Dr. Izzy Lieberman, Orthopaedic Surgeon, Texas Back Institute

Summary

Becker’s Healthcare Podcast: In-Depth Summary of Episode Featuring Dr. Izzy Lieberman

Podcast Information

• Title: Becker’s Healthcare Podcast
• Host: Grace Lynn Keller
• Guest: Dr. Izzy Lieberman, Orthopaedic Surgeon, Texas Back Institute
• Release Date: July 20, 2025
• Description: The Becker's Healthcare Podcast serves the U.S. healthcare community with daily 15-minute episodes featuring industry news, analysis, and insights from prominent healthcare leaders.

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Introduction

In the July 20, 2025, episode of the Becker’s Healthcare Podcast, host Grace Lynn Keller engages in a compelling conversation with Dr. Izzy Lieberman, a distinguished orthopedic surgeon from the Texas Back Institute. Recorded live at the 22nd Annual Spine Orthopedic and Pain Management Conference, the discussion delves into current trends, workforce challenges, the evolving role of spine care, and the integration of new technologies in the field.

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About Dr. Izzy Lieberman

Dr. Lieberman brings a wealth of experience to the conversation. With over 15 years at the Texas Back Institute, his background includes 13 years at the Cleveland Clinic and five years at the University of Toronto in Canada. Specializing in orthopedics and spine surgery, Dr. Lieberman is renowned for handling complex cases, including revision and deformity surgeries. Additionally, he is actively involved in development work, consulting with strategic companies, and managing his own startup within the spine care sector.

Dr. Lieberman [00:57]: "I do whatever anyone else doesn't want to do and I do a lot of revision, a lot of deformity work."

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Key Topics Discussed

1. Trends and Shifts in Spine Surgery

Dr. Lieberman identifies two major trends currently impacting spine surgery, both of which raise concerns:

• Social Media Influence:

  Social media's pervasive role in society extends into spine surgery, offering both opportunities and challenges. On one hand, it helps surgeons stay competitive and attract patients. On the other, it can lead to the promotion of unrealistic surgical outcomes.

  Dr. Lieberman [01:57]: "Social Media is embellishing what's going on out there in spine surgery... patients are saying, 'I do this operation under 45 minutes, minimally invasive, skin to skin,' but then they're back with me six months later because the surgery was not done appropriately."

  Additionally, online ratings pose issues with the prevalence of fake or unwarranted negative reviews, complicating reputational management for practitioners.

• Private Equity and Practice Consolidation:

  The trend of private equity firms acquiring spine practices is another significant shift. Dr. Lieberman expresses skepticism about the long-term benefits of such consolidations unless they offer tangible advantages to surgeons beyond mere practice efficiency.

  Dr. Lieberman [04:10]: "Until the private equity group can actually bring a benefit to the table to the surgeons... I really don't see any role."

He anticipates a pendulum swing away from private equity dominance as the model may prove unsustainable.

2. Staffing and Workforce Challenges

Addressing the broader workforce issues in healthcare, Dr. Lieberman discusses the mobility of the employment workforce and the changing expectations post-pandemic.

• Remote Work Adaptation:

  The rise of remote work demands flexibility. Texas Back Institute has implemented a hybrid model, allowing employees to work from home, the office, or a combination of both.

  Dr. Lieberman [05:22]: "We have taken steps to provide our employees with the ability to work fully from home, from the office, combination things."

However, this shift has introduced challenges in monitoring productivity, as he notes a decrease in efficiency when staff work remotely.

• Employee Retention Strategies:

  To combat high turnover rates, the institute fosters a collegial and family-oriented environment. Through team-building events and fostering camaraderie, they aim to create a work culture that encourages employees to stay.

  Dr. Lieberman [06:00]: "We have events, we bring people together, we do things. So you're building some camaraderie in the team and over time, we've started to see this."

This approach has begun to yield positive results, evidenced by a declining turnover rate.

3. The Evolving Role of Spine Care in Healthcare

As outpatient care continues to expand, spine care’s role becomes increasingly vital within the healthcare ecosystem.

• Sustainable Demand:

  Dr. Lieberman emphasizes the ubiquitous necessity of spine care, citing that everyone has a spine and an 80% chance of encountering spine-related issues in their lifetime.

  Dr. Lieberman [07:11]: "Spine is here to stay in the global healthcare. I think spine is going to be a much more important economic driver as well, especially with the aging population."

