Health

Open Innovative & Integrative Spine Clinic in San Luis Obispo County

There is axiom among back specialists that spine health is one thing that people never notice until something goes wrong. What makes that significant is that, when something does go wrong, all the other parts of the body that depend on the spine can be affected – and quality of life can diminish dramatically.

That’s why it’s so important that a new spine clinic is now open as the next phase of the Tenet Health Central Coast-UCSF Health neurosurgery affiliation. The clinic, which is located on the campus of the Sierra Vista Regional Medical Center, will offer experts from both THCC and UCSF to diagnose and treat spine or neuro issues with holistic and innovative treatments.

“Surgery is really a last resort,” said Dr. Phillip Kissel, the Director of Neurosurgery for Tenet Health Central Coast. “Therefore, a state-ofthe-art spine center that can effectively treat a myriad of spine and neuro conditions, bridges the gap between surgery and pain management. It’s really a tremendous benefit to the community to create greater local access to these integrative diagnostics and treatments.”

Indeed, a wide array of services are provided, including:

• Platelet-Rich Plasma (PRP) injection therapies;

• Interruption and blocking techniques to stop pain signals from reaching the brain;

• Electrodiagnostic testing, which is used to diagnose injuries and disorders of the peripheral nervous system (this testing includes analysis of the complex connections of the spinal nervous system and common conditions such as carpal tunnel syndrome);

• Diagnostic Imaging, including cervical, and lumbar discograms;

• Cervical, lumbar, and thoracic transforaminal epidural injections to ease pain in the lower back, mid-back and neck;

• Lumbar and cervical intralaminar injections to decrease inflammation and irritation of nerve roots or herniated disks;

• Costovertebral joint injections to help ease breathing;

• Minimally invasive spine surgeries – a technique that uses smaller incisions that, generally, can reduce the risks involved with traditional surgery;

• Holistic and physical therapies.

Typical conditions that can be treated, include:

• Back or spine fractures;

• Degenerative disc disease;

• Herniated disc;

• Kyphosis;

• Radiculopathy;

• Scoliosis;

• Spondylolisthesis.

Dr. Robert Gamburd, a professor on the UCSF Department of Neurological Surgery, is on the staff at the Tenet Health Central CoastUCSF Health spine clinic. The significance of the affiliation is underscored by the fact that U.S. News & World Report recognized UCSF Medical Center as the nation’s best hospital for neurology and neurosurgery in the 2021-22 Best Hospitals survey.

Importantly, Dr. Gamburd personally understands the patients’ point of view: “I live it every day,” said Dr. Gamburd, who has had two lower back surgeries. “So I have to practice what I preach about being an active participant in one’s own recovery and in self care. My condition is something I have to deal with for the rest of my life, so I know how the patients feel, often first hand. I try to provide approaches that are tailored to each patient’s needs, because each one is unique.”

Sansum Clinic Announces 2023 Visiting Professor of Surgery

Fabrizio Michelassi, MD, has been selected as the Visiting Professor of Surgery for Surgical Academic Week 2023 (March 13-16) announced Dr. W. Charles Conway, FACS, Visiting Professor of Surgery Program Administrator.

A world-renowned gastrointestinal surgeon with a strong expertise in the surgical treatment of gastrointestinal and pancreatic cancers as well as inflammatory bowel disease, Dr. Michelassi has contributed new insight in the surgical treatment of pancreatic and colorectal cancers, ulcerative colitis and Crohn’s disease though research and participation in multiple clinical trials. His experience and expertise in treating Crohn’s disease led him to develop a novel bowel-sparing procedure, now known as the Michelassi strictureplasty, designed to avoid sacrificing large amounts of the bowel at the time of surgery and facilitating quiescence of the acute disease affecting the diseased intestinal loops.

Dr. Michelassi has an abiding interest in educating and training the next generation of academic surgeons. Sansum Clinic’s Visiting Professor of Surgery Program provides expert educational seminars for practicing Santa Barbara surgeons and physicians. More importantly, the program allows surgical residents in training at Santa Barbara Cottage Hospital the chance to interact with the icons, leaders, and outstanding teachers of the art of surgery.

Dr. Michelassi will present a public lecture on Thursday, March 16 at 5:30pm at the Ridley-Tree Cancer Center at Sansum Clinic in the Lovelace Hall at 540 West Pueblo Street.

His topic: In the Eye of the Storm: Lessons Learned from the COVID Pandemic. The first COVID patient was admitted to New York Presbyterian Hospital on March 9, 2020. By April 12, New York Presbyterian Hospital had more than 2,600 COVID + inpatients. Elective and urgent cases were brought to a halt; resources were stressed from PPE’s to ICU capacity. The system reacted with innovative solutions; physicians, residents and staff were redeployed; ICU capacity was more than doubled. The needs of the healthcare providers were met with free meals, free downtown accommodations, mental health care sessions, and daily communications. Many lessons were learned which helped during the successive waves and which we have incorporated in our daily lives.

