Five spine surgeons share best practices for sharpening one's skill set and remaining on the cutting-edge of spine care.
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.
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Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, April 10, at 5 p.m. CST.
Question: What can spine surgeons do to ensure their skill set remains sharp?
Richard Kube, MD. Founder and CEO of Prairie Spine & Pain Institute (Peoria, Ill.): First, do not become complacent. I see many surgeons lose interest in new technology as they mature in their careers. Stay interested. Continue to raise your own bar. If you set these goals as your baseline, then you will be motivated to remain sharp. Whether it's adopting new technologies or having discussions with colleagues, there is always more to learn beyond simply reading journals. Challenge yourself to improve efficiency. Take on students or residents or fellows. These individuals will ask questions and keep you sharp as well. They will help you to continue rethinking problems and treatments, and the act of teaching helps you to clarify your own thinking. The same thing happens when you take them to the operating room.
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: Taking up a hobby involving dexterity, I think, is critical. There are some exciting companies beginning to test and develop some amazing technology that will allow fellows and surgeons to practice certain procedures from the comfort of the home. Mental rehearsal before any case, for me, is so important. During training, I noted the really excellent surgeons would essentially talk through the operation, and when coming upon certain aspects of the pathology, would use it as a signpost for continuing on the case. Rehearsal of what one will find in the operation (that is, a very small lateral mass, a spondylolisthesis, and so on) will help develop comfort, increase confidence and improve safety.
Issada Thongtrangan, MD. Orthopedic Spine and Neurosurgeon at Minimally Invasive Spine (Phoenix): I always keep an open mind for new technologies that can improve patient outcomes. I then do my own research and filter the data, which can be biased, and it is overwhelming at times to see what make senses and what doesn't. Once I identify what those are, then I am proactive about learning those techniques or technologies. There are many tools to keep myself up-to-date and keep my skill sets sharp, including visiting the experts, attending courses especially hands-on workshops, participating in specific group discussions to share experiences and teaching others.
Noam Stadlan, MD. Neurosurgeon at NorthShore University HealthSystem's Neurological Institute (Skokie/Evanston, Ill.): The best way to ensure a sharp skill set is ongoing practice and use. Multiple studies across disciplines have shown that continued practice is the most important factor in maintaining dexterity and motor skill. But equally important is the need to stay current on new techniques, knowledgeable regarding changes in treatment recommendations and always keep an open mind regarding ways to improve patient care and surgical outcomes. Keeping a sharp skill set is obviously important, but if those skills are used in procedures that are no longer considered optimal, patient care may suffer.
Mark M. Mikhael, MD. Spine Surgeon at NorthShore University HealthSystem's Orthopaedic Institute and Illinois Bone & Joint Institute (Chicago & Glenview, Ill.): To remain sharp, spine surgeons need to stay up-to-date with the literature and evaluate it critically. It's not just about reading the latest studies but assessing the quality of them. If the latest articles are not quality studies, then the conclusions are often not supported by the data presented and the surgeon should pause before implementing the findings. While surgeons should never switch to trending technology without established evidence of its efficacy, they should be open to change and avoid being set in their ways. And if they are performing a procedure they do infrequently, they should actively take courses to better hone their skills, whether it be a series of classes through the implant manufacturer or academic institutions. Lastly, be open to advice from colleagues. It is one of the hardest things for surgeons to do, especially from younger colleagues. But listening is free, and surgeons might hear something that will make their practice better and make them sharper in the surgical suite.