• Advancements in Treatment:

  Improvements in diagnostics, treatment planning, and surgical precision have made spine care more efficient and less invasive. These advancements support the trend toward outpatient procedures and enhanced patient outcomes.

  Dr. Lieberman [07:22]: "Our diagnostics are so much better at this point. Our treatment plans have improved substantially."

4. Innovations and Technological Initiatives

The integration of new technologies is pivotal in enhancing spine care's efficiency and outcomes.

• Data Analysis and AI:

  Dr. Lieberman highlights the importance of data analysis in optimizing clinic operations and patient care. The application of Artificial Intelligence (AI) promises to revolutionize personalized treatment by predicting surgical outcomes based on historical data.

  Dr. Lieberman [08:43]: "The AI component... data information that's going to come back to us is going to help us do better for our patients in the future."

This predictive capability enables surgeons to tailor operations more precisely, potentially reducing complications and improving overall patient satisfaction.

5. Overcoming Challenges and Future Outlook

In his closing remarks, Dr. Lieberman conveys an optimistic outlook for the future of spine surgery despite existing challenges.

• Positive Impact on Patients:

  He debunks the myth that spine surgery is fraught with complications, asserting significant improvements in patient outcomes and quality of life.

  Dr. Lieberman [09:46]: "The myth that having a bad back and undergoing spine care is going to be problematic is all just a myth. We can, we are doing better."

• Exciting Developments:

  With ongoing advancements in technology and surgical techniques, the field of spine surgery is positioned to continue making substantial strides in patient care.

  Dr. Lieberman [09:50]: "There is so much technology at hand right now. We just have to figure out how to use it to the advantage of our patients."

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Conclusion

The episode with Dr. Izzy Lieberman provides a comprehensive overview of the current landscape in spine surgery. From the challenges posed by social media and private equity to the strategies for workforce retention and the promising role of AI, Dr. Lieberman offers valuable insights into navigating the complexities of modern healthcare. His optimistic perspective underscores the potential for continued advancements in spine care, ultimately enhancing patient outcomes and sustaining the relevance of spine surgery within the broader healthcare system.

Dr. Lieberman [10:11]: "Despite all the rhetoric and scrutiny on spine surgery, it is an exciting time. There's a lot that we can do. We can really change our patients' lives now."

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Note: This summary excludes promotional content and focuses solely on the substantive discussions between the host and Dr. Lieberman, ensuring a clear and informative overview for those who have not listened to the episode.

Transcript

[A]

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[B]

Is Grace Lynn Keller with the Becker's Healthcare Podcast and we are recording live at the 22nd annual Spine Orthopedic and Pain Management Conference. I'm currently joined by Dr. Izzy Lieberman who is an orthopedic surgeon at the Texas back Institute. So Dr. Lieberman, thanks for being here. Let's start off by having you introduce yourself a little bit further and share more about your role in organization.

[C]

Thank you very much. It's a privilege and a pleasure to be here and sharing this information with you. I do work at the Texas Back Institute. I've been there for the last 15 years. Prior to that I was at the Cleveland Clinic for 13 years. I trained and worked at the University of Toronto in Toronto, Canada for five years. Before that. I principally do orthopedics and spine surgery. Today the easiest way to describe my practice is I do whatever anyone else doesn't want to do and I do a lot of revision, a lot of deformity work. I'm also involved in a lot of development work. I've got relationships with multiple strategic companies in terms of consulting and I've got my own startup company also that's involved in the spine space.

[B]

Wonderful. Well, thank you for being here and let's start our conversation by talking about trends and shifts. So what are you seeing right now in the industry that you think is most important for leaders to pay attention to?

[C]

