Latest / Becker’s Healthcare Podcast / Dr. Erich G. Anderer, Chief of the Division of Neurosurgery and Surgical Director of Perioperative Services at NYU Langone Hospital–Brooklyn

Transcript

Dr. Erich G. Anderer, Chief of the Division of Neurosurgery and Surgical Director of Perioperative Services at NYU Langone Hospital–Brooklyn · Becker’s Healthcare Podcast

• 0:00
  This is Carly Beam with the Becker Spine
• 0:02
  and Orthopedics podcast, and I'm thrilled to be
• 0:04
  joined today by doctor Eric Anderer,
• 0:07
  a neurosurgeon with NYU Langone Health. Doctor Anderer,
• 0:11
  thank you so much for being here today.
• 0:13
  I appreciate you having me on. So before
• 0:15
  we dive into our questions, could you just
• 0:17
  introduce yourself and tell us a bit about
• 0:19
  your background?
• 0:20
  Sure.
• 0:22
  As mentioned, my name is, Eric Anderer. I'm
• 0:24
  the chief of neurosurgery at NYU Langone Hospital,
• 0:27
  Brooklyn.
• 0:28
  I'm also the, the co director of a
• 0:30
  perioperative services,
• 0:32
  sort of a title that used to be
• 0:34
  known as surgeon in chief. So help run
• 0:36
  the ORs in Brooklyn.
• 0:38
  I was born in Japan, grew up in
• 0:40
  New York, have been in Brooklyn for the
• 0:41
  past twenty some odd years.
• 0:43
  So, it really, was sort of an honor
• 0:46
  when, you know, I was asked to sort
• 0:47
  of head up the the neurosurgery effort in
• 0:49
  Brooklyn,
• 0:50
  at the former Lutheran Medical Center. So I've
• 0:52
  been there since the NYU merger in 2016,
• 0:55
  and it's been, you know, almost ten great
• 0:57
  years there. That's great. And can you talk
• 1:00
  about just what are the top three trends
• 1:02
  that you're following in health care today?
• 1:06
  Sure. I mean, there's so much to talk
• 1:08
  about. I mean, obviously, the landscape is constantly
• 1:10
  changing, but I would say that the things
• 1:11
  that are,
• 1:13
  sort of top of mind for me, number
• 1:15
  one would be sort of access to information.
• 1:18
  I mean, it's something that, you know, with
• 1:20
  the Internet, with, you know, influencer culture, with,
• 1:23
  you know, sort of inundation
• 1:25
  of information out there, from various sources.
• 1:28
  You know, I think in a lot of
• 1:30
  ways, it's it's had a positive influence on
• 1:32
  the way that,
• 1:34
  I think people, experience health care. And what
• 1:36
  I mean by that is
• 1:37
  this sort of democratization
• 1:39
  of of information,
• 1:40
  I think has been helpful for people to
• 1:42
  be
• 1:43
  informed, let's say, about their conditions and such.
• 1:45
  So I don't think it's ever gonna replace
• 1:47
  going to a doctor, and I think that,
• 1:49
  really the best thing to do, when you
• 1:52
  have questions about your health, about,
• 1:54
  you know, something going on with you, one
• 1:56
  of your loved ones is to maybe take
• 1:57
  some of that information that you digest from
• 1:59
  other sources,
• 2:01
  and really sort of, help,
• 2:03
  you know, sort of, formulate questions, I think,
• 2:06
  that, that you can kinda go in with
• 2:08
  and be that much more informed when you
• 2:10
  go to your visit and get that much
• 2:11
  more out of your visit with your physicians.
• 2:13
  But I generally see it as a positive.
• 2:15
  I mean, clearly, there's, you know, some negatives
• 2:17
  and, you know, just obviously the the access
• 2:19
  to sort of voluminous amounts of information that
• 2:22
  is sometimes hard to to verify, can be
• 2:25
  somewhat problematic. But I think on balance,
• 2:28
  it's been a good thing, generally.
