Rafe Sales, MD, is a fellowship-trained orthopedic spine surgeon at Summit Spine Institute in West Haven-Sylvan, Ore., and co-medical director of the Spine Center at Providence Brain and Spine Institute in Portland, Ore.
Dr. Sales provides advice for physicians considering a career in spine, how he battles mental fatigue and more.
Question: What advice would you offer to younger physicians considering a career in spine?
Dr. Rafe Sales: I still believe that a career in spine surgery is the best career path for young surgeons and physicians. Being a spine surgeon has allowed me a wonderful balance of providing excellent care for my patients, being financially stable, and having a life outside of medicine. Without question there are difficult challenges facing all of medicine, but spine care still provides wonderful opportunities for research, clinical practice, product development, and family life. I would choose the same path without question if given the opportunity again. As a young spine provider, I would look for practice opportunities that fit your life goals, whether that be academic practice, private practice, or a research based career. There are many wonderful opportunities in the field of spine, and I don’t see that changing anytime soon.
Q: What are your best tactics for combating mental fatigue or burnout?
RS: The key to avoiding burnout and battle mental fatigue is finding a good work / personal life balance. Finding a way to get away from the hospital and get away from the stress of a busy spine practice can be difficult but is without question the key to avoiding mental fatigue. I try to leave work stress and issues at the door when I head home, which was difficult in my younger years but has become easier over time. Finding time for your family as well as for yourself is extremely important. Too often we associate our success in life with success at our job, and we as spine providers need to be able to separate the two. Being able to separate my work from my personal life allows me quality time outside of the workplace, which has allowed me to maintain enthusiasm for my practice and avoid mental fatigue.
Q: What do you see as the major challenges currently facing spine today?
RS: In my opinion the biggest challenges facing spinal medicine providers reflect the challenges facing healthcare in general. Providing world class spine care at a low cost is difficult but is something we must figure out. Over the next five to 10 years we will continue to see more procedures and care bundled together, and we will continue to face pressure to provide excellent care at lower costs. As we transition more spine care to an outpatient setting, we are able to better control these costs, but we need to maintain — if not improve — patient safety and outcomes. This will also involve keeping implant prices low while at the same time encouraging new product development, which will be difficult. Unfortunately, we have no choice, and will need to make these tough decisions moving forward.
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