How 6 spine surgeons approach physician safety


Healthcare professionals have faced increased risks in the last year. Violence against healthcare workers saw a significant increase globally in 2022. Meanwhile there are regular risks in the operating room with radiation exposure and other illnesses.

Six spine surgeons told Becker's how they manage safety precautions for their staff.

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: How is the payer market evolving in your market?

Please send responses to Carly Behm at by 5 p.m. CDT Wednesday, Aug. 30.

Editor's note: Responses were lightly edited for clarity and length.

Question: How are you addressing physician and healthcare employee safety where you work?

Chester Donnally, MD. Texas Spine Consultants (Dallas): Radiation safety is so important. I have shifted more and more of my cases to navigation due to my (rational) fear of cancer associated with surgical radiation. This also helps our team — scrub nurses, anesthesia and PAs. We all work way too hard to be taken out at an early age due to a possibly modifiable risk factor.

Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (West Bloomfield, Mich.): Ensuring physician and healthcare employee safety in Michigan involves implementing various measures. Some effective strategies include training programs to provide thorough training on safety, infection control measures, and emergency response procedures. Adequate staffing levels prevent workload-related stress and fatigue, which can compromise safety. Open communication channels foster a culture of open communication where healthcare employees feel comfortable discussing safety concerns. Employee wellness programs support the physical and mental well-being of healthcare professionals. This can include stress management initiatives, counseling services and promoting comradery.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: We listen to our staff. Because we are small, we can quickly adapt to changing regulations and guidance. Our patients have grown to trust us in the community and always know we have their best interests in mind.  

Joseph Koziol, MD. Chair of neurological surgery at Cooperman Barnabas Medical Center (Livingston, N.J): As part of its commitment to raising awareness around workplace violence and creating a safe reporting culture, RWJBarnabas Health has implemented policies and provided a series of trainings to ensure that our caregiving communities across the system are educated, prepared, and able to address any potential incidents quickly, confidentially, and without concern for social stigmas. At the department of neurosurgery at Cooperman Barnabas Medical Center, we support the hospital and systemwide efforts around safety and have conducted mandatory active shooter training for all physicians and staff, designed to instill the mindset and skills necessary to respond to an active shooter event.

Philip Schneider, MD. The Centers for Advanced Orthopaedics (Bethesda, Md.): Employee safety is a top priority at my practice. We have implemented a number of procedures and policies to ensure our physicians, care providers and staff work in a safe environment. We started mandatory active shooter training and testing for all employees, along with an extensive deescalation course to educate and prepare our employees to appropriately handle a threatening situation. In addition to specific training courses, we also secure all elevators before and after hours and have instituted a patient code of conduct that is posted throughout the office. There are a number of safety concerns that can impact employees, and we are actively and consistently making updates to our policies to ensure employees are safe and equipped to handle difficult situations. 

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The operating room, specifically in the healthcare delivery, presents an increased risk of injury to employees, with operating room staff (nurses and aides) having some of the highest rates of injury from lifting, retracting and setting up cases. Physicians likewise are at increased risk for skin barrier intrusion and exposure to HIV, HBV and HCV infectious agents over the courses of their careers. OSHA-assigned specifics and guidelines inadequately address the burgeoning populace, voluminous case carts and instruments or rapidity of turnover times to create more efficient turnovers.  

Our message is the same in dealing with carrier patients and case setups for ourselves, our staff and adjunct personal: Slow and methodical is openly discussed and expected in action.  Efficiencies are secondary when potential injury is heightened in its presentation. 

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