Dr. Frank Cammisa reflects on lifetime achievement award, future of HSS

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Spine surgeon Frank Cammisa Jr., MD, has had a long career at New York City-based Hospital for Special Surgery as its chief emeritus of spine. In June, he was recognized for his work and earned HSS' Lifetime Achievement Award.

Dr. Cammisa spoke with Becker's about his career and why he's excited for the next chapter at HSS.

Note: This conversation was edited for clarity.

Question: When you look back at your career, what are the defining moments that shaped you?

Dr. Frank Cammisa: I went to Tufts University in Boston for an undergraduate degree and thought my life would be in the Boston area. One defining moment that shaped my career was going to Columbia University College of Physicians and Surgeons for medical school, which fortunately brought me to New York City. After medical school, I was accepted for my orthopedic residency at Hospital for Special Surgery.

During residency, I found my interests were focused towards spine surgery. The second defining moment in my career was the opportunity to train for my spine fellowship at the University of Miami and the Miami Project to Cure Paralysis with Drs. Frank Eismont and Barth Green. The training I received in my fellowship provided me an excellent foundation in spine surgery, enabling me to return to HSS well trained and prepared to build a practice both academically and clinically.

After only a few years in practice at HSS, I was offered the position to be chief of the spine service, which was not only a defining moment in my career but afforded me the opportunity to lead a team over the next 20 years to build a world class spine service.

During that period, the growth of the spine service was rapid, growing from two to 20 surgeons focused entirely in spine surgery. As an academic institution, this growing service needed the infrastructure of a dedicated translational research program to build that collaborative bridge between physicians and scientists. In 2009, I began the integrated spine research program and recruited Celeste Abjornson, PhD, to be the director of the program so we could begin to answer significant clinical questions by developing research platforms from concept to clinical implementation. Our main areas of focus have been motion preservation, biologic agents utilized in spine surgery, manufacturing techniques like additive manufacturing (three-dimensional printing) towards truly biomimetic implants, and navigation/robotics for better surgical planning and guidance. I am truly fortunate to have great colleagues both in the clinical and research arenas, and working with them has allowed me to have a very rewarding career.

Q: Looking at the first half of the year, what are some of your top accomplishments?

FC: Personally, being awarded the HSS Lifetime Achievement Award is obviously number one. More broadly at this point in my career, I view professional accomplishments as milestones of improving patient care. Some of my research collaborations with industry are maturing to fruition and I think will greatly benefit patients in the near future. Over the last several years, I've been proud to be a member of the board of directors for Woven Orthopedics. Earlier this year, we received clearance from the FDA for a simple but elegant solution for fixation of implants to bone. This will be a great clinical benefit to many patients. In addition, I am part of two other company's boards of directors that are currently being reviewed by the FDA. After so many years of work, it is such an accomplishment to have such positive and exciting interactions at the FDA. First, OrthoBond, founded by Greg Lutz, MD, of HSS, has developed an antimicrobial surface treatment to prevent biofilm formation on implants. I accepted the position as chief medical officer because I believe the clinical impact to patients across orthopedics and other surgical areas of medicine is a true game changer. In the first half of this year, we recruited a new chair of the board, Eric Majors, who has lead successful start-ups such as AOM and K2M and benefited from clinical care with novel additions to spine surgery. The most groundbreaking and disruptive technology that I am currently working on is a seven amino acid peptide for regeneration of cartilage within the disc that may change the entire care continuum of degenerative disc disease, eliminating the need for surgery for a vast amount of patients. We were able to begin the FDA Phase III IND trial earlier this year and I am most proud of the clinical trial design and real world parameters that we are measuring to assess true value.

Q: In the second half of the year, HSS is going to have some big changes as Bryan Kelly, MD, steps into his CEO role. What do you expect from this transition, and how do you feel about it?

FC: Lou Shapiro has done a tremendous job as CEO of HSS for nearly two decades and has strategically and operationally positioned the hospital. With this transition, I'm extremely excited about Dr. Kelly transitioning from surgeon-in-chief to CEO. There simply isn't a better person for the job. His perspective as a surgeon, a businessman, and leader will bring great vision to the future of HSS. To have a CEO that has a true 360-degree perspective of both the medical issues and the business issues is phenomenal and extremely rare. In addition, he will have an experienced team with the transition of Doug Padgett, MD, who was associate surgeon-in-chief to the surgeon-in-chief, providing continuity to the mission. Dr. Padgett is not only a great surgeon and well respected but is a strong leader and mentor. I'm very optimistic about the future of HSS with them leading us.

Q: Is there anything new in spine surgery that you hope new generations of surgeons will embrace?

FC: Currently, it's robotics, it's navigation and it's trying to do things more minimally invasive. It's focusing on return to function, not just pain relief, thereby getting patients back to the lives they had prior to the onset of their clinical issues. The next generation of surgeons will be facing patients that live longer and are looking to maintain high activity levels. Personally, I think it's important for them to develop the academic side of their career even if their career path isn't at an academic center. Staying connected and keeping up on the latest advancements in research and development not only makes you a better surgeon but provides you the knowledge to offer cutting-edge solutions. If some day, we can fully understand the pathologic spinal disease progression, we can intervene earlier and more precisely, thereby improving clinical outcomes. However, the key to a successful career is always continuing to learn and advance your knowledge and skills.

Q: Are there any healthcare trends you're following closely?

FC: At least in the field of spine care, the focus is on evidence-based research, especially real-world outcomes utilizing big data platforms so that we truly understand if our surgical treatments are providing clinically important differences across a complex, highly variable patient population. Secondly, the trend towards more comprehensive multidisciplinary specialty interaction. Tearing down the barriers of compartmentalized medicine approaches, it is extremely important that spine surgeons work together closely with physiatry, neurology, anesthesia and pain management to really take global care of the patient. Finally, the world has changed post-COVID, and being able to interact with patients by new platform mediums like virtual appointments and interactive patient portals allows greater connectivity to your patients, which can only result in better care management.

Q: Is there anything else you want to discuss that we haven't touched on yet?

FC: Patient expectations. As information has become so readily available, both accurate and sometimes inaccurate, it is vital that clear expectations of the goals of the surgery and the clinical outcomes are well defined in terms that a patient can understand. Each patient is unique, as are their goals. At HSS, we have focused, especially in spine surgery, in terms of what patients' expectations are of surgery and seeing how the surgeon's and the patient's expectations of a procedure correlate. The research efforts in this area at HSS have been led by Carol Mancuso, MD. In collaboration with myself and many of my colleagues, Dr. Mancuso's team has worked to validate patient expectation outcome measures to elucidate the disparities and alignments of expectations, not only physically but psychologically. Patients well-informed about all expectations of surgery leads to better results.

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