I was born and raised in State College, Pennsylvania. I currently live in Manhattan and work at the Hospital for Special Surgery.
I studied psychology as an undergraduate, and I have found this incredibly useful in my day-to-day practice. In the management of low back pain, and spine conditions in general, I have found there is a strong positive association between psychologic well-being and successful surgical and non-surgical outcomes. Having patients recognize this early on in the course of their disease process is an area I focus on with new patients.
I work as a general internist focused on perioperative care of patients having spine surgery. This is a very niche area, and I work closely and collaboratively with a group of 14 spine surgeons, which I enjoy very much. I also have a small private practice of general medicine patients that I follow longitudinally as well.
I am a new member of NASS, having joined two years ago. I joined to learn and share unique approaches to optimizing perioperative outcomes for patients undergoing spine surgery. I’m a firm believer that select interventions before surgery can impact not only the surgical episode of care, but have potentially lifelong consequences (eg smoking cessation, management of cardiovascular disease and a focus on healthy nutrition and weight). There is a wealth of literature on perioperative care outside of spine surgery, as well as exciting opportunities to study within spine care. I have been impressed with the quality of presentations at national meetings, yet also see some real opportunities for expansion of the work on perioperative care in this arena, especially in the area of geriatric health and management of frailty.
Helping underserved patients to rapidly access appropriate care, and effectively utilize community resources, has been a challenge at times. While this issue is not unique to spine care, the timeliness of certain spine-related diagnosis highlights a certain urgency, and advocating for patients with limited resources can be a frustrating part of the day-to-day practice.
SpineLine is an excellent publication, and one that I find readily applicable to my daily practice. I was initially invited to write several reviews, and later wanted to continue to help shed attention on key perioperative issues that I believe are crucial to successful surgical outcomes. The committee is focused on evidence-based and timely publications, addressing areas of controversy, and common clinical scenarios, and the committee vision is nicely aligned with that of NASS in general, and serves a broad provider audience.
The meetings are an excellent way to network, and see the unique research taking place across the globe. Additionally, the challenges faced by many providers are similar, and it is helpful for me to see different strategies for tackling similar problems.
I think navigating a patient population that is often managed with opioid therapy over the long-term, before I even meet them, has been a real challenge for myself and colleagues. Striking a balance of doing no harm with effective pain management strategies has become an art and requires patience and time-intensive discussions with patients that can be challenging in the present healthcare environment.
I think the media has effectively covered the frustrations of many consumers, but at times not highlighted the success of certain government and private-sector programs that have been successful in preventive and proactive care. This later area needs more attention both from a media coverage standpoint, and with provider care, to help emphasize an increased proactive role patients can take in managing their health.
I read, mostly non-fiction, and love historical biographies. The Invention of Nature: Alexander von Humboldt’s New World (by Andrea Wulf), and Alexander Hamilton (by Ron Chernow) are two recent books I really enjoyed.