Spine Surgeon “Tough Love”

Spine Surgeon “Tough Love”

Spine Surgeon “Tough Love”

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No one should want to see a Spine Surgeon.  The evaluation is  secondary to pain, and loss of activity.  Spine Surgery is painful.  It is a necessary,  difficult process that is beneficial to the patient in the long run.  That definition can also be considered a form of  “Tough Love”.

Those who have delivered “Tough Love” know it can be equally hard on the deliverer of this love.   When I was in training,  I often had significant jitters about the nature of the planned surgery.  I was comforted knowing that my Professor was nearby,  in case the surgery became more difficult.  I  had concerns about the patient’s pain experience during the post-operative period.  It was difficult watching some of the  pain responses.

When I first started my practice,  I had that false confidence of all new surgeons.  while I appeared steady,  and competent,  secretly  I would wonder if I was really prepared for all the potential complications.  After more than 20 years in practice,  I no longer have jitters,  but I still make a mental check list,  and subconsciously prepare Plan A, B, C and D.   I know the patient will go through some pain.  I also know the operation should provide a benefit in the long run.

There is another form of Spine Surgeon “Tough Love”  that most will not understand.

Many people will have significant pain shortly after having a disk herniation.  If the patient does not have significant nerve related weakness,  or loss of bowel and bladder function,  there is a good chance the pain will subside within 6-8 weeks,  and surgery can be avoided.

Occasionally,  a patient will have such significant pain,  that they would ask for immediate spine surgery to relieve the pain.   As they do not have nerve related progressive weakness,  or Cauda Equina Syndrome,  the prudent course is to wait,  take medications,  and avoid surgery for 6-8 week period.  Statistically,  greater than 95% should get better,  but initially,  it can be a very difficult initial few weeks.  Often times,  the patients and their families have great frustration by that recommendation,  and will seek other opinions and treatments.  Without a trusting relationship,  it can get contentious.

Waiting is Spine Surgeon “Tough Love”.    Frankly,  most of my negative social media comments have come from patients that have been asked to wait before having surgery.    Somehow,  there is the belief that the surgeon was not caring,  or taking the pain seriously.  Patients may not understand that it would be easier,  and financially more beneficial,  if the Surgeon would just offer that early surgery.  But as a Surgeon,    my code of Professionalism,  and my Hippocratic Oath  directs me to provide the best information,  and the least risky solution for my patients.  Early surgery is not the best option in the above scenario.

Without Professionalism  and the Code of Medical Ethics,  it would be an easy decision to just “provide the customer what he wants”.  Early surgery for the customer,  and more revenue for the practice would definitely be the better business decision.  That is why the Field of Medicine cannot be just a pure business.  That is why Spine Surgeons must demonstrate “Tough Love”  for their patients.

 

Citations

  • Madkouri R, Grelat M, Vidon-Buthion A, Lleu M, Beaurain J, Mourier KL. Assessment of the effectiveness of SFCR patient information sheets before scheduled spinal surgery. Orthop Traumatol Surg Res. 2016 Jun;102(4):479-83. PubMed PMID: 27108260

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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