Orthopaedic Spine Surgeon - ask me anything

[orthos]

@orthos
Do you have a family?
If so, do you get to spend time with them?
Where do you think Healthcare is going in the future?
How many licks does it take to get to the center of a Tootsie Pop?

Yes.

Yes.

I think the future is bright. There is a lot of doom and gloom regarding reimbursements, moving toward ACOs, and the like. But, ignoring the business side of medicine, the science side is still progressing rapidly.

You'll learn that in residency.

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[orthos]

@orthos I was wondering what do you think leadership in medicine means. This is a concept that has alluded me.

I can see how JD's and MBA's are doctors because they are judges, congressmen, CEO's, and etc. But how is your average clinician a leader.

TY in advance.

Leadership in medicine is about making tough decisions. Whether that means tackling those decisions in a legal manner, business manner, or public health manner, is a matter of preference.

 

[orthos]

How did you do on the mcat? I searched the thread and didn't see anything before. What about step 1?

I did alright on the MCAT. About average for my entering class roughly 10 years ago. Step 1 issues I addressed earlier. Not high enough.

 

[Tipp]

@orthos Do you think that it is possible to craft your own practice and lifestyle to the same extent that you have in ANY surgical specialty/subspecialty, or is that somehow inherent to spine orthopaedics or the community that you chose to practice in? For instance, everyone talks about how neurosurgery is essentially kissing any type of family life goodbye; would a neurosurgeon even be able to find a niche like you have, if he/she wanted to? Or is there something about neurosurgery or any other surgical discipline that precludes that possibility.

 

[Xenoblade]

Have you ever pulled a muscle while in surgery?

If that happens, what happens? Do you schedule all of your surgeries next week? Do you take the week off? Are you insured? Does your boss get angry with you if you work in a hospital setting? Do you get written up or do you get reprimanded?

 

[The Buff OP]

@orthos How likely would a orthopedic surgeon get burnout in general orthopedic surgery? If there is some burnout, what orthopedic subspecialties would you think have the highest burnout rates?

 

[ridethecliche]

@orthos How likely would a orthopedic surgeon get burnout in general orthopedic surgery? If there is some burnout, what orthopedic subspecialties would you think have the highest burnout rates?

You are going to be working a metric crap ton. If you enjoy the stuff and actually want to learn it, you will see some really cool stuff. That keeps a lot of people going.

Many of the ortho residents I know are chill people. I see a few of them in they gym a few times a week and others I know are extremely friendly.

 

[The Buff OP]

You are going to be working a metric crap ton. If you enjoy the stuff and actually want to learn it, you will see some really cool stuff. That keeps a lot of people going.

Many of the ortho residents I know are chill people. I see a few of them in they gym a few times a week and others I know are extremely friendly.

I know all surgery specialties will have long working hours and I pretty much want to only go into surgery since I want to help people with my own hands; however, I get bored easily if I keep doing repetitive things.

 

[ridethecliche]

I know all surgery specialties will have long working hours and I pretty much want to only go into surgery since I want to help people with my own hands; however, I get bored easily if I keep doing repetitive things.

No offense, but then I'm not sure how much you'll like surgery. Sure, every case is a little different and anatomy can sometimes vary, but at the end of the day surgery is very procedural.

Some of the ortho onc guys I work with tend to do the most variable surgeries, i.e. femur mets, hip replacements, forearm/leg sarcomas, etc. All in the same week or even day sometimes.

What do you mean by general ortho surgery? Unless you're in a small town, people usually specialize: spine surgeons do spine, shoulder surgeons do shoulders, hip and knee docs do that, etc etc etc.

 

[The Buff OP]

No offense, but then I'm not sure how much you'll like surgery. Sure, every case is a little different and anatomy can sometimes vary, but at the end of the day surgery is very procedural. Some of the ortho onc guys I work with tend to do the most variable surgeries, i.e. femur mets, hip replacements, forearm/leg sarcomas, etc. All in the same week or even day sometimes.

What do you mean by general ortho surgery? Unless you're in a small town, people usually specialize: spine surgeons do spine, shoulder surgeons do shoulders, hip and knee docs do that, etc etc etc.

I know surgery is very procedural, in residency I will have to do repetitive surgeries so I can feel comfortable when I do them as an attending. What I meant is like seeing the same crap all the time how ER doc's get burnout and just not having a variety of surgeries to do. I'm still very open to what other specialties have to offer, but I always find myself watching surgery videos and I'm in love.

What I mean by general orthopedic surgery is just the doc's that do the 5 year residency.

