How 4 spine surgeons dealt with difficult conversations with colleagues


Four spine surgeons share the most difficult conversation they have ever had to have in the workplace.

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. We invite all spine surgeon and specialist responses.


Next week's question: Can independent physicians survive in today's rather volatile healthcare landscape?

Please send responses to Anuja Vaidya at by Wednesday, April 19, at 5 p.m. CST.


Question: What is the most difficult conversation you've ever had with a colleague?


Kern Singh, MD. Co-Director of Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush (Chicago): Trying to run an efficient and effective study with the colleagues in my research group can, at times, lead to difficult conversations. We'll have studies where it's important for all the physicians to contribute patients to the overall sample, but one member of the team has low enrollment rates. In these situations, even if it may create tension, I make sure to outline the consequences of their low enrollment and how the issue needs to be fixed.  


Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: I did once have to critique a more senior colleague while I was peer-reviewing something he had done. The colleague was belligerent and very difficult, and even started shouting at one point. I learned a lot. A lot about how professionals do not behave. It was watching how he handled criticism — from yelling, to questioning my credentials, to a rant on how I had no place to criticize him (when the hospital had picked my specifically) and I was able to see how vulnerable some people feel when they are being evaluated. I felt we both could have handled it better, but it was good. I learned how not to act when I would be in the same spot.  


Richard Kube, MD. Founder and CEO of Prairie Spine & Pain Institute (Peoria, Ill.): I had to terminate a junior associate. The individual was not following protocol, nor was he meeting productivity goals. I liked the guy and considered him a friend, which made it a very difficult conversation. In the end, keeping it very objective and fact based got me through it. Ultimately, the breakup was amicable. We still talk to each other and he occasionally refers patients to me.


Alden Milam, MD. Spine Surgeon at OrthoCarolina (Charlotte, N.C.): I have had to have the very difficult "you are detrimental to our group" conversation with a colleague. Not an easy conversation to have.


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