Spine surgery sits at the crossroads of need, nuance, and noise—and few people explain that terrain better than Dr. Rod Oskouian, a high-volume neurosurgeon who has led a complex spine program and also navigated care as a patient. Dr. Oskouian and Healthcare Bridge host, Nate Kaufman pull back the curtain on how consolidation, denials, and a flood of administrative demands reshape daily practice, why “low value” labels miss the mark, and what truly predicts safer outcomes when your back—or your future mobility—is on the line.
The conversation starts with the evolution of neurosurgery from community coverage to regional referral, as smaller practices disappear and tertiary centers take on the hardest cases across multiple states. From the OR to the boardroom, Dr. Oskouian unpacks how EMRs, siloed decision-making, and repeated reorganizations increase friction (SEE NATE’S ARTICLE Nathan Kaufman: How silos undermine U.S. healthcare | HFMA). He makes a bold case for a mindset shift: treat physicians as the primary customers of health systems so they have the tools, staffing, and data to deliver better patient care. That shift informs smarter choices about enterprise tech, integrated AI, documentation, imaging, and revenue workflows that either free clinicians to practice medicine—or bury them in clicks and appeals.
Kaufman and Dr. Oskouian into the data debate around spine surgery and “low value care,” exploring how Medicare billing data, coding incentives, and risk profiles can warp conclusions. He argues for outcomes that blend patient-reported measures with wearable-driven biometrics—steps, mobility, vitals, adherence—paired with honest risk adjustment for complex cases. For patients trying to choose a surgeon, they offer a pragmatic playbook: prioritize volume, fellowship-trained teams, multidisciplinary pathways, and centers that live and breathe your specific procedure. And they get personal as Dr. Oskouian recounts a severe ski accident, the authorization gauntlet he faced despite insider knowledge, and the hard lesson that navigating networks can matter as much as medical expertise.
If you care about healthcare strategy, spine outcomes, physician leadership, or how to advocate for yourself when it counts, this conversation delivers grounded insight you can use. Subscribe, share with a friend who’s weighing surgery, and leave a review with your biggest question about choosing the right surgeon—we’ll dig into it on a future show.
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