Podcast Summary: Advancing Non-Surgical Spine Care with Dr. Susan Sorosky

Podcast: Becker’s Healthcare Podcast
Host: Carly Beam (Becker's Healthcare)
Guest: Dr. Susan Sorosky, Chief Medical Officer and Co-Founder, Desert Spine and Sports Physicians
Date: November 3, 2025
Episode Theme:
This episode spotlights advancements and challenges in non-surgical spine care, featuring Dr. Susan Sorosky’s insights on regulatory headwinds, innovation in regenerative medicine, interprofessional collaboration, and the future trajectory of spine and musculoskeletal health.

Main Discussion Points & Insights

1. Dr. Sorosky’s Background & Practice Mission

• Dr. Sorosky is a board-certified physiatrist with specializations in interventional spine and musculoskeletal medicine. She is Chief Medical Officer and co-founder of Desert Spine and Sports Physicians in Arizona, and also serves as a fellowship director for an accredited program in interventional spine care.
  • “I am a board certified physiatrist...with an additional focus in interventional spine and musculoskeletal medicine...I am the CMO...and also am the fellowship director for an accredited fellowship...” (00:21)

2. Key Challenges Facing the Practice

Regulatory & Economic Headwinds (01:08 – 02:44)

• Rising costs for equipment, supplies, and staffing.
• Balancing growth and maintaining culture: Expansion requires excellent physician recruitment (often through their fellowship), advanced practitioners, and staff, with a constant attention to preserving practice culture.
• Upcoming Medicare Pre-Authorization Pilot:
  • Arizona is one of six states launching a 2026 Medicare pre-authorization pilot for certain procedures (e.g., epidural injections, nerve stimulators), which could cause a seven-day delay for care and increase administrative burdens.
  • “This will for us include certain interventional procedures...patients will be having probably a seven day period of pre authorization...likely risk delay of care for certain procedures.” (01:38)

3. Strategic Response to Prior Authorization

Patient Communication and Practice Transparency (02:44 – 04:32)

• Strong in-house authorization department helps preempt administrative delays.
  • “We have a really strong authorization department within our practice...” (03:03)
• Proactive patient education around potential delays.
• Cost Transparency: Patients in urgent pain can access procedures using posted cash prices, offering flexibility and faster care.
  • “On our website, we have a transparency page and issue all of our cash prices online...if a patient is in extreme pain and cannot wait...they also have a fairly easy route to have a procedure, cash pay if they decide to go that route.” (03:25)
• Patient sentiment: Many Medicare patients are frustrated, having chosen this plan specifically to avoid pre-authorization hurdles.
  • “Many of them chose Medicare over Medicare replacement plans due to the lack of pre authorization. So this is going to be a difficult road ahead...” (04:11)

4. Fellowship Program & Building Clinical Excellence

Fellowship’s Impact on Growth and Quality (04:32 – 06:12)

• Founded in 2011, accredited in 2018; 22 fellows have graduated, now practicing widely.
• Fellowship is central to practice recruitment and standardizing care; ensures “consistent and excellent” management for patients.
• Training focuses on both core and advanced skills:
  • Image-guided procedures (fluoroscopy, ultrasound)
  • Regenerative medicine (PRP, bone marrow concentrate)
  • Electrodiagnostics, rehabilitation, health, and wellness
  • “In our fellowship we really work hard to standardize...the advanced skills that physicians need in this non surgical spine and musculoskeletal medicine space.” (05:26)

5. The Future of Spine & Orthopedic Care

Evolution and Major Innovations (06:12 – 07:51)

• Shift towards proactive, restorative care: Moving from “band aid” treatments to biologics that foster true healing.
  • “There's been a huge expansion in regenerative medicine...the shift is really towards not a band aid, but true tissue restoration and healing.” (06:41)
• Key innovations:
  • Regenerative therapies like PRP (platelet-rich plasma) and BMAC (bone marrow aspirate concentrate/stem cells).
  • Research into new biologics: Example is a mesoblast/hyaluronic acid combination for degenerative disc disease.
    • “We're doing a research project on mesoblast, which is a combination of regenerative cells and hyur acid for degenerative disc disease.” (07:32)

6. Collaboration Between Pain Medicine & Surgery

Integrated, Multi-disciplinary Care Models (07:51 – 08:44)

• Strong partnerships with surgeons, orthopedists, neurosurgeons, and physical therapists.
• Emphasis on breaking down silos and sharing data for improved outcomes.
  • “Not just be these isolated silos of patient care, but to produce paradigms where we have more seamless management of patients and collaboration, perhaps even sharing data and functional outcomes...” (08:19)

7. Macro Trends in Non-Surgical Spine Care

Preventing Surgery & Focusing on Wellness (08:44 – 09:38)

• Growing patient demand and supporting insurance coverage for non-surgical therapies.
• Greater emphasis on prevention: Working upstream to identify and manage early degenerative changes, alongside foundational care in movement, exercise, and diet.
  • “Flipping the script a little bit, focusing on the prevention...identifying early degenerative changes and perhaps even with biologics so we can prevent things from deteriorating and getting so advanced.” (09:22)

Notable Quotes & Memorable Moments

• "This will...likely risk delay of care for certain procedures." – Dr. Sorosky on Medicare pre-authorization (01:40)
• "On our website, we have a transparency page and issue all of our cash prices online." – Dr. Sorosky on patient-centered cost transparency (03:20)
• "The shift is really towards...true tissue restoration and healing." – Dr. Sorosky, on regenerative medicine revolution (06:42)
• "We're doing a research project on mesoblast...for degenerative disc disease." – Dr. Sorosky, discussing next-gen biologics (07:32)
• "To not just be these isolated silos of patient care...collaboration, perhaps even sharing data and functional outcomes." – Dr. Sorosky, on interprofessional collaboration (08:19)
• "Flipping the script a little bit, focusing on prevention...finding things before they become an issue." – Dr. Sorosky on the promise of early intervention and prevention (09:21)

Timeline of Important Segments

• 00:21 – Dr. Sorosky’s background and practice mission
• 01:08 – Anticipated regulatory and reimbursement “headwinds”
• 03:03 – Operational strategies to address pre-authorization and patient communication
• 04:32 – Fellowship program and its role in practice growth
• 06:12 – Emerging trends: Regenerative medicine and the future of non-surgical spine care
• 07:51 – Collaboration with surgeons and integrated care models
• 08:44 – Broader trends: Rise of non-surgical therapies, insurance, and prevention

Tone of Conversation

The interview is pragmatic, forward-thinking, and expertly detailed, reflecting Dr. Sorosky’s commitment to innovation and quality. She maintains an evidence-based, patient-centric tone throughout, emphasizing adaptability and transparency.

For listeners seeking insights into the evolution of spine care, this episode delivers a concise yet thorough overview of the challenges and promising advances shaping the field today.