Comprehensive, Streamlined Care for Patients with Advanced Spine Care Needs

By: Valerie Lauer
Monday, June 13, 2016

At WellSpan Health, a standardized approach to patient management and a comprehensive range of services create an environment in which physicians can feel confident referring patients for issues of the cervical, thoracic or lumbar spine.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases estimates that four out of every five people will deal with back pain during their lives. Not only are spine issues common, but diagnosing their precise causes and safely guiding targeted treatments can be an involved process that requires a variety of therapies and multiple follow-up visits.

“Effective management of spinal pain and other back and neck concerns is our sole focus,” says Deborah Bernal, MD, Medical Director of Physiatry with WellSpan. “Our program manages all aspects of spine care, serving as the go-to resource for area physicians and patients.”

A Holistic Approach

As a physiatrist, Dr. Bernal is deeply familiar with comprehensive, integrated care. Her practice focuses on providing complete solutions, from effective diagnostics to targeted therapies to services that address the real-life psychosocial implications faced by patients with these health issues.

Dr. Bernal’s colleagues at WellSpan have a similar goal. Whether patients are dealing with nerve pain, spinal trauma, neck pain, chronic degeneration, disc herniation, cancer, musculoskeletal issues or other concerns, the physicians, advanced practice clinicians and staff with WellSpan Spine Care offer integrative solutions.

“The physiatrists in the program work collaboratively with orthopedists, neurosurgeons, physical therapists, occupational therapists, vocational therapists, industrial rehabilitation specialists and other supportive medical teams,” Dr. Bernal says, “to create care programs tailored to patient needs.”

WellSpan Spine Care also works closely with the providers at the WellSpan Center for Mind/Body Health. This allows physicians such as Dr. Bernal to incorporate massage therapy, yoga, acupuncture and other complementary therapies into patients’ care plans.

“Using a team approach, we connect spine care patients to the right providers and therapies in the most efficient manner possible. Our referral triage simplifies intake and opens lines of communication to keep physicians in the circle of care throughout the process.”
— Deborah Bernal, MD, Medical Director of Physiatry, WellSpan

Behavioral health services are available as needed to help patients navigate the ways spinal issues can impact their lives, such as living with chronic pain, managing depression or being unable to do some things they previously could.

Patients serve as key players on their own spine care management teams, completing strengthening and stretching exercises at home, using medications as prescribed to mitigate symptoms and pain, and voicing concerns and needs to providers.

Throughout the process, original referring physicians stay in the loop and serve as another key member of the patient management team, thanks to a seamless referral process.

Collaboration and Referral

For WellSpan Medical Group family medicine physician Chris Echterling, MD, WellSpan Spine Care serves as a trusted source of expert information and support.

“Most of my adult patients experience back and neck pain at some point, and it’s not uncommon for that to be their major concern and reason for coming to my office,” Dr. Echterling says. “In some cases, I can offer conservative treatment, but for patients whose concerns appear to be from an underlying issue, such as a herniated disc or immune suppression, and who need comprehensive pain management or the additional input and support of a specialist, I work with WellSpan Spine Care.”

Referral is straightforward, especially from the physician perspective. Offices can make referrals via fax or telephone, or by using the WellSpan EHR system if they are part of the network.

WSC-Doc With Male Patient -full

WellSpan Spine Care intake uses a triage system to identify patients’ concerns and ensure that those with immediate needs are seen in a timely manner. Referring physicians do not have to identify a specific team or specialty within the program at the time patients enter. Triage collects the necessary information from patients to identify which groups or subgroups within the program best meet their needs and ascertain that the appropriate specialist is seen the first time.

“I always know the specialist’s findings and recommendations for care,” Dr. Echterling says. “It’s important for me to stay in the loop with my patients, and this program allows me to do that. If my patients simply need a specific injection or short-term intervention from the spine care program, I may oversee that care. The center may send me a recommendation for treatment or reinforce my therapy recommendations, and patient care stays completely in my hands. Even if a provider with WellSpan Spine Care assumes treatment, I stay connected to the process as the primary care provider.”

Dr. Echterling also appreciates the spine care specialists’ focus on non-opiate solutions to pain management, addressing the issue of potential prescription medication addiction and abuse proactively.

Leaders in Spine Care

In addition to being home to an integrative spine care program, WellSpan Health is accredited by the Pennsylvania Medical Society to provide AMA PRA Category 1 Credits to provide continuing medical education. That gives spine care specialists an opportunity to pass on best practices and help establish standards for quality and patient care.

In these sessions, WellSpan providers offer information about primary care spine protocols, red flags that indicate an immediate referral to WellSpan Spine Care is necessary, and answers about the use of assessment tools and other resources to improve and streamline the care of those with spinal concerns.

“We have established a program that sets the standard for spine care in our region and meets or exceeds national standards,” Dr. Bernal says. “Now, our mission includes sharing the elements that make our program and patients so successful, while continuing to improve and perfect our process.”


To refer a patient to WellSpan Spine Care, call 877-483-6471 or 717-812-6009. For more information about WellSpan Spine Care, visit www.WellSpan.org/Spine.