Considering a career in spine? Best advice from 6 surgeons

Written by Alan Condon | August 28, 2019 | Print  |

Six spine and neurosurgeons reflect on the beginning of their careers and provide advice for physicians considering a career in spine.

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 is your opinion of the way the healthcare industry is covered in the media?

Please send responses to Alan Condon at by Wednesday, September 4, 5 p.m. CST.

Note: The following responses were edited for length and clarity.

Question: What advice do you have for young physicians considering a career in spine?

Andrew Cordover, MD. Andrews Sports Medicine & Orthopaedic Center (Birmingham, Ala.): I strongly encourage a young physician considering a career in spine to review all the subspecialties of orthopedics or neurosurgery. Spine surgery creates unique demands including technical, physical, and analytical. However, the outcomes can be very fulfilling. Innovations and technology are becoming more prevalent and are an added nuance to this field.

Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: To be honest, I cannot say spine is what it was 10 or even five years ago.  I would encourage them to get an education through post-graduate studies such as an MBA or JD. If I could do it again, I would pursue an MBA during my residency. One should also never go into contract negotiations blindly. Do not assume anyone will be honest, forthright or trustworthy in negotiations. Get everything in writing. Also, make sure you know that to enforce it (whatever it is), you will need to litigate. This gets expensive and soul-sucking quickly. If someone you are negotiating with starts out dishonest, promises you the world — walk away, no matter how good the money seems.  

Spine itself will continue to change. Good spine surgeons will be needed — but the gigantic pay checks many have enjoyed in the past have gone away. Instead, focus on the enjoyment in patient care, cleave tightly to your family and don't work to death. Make sure you enjoy them and get some activity by enjoying hiking, biking or swimming.   

Learn to say no to bad cases. Sometimes trying to do something that is beyond your skillset is a path to destruction. A patient's 5th revision surgery will more than likely not go well — no matter how good you think you are. T10 to pelvis is not the antidote to all back pain. Learn to put in spinal cord stimulators — they are a wonderful adjunct and can be very helpful in select cases.  

Christian Zimmerman, MD. Saint Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Place patient betterment in the forefront. As a change advocate for your community, and of a highly skilled talent and training, make an incredible, positive difference in patients' lives; — be that person. Live your training and your experience. Stay current in academics and teaching and celebrate success across the board. More importantly, avoid pontification, because most of your colleagues have heard it all before.

Scott Russo, MD. Orthopaedic Associates of Michigan (Grand Rapids): Choosing a career in spine surgery needs to be based on a love of complex conditions, a willingness to treat the whole person and engage their family. As well as a desire to embrace new technologies and do so with a cost conscientious mind.

Plas James, MD. Atlanta Spine Institute: I think it's important to be able to do both adult and pediatric spine care. It's also important to do a fellowship that is not only trauma, but actually has bread and butter elective case care like discectomies and fusions. Most of your career you will have walking patients without trauma.

Issada Thongtrangan, MD. Microspine (Phoenix): Know your limit and it's okay to say no — one of the hardest lessons for me to learn was that physicians cannot fix everything for everyone. It's okay to say no or you don't have the answer for it. It's definitely okay to ask for help or advice from seniors or colleagues especially at the early phase of your career. Be honest with your patients. Treat them like you would treat your best friend or family. Listen to them and above all else, do what is right for the patient.

More articles on spine:
NASS unveils '20 Under 40' spine surgeons for 2019
Dr. Death to hit TV screens: A timeline of the former neurosurgeon's case
How spine, neurosurgery departments are evolving — key thoughts from 4 leaders

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