There's there's two big trends that that I'm seeing right now, both of which personally are a little concerning to me. The first trend is the use of social media in spine surgery. Now it's permeated in everything in society today and absolutely there are benefits to it, but there are also some non benefits to it. It can be problematic. As spine surgeons we want to make sure that we competitive, we stay in the in in the practice, we can attract the right patients to us and the use of social media for that is exceptionally important. But I do see a trend where social Media is embellishing what's going on out there in spine surgery where individuals are promoting themselves inappropriately to a certain extent. I do a lot of revision surgery and unfortunately I see the guys on social media and then I see the patients coming to me, they're on social media and they're saying, oh, I do this operation under 45 minutes, minimally invasive, skin to skin. But then they're back with me six months later because the surgery was not done appropriate. So the use of social media has to somehow be regulated and monitored and, and likewise the ability for ratings online has become problematic now. There's a lot of fake ratings out there, there's a lot of legitimate ratings out there, but when there is a negative, unwarranted rating on somebody, that becomes very, very difficult to correct. So we need to figure all of that out. The second issue that I see as problematic now in spine surgery is the amalgamation of groups and essentially a lot of physicians moving towards an employee model or the PE firms that are coming up and are starting to gobble up spine practices. Now at Texas Back Institute we're a big group and we were looking at ways to maintain our relevance and sustainability. And we met with a number of the private equity groups and it dawned on me that if, if these guys think they can make money off of myself and my partners, we have to figure out how to make money off ourselves. Why, why are we giving it away to them? And until the private equity group can actually bring a benefit to the table to the surgeons and that benefit obviously is some form of contracting rather than just practice efficiency by rol. Unless they can do that, I really don't see any role. And we see this pendulum swinging towards the private equity and the roll up of the groups, but it's self limited. And that pendulum is going to swing right back and knock people over.

[B]

Absolutely. And I'd also love to touch on staffing and workforce challenges as these continue to be a concern across healthcare. So how is your organization navigating these pressures and what strategies have you seen work?

[C]

Well, the reality today is that the employment workforce is mobile. We're not getting beyond that. The post pandemic reality is that people want to work from home. If we want to maintain our current business profile, we have to be able to adapt to that. So we have taken steps to provide our employees with the ability to work fully from home, from the office, combination things. Working from home, you have to be able to monitor the employees. It's pretty clear that they are not as productive at home. As they are in the office. So that's been a challenge for us as a group, but we've been able to work through that. The transient nature of the employee workforce, they're just going after the, the higher paycheck. They'll go from our practice to the practice next door to the practice next door. And then eventually they come back to our practice again because they see that it's really not that much better, they're making any difference there. So we just have to accept that fact. But we have to add something to the mix. And what we've tried to add at Texas Back Institute is more of a collegial, family related type of approach to this, where we have events, we bring people together, we do things. So you're building some camaraderie in the team and over time, and we've started to see this. But over time we're seeing a drop in that turnover rate.

[B]

And as outpatient care continues to grow, how do you see the role of spine evolving within the broader healthcare ecosystem?

[C]

The good news about spine care is that everyone has a spine. The better news is that over your lifetime, everyone with a spine has got an 80% chance of a problem. So we know we're always going to be in business. There is no doubt that we can do more and we can do it better now in a less invasive, potentially outpatient environment. Our diagnostics are so much better at this point. Our treatment plans have improved substantially. The execution of surgery has become more precise, more efficient. The understanding of physiology has improved where we can be more predictive and avoid some of those complications. So spine is here to stay in the global healthcare. I think spine is going to be a much more important, important economic driver as well, especially with the aging population. And I see exciting things ahead of us with the technology that's out there. There is so much technology at hand right now. We just have to figure out how to use it to the advantage of our patients.

[B]

And that is a perfect segue, actually into my final question. Many organizations are exploring new technologies, partnerships or care models to improve efficiency and outcomes. Are there any innovations or initiatives you found particularly promising?

[C]

Critical review of how we do things is important. Now. We do have a lot of data analysis packages where we can look at our efficiency in the clinic, our outcomes in the operating room. We can look at our patient flow, patient satisfaction. So looking at all that, the ultimate though, and I'm kind of reluctant to use that term, but the AI component, everyone's using AI, AI. But the reality is that data information that's going to come back to us is going to help us do better for our patients in the future. If I know that I do operation X on patient Y the same way every time and I get this result, the AI is going to remind me, this is patient X. Do operation Y. This is what you're going to get. So that's where I think we're going to see a lot of benefit in spine surgery.

[B]

Wonderful. Well, as we wrap up, is there anything else you'd like to share that we didn't touch on today?

[C]

Just to reemphasize? Despite all the rhetoric and scrutiny on spine surgery, it is an exciting time. There's a lot that we can do. We can really change our patients lives now. And the, the myth that having a bad back and undergoing spine care is going to be problematic is all just a myth. We can, we are doing better.

[B]

Wonderful. Well, Dr. Lieberman, thanks so much for being here today on the Becker's Healthcare Podcast. Again, we're recording live at the 22nd annual Spine Orthopedic and Pain Management Conference.