Becker's Spine Review

Spine Surgeon Leadership 16 medicine as a profession. These days it is very easy to become distracted by the challenges of electronic records, rising costs, threats of liability, insurance authorizations, financial uncertainty and healthcare upheaval. In everything we do, we MUST remember these moments with our patients. Raj Rao, MD, Medical College of Wisconsin: The most fulfilling aspect of my career, without question, is seeing grateful and happy patients return to the office following surgery. Knowing that we've improved their quality of life and returned them to an activity level they thought was lost forever is quite thrilling. Each happy patient is the product of many years of years of training, hard work and evolving thought process and skill, and it's nice to see these efforts paying off. Other rewards of a career in academic medicine have been to see the end products of our research endeavors crystallize in the form of a manuscript in scientific journals and steady progression along the career track. Alexander Vaccaro, MD, Rothman Institute: The most fulfilling aspect of my career is making someone neurologically better. Patients are extremely appreciative if you are able to improve their quality of life. This often is the result of making their extremity pain better or improving strength in their arms and legs. Being able to take someone with a spinal cord injury and bring them back to a functional lifestyle is probably the most fulfilling aspect of my job. n Fostering Evidence-Based Spine Advances: Q&A With Dr. Daniel Resnick of NASS By Heather Linder D aniel Resnick, MD, is a board-certified neurosurgeon who subspecializes in spine surgery. He serves on the North American Spine Society's board of directors as the research council director. Dr. Resnick has been a member of the organization since 1999 and co-chairs the lumbar fusion task force.   He is a professor of neurological surgery at the University of Wisconsin School of Medicine and Public Health in Madison. Dr. Resnick completed medical school at the University of Pennsylvania. He completed his internship at Pennsylvania Hospital in Philadelphia and his residency at University of Pittsburgh Medical Center. Here Dr. Resnick discusses his work for NASS and the evolution the spine surgery. Question: Why did you choose to specialize in spine?   Dr. Daniel Resnick: My research during residency was on spinal cord injury, so it made the most sense to pursue spinal surgery as an academic pursuit. Q: Have you worked with any other spine surgeons or mentors who have shaped your practice? DR: Absolutely, Edward Benzel, MD, taught me about the "why's" of spinal surgery; William Welch, MD, Donald Marion, MD, and Peter Sheptak, MD, taught me a lot about the "how's" of spinal surgery. Hae-Dong Jho, MD, showed me how to push the limits of technical expertise. Gregory Trost, MD, has taught me a bit about common sense. Q: How has the practice of spine surgery changed since you first graduated from medical school? DR: [It's a] completely different field — new technologies and new appreciation for evidence-based medicine, the importance of unbiased research and management of conflicts of interest. Q: You've served as the co-chair of the lumbar fusion task force for NASS. What victories and challenges have you faced in regard to your work on the task force? DR: We have been able to preserve access to effective spine procedures for patients with debilitating pain due to degenerative conditions. The challenges continue, as payer policies keep changing in what Joseph Cheng, MD, has described as a "whack-a-mole" type fashion. [Dr. Cheng is an associate professor of neurological surgery at Vanderbilt Medical Center in Nashville, Tenn.] We are getting better at delivering cogent arguments, and the evidence base in the literature is improving as well. Dr. Daniel Resnick Q: What are your main goals as the Research Council Director? DR: My main goals at this point are to deliver a spine registry which is useful to multiple stakeholders and allows for the performance of comparative effectiveness research. At this point, no such product exists, and NASS is uniquely positioned to create one. I also continue to foster the evolution of evidence-based spine care, increased research support for spine related research and the development of patient safety initiatives. Q: What role do you think clinical research will play in the evolving spine industry?   DR: No evolution will be possible without clinical research. Q: Are you engaged in any spine research currently? If so, what specifically have you been studying? DR: I have been involved in several nascent registry projects which have served as pilot studies for the NASS and NPA registries. We continue to learn how to streamline the process and limit staff time required for participation. Q: What are the biggest challenges currently facing the industry? DR: Cynicism and growing distrust from the public and from spine care providers [are the biggest challenges]. The promotion of new products based on shoddy or no data does a disservice to our field and must be curtailed. Q: What is most fulfilling part of practicing as a spine surgeon? DR: We can make a real and important difference in people's lives. Alleviating pain and restoring function never, ever gets old! n

• Cover