AI in Spine Surgery: Preserving Clinical Judgment in a Data-Driven Era
episode
Becker’s Healthcare -- Spine and Orthopedic Podcast
16 min
2 speakers
8 chapters
transcribed 5 months ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is the significance of AI in spine surgery?
This is Carly Beam with the Becker Spine and Orthopedics Podcast, and joining us today is Dr. Morgan L'Oreal, a spine surgeon and past president of the International Society for the Advancement of Spine Surgery. And today we're going to have a great chat about AI and spine surgery and where all sorts kind of fits in the larger healthcare equation. So Dr. L'Oreal, thank you so much for joining us.
Thank you, Carly. It's a pleasure to be here.
Always great to have you back on the podcast. And before we dive into our questions, could you just give a quick overview of your background and your work?
Okay, well, I've been a spine surgeon and a hand surgeon and past president of ISAS, and I did a lot of work for policy, and I chaired coding and reimbursement task force for ISAS as well. So that's pretty much been my interest, and AI kind of fits in here because of its impact on policies as it impacts both healthcare delivery and, frankly – what we write and what we do moving forward. So hopefully this is relevant.
Absolutely. And I mean, obviously AI is everywhere in healthcare and healthcare conversations. I'd love to hear, start off, how you think about its role when it comes to spine surgery.
How does AI enhance clinical decision-making in spine care?
Well, I use AI, and I value it. It's an extraordinary analytical tool. If you step back for a moment, the scale of this technology becomes clearer. We remember the Internet took decades to reshape society, and today – We recognize the lack of Internet access represents a form of inequality. And so artificial intelligence is arriving very differently. Its growth isn't gradual. It's almost vertical. And now that capability sits inside the devices we carry in our pockets. But I think the real risk is often misunderstood. By that, I mean the real risk isn't that AI will get things wrong. that it will succeed while we slowly forget how. In spine care, the highest value work often happens before any incision is made.
That's when a surgeon integrates imaging, biomechanics, patient history, comorbidities, expectations, and risk tolerance into a coherent clinical judgment.
What are the potential risks of AI in healthcare?
Those cognitive steps are difficult to measure and are rarely reimbursed in proportion to their importance, but they determine whether the right patient receives the right intervention at the right time.
It's a really fascinating way of looking at it, too, which is the idea that AI is coming in before the actual surgery, but Obviously, some people are worried that AI might replace their jobs, including physicians. Do you see that being a concern?
Well, I don't think that replacement's the real issue, specifically for surgeons. Healthcare already operates through algorithms, reimbursement rules, prior authorization systems, coverage policies, and outcome reporting structures. But I can say this, AI will not enter medicine neutrally. Artificial intelligence will likely arrive through those same systems I mentioned. Unfortunately, skill erosion rarely shows up in the metrics we measure. Accuracy can improve while human judgment quietly declines. So I guess the real question becomes governance.
Yeah. Can you dive into that more governance specifically?
Yeah. Complex patients don't always fit neatly inside efficient systems. Historically, the surgeon in the loop judgment has allowed physicians to recognize when a patient doesn't fit the algorithm and to treat the patient rather than the pathway. Medicine requires flexibility because real patients are real complicated.
How can physicians maintain their judgment in an AI-driven environment?
Systems, however, often prefer predictability. Maintaining physician oversight, therefore, becomes critical as AI becomes embedded in those systems.
It's an interesting balance, it sounds like, between the algorithms and then figuring out those one-off cases. Can you give an example of where physician judgment still matters even when AI is helping out as a tool?
Sure. Well, I recently explored some cancer trend data within an AI system. And when I asked whether cancer incidents had changed after COVID, the analysis suggested that incident rates were largely unchanged.
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Chapters
8 chapters
1
What is the significance of AI in spine surgery?
0:00–1:26
2
How does AI enhance clinical decision-making in spine care?
1:26–2:37
3
What are the potential risks of AI in healthcare?
2:37–4:29
4
How can physicians maintain their judgment in an AI-driven environment?
4:29–6:31
5
What role does physician governance play in AI integration?
6:31–8:35
6
How can AI influence medical knowledge development?
8:35–10:43
7
What challenges arise from AI's impact on patient care?
10:43–12:57
8
What should physicians remember about the role of AI in their practice?
12:57–16:10
Speakers
2 identifiedMore from Becker’s Healthcare -- Spine and Orthopedic Podcast
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Scaling Orthopedic Excellence with Ravi K. Bashyal, MD
Advancing Surgical Intelligence in Spine and Cranial Care with Dr. Osamah Choudhry
Building Bridges and Advancing Innovation in Spine Surgery with Dr. Mauricio Avila