This is the second installment of a new series, The NASS Board Minute, featuring quick, one-question responses from members of the NASS Board of Directors on important issues in spine care. The Board represents a range of backgrounds and disciplines, all bringing deep levels of expertise and experience to the conversation.

In today’s article, we ask: What is the most important thing for young spine physicians to focus on as they enter the field?

Byron Schneider: The adage “treat the patient not the disease” is as true now as it has ever been. Pain is complex and understanding what other factors are mitigating a patient’s spinal pain is important. In training we are often measured on how often we are “right,” whereas the rest of your career the daily measure becomes the patient’s experience, which is often a reflection of having been heard and validated.

Knowing the right medical knowledge is the forefront of getting through medical training because it is the minimal criteria to being a competent physician. Knowing the patient becomes the criteria for being a well-established physician in the community. 

Andrew Schoenfeld: They need to focus on maintaining and growing their technical skills and learning how to indicate patients for operative and non-operative management. I tell my mentees that the time between graduating fellowship and board certification should almost entirely be devoted to the clinical aspects of your skillset. The administrative, leadership, and academic/research elements can be on-hold during that time.

Michael Fehlings: The most important thing is providing excellent person-centered, comprehensive spine care. Treat your patients as if there were family members.

Karin Swartz: Learning when not to operate will be a relevant part of growth, as will expanding on what your training taught you about how to operate. From a practice-of-spinal surgery perspective, it’s about getting comfortable with coding (language of CPT, jargon of coding and billing, where to find the information for accuracy), so that you are paid for the work you do, with emphasis on earnest compliance.

Attending a coding course early (first 9 months of practice) and then again at about 3 years is recommended timing for establishing basics and then refining – the yield from the courses pay for themselves. Further, you learn how you might leverage your membership status to help with coding and appeals.