Episode 143 - Todd Wetzel, part 2: Several Pounds of Our Time

F. Todd Wetzel MD

In this episode, # 143, I have the conclusion of my interview with Dr. Todd Wetzel Vice-Chair of the Department of Orthopaedic Surgery and Sports Medicine and Professor of Orthopaedic Surgery and Sports Medicine.  He shares more thoughts on the challenges in current clinical practice, what patients really need, prevalence of surgery, fee-for service and cost transparency.  This week on MCF.


Dr Wetzel obtained his MD from the University of Pennsylvania and completed a residency in Orthopaedic Surgery at Yale. He established the adult spine program at Pennsylvania State University School of Medicine, was the Chair of Surgery at UCH-Wiess, Vice Chair of the Department of Department of Surgery at the University, and head of the Quality Resource Program.

Dr Wetzel has been at Temple University since 2004 where he is currently Professor and Vice Chair of the Department of Orthopaedic and Sports Medicine, and Professor of Neurosurgery.

Aside from a practice in spinal surgery, Dr Wetzel is the author of over 200 peer reviewed papers, abstracts, and textbook chapters. He is also active in the North American Spine Society where he serves as president this current term.

Dr Wetzel was appointed to the Board of Trustees of the McKenzie Institute in 2010.

Show Notes 

Educating Patients Properly

Todd discusses some typical challenges in patient education:

Has the patient been misinformed? Is the patient biased? Is the patient taking opioids?

He discusses the hardest educational issue, being time. He also discusses overuse of injections and interventional care. We discuss the common issues with referral and patients “falling off the radar” after referral. 


The Role of Repeated End-Range Pain Response Assessment in the Management ofSymptomatic Lumbar Discs

Dr. Wetzel talks about the factors that drove his interests spinal assessment and its importance in identifying anticipated patient response to conservative or interventional spine care. This eventually led to the publication of the above in Spine 2003.


Lack of Transparency and Fee-for-Service

Dr. Wetzel talks about the regional density of spine surgeons and performance of particular surgeries, how this presents issues with fee-for-service reimbursement, and the impacts on economics and patient welfare. He speaks about the current issues with fee-for-service reimbursement and how MDT is an excellent transition point for the value-based model. 

Todd discusses some important points that may help improve the current situation.


The North American Spine Society

Todd talks about how comprehensive NASS has become, and the growing international footprint. He talks about the current endeavors, including education, research, the Spine Journal, lobbying and advocacy, and the National Spine Foundation.





Dr. Wetzel’s Take Home Messages

“Always remember first, our oath as healthcare providers to do no harm.”

He encourages us to be advocates for our patients, and continue to think (or transform our thinking) in a more precise diagnostic manner.