• 2:30
  So that would be one,
• 2:32
  you know, as a surgeon, it's hard not
• 2:34
  to talk about tech. Right? And so, that's
• 2:37
  another thing I think that I'm super excited
• 2:39
  about,
• 2:40
  robotics specifically in spine,
• 2:43
  but even sort of AI, applications, to
• 2:46
  sort of help us understand who are the
• 2:48
  right patients for surgery, how, you know, to
• 2:50
  predict, you know, how patients are gonna do
• 2:52
  afterwards,
• 2:53
  where to send them to recover the best,
• 2:55
  you know, that's rehab facility at home, that
• 2:58
  kind of thing. You know, so I think
• 2:59
  it's really revolutionized the way that we,
• 3:02
  we look at, at surgery and who should
• 3:04
  be having surgery and how how best to
• 3:06
  apply that.
• 3:08
  And then, you know, the other thing I
• 3:09
  think that's sort of out there,
• 3:12
  and this is, you know, at the government
• 3:13
  level, but all the way down to, you
• 3:15
  know, to sort of this the information sources
• 3:18
  that I was talking to talking about earlier.
• 3:21
  I think there's a lot of sort of
• 3:22
  focus on, the root cause of disease.
• 3:26
  And, you know, again, I mean, sort of
• 3:27
  a lot of chatter out there,
• 3:30
  you know, about that. But I would say
• 3:32
  that a focus on that specifically,
• 3:34
  sort of divorced from, you know, all the
• 3:36
  other
• 3:37
  kind of, you know, either political, social, cultural
• 3:40
  things that can be sometimes associated with that
• 3:42
  discourse. I think, that's also on balance,
• 3:45
  a a positive thing for patients and and
• 3:48
  physicians because I think that, you know, the
• 3:50
  reality is,
• 3:51
  who doesn't wanna get at? What is it
• 3:53
  that's making us sick? And how do we
• 3:56
  stay healthy? And, you know, even as a
• 3:58
  surgeon,
• 3:59
  how do we keep people from having spine
• 4:01
  surgery?
• 4:02
  You know, there's always gonna be a need
• 4:03
  for people to have have surgery, to have,
• 4:06
  you know, some sort of structural problem fixed.
• 4:09
  But the hope is that, we're really gonna
• 4:12
  be,
• 4:12
  applying that,
• 4:14
  you know, in sort
• 4:15
  of very focused cases,
• 4:17
  and for the vast majority of people that
• 4:19
  experience the very, very common symptom of back
• 4:22
  pain. Right? I mean, who hasn't had back
• 4:24
  pain out there?
• 4:25
  Right. Hope is that it's only the small
• 4:28
  minority of people that have that are gonna
• 4:30
  that are gonna really need surgery. So, again,
• 4:32
  sort of looking at the root cause of
• 4:33
  this, how to get people out of, you
• 4:35
  know, sort of a sedentary lifestyle, how to
• 4:37
  get people eating better, how to get people
• 4:39
  moving again,
• 4:41
  I think those are all, again, on balance
• 4:43
  sort of net positives. So those are the
• 4:45
  three things I'm looking at. Yeah. And I
• 4:46
  wanna follow-up you on your what you're just
• 4:48
  talking about, these root causes of
• 4:51
  disease and,
• 4:52
  spine
• 4:53
  pain, etcetera.
• 4:55
  Can you talk about just any initiatives or
• 4:57
  findings that you've been involved in,
• 5:00
  with NYU
• 5:01
  to address those head on in the community?
• 5:04
  Sure. I mean, you know,
• 5:06
  obviously, anything involving spine surgery and the way
• 5:09
  we do spine surgery,
• 5:11
  you know, is gonna be, I'd say, a
• 5:13
  a good thing with respect to the field
• 5:15
  and how we're gonna treat patients that have
• 5:16
  this disease. And there's so much of that
• 5:18
  going on. You know, there's a lot of
• 5:19
  stuff going on with, you know, the ways
• 5:21
  to do surgeries, the ways to leverage robotics
• 5:23
  to do, surgeries in ways that are,
• 5:26
  you know, less invasive. And, you know, let's
• 5:28
  say, for example,
• 5:30
  doing a two part surgery in one sitting
• 5:32
  using,
• 5:33
  robotic technology,
• 5:34
  in ways that we weren't weren't able to
• 5:36
  do before.
• 5:37
  You know, that's that a lot of that
• 5:38
  research is being done here, by, you know,
• 5:40
  by our colleagues.
