When I am asked about problems in our country’s healthcare, I always think back to the story of Debra*, a 72-year-old woman who came to my clinic for rehab after a disastrous spine fusion surgery.
Debra had experienced severe back pain and had heard about a nearby spine surgeon who had the “magic touch” and could guarantee pain relief after just one surgery. She decided to jump at the chance as it seemed too good to pass up. The magic fix, unfortunately, was also too good to be true. For her simple back pain, she had received a multilevel spine fusion surgery with 21 screws drilled all the way down her spine (see image). These extensive, overly aggressive surgeries are a cash grab for spine surgeons as decreasing spine mobility can temporarily decrease pain, but will often result in exponentially worse pain after a few years, leaving patients debilitated and with a little-to-no range of motion, dependence on prescription opioids, and even permanent disability.
When Debra came to me, she could barely walk and needed opioids around the clock to cope with the pain. We helped her through extensive physical therapy, but she was ultimately unable to regain most of her mobility and independence. The damage was already done and sadly she would have to struggle with chronic pain for the rest of her life.
As a practicing physical medicine and rehabilitation physician (aka a doctor of function), I feel a visceral punch to the gut every time I see a patient like Debra, whose pain and fear were exploited by physicians selling false hope for monetary gain, and offering the most aggressive and expensive treatment as a first-line option. And like Debra’s case, these aggressive options often lead to a lifetime of catastrophic chronic pain and drug dependence for the patient. In short, they are making what was a simple claim into a catastrophic event.
Why choosing the right doctor is essential
Seeing these ramifications of aggressive surgery and false promises breaks my heart, but unfortunately, these scenarios happen all too frequently. In the US, 40% of patients who undergo spine surgery experience chronic pain and pain-related disability long after the procedure, and 44% are more likely to become dependent and prolonged opioid users as a direct effect of the surgery.¹,²
Choosing the right doctor at the outset has a ripple effect on the patient's outcomes and quality of life, and impacts their families, employers, community, and society at large. Currently, there is no unbiased or systematic process in place to help guide patients when making the important decision of choosing a doctor. This is made all the more difficult in the face of the multibillion-dollar industry that profits from excessive opioid use and aggressive procedures that result in $2-8.5 billion of needless spending every year.³
Although physicians take an oath to first "do no harm", acting in the patient’s best interest doesn’t always happen. And when providing procedures and surgeries, it is imperative to only do so when the benefits outweigh the risks. On the other hand, it is a misconception that the Hippocratic Oath and monetary gain are mutually exclusive.
“There is nothing wrong with profits if we provide value in return, but we should never promote harm in order to achieve profit.” - Ali Alhimiri, MD
Why choose Modus?
We believe the physicians who go above and beyond for their patients should be recognized and rewarded for their patient-centered, value-based care, which correlates with better patient outcomes and a lower total cost of care. Our approach contrasts with today’s established trends of providing care via discounted networks, in which clinicians are compensated at a lower rate for providing treatment. This drives clinicians to promote a higher volume of lower-quality care,which can expose patients to more aggressive and expensive procedures, increasing their risk for poorer outcomes. The US healthcare system needs a way to identify outstanding doctors, reward them for doing the right thing, and empower them with access to best practices guidance.
At Modus, we decided to take on the challenge of improving the MSK healthcare system. Our sophisticated and patented technology rates doctors within an existing network to ensure patients are guided only to those who have shown consistent adherence to best practices. This fast and intuitive technology uses real-time feedback to direct quality care, and rewards doctors for patient-centered care focused on functional outcomes.
Thanks to this technology, Modus can predict patients' risks of long-term disability, and provide recommendations for tailored approaches to high-risk patients. This AI-driven clinical best practices technology aggregates and learns from available data and physician experience, and only improves with more time and data points. We strive to provide you with the safest, most reliable doctors to help you achieve your desired results.
Modus - a 360 solution
At the core of a healthcare system, patients seek medical care to improve their quality of life, physicians strive to provide high-quality care while retaining autonomy and compensation, and employers work to lower the overall associated cost. Modus aligns the interests of all three parties by not only achieving each of their goals but forming a high-tech network that enhances this complex interplay of factors and improves the healthcare system as a whole.
Don’t let one bad decision determine the outcome of your quality of life. Turn to Modus, we would love to tell you more about how it can help your organization, so don’t hesitate to reach out for more information.
*Name has been changed
References
- Chan, C. W., & Peng, P. (2011). Failed Back Surgery Syndrome. Pain Medicine, 12(4), 577–606. https://doi.org/10.1111/j.1526-4637.2011.01089.x
- Lawal, Oluwadolapo D., et al. "Rate and risk factors associated with prolonged opioid use after surgery: a systematic review and meta-analysis." JAMA network open 3.6 (2020): e207367-e207367. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767637
- Schwartz, Aaron L., et al. "Measuring low-value care in Medicare." JAMA internal medicine 174.7 (2014): 1067-1076. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1868536
- Gold, M. Financial incentives. Journal of General Internal Medicine, 14(S1), S6–S12. (1999) https://doi.org/10.1046/j.1525-1497.1999.00260.x
