The fourth, and final, session of the 2020 Castellvi Spine Conference was focused on the near- and long-term impacts of COVID-19 on spine and orthopedic practices, and healthcare as a whole. The session, held on October 1, began with a pair of industry talks from Baxter Advanced Surgery, and SI-BONE, Inc. Robert Norton, M.D. discussed Baxter’s perioperative blood management solutions, and Isador Lieberman, M.D., discussed his experience and the clinical evidence supporting the SI-BONE’s iFuse implants. Lieberman focused on the more recently cleared indication using the implants in the Bedrock™ procedure, which allows the triangular implant to be inserted alongside sacral-alar iliac screws to provide greater fixation of the sacroiliac joint.
Throughout the evening there were discussions that highlighted the different experiences between surgeons across the country. James Billys, M.D., from Odessa, Florida, moderated this final session. The panelists represented some Sunbelt states (Texas and Florida), and the East and West Coasts.
The CME talks began with Sigurd Berven, M.D., who is a surgeon at the University of California-San Francisco. He discussed the effects of COVID-19 on patients, surgeons, and the healthcare system. He discussed the rise of telemedicine, and that it still makes up a substantial portion of patient visits, still much higher than pre-pandemic rates.
Next, Alexander Vaccaro, M.D., discussed the impact of COVID-19 and restrictions on elective surgery at the Rothman Orthopaedic Institute, where he is a partner. He indicated the dire straits the organization was in as the pandemic intensified. With elective surgeries severely limited in the areas that the group operates (Pennsylvania, New York, and New Jersey) most orthopedic surgeons had no cases, generated no revenue, and looked on enviously as the spine surgeons performed more urgent cases that were still allowed. As the case counts increased in the North East, the unlikelihood of returning to normalcy became much more apparent, leading the organization to furlough substantial portions of its surgeons and staff. Partners also took extreme pay cuts to keep the group afloat. The experience was similar in other regions where the pandemic hit most severely.
Finally, Stephen Hochschuler, M.D., a surgeon at Texas Back Institute (TBI), located in the Dallas, Texas area, discussed his different experience. Unlike the North East, Texas resumed elective surgeries early in the pandemic. With expanded telemedicine options, careful adherence to COVID protocols, and favorable governmental policies, the surgeons at TBI, were minimally affected, especially compared to those at Rothman.
The discussion touched on a few politically sensitive areas, namely whether or not a single-payer system would have helped or hindered the progression of the pandemic and individual’s ability to seek help.
The robust discussion was a fitting end to the last session of the Castellvi Spine Conference. All of the panelists shared similar feelings about their optimism and excitement to attend the 2021 meeting, currently scheduled for early May.
