Latest / Becker’s Healthcare Podcast / Frank D. Vrionis, M.D., M.P.H., PhD, Chief of Neurosurgery at the Marcus Neuroscience Institute

Transcript

Frank D. Vrionis, M.D., M.P.H., PhD, Chief of Neurosurgery at the Marcus Neuroscience Institute · Becker’s Healthcare Podcast

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  This is Carly Beam with the Becker Spine
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  and Orthopedics podcast.
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  And today, I'm thrilled to be joined by
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  doctor Frank Varonis, chief of neurosurgery
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  at the Marcus Neuroscience
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  Institute.
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  Doctor Varonis, thank you so much for being
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  here today.
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  Thank you, Carly.
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  Pleasure to be here.
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  And so, doctor Varonis, before we dive into
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  questions, can you introduce yourself and share more
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  about your background?
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  Sure.
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  So I'm,
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  Frank Villones.
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  I'm a neurosurgeon.
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  I have been, practicing for many years.
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  I did my
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  medical school in Athens, Greece.
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  My master of public health at Harvard, my
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  PhD at Duke,
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  and my residency in neurosurgery at Tufts Medical
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  Center.
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  I
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  Prior
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  to coming here to,
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  Boca Raton, I was,
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  for sixteen years at,
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  USF and,
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  Moffitt Cancer Center,
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  where I also served as,
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  chief of neurosurgery.
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  That's in a nutshell,
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  my synopsis of my
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  life so far.
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  It's a great impressive background
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  you have. It looks like just from all
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  over the world as well.
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  And, you know, I'm wondering, doctor Varonis,
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  what are the top three trends that you're
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  following in health care today?
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  Yeah.
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  Certainly, I mean, I'm I'm interested
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  in,
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  health care as as a general,
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  rule.
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  But in particular,
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  things that can
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  help with the efficiency of delivery of the
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  health care such as,
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  AI.
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  That's one thing.
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  Also,
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  technology,
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  innovations,
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  and also research.
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  There
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  are some of the things that,
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  I would be interested in and,
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  the the strengths and the weaknesses
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  of, the system. As you know, there's no
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  health care system that's perfect,
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  so
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  it's important to try
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  even in small ways,
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  to to improve on the current one.
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  Absolutely. You touched on some really big things
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  going on here. You mentioned health care delivery,
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  AI, and research. I want to, hone in
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  a bit. I'd love to hear how
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  you're using AI in your practice. I know
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  a lot of spine surgeons I've talked to,
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  they've shared just the various ways it's helped
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  them both in the clinical office setting,
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  with surgery itself. I'd love to hear your
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  perspective.
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  I
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  mean,
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  AI from, my perspective
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  right now is on the research tool.
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  We've developed,
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  an AI software,
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  that applies to spine,
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  so that,
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  for example,
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  if,
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  somebody
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  we can enter somebody's CAT scan or MRI,
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  in the system, and then the AI can,
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  deliver for us,
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  a computer model of somebody's spine, and then
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  we can
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  potentially ask questions,
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  from a biomechanical
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  standpoint.
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  Like, if we do this intervention,
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  what will happen to the spine and so
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  on and so forth. So from a research
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  standpoint, that's, more or less what I have.
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  We have I have been involved,
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  as far as AI is concerned, but
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  I can see that AI has a lot
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  of other applications
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  potentially in medicine. We see AI
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  reading,
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  CAT scans sometimes,
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  or or getting warnings
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  about,
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  somebody's CAT scans.
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  And I think there's also a lot of
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  potential applications of AI,
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  not just,
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  in data analytics, but also in,
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  responses to patients' questions and so on and
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  so forth.
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  Definitely. That's really interesting what you're saying about
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  research.
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  What do you predict?
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  Like, how much will AI
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  grow in the research well realm are you
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  expecting?
