He has extensive leadership experience in the spine care industry, including serving as the president of the New York State Neurological Society from 2007 to 2009. Dr. Onesti is also a current member-at-large of the Nassau County Medical Society board of directors and a past member of the board of directors of the American Association of Neurological Surgeons.
Here are Dr. Onesti's five qualities for a spine leader in today's industry.
1. Keeping up with technology. Spine surgery technologies are constantly updating, and spine industry leaders need to stay on top of the new devices and procedures emerging into the market.
These technologies can provide better access to the spine and new techniques for surgeons but they present new challenges as well. Developing tools often drive the market, and spine leaders must evolve to keep up, Dr. Onesti says.
"There are many instances where you have these sophisticated instruments and tools and we are not quite sure what to do with them," he says. "The technology is racing ahead of our ability to know exactly when and how to use it."
To stay educated about the best procedures available, Dr. Onesti looks to his peers. The key is always working with people who are more experienced than you are in a particular area, he says.
"I love to collaborate with excellent orthopedic and neurological spine surgeons and am constantly learning," he says. "I learn from younger surgeons who have incorporated new technologies into practice as part of their training. Working with your colleagues is key."
2. Meeting patient demands. Minimally invasive spine is becoming more important and is evolving all the time, making it necessary for surgeons to become more experienced and comfortable with the indications of minimally invasive procedures.
Patients are demanding less invasive procedures, Dr. Onesti says. Expectations have also been raised since surgical outcomes for many procedures are often better than in the past when spine surgery had a less positive reputation.
"As patients are becoming better educated as medical consumers, they are empowered to choose and demand to know more," he says.
Meeting demands, though, also involves imparting realistic expectations to patients. Minimally invasive procedures are still surgery, just less invasive to soft tissue. The most minimally invasive approach is not to do surgery, he says.
"Patients all want this magical surgery with no risk and a guaranteed outcome," he says. "It's our job to work with patients so that their expectations about their surgery are in line with our own. In this way we help patients make truly informed decisions about going ahead with an operation.”
3. Keeping patients the priority. Though much has changed in the spine surgery industry in the last 10 years, the main priorities of spine leaders remain unaffected — the patient is still the top priority.
"In a certain sense, spine practice has not changed because your primary role is being a doctor and trying to take care of the patient and improve their life," Dr. Onesti says.
Rarely is spine surgery performed in life-threatening situations; rather, most spinal procedures are to improve a patient's quality of life. When working with a patient to alleviate their pain, a physician is entering into a partnership with the patient, he says. Surgeons who keep their patient's health and happiness as a top priority will enjoy the most rewards.
"Patients come to you looking for a better life for themselves," he says. "Caring for them is a wonderful thing to do. When things go well, it's magical. There is no professional feeling on earth like it."
4. Representing all types of spine surgeons. It is crucial for spine leaders today to represent the interests of all types of spine colleagues, from orthopedic spine surgeons to neurosurgeons, from academics to surgeons in private practice.
Being able to speak for the entire range of spinal surgeons requires awareness of what different fields are facing and compassion for fellow surgeons' obstacles. In addition, leaders in spine surgery need to be able to speak for all spine surgeons to many different audiences.
"A leader has to be an educator to the patients, the government and the insurance industry," he says. "We need to interact with one another, whether it's working with other government entities or insurance companies, to educate them on what is going on in all aspects of spine surgery."
5. Advocating the importance of healthcare. Access to care and government spending are prominent issues in today's healthcare industry. Spine leaders should take up the role of advocating for availability and coverage of necessary procedures and for adequate resources to ensure all patients who need help can get it.
"It's no secret that healthcare is going to be one of our biggest federal budget items, perhaps the biggest," Dr. Onesti says. "Healthcare is one of the most important things we do as a country. What is more important than our health?" As the average age of the population increases, the demand for spine surgery and related procedures will continue to increase at a significant rate.
A leader in the spine and health community needs to explain to people outside of the field why this is money well spent, he says. This advocacy can take many forms, including promoting randomized trials to test the efficacy of procedures and finding ways to keep down the total costs of procedures.
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5 Qualities for a Spine Leader in Today's Industry FeaturedWritten by Heather Linder | October 04, 2012
Stephen Onesti, MD, is a neurosurgeon with Neurological Surgery, P.C., in Long Island, N.Y. His focus is spine surgery, and he has been practicing for nearly 20 years.
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