There are several tactics orthopedic and spine surgeons can use to build a good reputation in the community and leave a lasting mark on the spine field. Depending on where they are in their careers, surgeons can make different moves to build strong a foundation and grow their reputation. "For the first three to five years, the agenda for any practicing orthopedic surgeon is different than what it transitions into for the middle 10 years, and again different to what it transitions into for the final 10 to 20 years," says Dennis Crandall, MD, founder of Sonoran Spine Center in Mesa, Ariz. "It depends on where the surgeons are in their careers and what they want to focus on."
Dr. Crandall discusses where surgeons should focus their energy in each stage to really maximize their clinical and non-clinical contributions to spine care.
First one to five years
1. Make social rounds in the community. The first thing orthopedic surgeons should do when they open their practice is make social rounds in the community. Meet with referring physicians and orthopedic surgeon colleagues alike to make introductions and begin a productive relationship.
"There is no substitute for the good will that is generated when a newly-trained orthopedic surgeon makes social rounds in the community, presenting himself in the office of established physicians and orthopedic surgeon colleagues," says Dr. Crandall. "He might be introducing himself to competing physicians, so make sure they know it's a courtesy call coming out of respect for their experience."
Surgeons who are more reserved must overcome their shyness to really take advantage of social call opportunities.
2. Communicate with referral sources. Focus on taking good care of patients early on in your career and develop a relationship with referring physicians. They will appreciate communication about their patients and continue to refer to physicians who achieve good outcomes.
"The biggest focus ought to be on how they can best take care of patients and get the best results possible with the fewest complications, and stay in touch with referring physicians," says Dr. Crandall. "Share with them how things are going and thank him for the referral."
3. Start with simple cases and achieve good results. New surgeons right out of training may want to tackle complex cases, but the best way to build a good reputation is by achieving positive results with the simpler cases. The more complex the case, the higher risks are involved for complications.
"Someone who has been in practice for 10 years has a reputation that could tolerate a major complication or two from the complex case; for someone who is just starting out, their reputation cannot withstand many significant complications," says Dr. Crandall. "Otherwise they are known as the surgeon that none of the nurses would send their family to because they get complications. For a new orthopedic surgeon in the community to take a big case is a tempting disaster."
4. Partner with more experienced surgeons on complex cases. Instead of taking on complex cases alone, ask more experienced surgeons to take the lead on the case and you can assist. If a complication does occur, both surgeons share responsibility, and if the case goes well you can boost your reputation.
"If you contributed to something that went well, your reputation can incrementally grow in the eyes of the people who referred you," says Dr. Crandall. "You want to build our reputation, do good work and take care of your patients, keep in touch with referring surgeons and go out and meet other surgeons in your community, you'll do well."
Middle three to five years
5. Participate in hospital and society committees. Once surgeons become established in the community, they can spend extra time and energy building a reputation professionally. They can begin by joining hospital committees and becoming more active with state and national medical societies.
"Find somewhere you are interested and begin to serve," says Dr. Crandall. "This gets your name and reputation spread further than the local community. That helps with referrals because new people in new areas will begin to refer to you, and it projects leadership. To be viewed as a leader within the specialty community is something all orthopedic surgeons would like to achieve, and you have to build your network."
6. Become academically active. In addition to serving on committees, begin to develop academic work. Whether instructing at an academic center, engaging in research or compiling data in private practice, working on academic endeavors is possible.
"During your first three to five years when you are focusing on surgery and sharpening your skill, you need to collect data on how your patients are doing on your surgery," says Dr. Crandall. "You may not be able to do anything with that research right away, but during the middle phase you can begin asking the academic and research questions and then attempt to answer those questions based on your studies."
Start with retrospective studies and then develop new questions for prospective studies.
7. Begin to develop clinical studies. Start collecting data as early as possible, and in the middle of your career you can begin to lay the groundwork for developing your own studies that could take years to complete.
"Research is important for clinical questions you have and find a better way to treat your patients," says Dr. Crandall. "These studies also project leadership. The more involved you are in academics, the more you grow by the talks you give and research you present at meetings."
8. Start teaching and educating others. Embark on efforts to build your reputation in teaching. This might entail training residents and fellows, instructing at technical courses for national meetings or teaching primary care physicians and other providers about orthopedic conditions.
"There are a lot of opportunities to teach residents or physical therapy students, and participants in physician assistant programs, who are eager to learn more about orthopedics," says Dr. Crandall. "Teaching becomes a way of getting your name out, meeting people you wouldn't otherwise meet, and extending your sphere of influence. That middle phase of the career is the time when a person ought to be involved in things that are outside of pure clinical practice."
Last 10 to 15 years
9. Pass along more complex cases. Surgeons in the later years of their careers can allow mid-career surgeons to take the more complex cases, or work with them to pass along experience and expertise.
"The end of the career is a period of time when a surgeon is operating at full speed, peak efficiency and is well known in the community, and hopefully known outside of the community as well for what they've done to develop the field," says Dr. Crandall. "This is a time when the surgeon doesn't have to do all the difficult cases. Surgeons at this point might not get the same level of satisfaction in the third phase as in the second phase of doing these cases. Surgeon can turn these cases over to their more junior colleagues."
With any extra time, surgeons can work on passing along their knowledge in a non-clinical setting.
10. Find more opportunities to give back to the spine community. Surgeons who are well-established with a good clinical reputation can begin to expand their horizons and find new opportunities to contribute to the field. Opportunities might include additional research, becoming involved in society leadership, teaching or innovating with device companies.
"You can focus on developing new techniques or products that are a different way of doing things," says Dr. Crandall. "These things will add to the specialty and the way we take care of our patients. Find the things you are interested in that will be most effective and efficient to build your career and extend your reputation, and lay the groundwork for the next phase of how you continue."
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