Sometimes taking a chance makes all the difference. Four spine surgeons shared the gambles they took in their work this year from changing patient approaches to pursuing further education.
Note: Responses were lightly edited for clarity.
Question: What’s a risk you took this year that paid off this year?
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: One of the risks that has paid off is doing longer appointments with patients and spending more time getting to understand patients’ main issues and their histories. I think too many doctors don’t spend enough time understanding why patients are coming in to see them. Understanding patient background such as how long they’ve been dealing with problems and what their goals are of treatment has really helped me dial in to selecting treatment plans for patients. I realize that not all my colleagues are able to do that. They don’t have the luxury of doing that. If you can spend an extra five to 10 minutes, which obviously might put you behind, it’s a great investment in time. I encourage everybody who can, to spend a little bit extra time with their patients, getting to know them, getting to understand them.
I had a patient who had several opinions about what he should have done surgically. Several physicians told him he needed a fusion. When I started talking to him, it became very clear that he had zero back pain and that he had mostly leg pain, and that he really needed something like a decompression. After those three or four visits, we did surgery, and he was very happy. I think we saved him from a bigger surgery. That’s no guarantee he won’t need something bigger later on, but it became very clear that even if he does need something bigger later on, he was very happy with an interval step that directly addressed his problems. I find that the patient buy-in is greater when you have those long conversations with them. The patient understanding of outcomes and potential complications is stronger and you feel more confident.
Morgan Lorio, MD. ISASS past president and chair emeritus of the Coding & Reimbursement Task Force: This year, I took the risk of stepping fully into a translational role that bridges medicine, neuroscience, genetics, spiritual care and policy. It meant co-authoring multiple interdisciplinary manuscripts through learned policy leadership — stretching far beyond the traditional boundaries of spine surgery. In doing so, I embraced an unexpected vocational integration: the surgeon and the chaplain in ongoing dialogue.
The risk paid off. These collaborations helped shape the emerging Hierarchical Neuro-Spiritual Model (HNSM), which is now gaining traction across chaplaincy, medicine, addiction science, and health policy. What began as a professional risk became a renewed sense of purpose.
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): A major risk I took this year was deciding to pursue an Executive MBA while maintaining a full clinical and academic spine practice, which meant flying out every other weekend for classes and restructuring much of my personal and professional time. It was a significant investment and disruption, but it has already paid off by expanding my understanding of healthcare economics, leadership, organizational strategy and systems design. The perspectives gained have directly strengthened how I interact with my teams, evaluate technology/innovation, and communicate ideas effectively. And I have met some incredible people along the way that will be lifelong friends and colleagues. And still another year plus to go.
Lali Sekhon, MD, PhD. Spine Surgeon at Reno (Nev.) Orthopedic Center: Growth. We added surgeons. We expanded our ASC. Added another urgent care. Our investment has been in ourselves and we control our destiny.
