title: The establishment of a primary spine care practitioner and its benefits to health care reform in the United States.
abstract: It is widely recognized that the dramatic increase in health care costs in the United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care. In no area of medicine is this more true than in the area of spine related disorders (SRDs). Costs of medical care for SRDs have skyrocketed in recent years. Despite this, there is no evidence of improvement in the quality of this care. In fact, disability related to SRDs is on the rise. We argue that one of the key solutions to this is for the health care system to have a group of practitioners who are trained to function as primary care practitioners for the spine. We explain the reasons we think a primary spine care practitioner would be beneficial to patients, the health care system and society, some of the obstacles that will need to be overcome in establishing a primary spine care specialty and the ways in which these obstacles can be overcome.
authors.affiliation: Rhode Island Spine Center, 600 Pawtucket Avenue, Pawtucket, RI 02860 USA. rispine@aol.com.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Murphy
authors.forename: Brian D
authors.initials: BD
authors.lastname: Justice
authors.forename: Ian C
authors.initials: IC
authors.lastname: Paskowski
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Perle
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Schneider