Reservations are required for the presentation. Please contact Devin Scott at 805.681.7762 or dscott@sansumclinic.org

This unique educational program advances the level of surgical care available in our community and is made possible by generous support from the Title Sponsor Cottage Health, and grateful patients, medical groups, individual community surgeons and physicians, and corporate donors.

Dr. Michelassi follows eight previous Visiting Professors: Dr. John L. Cameron (Johns Hopkins) 2012, Dr. Hiram C. Polk, Jr. (University of Louisville) 2013, Dr. Julie Ann Freischlag

(UC Davis School of Medicine) 2014, Dr. Keith D. Lillemoe (Massachusetts General Hospital) 2015, Dr. Michael G. Sarr (Mayo Clinic) 2016, Dr. Barbara Lee Bass (Houston Methodist Hospital), Professor O. James Garden (University of Edinburgh) 2018 and Dr. David V. Feliciano (University of Maryland Medical Center) 2019. In 2021 we featured the following speakers: Deanna J. Attai, MD, FACS (David Geffen School of Medicine at UCLA), Wen T. Shen, MD, MA (University of California, San Francisco), Jennifer Suzanne Davids, MD (University of Massachusetts Memorial Medical Center), and Alfredo M. Carbonell, II, DO, FACS, FACOS (UCS School of Medicine Greenville, SC).

Dr. Conway took over the reins of the Visiting Professor of Surgery Education Program in 2018 from Dr. Ronald G. Latimer, who established the program in 2010 with the Department of Surgery and Sansum Clinic. Dr. Conway joined Sansum Clinic in 2017 and is a fellowship-trained surgical oncologist at the Ridley-Tree Cancer Center, with nearly 10 years of high-volume surgical experience dealing with complex cases.

Thursday, March 16 5:30pm

Ridley-Tree Cancer Center at Sansum Clinic

Lovelace Hall

540 West Pueblo Street

Reservations are required. Please contact Devin Scott at 805.681.7762 or dscott@sansumclinic.org

By Maximilian J. Pany, BA; and J. Michael McWilliams, MD, PhD

It is well understood that physician behavior is a primary driver of patient outcomes and health care spending. Physicians are expected to be well-informed agents who are intrinsically motivated to optimize care for their patients. Yet deficits in quality are pervasive, and effective strategies to influence physician decisions and performance remain elusive. That physicians are also motivated by profit has inspired 2 decades of efforts to link payment to performance on quality measures. These pay-forperformance schemes have produced minimal gains for various reasons, including measurement challenges and inherently weak incentives, and have had unintended consequences.

More recently, interventions have focused on nonfinancial incentives that influence physician behavior. The application of behavioral science to health care has conceived a range of nudges

(eg, use of defaults, public commitments, or information framing) that have successfully prompted higher-value decisions. While a clear advance, these approaches have so far been applied mainly to specific measures or clinical decisions using scripted interventions, such as peer performance comparisons or required justification to discourage inappropriate antibiotic prescribing. Broader applications could have a greater impact.

In particular, the influence of peer observation and approval is likely to be powerful in medicine and could be more productively deployed. Physicians are motivated to demonstrate their competence to other physicians not only for financial gain (eg, to earn favorable evaluations as trainees or to attract referrals), but also because they may derive professional satisfaction from upholding standards when observed.

Behavioral science has long demonstrated peer and audience effects, by which the physical or imagined presence of others improves performance. These effects can be particularly powerful when peer relationships are strong and when peers share high standards and common purpose. Accordingly, an audience of familiar peers may elevate physician performance, not only by subjecting it to informed scrutiny, but also by providing an opportunity to demonstrate commitment to what is valued by the profession. If strong, the motivational effects of peer interaction could have profound implications for the organization of care delivery, including potential gains from models encouraging peer familiarity and visibility—gains that could accrue over many dimensions of care without requiring decision-specific interventions.

Get To Know Your Peers

CCMA Physician Happy Hours

Grassini Tasting Room, Santa Barbara

In this study, we used 2016 to 2019 electronic health record data on referrals initiated by primary care physicians (PCPs) from a large academic health system to investigate the association between PCP-specialist co-training and patient experiences with specialist care. Training together is 1 source of professional peer relationships that, when present, may motivate physicians to deliver better care. Specialists are aware that PCPs can observe aspects of their care through reading their notes and talking to patients; the presence of a strong peer relationship may also remind them of commonly valued precepts of professionalism. Accordingly, specialists may aspire to deliver their best care when seeing patients whose PCPs they know.

Tuesday, January 31, 2023

Tuesday, May 2, 2023

Tuesday, August 1, 2023

Café Roma, San Luis Obispo

Wednesday, February 1, 2023

Wednesday, May 3, 2023

Wednesday, August 2, 2023

Read the full study, Physician-Peer Relationships and Patient Experiences With Specialist Care, on JAMA Internal Medicine, originally published online January 3, 2023. doi:10.1001/ jamainternmed.2022.6007