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  You know, I think I think it will
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  grow to some
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  degree. Now what how exactly it's going to
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  work and,
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  you know,
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  and how AI is gonna be coordinated
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  and so on,
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  it's difficult really to predict. But for example,
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  to give you some,
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  idea, we we get,
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  you know,
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  health professionals
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  get thousands of phone calls a day.
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  You have to have,
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  people answering the phone.
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  A lot of the questions, like, 80% of
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  the questions are routine,
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  and, potentially,
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  AI can answer those questions. So you can
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  have,
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  something automated,
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  whatever,
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  and answer those questions and only
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  reserve,
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  you know, a a face to face, so
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  to speak, or
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  a person to person
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  response
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  for the 20%
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  of the questions that they really need somebody
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  who knows more about things.
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  So just just a a very
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  you know, just an idea, so to speak.
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  I see also AI being,
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  I think already is
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  applied
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  in terms of,
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  you know, billing or,
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  scheduling
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  or,
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  main times,
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  for insurance companies,
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  as far as,
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  deem as to whether service is appropriate or
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  not appropriate.
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  AI has the potential
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  to analyze very quickly,
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  a lot of data and respond to things,
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  much faster than a human can.
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  So so there's a lot of,
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  little ways that AI can make a difference,
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  primarily in the efficiency of health care delivery.
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  Definitely.
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  And when you think about, the Marcus Neuroscience
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  Institute and in your department,
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  how are you thinking about growth in the
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  next twelve to twenty four months?
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  Growth
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  typically,
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  happens,
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  in in the sense of, hiring,
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  more people to cover,
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  certain gaps,
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  that we have,
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  maybe neurology or surgery,
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  pain management,
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  rehabilitation,
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  things like that.
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  So growth is through
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  people, but also
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  through,
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  new technologies,
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  robotics,
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  augmented
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  reality,
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  things like that,
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  as well
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  as, research.
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  We
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  have been
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  fortunate to receive,
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  especially today's day where research dollars are very
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  difficult to find,
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  we
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  have been able to receive,
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  research funds from,
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  the Marcus Foundation, which is a philanthropic,
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  foundation.
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  And through that, we pursue
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  research in,
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  domains such as brain tumor research,
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  drug delivery,
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  spine research, so on and so forth.
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  So these are the areas where we we
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  see a lot of
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  potential,
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  expansion and growth.
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  And,
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  we we like to stay
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  stay current and on the cutting edge of,
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  things.
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  Yeah. And are there are there any other
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  spine and,
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  neurosurgery
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  technologies besides, you know, the AI that we've
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  discussed? Are there any other technologies
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  that really excite you lately?
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  What I've been, very excited about, inspiring especially,
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  without trying to to get into,
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  too many details and being esoteric is the
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  motion preservation
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  technology that has been,
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  has become part of, my practice in spine
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  on a daily basis.
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  And,
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  as you know, in, spine, we have essentially
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  two types of procedures.
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  So just to be very simple here, simplistic,
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  we can decompress something or free up something,
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  or we can,
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  do,
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  reconstruct
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  the spine.
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  Reconstructing
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  the spine typically has been the domain of
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  fusions,
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  where you glue together pieces of the spine.
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  This works in the short term, but in
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  the long term, a lot of times, people
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  develop problems
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  above or below their fusions because of the
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  stresses
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  that developed,
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  develop,
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  adjacent to a fused segment of the spine.
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  So motion preservation
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  in the sense,
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  of,
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  disc replacement,
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  as well as facet replacement
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  has been
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  a thing that
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  really can restore the motion segment and prevent
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  this domino effect that we see
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  with fusions
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  and stop that particular cascade of
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  more segments that need to be fused that
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  lead to
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  lack of mobility and certainly disability
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  in the end.
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  Yeah. And definitely with, you know, with spinal
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  fusion, I know that's still
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  largely considered the gold standard in spine, and
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  then we also have
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  the push towards motion preservation and its benefits.
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  How are you in your practice,
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  how are you kind of balancing
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  the the benefits and needs of both in
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  your patients?
