'The purest medicine that can ever be practiced' — Dr.  Gregory Mundis on medical missionary work & trends in spine surgery outreach


Gregory M. Mundis Jr., MD, is an orthopedic spine surgeon and spine surgery fellowship director at San Diego-based Scripps Clinic Medical Group. He also serves as the acting co-director of the medical missionary organization Global Spine Outreach, along with fellow orthopedic spine surgeon and co-director Anthony Rinella, MD.

Dr. Mundis recently spoke with Becker's Spine Review about Global Spine Outreach, directing a spine surgery fellowship as well as the future of spine surgery education and outreach.

Question: How has your role as acting director of Global Spine Outreach impacted your practice?

Dr. Gregory Mundis: It has impacted my practice in several different ways. The time commitment necessary to be engaged in Global Spine Outreach goes above and beyond my regular medical practice; it has a substantial time impact on my medical practice.

The flipside of that is that it's amazing to see my patients at Scripps getting engaged in my world apart from my work life. It's very common for them to give and donate their time and energy to our missions. One patient makes blankets for all the kids who we travel to see and take care of. It's been fun because it helps create a deeper connection with my patients, which is awesome because strong patient-physician relationships are so important.

Also, there's no question that operating with other surgeons in different environments expands your skillset. It makes you think differently about the resources that you have, and about what's really necessary to get the job done. This creates the opportunity to have a positive financial impact on my practice here, where we realize that in certain situations, we may not need to spend as much money to get the job done and equally as well. You also get to operate with other surgeons who do things differently, and you wouldn't expect to walk away from an outreach trip learning from another surgeon, but you do, which is so rewarding.  

Also, there's all kinds of energy that comes from a surgical mission experience. When you go on a mission there is no financial incentive, there is no time incentive, there's no incentive at all except helping kids. It's the purest medicine that can ever be practiced.

Q:  What advice do you have for other spine surgery fellowship directors?

GM: One of the unique things we're doing here at Scripps is having a private practice scenario while also having a very strong spine fellowship program. As part of our program, I've told every fellow that comes in that part of their rotation with me is to join me on a mission. Every time we have a fellow come in they all spend the week with me in one of the countries that we travel to. We know from published data that when surgeons participate in medical missionary work during their residency or fellowship they're much more likely to continue doing something like this when they're in practice.

I think it's vital for spine fellowship directors to incorporate mission work into their programs. Even if the fellowship directors don't go themselves, they should make it available to their fellows. You're going to see pathology you will have never seen at home; you're going to see treatments that you're not used to; you're going to be put outside of your comfort zone culturally, socially and in practice. These are all tremendous opportunities for professional and personal development.

Q: What major trends are you seeing in spine surgery education and outreach?

GM: There’s a growing amount of interest on the part of surgeons of all ages, so I think we’re going to see more and more involvement with medical missions. One of the keys going forward will be improving our ability to place surgeons in an environment where they can best use their unique gifts. In other words, taking a surgeon who does adult degenerative spine surgery is probably not best suited doing a pediatric scoliosis mission.

One of our goals at Global Spine Outreach will be to bring the various medical mission nonprofits together. Not to consolidate them, but to empower them. We can make a network to connect people to the best fit.

Outreach is one of those very unique opportunities where you get to actually operate with another surgeon, and we have some really prominent surgeons involved. To be able to take a guy who's very early in his career and be able to operate with this really prominent surgeon when they didn't do a fellowship together that's a pretty cool opportunity. There's a lot of leapfrogging that happens on these trips. I think that's why surgeons who participate are so energized to do it again.

I think it's in all of us to do mission work. I just don't think we've made the mechanism of doing it easy enough. It's hard to find out who's going where and how to get involved. If we could lower the effort threshold that people need to put into it to actually go serve, I think we'll see a massive expansion in this field.

Q: Is there a particular development coming up on the horizon that you're excited about?

GM: One thing we're doing now at Global Spine Outreach is creating a database and dashboard to patients in order to make sure you have the appropriate follow-up over time. We just received a significant grant for this, and we're very enthusiastic to get this effort moving forward. We're very excited to say that the trend for this type of work shouldn't just be altruistic; rather, it should also be scientific. I think we’re going to see a trend toward more science in the outreach setting.

Click here to learn more about Global Spine Outreach.

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