Seven spine surgeons discuss the key qualities of great spine specialists.
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: What are the latest spinal fusion trends in 2018?
Please send responses to Anuja Vaidya at firstname.lastname@example.org by Wednesday, May 30, at 5 p.m. CST.
Question: What is the most underrated quality of a great spine surgeon?
Payam Farjoodi, MD. Orthopedic Spine Surgeon at Spine Health Center at MemorialCare Orange Coast Medical Center (Fountain Valley, Calif.): Equanimity. Not getting too high with the ups and not getting too low with the downs.
Mark M. Mikhael, MD. Spine Surgeon at NorthShore University HealthSystem's Orthopaedic Institute and Illinois Bone & Joint Institute (Chicago & Glenview, Ill.): While technical skills are vital to be a great spine surgeon, perioperative interactions with patients and family cannot be understated. Spine pathology and surgery can become routine workflow for many surgeons, but the education of pathology and treatment plan is often very new and foreign to most patients.
Surgeons must not forget that although they have "done this a hundred times," for most patients, this is the first time. The most underrated quality of a great spine surgeon is the time spent with patients before surgery educating them on the problem, reviewing the treatment options and helping them understand the information provided. During this time, surgeons gain the patients' trust and their commitment to the treatment plan. This continues with seeing them during the hospitalization, reassuring them that all is progressing as expected and answering their questions as they arise.
Finally, visiting with patients postoperatively is important to understand if you set the right expectations and if the patient felt as though you guided them through the surgical process well. This is an opportunity for the surgeon to learn from the patients: Are there better ways to prepare patients? Am I setting the correct expectations?
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: [The spine surgeon's] ability to take responsibility when things don't go as planned. His honesty, modesty and humanity for dealing with a successful surgery or failure, and finally, his ability to give the same level of respect to a person of the most meager of means and the famous director or CEO that walks through his door.
Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): It is great bedside manner. This is not something most doctors, and spine surgeons in particular, are usually rated or ranked by. However, excellent bedside manner and the ability to build trust with a patient are very important. The patient is usually worried about making the decision for the surgery — the world is full or rumors (even among other physicians) about how horrible, devastating and debilitating spine surgery is. Putting the patient’s mind at ease and getting them to understand the actual risks and benefits of the operation goes a long way in letting them make an informed decision and be comfortable with undergoing a spine surgery.
Having great bedside manner also gets the patient to listen better and truly understand the importance of strict adherence to the preoperative and postoperative instructions, making the surgical outcome that much more successful, which in turn, will make one into a "great spine surgeon."
Alden Milam, MD. Spine Surgeon at OrthoCarolina (Charlotte, N.C.): Listening to the patient.
Michael J. Musacchio, Jr., MD. Spine surgeon at NorthShore University HealthSystem's Neurological Institute (Chicago): The most underrated quality of a great spine surgeon is not accepting poor outcomes. There is risk and failure inherent in all surgeries and treatments, but spine surgeons should still strive for 100 percent success. In some cases, it is easy to ignore or downplay poor outcomes. For the sake of the patients, surgeons should constantly reassess surgical failures for reversible solutions. This applies to recurrent discs, failed fusions, an under diagnosis of instability and more.
It is also important for surgeons to be proficient in various approaches, including anterior and posterior approaches, minimally invasive techniques and motion preservation. That way, they can apply the best treatment based on the patient's condition and not solely on the surgeon's preference.
Rajesh G. Arakal, MD. Spine Surgeon at Texas Back Institute (Plano): Humility, knowing your limits and doing the right thing.