Differences in Canadian, U.S. spine care: Q&A with Dr. Stephanie de Vere

Written by Alan Condon | October 21, 2019 | Print  |

Stephanie de Vere, MD, is an orthopedic spine surgeon with Kansas City, Mo.-based Sano Orthopedics.

After completing her residency and two complex spine fellowships in Canada, Dr. de Vere moved to the U.S. and began practicing at Sano in August.

Here, Dr. de Vere discusses notable differences between the U.S. and Canadian healthcare systems and outlines her professional goals at her new practice.

Question: What lessons do you think the U.S. healthcare system can learn from Canada's?

Dr. Stephanie de Vere: I think the U.S. healthcare system is great in many aspects. Here, my patients have access to physical therapy daily, private rooms, and don't wait many months for necessary imaging. I do think by training in Canada, I am very conservative and want to exhaust all non-operative options before offering surgery. I believe patient expectations are more realistic when they know all other treatment options have been exhausted. 

Q: As a spine surgeon, what are the most significant differences between practicing in Canada and the U.S.?

SDV: So far, not too much. There is more control here and much more help to get my work done. PAs are very uncommon in Canada but are an incredible resource for surgeons and patients. The focus on customer satisfaction pushes everybody from the porter to the CEO to pay attention to patient outcomes.  

The insurance system adds a tremendous amount of bureaucracy and is frustrating as a newly landed surgeon.

Q: Why did you choose to join Sano Orthopedics? What are you most looking forward to in your new practice?

SDV: Sano and I are a very natural fit. Knowing that I was coming from a universal to private healthcare system, it was imperative to find a supportive group. Sano is a mixed subspecialty group, and there is no competition within the group. Sano also encourages pro-bono work and volunteering, which I appreciate.  

Q: What are the biggest takeaways from your spine fellowships at the University of Ottawa and the University of Toronto?

SDV: In Canada, spine surgery is very regionalized. Both had a catchment area of more than 1.5 million and 1,300 beds. The volume was extremely high, as was the complexity of the cases. 

Q: What are your professional goals for the next five years?

SDV: My goal is to build a strong community spine program. My first focus is always helping patients make the best choice and surgical outcomes. I hope to always keep this and find colleagues who share this thinking as we grow the program. I am also affiliated with a great medical school and hope to continue growing as a teacher.

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Dr. Thomas Loftus: How a single-payer system would harm spine practice in the US

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