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 research projects are you involved in this year?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CST Tuesday, Feb. 18.
Editor’s note: Responses were lightly edited for clarity and length.
Question: How are you keeping a cohesive culture across your practice locations?
Michael Briseño, MD. North Texas Orthopedics & Spine Center (Grapevine): One of the biggest challenges, especially in a volatile economy and healthcare environment, is maintaining a cohesive culture. We have found that utilizing exceptional leaders and managers in our clinics is crucial to meeting this challenge. We emphasize to our clinic leaders the importance of empowering our employees to take ownership of their tasks, responsibilities and duties without feeling micromanaged. We want to show faith and trust in our staff to carry out our goals of exceptional patient care combined with empathetic customer service. When we show trust in our employees, they feel valued, respected and are eager to live up to the standards we set.
Brian Fiani, DO. Spine Surgeon. (Birmingham, Mich.): Consistent Communication: Regular meetings and updates with all staff members, regardless of location, help ensure everyone is on the same page. Utilizing video conferencing tools can bridge the gap between locations.
Philip Louie, MD. Virginia Mason Franciscan Health (Tacoma, Wash.): First off, maintaining a similar cohesive culture across different practice locations is probably one of the most difficult tasks that we face. I think that we have learned that, although systems can help support elements of a cohesive culture — it is the people (and their intentional efforts) that drive the ability to create and maintain a “cohesive culture.”
Bringing people together for combined events and projects and reinforcing a shared vision is essential.
Journal Clubs
Visiting Professorships
Dinners/Social Events/Group Workout classes (misery loves company)
Multisite research projects
However it’s equally important to recognize that each practice thrives best when it develops its own unique culture—one that reflects its team, community, and specific dynamics. The key is ensuring that while each practice location maintains its individuality, it remains fairly rooted in the foundational values and principles that define the group as a whole.
Alexander Tuchman, MD. Cedars-Sinai (Los Angeles): At Cedars, we believe that fostering productive academic communication is the key to building a cohesive culture across multiple practice locations. Our spine program includes over 40 spine surgeons providing care across five campuses, making effective communication essential but inherently challenging.
To bridge this gap, we utilize a combination of in-person and virtual meetings every week, ensuring continuous dialogue and a shared commitment to quality care. A cornerstone of our approach is our dedicated weekly Spine Grand Rounds, held in person at our main campus and broadcast to all members of the Spine Center. Additionally, we host daily educational and work conferences focused on spine care, including our Spine Tumor Board, Deformity Conference, multiple indications conferences, and structured didactic sessions for residents and fellows.
By creating multiple forums for open discussion, we not only enhance communication but also foster camaraderie and strengthen our team dynamic. This collaborative approach helps unify our diverse group and ensures the highest standards of patient care across our entire program.
Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: Keeping a cohesive culture across disparate practice locations as we do at the Ayer neuroscience Institute at Hartford healthcare requires first and foremost that everyone feels that they are part of one team. Combined meetings that enable us to collaborate and share best practices across our practice locations are an important part of the strategy. Celebrating wins collectively is equally important. Promotions are celebrated across our system, not just at the practice location where that individual works. Our leaders make an effort to show their presents equally among the disparate practice locations. This is a very important part of creating that cohesiveness.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The complexity and liability surrounding the nervous system and its surgical adjuncts is without questioning its skill and detail attention is requisite. Maximizing systems in the OR, Anesthesia and post operative management equate to optimal efficiencies and patient safety best afforded to patients and families. Available multidisciplinary services within large health systems are likewise necessary especially for the more infirmed and aged. The presence of these entities and proper, like-minded staff facilitate/drive a successful, outcome centered practice.
Culture and its maintenance are principles withheld from the initial hiring of staff while incorporating technical superlatives with team minded members. Stochastic practice patterns and healthcare delivery systems when connotated within surgery are literally a dice-roll when other well-established order predominates. Hierarchy is an unspoken elephant, whereby equanimity and job recognition carry the day and likewise the future to both patient and outcome success.
