Dr. Lauren Matteini is a spine surgeon and partner at Fox Valley Orthopedics in Geneva, IL a suburb of Chicago.  She’s been in practice for ten years. Join in as we chat about what she sees are potential roadblocks for orthopedic ASCs in 2024, opportunities on the horizon, and her inspiration for starting Boss Lady Docs, a female physician networking group with over 200 members.

Advantien: Can you tell us a little about your background and inspiration for founding Boss Lady Docs?

Dr. Lauren Matteini: I did all my training on the East Coast and I came to Chicago in 2016 to work at Loyola. In 2020, I joined Fox Valley Orthopedics. I have been here for over three years and have already been made a partner in the practice. I have firm roots here now, but it wasn’t always that way.

I really struggled initially in the COVID era to make a connection with colleagues as we weren’t able to meet in person and all of the hospital meetings were virtual as well. I relied heavily on texting, cold calling, and “meeting” people through e-chat. That’s realistically how BLD started, it was just me trying to make connections in a new practice and a new area.

Advantien: COVID was such a hard time for everyone, I love that you took such a proactive approach to building a community with other like minded doctors. Was it well received?

Dr. Lauren Matteini: Absolutely, I found kinship with a lot of the women physicians who were like me and struggling to feel connected during COVID. We started out with Zoom happy hours, but once the vaccination came out and the CDC said it was safe for in-person meetings, we had our first in-person get together.

Advantien: So Boss Lady Docs started in 2020, where is it today?

Dr. Lauren Matteini: We are now 221 physicians, all women, all MD or DO, all within about 45 minutes of each other throughout the Fox River Valley in the Chicago suburbs. We generally refer patients among each other, but we aren’t all aligned with the same hospital systems. Many of us are in private practice. The group has a wide swath of specialties from primary care to surgeons and everything in between.

It’s grown tremendously and we’re just trying to make a difference for each other and for our patients. It gives us an opportunity to stand up to corporate medicine, fight the good fight, and help each other. It’s important that we have a strong voice.

Advantien: Speaking of struggles, how have things changed for you as a spine surgeon practicing at an ASC?

Dr. Lauren Matteini: Problem number one is more denials. In the time that I’ve been with Fox Valley Orthopedics, the insurance companies, CMS in particular, have changed what are considered ASC-approved codes. The CMS coding guidelines have been extremely slow to recognize ASCs as being a safe place to do certain surgeries. They’re not permitting us to perform outpatient surgery in an outpatient setting, even though it is more cost-effective and a great deal safer (and more comfortable) for patients.

Surgery in an ASC is infinitely better for patients in the appropriate circumstances. You’re dealing with a small group of professionals dedicated and trained in these kinds of procedures. The level of exposure to infection is far lower. Unfortunately the insurance companies are forcing patients into hospitals and in some cases, many hospitals are still bogged down with lingering issues from COVID, staffing issues, and the like. I think corporate medicine is really missing the mark on patient care. Realistically, they’re not being proactive in cost savings and they’re not being proactive in patient safety. As an ASC, we’re trying to resolve these issues but we often face roadblocks.

Advantien: So I’m curious, how are you balancing the need to maintain or increase your patient volume while still providing quality patient care in a financially strained environment?

Dr. Lauren Matteini: It’s so important to educate the patient, pulling back the curtain so they know the insurance company doesn’t have their best interest at heart. It can be deeply challenging when the general public thinks that we’re in cahoots with the insurance companies. It’s really making sure that a patient is well-informed, explaining that we’re doing everything we can to get them the most coverage possible. Unfortunately, because we’re the ones in the room with them when they find out insurance doesn’t want to approve something, we’re often held responsible. In reality, we’ve done everything we can behind the scenes to provide the safest and most cost-effective care. We are a team with our patients – never their opposition.

Advantien: That’s a really tough position to be in, does it ever affect how you provide care?

Dr. Lauren Matteini: Unfortunately, yes. For example, if an insurance company won’t cover a certain code or type of implant I’ll have to use a different implant and change my surgical plan to accommodate the insurance company guidelines. I have had that happen, and the patient doesn’t understand why. All we can do is try to educate people about the nuances of what we’re dealing with behind the curtain. I think the more that we empower our patients to learn how the system works, the better off they’ll be because they can make an educated decision on the insurance company and plan that they choose.

Advantien: As you know, orthopedic implants are often the largest expense for orthopedic surgeries right after labor. With everything that you just mentioned about the evolving ASC landscape, what would you personally like to see with orthopedic implants right now?

Dr. Lauren Matteini: I think there is going to be more partnership with companies developing products and providing implants for individual ASCs. Working together as a team will allow us to best serve our patients.

If we can all work together from a cost-saving perspective where the manufacturers of the implants are getting an adequate price for their implants and our patients are getting an adequate price for their surgery then we’re able to keep our doors open and provide good patient care. That’s the ideal – a good result for the patient. When we’re trying to identify cost savings and optimize our supply chain it is really important to work with partners who can create implements and hardware for us.

Advantien: Agreed, it certainly does take a lot of collaboration to ensure both profitability for the ASC and excellent patient outcomes. Looking ahead, what do you think are some of the big changes we’ll see with ASCs?

Dr. Lauren Matteini: Nothing. CMS has already given us their guidelines for 2024. We already know that there are certain sports medicine procedures as well as total shoulders, I believe, that are approved to be outpatient in an ASC. As far as I know, there won’t be any additional changes for the remainder of the year for spine.

I am already looking towards 2025 and hoping that CMS will be able to change some things for us with the data that we’re providing to them. Outpatient lumbar fusions are safe, cost-effective, and patients are so relieved to recover at home instead of in a hospital setting. By offering this option when appropriate, we’re taking some of the burden off of hospitals and allowing their staff to concentrate on inpatient needs. Further, we’re lessening the financial burden of a full inpatient experience.

Advantien: That’s powerful and we certainly need forward thinking surgeons like yourself standing up and speaking out so we can enact change that will benefit the patients and physicians, not just the insurance companies. 

Thank you so much for sharing your insights with us today, I greatly appreciate your time. If our readers want to learn more about you and Boss Lady Docs, what’s the best way to connect with you? 

You can reach out to Dr. Matteini via email at lem@fvortho.com, Instagram at @drlaurenmatteini or connect with her on LinkedIn. Boss Lady Docs is also active on Instagram at @boss_lady_docs.