How 8 successful spine surgeon leaders cultivate these skills


Eight spine surgeons discuss the key traits of leaders in the spine care arena.

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.

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Question: What are the key leadership skills successful spine surgeons cultivate?

Peter Derman, MD. Spine Surgeon at Texas Back Institute (Plano): Leadership involves cultivating an environment in which a team can thrive. In the clinic or the operating room, successful surgeon leaders are cognizant of the various learning and working styles of those around them. Motivating others to excellence is not a one-size-fits-all endeavor. Making the effort to learn about what makes others 'tick' will yield a more pleasant environment and a more effective team.

Mark M. Mikhael, MD. Spine Surgeon at NorthShore University HealthSystem's Orthopaedic Institute and Illinois Bone & Joint Institute (Chicago & Glenview, Ill.): I see spine surgeons mostly cultivating four skills to be successful leaders. Firstly, communicate. Surgeons need to deliver information to patients and colleagues accurately and in an understandable way, so that information is retained and repeatable. Secondly, listen. Treat the patient, not the MRI, as we say in orthopedics. Tune into what the patient is saying to you. You might pick up on an issue unrelated to what you are seeing on the scans.

Thirdly, continually learn. Never stop learning — from others' mistakes and the literature. Stay updated on proven, evidence-based research, so you can take the latest knowledge to the OR, giving your patients the best possible outcomes. And finally, walk the walk. Surgeons need to lead by example, if they expect excellence from their team. You need be innovative, stay ahead of surgical trends and perform at the top level.

Richard Kube, MD. Founder and CEO of Prairie Spine & Pain Institute (Peoria, Ill.): There are many skills required of leaders. One that is important is the motivation of others. Don't just talk, do. No one is motivated by an armchair quarterback. Be willing to do any task; you will demonstrate to others you value their role and do not consider it beneath you. Engage with others by allowing their input when appropriate. People are much more motivated to take care of something they view as their own. Take care of yourself last.

We strive to motivate in this manner in our practice as a matter of routine. While we do see turnover in our office as offices do, the majority of our staff has been here for several years. If you show respect, set expectations and motivate directly as well as through inspiring self-motivation, you can have a happy and healthy work environment where those you are leading feel successful and fulfilled.

Payam Farjoodi, MD. Orthopedic Spine Surgeon at Spine Health Center at MemorialCare Orange Coast Medical Center (Fountain Valley, Calif.): As a surgeon, you are looked upon as a leader in the operating room. You are in charge of the team there, and I think that environment dictates a lot about the type of leader you will be in your practice setting as well. I think expecting excellence by setting that example through your own actions is key. I also find it beneficial to make clear your expectations of each person in your team, and make sure they feel appreciated and rewarded when those expectations are met. Creating pride in being part of your team rather than being derogatory has been an effective strategy in my practice.

Jack Zigler, MD. Co-Director of the Center for Disc Replacement at Texas Back Institute (Plano): A strategic vision that has a multi-year horizon, so that practice-building decisions can be made proactively instead of reactively. Also, selflessness, that is, deferring individual personal gain for decisions that work for the group. Finally, always considering appropriate patient care ahead of any other goal.

Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: True leadership is a difficult thing to find. In my life I have tried to model myself after people whom I found were leaders in their field and among their peers. These people had several really important personality traits in common. They asked and expected excellence from themselves and their peers. The best was the only acceptable effort from them and those who surrounded them. They pushed the limits of what they thought the limit was. They sought to extend their field and enhance it by questioning common-held misconceptions of what was possible.

They never compromised on patient safety and always reminded themselves that there was a human being on the table in front of them, not a 'case.' Lastly, they held themselves accountable for complications, unexpected outcomes and errors. They did not point fingers at others around them when things went sideways. Instead, they stood up, took responsibility and learned from their missteps and grew themselves by showing their humanity and humility.

Stephen H. Hochschuler, MD. Co-founder of Texas Back Institute (Plano): Delegation, sharing the spotlight, coaching, picking the best and forming a true team.

Michael F. Duffy, MD. Spine Surgeon at Texas Back Institute (Plano): Being a spine surgeon is a very dynamic position in the medical field. The days of only needing medical knowledge and technical skill have passed. One of my mentors always said to be able, available and affable.

To have a successful practice, all interactions with patients, employees and the community depend on appropriate communication. Discussions with patients regarding expected outcomes and informed consent are an integral aspect of a practice, and furthermore can help mitigate potential legal action. With your staff, expectations and work environment all depend upon the physicians' ability to communicate appropriately and professionally.

From a business standpoint, it is extremely important for a spine surgeon to be efficient with documentation in the office and efficient procedurally, in order to maximize successful outcomes and maximize work productivity.

Finally, interpersonal skills and the ability to relate to other people are of utmost importance in order to have a successful image in the community and online reputation. Every interaction a spine surgeon has reflects upon his or her medical practice in both a positive and possibly a negative manner. Patients tend to seek medical advice from physicians they feel they can relate to and connect with.




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