Becker's Spine Review

23 Thought Leadership 2 physicians on mistakes young orthopedic surgeons should avoid By Carly Behm L ooking back at their careers, many orthopedic sur- geons can point to mistakes they wish they avoided when they first started in the field. Two surgeons told Becker's Spine Review their advice for young orthopedists. Question: What's the biggest mistake early-career ortho- pedic surgeons should avoid? Ronald Hillock, MD. Nevada Orthopedic & Spine Center (Las Vegas): Most of my peers did not stay with the first position they took out of their residency or fellowship. I was certain I had made the correct choice. I was a salaried ac- ademic surgeon. I over-extended to buy "the house.' Eigh- teen months later, I was left with a practice that I did not like and too much debt based on that choice. I had to move, take massive losses on the investment into the house and start over in a new community hundreds of miles away. I was wrong about almost every business decision in my first position out of training. It took seven to eight years to over- come that bad choice. My advice is to proceed with caution. Enter the new prac- tice setting with an exit strategy if it is not what you thought it would become. Read the contract with a lawyer and un- derstand the noncompete clause and such before signing any deal. Jason Snibbe, MD. Snibbe Orthopedics (Los Angeles): The biggest mistake is trying to restrict your practice. Sur- geons should see any patient that needs help. Orthopedic surgeons should see all types of orthopedic problems and refer them out for treatments that you don't do. This builds a strong practice and develops strong relationships with physical therapists, pain management doctors and spine surgeons. Seeing more patients will build a strong follow- ing. The other mistake is not educating yourself on the business of medicine. You should spend time on the weekends or after hours learning about overhead, insurance reimburse- ment, employee management and practice management. Surgeons should also learn about taxes and the benefits of having a corporation. n Will robots replace orthopedic surgeons? By Marcus Robertson M edical technology is always advancing, and ro- botic surgery has been attracting more attention in recent years. Some hail it as the future, while others remain skeptical of the hype. Ravi Bashyal, MD, director of outpatient hip and knee re- placement surgery at NorthShore University HealthSystem in Chicago, sat down with Scott Becker on "Becker's ASC Review Podcast" and weighed in. Question: Robotics in surgery — is it just another tool? Or will it replace surgeons? Dr. Ravi Bashyal: You can't skip learning how to do the op- eration properly and just count on the computer to do it for you. I like to think of it in terms of golf. If you think about Jack Nicklaus, all the clubs that he used, his woods were literally made out of wood. He did the best he could with those golf clubs. If Jack Nicklaus from 1975 were to play in a tournament today with the same equipment and the same training and the same preparation, he'd be demolished. But that doesn't mean that he's not one of the all-time greats. The golfers today have better equipment. They have better preparation, they have better planning. They have technol- ogy that helps them be a better golfer. [Robotic surgery] takes people and it enhances their skills and ability. I think that if we use it in a non-substitutive manner — meaning we're not using robotics or computers to take the place of our thought process or to make us do less work — we're using them as enablers. That's going to really help us take better care of our patients and have better outcomes, which at the end of the day is what's most important for all of us. I think that on the planning side of things, it allows us to be ready with a game plan when we get to the operating room. And just like any other field, if you've got a good plan going in, you're much more likely to execute efficient- ly and accurately, whether it be robotics or patient-specific instrumentation. A lot of that requires you to have some thought and insight into the case before you're in the oper- ating room, which I really think is half the battle. n

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