therapist and a psychologist. Legacy acted after finding that a significant number of patients in its pain program were there following unsuccessful back surgeries.

Patients often have unrealistic expectations about spine surgery, said Katie O'Neill, Legacy's director of clinical and support services. She said they may think, “I'm going to get my spine surgery and in three weeks I'm going to walk normally.” But, she added, “that's not what's going to happen.”

Legacy's employee program initially was resisted by surgeons and patients, but many now praise it, she said. While the number of spinal procedures has not dropped, the program has been successful enough that later this year, the system plans to open a spine care center that offers the same array of services for non-employee patients.

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Source: Modern Healthcare