Is this a common dynamic?

[drusso]

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[SSdoc33]

ive noticed that the surgeons dont like MILD. it is removing tissue and feel more "Surgical" to them. a simple laminectomy for stenosis is their bread and butter so i can see why they might get territorial.

SCS is a different ballgame. most dont GAF

 

[SpineandWine]

Spine surgeons typically don’t like SCS (overutized and they keep having to take it out for adjacent level disease which they feel is surgical issue).

They don’t like MILD because they visually decompress the spine and ligamentum flavum hypertrophy doesn’t occur in isolation. They believe typically it’s a sham decompression.

 

[bedrock]

I think I said this before, but I would think surgeons wouldn’t care about MILD on 85yrs + patients who would not be offered surgical anesthesia, and so couldn’t have surgery even if they wanted to.

 

[Ducttape]

i have really not encountered pushback because of communication and staying in each other's lanes.

one of the spine surgeons will implant surgical leads, so that helps.

MILD doesnt bother surgeons because all of my MILD cases are seen by surgeons and surgery is denied by surgeon or refused by patients.

I think I said this before, but I would think surgeons wouldn’t care about MILD on 85yrs + patients who would not be offered surgical anesthesia, and so couldn’t have surgery even if they wanted to.

yes.

 

[SSdoc33]

I think I said this before, but I would think surgeons wouldn’t care about MILD on 85yrs + patients who would not be offered surgical anesthesia, and so couldn’t have surgery even if they wanted to.

i can see how it would be overutilized, tho. i see it all the time in healthy 60 year olds b/c they want something less invasive

 

[Ducttape]

you do?

none of the private carriers in this area approve, so it is exclusively medicare population in my area.

 

[SSdoc33]

you do?

none of the private carriers in this area approve, so it is exclusively medicare population in my area.

i see some private pay. but medicare starts at 65.

 

[Agast]

I’ve gotten referrals for SCS from spine surgeons who don’t know when it’s indicated but they do know they don’t want to touch the patient.

Then I have to explain to the patient why I’m not trialing them. Awkwardly.

 

[bedrock]

i can see how it would be overutilized, tho. i see it all the time in healthy 60 year olds b/c they want something less invasive

I agree that is incorrect. A 60 yr old needs a proper laminectomy and not MILD.