• 5:42
  And so that's that's certainly, I think, something
• 5:45
  that is, you know,
• 5:47
  you know, a positive in terms of how
• 5:49
  to how to treat and how to, you
• 5:51
  know, kind of move forward with, with treatment
• 5:53
  algorithms.
• 5:54
  But on the other hand, again, kinda getting
• 5:56
  back to the idea of
• 5:58
  who is it that needs surgery.
• 6:01
  You know, I think that the goal really
• 6:03
  is in general
• 6:05
  for people with back pain to avoid surgery.
• 6:07
  And how do we do that? Well, you
• 6:09
  know, there are ways of looking at,
• 6:11
  you know, other types of treatments, other types
• 6:13
  of modalities
• 6:14
  to help with this.
• 6:16
  And, again, if it's, like, you know, looking
• 6:17
  at returning to activities, returning back into, you
• 6:21
  know, sort of functional movement,
• 6:23
  there are, you know, modalities, I think, that
• 6:24
  we can look at that are that have
• 6:26
  been beneficial. So yoga would be one, for
• 6:28
  example.
• 6:29
  You know, anyone that knows me and that's
• 6:31
  talked to me knows that I'm sort of
• 6:32
  a fan of yoga, sent my patients into
• 6:34
  it.
• 6:35
  And, again, not necessarily you know, I don't
• 6:37
  want them jumping into, like, hot yoga or
• 6:38
  doing handstands or anything like that. But, you
• 6:40
  know, I think,
• 6:42
  do going into, like, a, a beginner type
• 6:45
  of program that's modified for people with back
• 6:47
  pain, I think, can be very, very beneficial.
• 6:50
  I actually,
• 6:51
  you know, wrote a paper with this yoga
• 6:53
  teacher named Eddie Stern who,
• 6:56
  actually is the one that brought Ashtanga yoga
• 6:58
  as a practice to America from India.
• 7:01
  And, he is, very interested, I think, in
• 7:04
  in this dialogue
• 7:06
  between sort of more conventional,
• 7:08
  intervention based, medicine and how to use these
• 7:11
  other modalities that have been really in place
• 7:13
  for, you know, centuries,
• 7:16
  to help, kind of be adjuncts, to help,
• 7:18
  you know, to I'd say together
• 7:20
  formulate this kind of unified way of treating,
• 7:23
  treating back pain and spine disease.
• 7:25
  That's fascinating. And then I also want to
• 7:28
  circle back to what you're saying about this
• 7:30
  information
• 7:32
  culture we have now. It's I've actually wrote,
• 7:35
  an article
• 7:37
  recently,
• 7:38
  I guess,
• 7:39
  this week as of,
• 7:40
  you know, November 21 or in this this
• 7:43
  week. And, you know, hearing from sponsors and
• 7:46
  how they have conversations,
• 7:48
  how they
• 7:49
  address patients who come in with their own
• 7:52
  research,
• 7:53
  their own,
• 7:55
  ideas, perhaps maybe misconceptions,
• 7:57
  you know, after consulting
• 7:59
  influencers,
• 8:00
  doctor Google, quote, unquote.
• 8:02
  I'd love to hear your advice on
• 8:05
  how spine surgeons should, you
• 8:08
  know, base or address approach these conversations
• 8:12
  with, you know,
• 8:13
  with this information culture.
• 8:15
  Yeah. No. And I I think that's a
• 8:16
  good question. And I think that, you know,
• 8:18
  truthfully,
• 8:19
  a lot of surgeons, I'd say initially,
• 8:22
  and a lot of, you know, doctors in
• 8:24
  general initially,
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  can be a little bit, apprehensive or dismissive.
• 8:29
  Like I'd I'd say, when those things kind
• 8:31
  of things come up. But I I I
• 8:33
  honestly look at it as an opportunity,
• 8:35
  because anybody that comes in that's informed,
• 8:38
  that know that, you know, knows how to
• 8:39
  speak the language, knows,
• 8:41
  you know, the terms,
• 8:43
  knows,
• 8:44
  you know, a little bit about the way
• 8:46
  this disease process works,
• 8:48
  you know, from and getting this from from
• 8:50
  various sources, I think,
• 8:52
  is not necessarily
• 8:53
  a bad thing. And I think that what
• 8:55
  you can do is it kinda sets the
• 8:56
  groundwork for conversation.
