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AANS Neurosurgeon Spotlight: Winter 2020 – The Mind of a Neurosurgeon Part II

By AANS Spotlight, MedEd, Medical Liability, MentoringNo Comments

Articles in the latest issue of AANS Neurosurgeon: “The Mind of a Neurosurgeon” take on the daunting task of better understanding what makes us tick! Many of the best and brightest have graciously considered aspects of this question and shared their poignant thoughts:

The Case for Mindfulness and Compassion

James R. Doty, MD, FAANS

  • Focus Lost. Every moment in surgery can be critical, right to the very end.
  • Focus Regained. I am working blind, so I open my heart to a possibility beyond reason, beyond skill and I begin to do what I was taught decades ago, not in residency, not in medical school, but in the back room of a small magic shop in the California desert.
  • For some it manifests as forgetfulness. Others experience compassion fatigue. Some experience moral injury and completely lose their motivation to serve their patients. In the worst cases, as defined by the ICD-10, physician’s burnout results in a state of vital exhaustion.
  • Being able to apply mindfulness training and a self-compassionate attitude to my profession gave me permission to attend to my own health and well-being.

The Impact of Medical Review Panels

Jennifer Kosty, MD; Bowen Jiang, MD; Devon LeFever; Jared R. Broughman; Frederick White, MD; Katie O. Orrico, JD; Bharat Guthikonda, MD, FAANS

  • Between 1990 and 2010, the National Practitioner Data Bank estimated malpractice and liability claims from adverse surgical events to be over $1.3 billion.
  • The Medical Review Panel (MRP) and Patient’s Compensation Fund are completely self-funded by physician participants, filing fees and investment income.
  • Once initiated, the panel has a 180-day period to render a decision with three possible outcomes: (1) Evidence demonstrates breach of the standard of care; (2) Evidence does not demonstrate breach of the standard of care; or (3) A question of fact exists bearing on the issue of liability which does not require expert opinion and therefore the MRP cannot render a decision.
  • Although the MRP has largely been beneficial for Louisiana, not all states have had similar experiences.

Inspiring Diverse Minds: The Value of Online Mentorship

Tiffany Ejikeme; Jennifer A. Sweet, MD, FAANS

  • Mentoring has been shown to be the most important factor for medical students in their choice of a specialty.
  • One specific challenge to mentorship relates to diversity. I have not come across many neurosurgeons who look like me, a black woman.
  • Staff physicians must relate to their students beyond the academic scope to form more authentic and effective relationships.
  • Further complicating the mentorship equation is how the medical student experience has evolved with the advent of technology.
  • Supporting efforts like WINS’ online mentorship portal, will help foster and develop mentorship relationships for students around the world.

Alternative Mind: How Non-traditional Experiences Enrich Neurosurgical Training Part 2

Juliana C. Rotter, MD; Avital Perry, MD; Christopher S. Graffeo, MD

  • Advanced communication skills and training are a crucial skill brought to neurosurgery by those coming in with background in business, administration or leadership.
  • The military mindset has a number of enriching elements including discipline to prioritize mission first as well as creating routinized procedures for debriefing, preparation and review.
  • Taken together, the less-traveled pathways have the potential to improve communication, diversify the collective skillset, enhance leadership and maintain the essential focus on the needs of the patient.