Spine leaders' playbook: Best tips for the next generation of surgeons

Practice Management

From managing your finances to building your referral base and choosing the right place to practice, the challenges for new spine surgeons are many.

With these in mind, seven spine leaders shared their advice for the next generation of spine surgeons graduating from residency and fellowship programs this year:

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.

Next week's question: What's the next regulatory change you would like CMS to implement?

Please send responses to Alan Condon at acondon@beckershealthcare.com by 5 p.m. CDT Wednesday, April 20.

Editor's note: Responses were lightly edited for clarity and length.

Question: What tips do you have for spine surgeons beginning practice this year?

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: I recommend all spine surgeons entering this space do three things:  

1. Get a good lawyer to look through your recruitment agreement and employment contract.

2. Have a clear mind when it comes to jobs. Do not settle for less and think it's normal to accept less than Medicare rates for any service or operation.

3. Build a coalition and camaraderie with your local surgeons. Together you can create a marketplace, but also be able to protect one another from predatory practices by corporate medicine.  

William Taylor, MD. University of California San Diego: Continue to make efforts to manage your online reputation. Social media will continue to be a dominant player in initial patient decisions and opportunities for practice advancement.

Emeka Nwodim, MD. The Centers for Advanced Orthopaedics (Bethesda, Md.): My advice for spine surgeons just beginning their career includes:

1. Trust your training.

2. Remember to communicate — and listen.

3. Be patient with your own growth and development.

4. Prioritize work-life balance.

5. Find the right balance between innovative spine technologies and approaches that stand the test of time.

6. Understand the business of medicine, beyond clinical care.

7. Know your value.

John Burleson, MD. Hughston Clinic Orthopaedics (Nashville, Tenn.): You are smart or you would not be where you are. But do not reinvent the wheel. Talk to people that have come before you, ask them what questions you should be asking, and make sure you're doing what you're doing for the right reasons. Pick a location that's good for you and your family in a group or academic institution that will support you and your goals. And by all means, write down a financial plan. You're about to have a change in your income that will not happen again in your life. Do you want to go into that with a plan that allows you to scale your personal finances in a way that is safe? No one should be a spine surgeon in the United States and worried about paying their bills or sending their kids to whatever school they want to. But it happens all the time because people don't have a plan and their expenses rise to meet their income. Don't let that be you. Be smart, ask for help, ask for advice, and plan ahead!

Navin Sethi, MD. The Centers for Advanced Orthopaedics (Bethesda, Md.): The biggest tip I have for spine surgeons starting out is to believe in themselves and trust in their education. Despite any external pressures they may face, if they listen to their intuition, they will find success.

Ali H. Mesiwala, MD. DISC Sports & Spine Center (Newport Beach, Calif.): Take your time to establish a quality practice. Set short-term, mid-range and distant goals. Focus on excellent outcomes at the outset, and do not worry about volume of cases. Once you feel you have mastered the basic skill sets that you need, then begin integrating newer procedures and technologies, and consider moving to the outpatient setting.

Issada Thongtrangan, MD. Microspine (Scottsdale, Ariz.): Three pieces of advice:

1. Make friends with senior colleagues and know your limits. Don't let your ego blind you. Don't be shy to ask for help. They have a ton of experience that you do not have, so it is better for the patients.

2. You will make mistakes, but make sure you learn from your mistakes.

3. Call your referral sources. This is the best return of investment, in my opinion.

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