• 8:59
  And in some ways, it means I think
• 9:00
  you're just that much farther ahead when you
• 9:02
  really have the conversation. So I would say,
• 9:05
  don't necessarily look at it as an annoyance
• 9:07
  or as a hindrance to a discussion like,
• 9:09
  oh, yeah. Well, that was doctor Google. It's
• 9:10
  not that you know, there is information out
• 9:12
  there, and I think what you're really looking
• 9:13
  to do is provide the context for it.
• 9:16
  And so, I usually look at it as
• 9:18
  as an opportunity. It's like, oh, well, tell
• 9:19
  me about what you read. Tell me about
• 9:20
  what you you know, the the different approaches
• 9:23
  that you have, read about to treat your
• 9:25
  your disease,
• 9:26
  or your issue. And, and I'm happy to
• 9:28
  kind of give you my take on it
• 9:30
  and why it is that I think, you
• 9:31
  know, x, y, or z is the way
• 9:33
  to go. So, honestly, I I sort of
• 9:35
  see it as an opportunity,
• 9:37
  rather than a hindrance to sort of a
• 9:39
  a burgeoning doctor patient relationship.
• 9:42
  Absolutely. And it sounds like it's a very
• 9:44
  it opens the door for more collaboration between
• 9:47
  what the patient comes in knowing and then
• 9:50
  what you know in terms of the best
• 9:52
  course for treatment.
• 9:54
  Absolutely.
• 9:55
  And then I wanted to ask you, how
• 9:57
  are you thinking about growth over the next
• 10:00
  twelve to twenty four months?
• 10:03
  Yeah. I mean, for me,
• 10:05
  personally, I mean, you know, again, given my
• 10:07
  background kinda working in a hospital in Brooklyn
• 10:10
  that was, you know, truthfully a safety net
• 10:12
  hospital,
• 10:13
  had been doing great work, but, you know,
• 10:15
  I'd say under resourced,
• 10:18
  you know, in a community that is very
• 10:20
  highly sort of, Medicaid population,
• 10:23
  and that really probably didn't have the access
• 10:25
  to the level of care they're getting now
• 10:27
  in their borough.
• 10:28
  I see growth as providing care for people
• 10:31
  where they are, where they live.
• 10:33
  There's a lot of opportunities out there for
• 10:35
  that. And again, just to use our example,
• 10:37
  it used to be that if you wanted
• 10:39
  complex spine surgery with robotics and all the
• 10:41
  bells and whistles, you had to cross the
• 10:43
  river.
• 10:44
  You had to go into Manhattan to do
• 10:45
  that. And, you know, since, we've had this
• 10:48
  relationship and basically have, have built,
• 10:51
  you know, this,
• 10:52
  NYU Langone Hospital Brooklyn, which is essentially,
• 10:56
  you know, the same care. And we get
• 10:58
  you whatever you're doing we're doing in Manhattan,
• 11:01
  theoretically, we're gonna be trying to be doing
• 11:03
  the exact same thing in Brooklyn.
• 11:05
  And the goal really is to provide the
• 11:07
  same level of care,
• 11:09
  in in the context that, you know, where
• 11:11
  you live, you know, with your families,
• 11:13
  with your community without you having to actually
• 11:16
  travel for it.
• 11:17
  So Very well said. Yeah. I think that's
• 11:19
  that's the biggest opportunity for growth. It's based
• 11:21
  because there's so many places out there where
• 11:23
  that's the case, where they just don't have
• 11:24
  that, you know, access to the same level
• 11:26
  of care. You have to be sent into
• 11:28
  something like tertiary,
• 11:29
  you know, academic medical center. And I think
• 11:32
  that, the owner should be on these medical
• 11:34
  centers,
• 11:35
  to go out there and to and to
• 11:37
  build the resources and the communities that people
• 11:39
  live in.
• 11:40
  Yeah. And how are you addressing how will
• 11:42
  you tackle
• 11:43
  any sort of major headwinds to these goals,
• 11:46
  whether for the growth and community care?
