Stop, look & listen: 5 spine surgeons discuss ways to improve patient experience

Written by Anuja Vaidya | October 22, 2015 | Print  |

Here five spine surgeons discuss best practices in improving patient experience and satisfaction.

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.

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Please send responses to Anuja Vaidya at by Wednesday, Oct. 28, at 5 p.m. CST.


Question: What are some ways for spine surgeons to improve patient experience?


Richard Kube, MD, Founder, CEO, Prairie Spine & Pain Institute, Peoria, Ill.: We try to set expectations immediately. We have created a warm environment that is comfortable and inviting to the patients. We hone our educational materials and the delivery of that information by the providers so that they understand and we have the ability to deliver. We communicate regularly with the patients so they know what we expect of them in addition to setting their expectations from us.


Many of the things we do are small, but those are often what are noticed by patients. Think about the waiting service at a good restaurant versus a great restaurant. There is no earth shattering difference, just the subtle touches that let you know you are important and your business is desired and appreciated. We are also a service industry, and those same principles apply.


Patrick C. Hsieh, MD, Director, Minimally Invasive Spine Program, USC Spine Center, Keck Medicine of USC, Los Angeles: Patients faced with the prospect of requiring spine surgery can face significant fear and anxiety. While my primary goal as a spine surgeon is to deliver top-notch surgical care to our patients, I feel it is equally important to provide compassion and empathy to patients faced with the uncertainty of their medical conditions and disability. Therefore, it has been my priority to surround myself with a team of knowledgeable, supportive and caring staff. Patients need to feel safe and confident that they are in good hands.


Surgeons can improve the patient experience by taking the time to answer all questions, and to listen to and address each concern. Fundamentally, I am a believer that if surgeons can place themselves in the patients' perspective then we would better understand the concerns they have and the ways we can manage their physical and emotional distress.


Brian R. Gantwerker, MD, The Craniospinal Center of Los Angeles: Listen. Put patient feedback into action. Listen to their complaints, and also get the information from your front office on patient experiences and where they can get better. Don't assume everything is perfect in the waiting room.


Mark Nolden, MD, NorthShore Orthopaedic Institute, Chicago: I see the patient experience improving in four areas — proper management of postoperative expectations with better patient outcomes data from current research and patient-completed outcomes measures; better preoperative and postoperative pain management; improved preoperative education and appropriately applied minimally invasive surgical strategies.

Regarding expectations, I inform patients that surgery is an effective tool for improving quality of life, but it's not a back pain cure. Surgery can eliminate associated neurogenic leg pain and associated symptoms, but rarely will it completely relieve chronic back pain. Back pain, however, can be significantly mitigated. Surgeons need to be clear on the realistic results of surgery performed under all indications.

Also, pain needs to be effectively treated. A team approach involving nurses, physician assistants, residents and pain specialists — before and after surgery — and open communication with the patient at all points of the care continuum will help put patients at ease. Postoperative pain management protocols are extremely helpful. Postoperative pain is oftentimes the patient's greatest fear. Communicating a clear plan of action regarding aggressive pain management will calm concerns and assuage fears of surgical procedures.

A preoperative educational class that walks the patient through each step of the surgical process is extremely beneficial. It is well-received by many patients. They get a complete picture of the surgical procedure and before proceeding to surgery, they are well-informed with respect to postoperative care and postoperative expectations.

Finally, if a minimally invasive or less-invasive approach will achieve both surgeon and patient treatment goals, it should be pursued. Limiting surgical trauma and shortening hospital stays always improves patient experience.


Thomas McNally, MD, Medical Director, Chicago Spine Center at Weiss Memorial Hospital, Chicago: Listening to the patient is important, and often that is most effectively accomplished when a team approach is utilized. Multidisciplinary medical professionals working together throughout the entire treatment process often leads to a better outcome both with respect to keeping the patient engaged and uncovering their issues, concerns and goals. Many times this involves having the various team members ask the right questions. Repeating information to the patient and having them hear a consistent message from their treatment team allows them to ask more questions and improves comprehension. Discussing the diagnosis and treatment plan in layman's terms puts the patient at ease and they will remember more of what you discuss.

In the end, the patient has to be their own advocate and take charge of their health. We are there to help them achieve their goals, so understanding their pain and needs by listening will improve the patient experience.


More articles on spine:
Healthgrades honors Rockford Memorial for spine surgery excellence
5 things to know about National Spine & Pain Centers' Inaugural Symposium: 'The Business of Pain Medicine'
Spinal fusion, physiotherapy vs. physiotherapy for radiculopathy: 7 key factors in favor of surgery

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