The best career advice 6 spine surgeons received


From getting your practice off the ground to owning complications when they occur and learning from mistakes, six spine surgeons from private practices across the country shared the best advice they've received from another surgeon.

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. Becker's invites all spine surgeon and specialist responses.

Next week's question: What would it take for you to sell your practice this year?

Please send responses to Alan Condon at by 5 p.m. CST Wednesday, March 16.

Editor's note: The following responses were lightly edited for style and clarity.

Question: What's the best advice you received from another spine surgeon?

Alex Vaccaro, MD, PhD. Rothman Orthopaedic Institute (Philadelphia): The best advice I've received from another spine surgeon was to first and foremost be a good team player. This remains a priority of mine since residency, and it has motivated me to take better care of patients, mentor students and trainees and lead impactful research. In spine surgery, we are always part of a team, and being a good partner allows us to build quality teams that enable us to thrive. As an organization, it is important to celebrate successes, but as a high-functioning team we must always remember that it is through failure that lessons are learned and true personal growth occurs.

Richard Kube, MD. Prairie Spine & Pain Institute (Peoria, Ill.): When I was starting my solo spine practice, I had an opportunity to continue some part-time presence with the group I was leaving. It seemed at the time a good option as I would have continued cash flow while I was building my new practice. I discussed this idea with my fellowship director, and he strongly advised against it. I was concerned about leaving the known revenue. I remember Dr. Holt said in his Tennessee drawl, "Rich, you gotta let go eventually. It's like they have to take your leg off and you're asking them to cut really slow so it doesn't hurt as bad." 

That resonated with me. He had the wisdom to know what I now know: A startup will take all your energy. If the new practice was to succeed, I had to be completely committed. If there is a path other than forward, you aren't really committed. You will waste time deciding whether to go forward or retreat. Businesses die during those periods of inertia.I took that advice, and it has served me well.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: The best piece of advice I ever received was not from a spine surgeon but a plastic surgeon. He told me that I needed to hang my shingle where I wanted to be. This is counter to much of the advice I received at the beginning of my career, admonishing me to go where I could do a lot of cases and make a lot of money. But I wanted to be present for my wife and son, near our home. I would make less and likely have to compete with an increasing number of surgeons in the area. But at the end of the day, I get to be with my family and take care of patients in my own community. And when I get recognized, like I did recently on a walk with my wife and son, and a patient told me I changed his life for the better, I have an inimitable sense of pride.

Neel P. Shah, MD. DISC Sports and Spine Center (Newport Beach, Calif.): As I progress in my career and practice of spine surgery, one piece of advice that I received and that I pass forward is to accept complications and less-than-ideal outcomes. Be proactive about complications — facing them instead of trying to bury them; they will always grow bigger!

Patrick Roth, MD. New Jersey Brain and Spine (Oradell): The best advice I received was being advised to build my practice organically. It is possibly easier to build a practice by catering to those who manage spine care, such as workers' compensation nurses or lawyers, but I believe it is much more sustainable to build a practice by pleasing your patients.

John Burleson, MD. Hughston Clinic Orthopaedics (Nashville, Tenn.): Treat patients like they are your own family members. Do for them what you would want someone to do for your family members. Take time to understand what's going on with them in terms of their spine, but also in terms of their overall health and well-being. Being a spine surgeon simply means that your major form of intervention if necessary is to perform surgery on someone's spine. It does not mean that you stop being a physician.

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