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pportunities still abound in outpatient spine, but they
have a warning label attached. "This isn't the old out-
patient surgery game of 15 years ago, where as long as
you got the cases, you were going to make a lot of
money," says Sanjit Mahanti, MHA, chief hospital busi-
ness development officer at Keck Hospital of USC in Los Angeles. "It's
a business where you have to manage all the parts and pieces of it."
The day-to-day includes an array of variables and moving targets
that demand full attention. That's on top of the need for highly skilled
surgeons and the upfront costs, which are steep.
"There's a lot of cost outlay you need to deal with," says Mick Perez-
Cruet, MD, MS, vice-chairman and professor at the department of neu-
rosurgery, Oakland University William Beaumont School of Medicine,
in Royal Oaks, Mich. The list, says Dr. Perez-Cruet, includes:
• a microscope (at least $200,000, can go much more);
• OR tables (around $100,000);
• instrument sets (starting at about $50,000 each); and
• fluoroscopic units (between $100,000 and $300,000).
Ongoing costs
Once you're up and running, you'll need to diligently manage the ongoing
costs. You need physicians who are more than just adept. They also need
to be cost-conscious.
"There's potential to really reduce prices on implants, screws, discs —
all those things can actually be standardized if there's incentive to do
so," says Mr. Mahanti. "That's always been the hard part, especially with
very highly skilled spine surgeons. They all have their nuances and pref-
S P I N E S U R G E R Y
It's an attractive option when
you can manage all the pieces.
Jim Burger
Associate Editor
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