The best advice for young spine surgeons at the beginning of their careers

Anuja Vaidya -   Print  |

Five spine surgeons discuss what they wish they had known at the onset of their careers.

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 are you most thankful for this year?


Please send responses to Anuja Vaidya at by Wednesday, Nov. 22, at 5 p.m. CST.


Question: What do you wish you had known during your first year of practice?


Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: The list is too numerous to be enumerated here. I am going to say that I wish that I had known how to be collaborative. After leaving my first job, I was overjoyed to start private practice. I felt that I could take on the entire community. My hubris, while not my undoing, did create unnecessary tension with my colleagues. Had I not been so afraid of not succeeding, I could potentially have created professional relationships that could have endured the tumult now happening.  


But, thankfully, as I have settled in, got more experience and had my share of difficulties, I have learned to collaborate and share information. I feel now that we as a surgical community have power together if we can find a way to sit at the same table. And, I think the cream will continue to rise to the top.


Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): I wish I had known more about how to run a private practice. During the training years, we did not get much teaching on marketing yourself, billing and how to deal with insurance rules, pre-certifications, appeals and overhead expenses as well as how to select and hire staff and assistants. All of that was on-the-job training for me, and it was sometimes was more complex or time consuming than the actual clinical patient care and surgery.


Stephen Tolhurst, MD. Spine Surgeon at Texas Back Institute (Plano): Everyone wants to become busy quickly. Taking the time to enjoy your family and your free time while your practice is building can be difficult, but is very rewarding. Soon your schedule will be hectic and you will wish for those opportunities again. Professionally, use your free time to establish and learn from surgeon mentors who can help you throughout your career. Taking the time to study new techniques or to fill in any gaps in your fellowship training can significantly enhance the skill set and range of services you offer your patients.


Gerardo Zavala II, MD. Director of Spine Surgery at St. Luke's Baptist Hospital (San Antonio): Listen to the older surgeons.  Despite you coming out of training and you knowing the medical aspect of a surgery, it is never a substitute for the practicality and imperfections of real life. Be open about your deficiencies early with someone more senior than you. Your patients will benefit from it and you will mature faster as a surgeon. Often younger surgeons struggle with addressing possible shortcomings with others, not realizing that all surgeons went thru the same difficulties.


Isador H. Lieberman, MD. Spine Surgeon at Texas Back Institute (Plano): I wish I had known how much fun and gratifying it can be to help people smile.


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