NASS On Spine

May 03, 2016

Q&A With Matthew Smith, MD

1. What is your hometown and where do you currently live?

I grew up in Calgary, Alberta and currently live in East Greenwich, RI.

2. What is your educational background?

After attending medical school at Queen’s University in Kingston, Ontario, I completed my residency in Physical Medicine & Rehabilitation at Stanford. I worked at Kaiser Permanente for three years, then returned to the University of Michigan for a fellowship in spine and musculoskeletal medicine. Most recently, I completed an Executive Master of Healthcare Leadership at Brown University.

3. Tell us a little bit about your practice/specialty …

I started East Greenwich Spine & Sport in 2003 as part of the outpatient rehabilitation department of our local hospital. In 2005, I incorporated as a private practice with my partner, who is a D.O. specializing in neuromusculoskeletal medicine (NMM). Since then we have fluctuated between four and five providers, including physiatrists, NMM specialists, primary care sport medicine physicians and nurse practitioners. In July 2014, East Greenwich Spine & Sport transitioned from private practice to a member of the local hospital physician organization. In addition to performing fluoroscopically-guided spine procedures, I offer acupuncture/integrative healing, electrodiagnostic evaluations and medicolegal consultative services.

4. How long have you been a NASS member and why did you join?

I have been a member of NASS since shortly after completing residency in 1999. I originally joined for educational purposes regarding clinical spine medicine. While I still benefit from that component of NASS, I have more recently come to value NASS’ role in policy and advocacy.

5. You recently attended a NASS Advocacy Conference in Washington DC. Why do you think it’s important to get involved with health care advocacy/political issues?

Clearly, we are in a time of major change. We must be part of the conversations happening in committees at local, state and national levels. While it may be cathartic to kvetch about the injustice of a utilization review on one patient, it doesn’t change anything to win one coverage battle or to vent at one claims adjuster. Only we can assure someone is considering our interests. There is also an opportunity to craft good policy. In Washington, I was struck by two things: first, how thoroughly political staffers understand health care policy and, second, how poorly the politicians themselves understand health care policy. It is essential that we engage in political advocacy, because we can hold tremendous sway over the opinions formed by politicians.

6. What did you learn at the conference that might better inform you for future advocacy efforts?

Politicians welcome conversations with the people affected by their decisions. Moreover, I believe they value helpful discussions that seek to find solutions to complex problems more than discussions with a lobby that champions narrow interests. There are numerous people easily accessible to every NASS member who have the ability to influence health care policy. They want to hear from us.

7. What do you think is the most pressing issue or issues in spine care today?

How will specialists fit into alternative payment models? While I generally believe that improvements in practice paradigms must happen in concert with aligned payment models, it is not clear how specialists will be integrated into care teams. While integrated delivery systems may work for some, private organizations of spine specialists are sure to persist for the foreseeable future. The rules regulating relationships between specialists and the primary care networks accountable for increasing numbers of patients are still being determined.

8. What advice would you give to a young, aspiring spine doctor (or spine care provider)?

Wow, this question makes me feel old! Do the right thing. Be wary of technology that bursts onto the scene with great fanfare. Be wary of trying to cure misery with metal. While the business of medicine is susceptible to market whims, people will always turn to you if they trust your integrity.

9. Why should members attend NASS meetings?

The meetings represent the fruits of NASS members’ dues and volunteerism. NASS faculty and staffers work year-round pursuing missions of advocacy and education. NASS meetings are the best way for members to learn and network while engaging in the health care system to create the spine care industry that they want.

10. What do you do for relaxation in your down time (example: hobbies, sports, travel)?

I enjoy skiing, sailing, teaching taijiquan, coaching basketball, reading to my daughters and cooking with my wife.


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