Becker's Spine Review

January Issue of Becker's Spine Review 2019

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11 Thought Leadership Dr. Richard Fessler: The top practice challenge + 5 pieces of advice for new spine surgeons R ichard Fessler, MD, is a board-certi- fied neurosurgeon at Chicago-based Rush University Medical Center. He has focused his practice on minimally invasive spine surgery as well as treating spinal cord injury patients. Here, Dr. Fessler discussed the biggest chal- lenges for his practice today and offers five pieces of advice for new spine surgeons em- barking on their careers Question: What is the biggest challenge your practice is facing today? How are you overcoming it? Dr. Richard Fessler: I have several major challenges at my practice. First, my referrals are far more than I can handle. I handle this in three ways. First, I have a nurse practitioner that sees most of my returns ex- cept for the first postoperative visit. Second, I refer many patients to my junior partners, especially if they happen to specialize in the pathology of the particular patient. ird, I evaluate referrals to see if they are appropriate for my specific practice. Q: What are your top one or two goals for your practice over the next three to five years? How do you see it grow- ing and developing? RF: Number one and two are to continue developing minimally inva- sive alternatives for open spine procedures and making current MIS procedures even more minimally invasive. Q: What advice do you have for new spine surgeons just entering the field? RF: So many things: 1. Recognize that when you finish residency you are not fully trained. You will learn more in your first few years of practice than you did in residency. 2. Be prepared that your first job will most likely not be your last job. 3. Work hard. 4. Don't whine or demand. 5. Understand that as important as your career is, your spouse and chil- dren are much more important. Don't lose them. n The biggest challenge in spine? Dr. David Rothbart says it will be demonstrating value D avid Rothbart, MD, a spine surgeon with Spine Team Texas in Southlake, dis- cussed the biggest challenges his practice has faced and where he sees the best opportunity in the future. Question: What is the biggest challenge your practice is facing today? How are you overcoming it? How do you see it growing and developing? Dr. David Rothbart: The transition of volume-based reim- bursement to value-based has not significantly impacted spine surgeons in most markets thus far. We must be poised to evolve and be able to demonstrate our value. Building the infrastructure to accomplish this and selecting the right part- ners will be critical. Q: What are your top one or two goals for your practice over the next three to five years? DR: We have multiple opportunities for growth over the next few years. Selecting the right cadence, partners and scale of growth can be a daunting task for physicians. We utilize a combination of strong executive leadership within our orga- nization as well as outside consultants with extensive health- care expertise in our decision-making process. Q: What advice do you have for new spine surgeons just entering the field? DR: Spine surgeons completing their training have just fin- ished an average of 15 years of education, residency and fel- lowship. This often leads to a thought process programmed in one-year increments. In selecting a practice, one needs to be thinking in three-, five- and 10-year increments. Rather than merely evaluating a potential job on the current per- formance of the practice, closely explore the growth poten- tial of the practice given the rapidly changing environment. Don't necessarily jump solely at what appears to be the best offer now. Rather, ask yourself if this opportunity has the po- tential to grow and thrive over the next decade. n

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