Becker's Spine Review

30 Thought Leadership How 9 spine surgeons keep their skill sets sharp: Drs. Robert Bray Jr., Neel Shah & more By Alan Condon F rom pursuing learning opportunities to discussions with colleagues and continu- ing to practice your cra, nine spine sur- geons share how they maintain their skill sets. Note: e following responses were lightly edited for style and clarity. Question: What can spine surgeons do to ensure their skill set remains sharp? Robert Bray Jr., MD. DISC Sports & Spine Center (Newport Beach, Calif.): My answer to staying sharp is to keep working. If you don't belong to an ASC model, seek out a com- mitment to one. While I firmly believe this is the progressive future of spine, it has been very well-suited to responding to and remaining functional during the pandemic. More needs to be done to integrate into hospital systems for the long term. Many academic and educa- tional opportunities exist online and are a vital part of education, but nothing replaces staying busy for surgeons. Now, and for the near future, the ASC model will be an important and growing part of the healthcare delivery system. Proven quality, cost efficiency and ability to react and adapt will continue to expand this model. For the surgeon, it is a safety net to function. For the system as a whole, it needs to integrate to en- sure maintenance of care for needed services. Michael Musacchio, MD. NorthShore Neu- rological Institute and NorthShore Spine Center (Evanston and Skokie, Ill.): First, you must stay current with literature and peer-re- viewed articles. e field continues to evolve, particularly with minimally invasive approach- es, motion-preservation alternatives to fusion, computer navigation and robotics. But more than reading is necessary with these evolutions in techniques and technologies, which require new skills and workflow developments. Industry-sponsored training programs, such as cadaver labs, saw bone events and related we- binars – many which are free – are invaluable for learning and practicing new techniques. It is important to keep in step with new technol- ogies to avoid making major leaps to catch up with modern spine techniques and theory. Todd Lanman, MD. Lanman Spinal Neuro- surgery (Beverly Hills, Calif.): Surgical skill sets are quite different from diagnostic skill sets, and are oen best maintained by oper- ating on patients several times a week. One method is to maintain good physical condi- tioning, strength and exercise, as long sur- geries can be quite gruelling and taxing. To remain healthy and sharp, it's important to re- main in good physical and mental condition. Diagnostic skill sets oen come with time and learning, listening and aggressively being in- volved in conferences and discussions with other surgeons as well as collectively coming up with more diagnostic options to provide better skills when seeing patients individually. Having extensive training in physical examination is critical. I'm very concerned when I have a pa- tient tell me that the physician they saw before me only looked at their MRIs, and they did not have a thorough physical examination. Taking a careful history and listening to the patient, and combining that with a careful physical exam and diagnostic studies, keeps the surgeon sharp in order to make the correct diagnosis and plan the correct surgery. Listen- ing to the patient is probably the most key skill set that a surgeon needs to develop. Grant Shifflett, MD. DISC Sports & Spine Center (Newport Beach, Calif.): Assess and reassess, and never stop trying to get better. You must constantly evaluate yourself and your outcomes. Always look for less invasive approaches to problems and ways to expedite your patients' return to the things they love. Attend conferences, listen to webinars, learn new tips and tricks from colleagues and crit- ically read the literature. Neel Shah, MD. DISC Sports & Spine Center (Newport Beach, Calif.): Medicine is described as a practice for a reason. We, as physicians, are constantly learning. What we do is a lifelong practice. Physicians should always be striving to learn as we travel through our careers. e routine way to stay on top of our professions is to read the latest literature, attend meetings and participate in conferences. But, along with this learning, my philosophy on staying sharp en- tails evolving and not being complacent. Medicine is changing at an incredibly rapid pace. I believe that the best way for me to stay sharp is to constantly evaluate how I am going about treating the disorders and pathologies in spinal surgery, as well as how I am going about performing surgery. at being said, I am always cautious when evaluating new technologies, but am also willing to implement them into my practice as long as they are safe and efficacious. Alok Sharan, MD. NJ Spine and Wellness (East Brunswick, N.J.): Constant learning is critical for surgeons to keep their skills sharp. Unfortu- nately, time is very limited for many of us, so it becomes very challenging for surgeons to con- stantly update their skills. We created Doc.Social as an online learning platform so surgeons can have access to a multitude of resources to help update their skills. On our site, we have tradi- tional online lectures and courses. Realizing that education comes in many forms, Doc.Social also has groups whereby people can have discussions on specific topics such as robotics in surgery and podcasts to hear what [key opinion leaders] have to say about certain topics. Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): Just like in any other field, you have to practice. More importantly, you have to analyze each case — the actual surgery and outcomes — and understand what went well and what can be improved. I also recommend collaborating with fellow surgeons on a regular basis: discuss cases, attend conferences, stay up to date on the latest publications. e spine field is constantly evolving. Even if your skills are sharp, there are always new skills and technolo- gies to learn to improve our patients' outcomes. Brian Gantwerker, MD. Craniospinal Cen- ter of Los Angeles: Skills remain sharp with practice. If cases are canceled or delayed due to the pandemic, taking industry-offered courses can be helpful. Other skills can be practiced cognitively, by watching interesting surgical videos from resources like VuMedi, the Neurosurgical Operative Atlas and You- Tube. inking through a case when you look at patient films, even if you are not doing the case for some time, will also keep those syn- apses firing. Richard Chua, MD, Northwest NeuroSpe- cialists (Tucson, Ariz.): Keep reading the literature, attending conferences, attending cadaver and other demonstrations. Take ad- vantage of educational resources provided by our societies and industry partners. Set goals for improvement, practice, re-evaluate and re- vise. I know that I can make every operation better, each and every time. n

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