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