 

[ridethecliche]

It's funny... When you have rotations after the first couple of years, residents that have already been accepted to fellowships skip/trade rotations. One of the ortho residents I work with traded for a spine rotation again. At this point (past year 3.5ish) they're just trying to get as much experience and research in their subspecialty as possible so they can get a good fellowship and then forward from that.

If you're talking about attending load, then the spine docs I work with get their 'variety' from doing different parts of the spine. They can do a cervical and a lumbar case in the same day, but also there are myriad different approaches used depending on the pathology. A lumbar fusion done by anterior (ALIF) is different than from the trans (TLIF) or the posterior approaches. The same is true for the neck. Then some cases are disc replacements, which are different again.

One of the surgeons I work with does ortho spine onc, so he'll do mets cases as well as primary spine tumors. Another is a deformity specialist, so he'll do lots of scoliosis surgery as well.

The most varied surgeries I see, anatomically speaking, are by the ortho onc docs who could do an arm, hip/femur, and chest wall all in the same day.

 

[Dr. T]

I hear a lot of rumors that "oh you may make 350k a year but you don't make that much after malpractice and other expenses." Is this true? I know you cannot disclose your income but is there a general range I could expect my malpractice to cost as an ortho surgeon? Also is there any other major expenses I should expect if I am not doing private practice? If you cannot disclose amounts could you disclose percentages? Last question. I was told by the Air Force that they could do an all expenses paid deal for my med school including an income during med school but when I graduate I would owe them 4 years. Would you take an offer like this? Or should I just tough out the loans? Thank you so much for this forum.

 

[nokia stuff]

How do you feel about premeds shadowing you? Did you shadow in ortho during your premed days and if you did, how long did you shadow for?

 

[yogalover01]

What is your opinion about women in this field? Thank you.

 

[JoyKim456]

Where did you go for undergrad and med school? Sorry I'd you answered this earlier, I jumped to the last page to ask this.

 

[yonderson]

How many of your procedures consist of you looking through a microscope the whole time? I feel like that would be more comfortable than craning your neck down for 3+ hours.

 

[Xenoblade]

Well, I failed a class. So I won't be going into ortho.

It was nice playing, but I am the weakest link. Good bye.

 

[llamaoverlord]

Can I message you and ask you some questions?

 

[pioneer22]

is this still around?

 

[dlpatters]

Hi Orthos,

My name is Daniel. I broke my spine in 1992 in a car wreck. T5-T9 was crushed. Now my neck and lower back over arch to compensate for the curvature at T6 (85% currently.) I've included photos of the X-rays below that show more detail. I've been to several spine surgeons and wanted to keep my feelings out of this post in hope to get the best recommendation. Are there any Spine Surgeons out there that could give me some advice?

Thanks,
Daniel

 

[TheBiologist]

Hi Orthos,

My name is Daniel. I broke my spine in 1992 in a car wreck. T5-T9 was crushed. Now my neck and lower back over arch to compensate for the curvature at T6 (85% currently.) I've included photos of the X-rays below that show more detail. I've been to several spine surgeons and wanted to keep my feelings out of this post in hope to get the best recommendation. Are there any Spine Surgeons out there that could give me some advice?

Thanks,
Daniel

Unfortunately SDN is not for medical advice

But I have a Q for OP- how long was your residency?


Sent from my iPhone using SDN mobile

 

[pioneer22]

Unfortunately SDN is not for medical advice

But I have a Q for OP- how long was your residency?


Sent from my iPhone using SDN mobile

this is standard—Ortho = 5 years...spine fellowship = 1 year....total = 6 years

 

[SteyrFWB]

When doing a scoliosis rod placement, and patient is not moving legs afterward, have you ever have the gall to do an old fashion rectal tone exam to make sure spine nerve conduction is OK? or do you fret hours and days to have neuro sciences people to tell you you are OK?

 

[I'mJustCurious]

1. Is the money worth the hard work?
2. Any current hobbies?
3. Were there any hobbies that you did while in school?

 

[NotaCop]

Hi Orthos,

My name is Daniel. I broke my spine in 1992 in a car wreck. T5-T9 was crushed. Now my neck and lower back over arch to compensate for the curvature at T6 (85% currently.) I've included photos of the X-rays below that show more detail. I've been to several spine surgeons and wanted to keep my feelings out of this post in hope to get the best recommendation. Are there any Spine Surgeons out there that could give me some advice?

Thanks,
Daniel

This is not medical advice per se so I think it is allowed:

Look up Dr. Alex Vacarro in Philadelphia, I'm friends with his son and from what I gather from hanging with the kid he is one of the leaders in the field (600+ pubs, head of a hospital, Eagles team consult, recently knighted in Italy lol, etc.) If you have the finances it may be worth trying to see him.