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  I mean, the the issue is more or
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  less the indications,
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  as well
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  as,
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  what can you do
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  because
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  many times,
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  our biggest problem actually with motion preservation
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  is getting insurance approval.
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  A lot of insurance companies, they consider it
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  experimental
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  despite the fact that there is, like, decades
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  of research and,
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  pretty much everything that we use is FDA
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  approved. So,
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  when something is FDA approved, I don't know
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  how people can claim that's experimental.
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  But but, insurance denials is a big obstacle,
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  to utilizing,
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  these technologies.
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  I think,
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  especially for young people, you would like to
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  do as much motion preservation
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  operations
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  instead of fusions. You don't want to have
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  30 year olds, with fusions because then, inevitably,
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  they're gonna have more issues down the road.
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  If somebody's very old
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  and their spine
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  is very rigid and, you know,
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  semi,
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  fused, so to speak, then, you know, motion
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  preservation may not be the best,
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  option there.
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  But,
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  I think,
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  still,
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  to some degree, we
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  you know, it it's it's an art and
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  not
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  a science,
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  I mean, to some degree, because
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  we're still learning about how we effectively can
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  utilize these type of technologies.
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  And thank you for breaking that down. My
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  last question for you, doctor Varonis,
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  what do you think will be a key
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  disruptor to spine surgery and neurosurgery
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  in 2026?
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  I think,
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  increasingly, the biggest disrupt and the biggest problem
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  we have
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  is is coming from the insurance industry
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  and the cost of health care products.
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  So that's that's the biggest issue and whether,
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  first of all, patients can't afford
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  insurance
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  because insurance is very expensive.
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  Second, whether insurance will cover certain
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  items because,
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  as you know,
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  we don't have,
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  too many
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  restrictions as to how much
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  a new drug or a new device
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  can cost in The US. You know, FDA,
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  delivers
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  or is concerned with safety, but there's no
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  price control. So anybody can essentially
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  price it any way they want. So so
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  pricing of of new
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  technologies or new products,
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  lack of insurance coverage,
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  denials
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  by insurance,
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  and affordability
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  of health care,
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  is is the potential
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  disruptors,
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  that I see that can curtail,
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  innovation
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  and, force us,
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  against the wall.
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  I mean, physicians are in in the practice
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  of medicine
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  because they like what they do, but we
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  constantly have to shape what we do and
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  fight for what we believe
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  with a lot of other,
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  stakeholders in the health care
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  industry,
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  in order to get the maximum benefit for
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  the patient.
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  And that's not an easy thing. You know?
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  And something
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  has changed over the years. It was not
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  like that when I first,
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  practiced medicine. We didn't have to worry about
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  those things.
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  But now this is peer reviews,
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  peer to peer, so to speak,
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  denials,
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  things like that are gonna be obstacles
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  in the health care delivery
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  because of cost primarily,
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  and they're gonna limit,
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  you know, the access,
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  of the best technologies to a lot of
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  patients.
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  Yeah. Doctor Ramos, I wanna just check on
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  one quick follow-up. With all these headwinds you're
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  describing,
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  how what how are you strategizing
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  to get ahead of these next year?
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  Well,
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  we
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  really cannot
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  strategize on those things because
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  they're beyond our controls, to be honest with
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  you. I mean, whether
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  Aetna approves something or,
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  United
• 15:36
  approves something or doesn't approve something is is
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  impossible for us to to really play any
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  kind of role.
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  But, what we do, you know, that we
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  can do is
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  educate patients about,
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  the type of technologies we have now and,
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  provide patients with options, you know, because
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  also what I've noticed in health care,
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  inspiring particularly, is a lot of patients are
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  uninformed.
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  They they only have the only they're only
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  given one option.
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  And sometimes that's not the best option,
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  for them.
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  Alright. Well,
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  thank you so much for joining the podcast
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  today, doctor Varonis. It's been a pleasure speaking,
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  and I look forward to connecting down the
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  line. Thank you, Carly. I appreciate, the opportunity.