Lessons 9 spine surgeons share with the next generation


The wisdom of mentors is often passed down and becomes important to new generations. Nine spine surgeons share tips and advice from their training days that they pass along.

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 question: What spine surgery trend needs to be phased out in 2024? 

Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CST Wednesday, May 15.

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

Question: What is one key lesson from a mentor that you pass along to spine residents and fellows now?

Jeffrey Carlson, MD. Orthopaedic & Spine Center (Newport News, Va.): My instructors were very bright surgeons and administrators that taught me how to approach questions, not the specific answers to the questions. It is most important for young physicians to contemplate and ponder current considerations in spine surgery. The path to the best answers for difficult issues will change with time and technological advances. I want those that are continuing in their educational pursuits to expand our knowledge of the spine by investigating creative approaches to our current limitations. The key lesson is to evaluate our current boundaries with new perspectives so they can advance our understanding and improve our field.

Harel Deutsch, MD. Co-Director of the Rush Spine Center (Chicago): My mentor, Regis Haid, MD, explained during my fellowship that I was learning how to do spine surgeries but that in the future I will probably not be doing these surgeries. The basic skills will allow me to learn how to do the surgeries of tomorrow and that surgery is a life-long learning process.

Chester Donnally, MD. Texas Spine Consultants (Dallas): We must emphasize that radiation safety is so important, and in 2024 we have technologies to limit radiation exposure. 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 surgical teams! Scrub nurses, anesthesia, and PAs! We all work way too hard to be taken out at an early age, due to a modifiable risk factor.

John Dimar, MD of Norton Leatherman Spine: I teach them to remain enthusiastically curious their entire career, to commit to lifelong learning and to direct all their accumulated knowledge and expertise in providing their patients with absolutely the best possible care available.

Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (West Bloomfield, Mich.): One key lesson from a mentor that I pass along to spine residents and fellows is the importance of continuous learning and staying updated on the latest advancements in the field. It's crucial to never stop seeking knowledge and improving your skills to provide the best possible care for your patients. 

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: One of my mentors was a Vietnam veteran and 2-time bronze star winner. He was rough around the edges, smoked cigarettes and swore like a sailor. He was an outstanding surgeon, and was totally dedicated to his patients. If he had folks in the hospital, he would always personally round. He believed in stewardship of the patient and ownership of your problems. He was of an older paradigm, that should be recalled and emulated. It makes me concerned that we are all running to do more, more, more, and patients are just cases, not people.  

Noam Stadlan, MD. Endeavor Health Neurosciences Institute (Skokie and Highland Park, Ill.): My chairman taught me to see the patient as a person, not a disease. This meant trying to understand their problem in its entirety and taking responsibility for trying to find a solution, even if it wasn't surgery. I try to pass this on to my entire team, including residents and fellows.

Kushagra Verma, MD. DISC Sports & Spine Center (Marina del Rey, Calif.): I'm very fortunate to have had excellent mentorship early on in my career. When I was a medical student at NYU, I worked with prominent spine surgeons in New York, and I was mentored by Oheneba Boachie, MD; Thomas Errico, MD, and Baron Lonner, MD, who were all scoliosis surgeons at the time.

One thing that I learned from them is to have a deep passion for your craft and take excellent care of patients. I also learned from them the value of outreach work and how it can affect and shape a surgeon's career and practice. I also think it's incredibly valuable for surgeons to be constantly involved in research and look to innovate and improve the quality of their specialty. These are set lessons I learned from my mentors early on. They encouraged a strong focus on research, attending meetings such as the scoliosis research society, and working to collaborate with good surgeons that take a different approach to surgery. The spirit of collaboration benefits all of us and advances our specialty forward.

For future residents and fellows considering spine surgery, I think there's incredible value in mentorship. Being in a clinic and seeing how grateful patients can be after surgery, and at the same time, being in the operating room and seeing spine surgery firsthand can be a very powerful experience. Complex spine surgery is especially gratifying because you're able to completely change the shape of a person's back and also transform their life in a way that is truly revolutionary. Minimally invasive surgery is similarly incredible because it offers a tremendous improvement in a patient’s life with an outpatient procedure. Both areas of spine surgery are remarkable.

One of the other very exciting things about spine surgery is the merger of both complex spine surgery and minimally invasive surgery. Some of the more routine pathologies are now managed in an outpatient setting and are managed with a minimally invasive approach and a much easier recovery than in previous years. More complex pathology is also being managed better with more diligent attention to outcomes, more collaboration with other specialties, and a greater emphasis on research. In my opinion, spine surgery is one of the most dynamic and exciting specialties within orthopedics and, after becoming more interested in spine surgery, I often find residents and fellows are not excited by other specialties in orthopedics in the same manner.

I'm very grateful to have had excellent mentorship early on, and it's my passion to offer this same experience to the next generation.  

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): By the best of good fortune and delectation, my fellowship in complex spinal disorders was completed in the pinnacle of timing and places with a mentor of the highest esteem and position in neurosurgery. As the last singular fellow in a centuplicate cohort , the responsibilities were the patients, their loved ones, outcomes and coworkers as the BNI Program and honor to profession were the pillars of striving. There was the highest level of professionalism, duty to family and community. Protection of life and alleviation of suffering was the holistic raison d'etre; all were aware and all were committed.

Life lessons learned: Time resourcing and prioritizing. Training was consumptive and expectations were high. Yet, the most important and deserving persons in life mattered more and their positions in one's life were foremost. This message was integrated cleverly from day one to finality. This culture and working philosophy accompanied an impenetrable esprit de corps for all coworkers and staff. The reputation, outcomes and legacy are the shared result of these stalwart mentors and stand to this day. My personal honor and pride in being a part of that institution and mentor, VKHS, resounds with unwavering respect and appreciation for his tutelage, didactics, and mostly, his unconditional support to this profession and its members. Ich bin dir dankbar! [I am grateful to you!]

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