When John O’Toole, MD, chair of the department of neurological surgery at Rush, walks into work, what excites him most is not the chance to lead a department recognized on U.S. News & World Report’s Best Hospitals 2026-27 list for neurology and neurosurgery — it is the opportunity to grow his own knowledge through intentional teamwork.
Chicago-based Rush University Medical Center took the No. 5 spot on the annual list. Dr. O’Toole connected with Becker’s to share how collaborating across departments and encouraging curiosity allows him to lead an award-winning team.
Excellence across 4 fronts
Dr. O’Toole said success is not reliant on any single factor. He pointed to how well those factors work together.
“Highest quality in patient care, highest quality in the education of our trainees, highest quality in our research and highest quality for leadership at the local and national level,” he said. “Those are the features of an elite neurosurgical program.”
Dr. O’Toole said none of that happens through individual brilliance alone.
“In all of that you need excellence at the individual level, but it’s really about building appropriate teams where those excellent individuals complement each other, support each other and build each other up,” he said.
He described that as a two-part effort: recruiting subspecialists who are excellent within their own discipline, then figuring out how to partner them with affiliated specialties the department works closely with. He said his team has been able to build relationships through communication with anesthesia, radiation oncology, general surgery, thoracic surgery and rehabilitation, along with researchers across the university.
“What distinguishes these top-tier programs is the ability to build teams not just within the discipline of neurosurgery, but across disciplines,” he said.
Asked for an example of that cross-departmental collaboration changing outcomes, Dr. O’Toole highlighted two areas: perioperative care and oncology.
Years ago, he said, the department began working with anesthesia partners to adopt enhanced recovery after surgery protocols for postoperative management, starting with spine patients and later extending to some cranial cases.
“Reducing postoperative pain, increasing mobilization, decreasing perioperative opioid requirements and reducing length of stay,” he said, describing the results. “That’s a simple example of partnering with our affiliated specialists to improve our patient care.”
The oncology side follows the same model. Rush has built comprehensive clinics and tumor boards for brain and spine tumors that bring together neurosurgeons, radiation oncologists, neuro-oncologists, interventional radiologists and diagnostic radiologists — co-located physically and connected through shared multidisciplinary tumor boards.
“So that the care of these patients is centralized, streamlined and communications are essentially real time and immediate, expediting and optimizing the care of these complex patients with brain and spine tumors,” he said.
A shared culture of curiosity
As chair, Dr. O’Toole said one of his favorite parts of the job is the daily work of coordinating across departments — not despite the friction it can create, but because of what it teaches him.
“It’s always enlightening and educational,” he said. “It’s absolutely fascinating to work with folks from the other departments and get their points of view and perspectives on patient care and operations and research, and I’m always learning something new.”
He said his team is able to improve patient care because individuals across departments want to learn from each other.
“We all have something to learn from each other,” he said. “So it’s intellectually stimulating, and we know that by doing this, we’re going to get better outcomes for our patients, and at the end of it, we all become more efficient because we have more hands on deck.”
He described the resulting dynamic less as a strict hierarchy than as a shared effort.
“Sometimes there’s a captain of the ship depending upon this specialty, but very often it’s more of a collaborative effort,” he said. “That’s honestly one of the things I’ve learned to enjoy the most about this position.”
For a chair overseeing a program that spans multiple hospitals and outpatient sites, Dr. O’Toole said the through-line is not a piece of technology or a single strategic bet. It’s the people.
“The strength of a department like ours is really dependent upon the character and quality of the individuals that make it up,” he said. “I’m lucky in that I get to lead a group of people that I have tremendous respect and, frankly, admiration for, and all of whom understand that the whole is greater than any individual.”
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