Affability, adaptability, resilience — skills spine surgeons seek in the professionals who help them


Three spine surgeons discuss the skills they require in the medical professionals they hire.

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 do you think is currently the biggest obstacle facing spine providers in the modern landscape?

Please send responses to Alan Condon at by Wednesday, Aug. 7, 5 p.m. CST.

Note: The following responses were edited for length and clarity.

Question: What are the key skills you look for when selecting physician extenders, such as physician assistants or nurse practitioners?

Srdjan Mirkovic, MD, Spine Surgeon at NorthShore Orthopaedic & Spine Institute (Chicago & Glenview, Ill.): It has been a real asset to have a veteran physician assistant working alongside me. The essential skill that has been most valuable to me has been her affability. A PA needs the skills to connect with patients, which include being a good listener and explaining conditions, treatments and surgical processes well. I would also look for a PA who is an excellent medical practitioner. The PA needs to be thorough and familiar with different tests and imaging as well as be sharp with assisting in the operating room. In addition, a PA should be good with screening patients and checking for medical clearance.

Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: I have worked with a number of PAs over the years, usually functioning in the emergency room and even in the operating room. In my own practice, part of my brand has been direct doctor contact. Some other physicians have used them successfully, but I favor working with patients directly. I don't favor commoditizing patients or their time.

Issada Thongtrangan, MD. Orthopedic Spine and Neurosurgeon at Minimally Invasive Spine (Phoenix): Of course, the candidate's education, training and clinical skills are important, but there are several aspects that will make them stand out among others.

Being patient- focused. The roles of NPs and PAs center around patients and therefore they must deliver quality care with attention to the detail. They need to be approachable and display compassionate care for patients.

Adaptability. They need to be flexible in their approach, embrace change and [be] willing to learn.

Taking ownership. NPs and PAs need to make independent decisions, be autonomous and take accountability for their actions. They should not blame others for mistakes that occur. They also need to take initiative and be proactive in their approach.

Time management and ability to multitask. Individuals in these roles have a lot of competing priorities to manage. They must be able to shift focus quickly and prioritize their assignments appropriately.

Leadership. NPs and PAs must be confident in their decisions and be able to direct nurses, medical assistants and staff as necessary. They must display confidence in their abilities and influence others when needed.

Resilience. NPs and PAs need to have the courage to stand up for what they believe in and not be easily offended. They need to think in terms of what is best for patients. Additionally, they must be able to react well to constructive criticism from their leaders and from patients during difficult encounters.

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