• 11:50
  Yeah. I mean, you know, I'd say that
• 11:52
  that most of the headwinds,
• 11:54
  are sort of
• 11:56
  infrastructural. Right? I mean, the it's you're certainly
• 11:59
  not gonna get a lot of, you know,
• 12:02
  headwinds from people. You know, everywhere we've gone
• 12:04
  in the community, we've get given talks in
• 12:06
  the community, people are are, you know, generally
• 12:08
  very, very happy about what's going on.
• 12:10
  And oftentimes, they're surprised to hear kind of
• 12:13
  the level of care that's, that's happening really
• 12:15
  in their backyard.
• 12:16
  The headwinds tend to be infrastructural. Right? So
• 12:18
  it's all, like, kind of the the more
• 12:20
  boring stuff, but the stuff that's vital, it's
• 12:21
  like money, resources, allocation, you know, the, you
• 12:25
  know, the changing
• 12:27
  environment at the federal level, government reg regulatory,
• 12:30
  changes. So these things all have an impact
• 12:33
  on how you do things because, you know,
• 12:35
  at the end of the day, these things
• 12:36
  also can't, they have to be self sustaining
• 12:39
  in some ways.
• 12:41
  And, you know, there's, you know, the saying,
• 12:43
  you know, sort of no margin, no mission.
• 12:46
  So, you know, fiscal responsibility obviously has to
• 12:48
  play a part in this because, you know,
• 12:49
  if you don't, you know, you can't take
• 12:50
  care of people if you can't keep the
• 12:52
  lights on. And there are just many other
• 12:54
  factors that go into that,
• 12:56
  that may seem sort of boring or whatever,
• 13:00
  but that you have to take into account.
• 13:01
  So, honestly, I would say it's mostly sort
• 13:04
  of the, you know, the regulatory financial environment,
• 13:07
  that is probably the what's giving the most
• 13:09
  headwinds to to this type of growth that
• 13:10
  we're speaking of.
• 13:12
  Got it. And my last question for you,
• 13:14
  doctor Ander,
• 13:15
  is what do you think will be a
• 13:17
  key disruptor to spine surgery and neurosurgery
• 13:21
  in 2026?
• 13:25
  You know, I mean, I think that disruptor
• 13:27
  is interesting.
• 13:28
  So, I mean, that's clearly, the the obvious
• 13:30
  answer to that in, at any, surgical field
• 13:32
  is gonna be tech. Right? So, you know,
• 13:34
  advanced robotics,
• 13:37
  and and this kind of thing, I think.
• 13:38
  But I, you know, I would say if
• 13:40
  we're talking disruption and just sort of thinking
• 13:42
  outside the box here, just there there's just
• 13:44
  so much stuff going on,
• 13:46
  with AI, predict predictive analytics, like, all this,
• 13:50
  you know, where where I think that we're
• 13:51
  actually gonna probably end up,
• 13:54
  you know, basing,
• 13:56
  some treatment on algorithms that were sort of
• 13:58
  written,
• 13:59
  via some kind of AI model. And a
• 14:02
  lot of that's actually being done in the
• 14:03
  neurosurgery world. And and, at NYU, it certainly
• 14:06
  is,
• 14:07
  you know, where we can sort of use
• 14:09
  de identified data
• 14:10
  to, like, you know if somebody comes in
• 14:12
  with this complaint,
• 14:14
  at this time of day with this, you
• 14:16
  know, we can almost predict kind of where
• 14:19
  they're gonna go, what, like, what kind of
• 14:22
  problem they're gonna have, where they're gonna get
• 14:24
  discharged,
• 14:24
  to all these things, which I think is
• 14:27
  gonna be sort of interesting, because clearly, it's
• 14:29
  you know, you we're gonna have to have
• 14:31
  some sort of human oversight into how this
• 14:33
  is done.
• 14:34
  But, you know, to sort of harness,
• 14:37
  the the power of of AI and tech
• 14:39
  in general, I think for these types of
• 14:41
  things is really gonna change the way that
• 14:43
  we, that we diagnose and treat disease.
• 14:46
  Well,
• 14:47
  doc doctor Andrew, thank you so much for
• 14:49
  joining us today. It's been a pleasure speaking
• 14:51
  with you, and I look forward to connecting
• 14:53
  again down the line. Thank you so much
• 14:55
  for having me.