I became a neurosurgeon because I love making things better. Since founding my first company as a teenager, I have always pushed to make the world a better place. I developed and patented medical devices, founded and advised companies, and pursued years of medical training to improve healthcare. As a neurosurgeon, I was awestruck by modern medicine’s ability to make things better—to ameliorate the sick, reverse paralysis, and help an individual in a true time of need. But I also saw how modern medicine can make things worse, especially when it comes to treating back, neck, and joint pain.
When surgery hurts
Operating at Yale, Geisinger, and other institutions throughout my career, I saw that many people who received back surgery did not get better. I saw that many people whom we recommended undergo major operations—all with significant risks and long recoveries—would have been better served with conservative, non-operative care. I saw the statistics on paper and the lives impacted in front of me. I came to realize that as a surgical community, we just operate too much.
The impact of this problem is staggering. Back pain is one of the most common conditions across all of humanity and all countries. At least 80% of adults experience back pain that disrupts their lives at least once. It is a top reason people see a doctor, and it is the number one cause of global disability.
In the United States, we perform hundreds of thousands of back surgeries every year to treat this massive problem. But research shows that up to 50 percent of these surgeries are inappropriate or unnecessary (Harvard Business Review, 2017). Yes—half! This means that one out of two people who just received surgery for back pain could have gotten better without anesthesia, without cutting, without placement of metal inside their bodies, and without costly medical bills. And as surgery is not without risk, these same individuals were put in danger of complications ranging from an infection to worsened pain, paralysis, or even death.
How can we stand by?
As a surgeon, these facts are disturbing. How can we cut people open if it is not necessary or required, or if someone could have gotten better without being subjected to the risks of surgery? Surgery is an imperfect sport. Some people get hurt and some people do not get better. For many patients, surgery should be a last resort, not a knee-jerk reflex.
The root of the problem
Even though these statistics impact hundreds of thousands of lives every year, there is little movement within traditional healthcare to treat the problem. This is because surgery utilization is intricately connected to multiple factors including how we train our medical providers, societal expectations for a quick fix, and healthcare reimbursement models.
The current system incentivizes surgeons to operate—we get paid more, to do more. Surgery is also one of the main revenue generators for hospitals. Unless major institutions disrupt their business models, innovation is not likely to happen from within healthcare. To make things better, change needs to start from outside of the traditional system. We need to take a step back as a society and ask: Is the care we are providing appropriate, evidence-based, and needed? Is surgery a requirement or an option? How often does a patient know that a care path is an option versus a necessity?
We have to do better
I pivoted from performing neurosurgery to building Vori Health to address these questions and solve these problems. It was something I had to do. It was an opportunity to make things better.
Vori Health is now an award-winning, nationwide, virtual-first, musculoskeletal (back, neck, hip, knee, shoulder, etc.) medical practice focused on appropriate, evidence-based care. We use a unique care model that helps patients find the best path forward. We connect patients to a trained care team that includes a non-operative specialty medical doctor, physical therapist, and health coach navigator who work together to coordinate all aspects of care.
Treating patients as our loved ones
Traditional healthcare treats patients as diseases that need to be fixed, leaving the individual out of most decisions. We treat all patients as if they were our loved ones. We practice true shared decision-making that puts patients at the center of their care. We build care plans around patient goals. We empower patients with knowledge, educate them about their options, and navigate them to the best choice for their needs. We strongly recommend that all non-surgical options be exhausted before considering surgery, and even then, we make sure patients understand whether surgery is really necessary or still optional.
I am proud of our mission and the work we are doing at Vori Health. We are serving patients better than we could in the traditional health system. Healthcare is broken, but it does not have to be. If we keep pushing, we can make the world a better place.
As a board-certified, fellowship-trained spine neurosurgeon, it is a privilege to practice medicine, and an even higher honor to do it with the amazing team at Vori Health. Together, we are dedicated to a new model of care that always puts the patient first. We’re on a mission to empower humanity to live a healthier life. Join us in driving the change we need to heal the global musculoskeletal paindemic.