Richard Wohns, MD, discusses his key thoughts on healthcare today and leadership for the future.
Dr. Wohns holds several leadership positions, including:
• Founder, President of NeoSpine
• Past President of the Western Neurosurgical Society
• Health policy consultant to NuVasive
Chief Medical Officer of angelMD
College: Harvard College
Medical School: Yale University School of Medicine
MBA: University of Washington
JD: Seattle University
Dr. Wohns discusses why he decided to go into spine surgery, big influences on his career and where he sees healthcare headed in the future.
Q: Why did you decide to become a spine surgeon? What continues to intrigue you about the opportunities in spine?
Dr. Richard Wohns: I began my career in neurosurgery and focused on brain tumors, cerebrovascular, trauma and complex spine surgery. When I went to business school, my microeconomics professor went around the class and asked all of us, "What business are you in?" When I answered neurosurgery, he said, "That is your practice, not your business — so what is your business?"
I then answered that I take care of people with spine and brain problems. He again forced me to get more granular, eventually helping me to answer that my primary business was relieving pain. Then he drilled down further and said, "How do you most commonly relieve pain?" I answered spinal surgery. He then said, "And what is special about your approach to relieving people’s pain with spine surgery?"
At that time, I had just started doing minimally invasive and outpatient spine surgery, so I said I performed a variety of classic procedures but also new innovative techniques, and particularly new innovative techniques in a unique new environment (this was 1995). He said, "Ah, ha! That is your business. Give up everything else, and focus on this." So I eventually did.
Q: As the leader of a top neurosurgical practice in the country, what are your top three keys to success?
RW: Work hard, work smart and be the best at what you do.
Q: Which books and/or authors have had the biggest impact on your career and success so far? What are your favorite books all-time?
RW: My favorite books are mountaineering classics, which reflect the adventure and indomitable spirit of the climbers who have done first ascents in the Himalayas. "Blank on the Map," by Eric Shipton is my favorite. The innovative nature of these climbers has always been a motivating factor in my career, helping me look for "Blanks on the Map" in neurosurgery.
As far as a book that helped me become an efficiency expert in the operating room, as efficiency is one of the pillars of an outpatient spine surgery practice, my favorite book was "The Goal" by Eliyahu Goldratt, known for his Theory of Constraints. This book can be used for case studies in operations management, with a focus geared towards the Theory of Constraints, bottlenecks and how to alleviate them, and applications of these concepts in real life. It stresses the importance of strategic capacity planning and constraint management.
Q: What is the craziest case you've had?
RW: I was called to the ER to see a patient in a motor vehicle accident. He walked in, awake, alert, oriented, but had the base of his rear-view mirror firmly stuck in his right temporal bone.
Q: What are your favorite activities outside of the office?
RW: I love cross-country skiing, Tae Kwon Do, cycling, tennis, hiking/climbing and downhill skiing. I have achieved a 4th degree Black Belt in Tae Kwon Do, which is master level. I continue to practice with my 7th degree master, including sparring, forms, hapkido and Eido (sword technique).
Q: What professional accomplishment or milestone are you most proud of?
RW: I am very proud of my reputation for excellence and for being a thought-leader. I enjoy the recognition by patients, friends and colleagues for my role in pioneering outpatient spine surgery including innovations and techniques, and for my business and legal analytic skills, plus being a creative force.
Q: What issues in healthcare continue to keep you up at night? Are you seeing any progress toward resolutions?
RW: These things do not keep me up at night. As long as I continue to always provide the best care possible, with the best service, outcomes, and cost, I will not lose sleep.
Q: How do you see healthcare evolving over the next 10 years?
RW: Despite the dramatic paradigm shift where, in many large urban regions in most states, specialist physicians have become hospital employees, I do not think that this model is sustainable. Likewise, I think that the present academic model has flaws and is not as appealing as in the past. I question whether we will see a pendulum swing back to a more diverse spectrum of independent specialists whose value propositions include transparent outcomes and pricing, A.K.A., their true value. I am a firm believer in market-driven healthcare models, and think that patients want value and will recognize that it may not be best provided by government regulation or the corporate practice of medicine.
Q: How is your practice preparing for the future? What changes is the practice making with centers to prepare for challenges or take advantage of new opportunities?
RW: We are actively positioning ourselves in the new order to be THE center that provides the core values which are the cornerstones of the Affordable Care Act, while still providing a boutique/concierge experience.
Q: Who were your mentors and how did they impact your career so far?
RW: My original mentors at Harvard College were world-class scholars in molecular genetics, then later, in literature. My mentors at Yale Medical School were Dr. Etsuro Motoyama, my faculty advisor, and Dr. William Collins, chief of neurosurgery. In residency, some of the giants in neurosurgery and the corpus of neurosurgery were my mentors. My fellowship at The National Hospital, Queens Square, London, particularly impacted and helped change my career from an academic path to a practice path. The main mentor in business school was my microeconomics professor, Charles Hill. He motivated me to write then critiqued my business plan which first outlined the concept and development of outpatient spine surgery centers.
Q: What is the best advice you have for someone starting out in the business of healthcare to achieve success in the field?
RW: Formally study business, i.e., get an MBA. Apply the principles you learn, and don't be afraid to take chances. True entrepreneurs are not afraid to bet the farm on their dreams.