While it’s important for any surgeon to have the necessary clinical
skills used to perform their jobs, there are key skills beyond clinical
care every spine surgeon should have to ensure excellence.
We sat down with Dr. Joshua Schwind, an orthopedic surgeon at Hoag Orthopedic
Institute, to find out what non-clinical skills every surgeon needs to have.
Q: Describe non-clinical skills.
A: Non-clinical skills can be described as four domains, which are cognitive,
interpersonal, performance optimization, and professionalism. More specifically,
there are seven strictly non-clinical skills that seem critical to develop
to be a successful surgeon; these are situational awareness, decision-making,
communication and teamwork, leadership, task management, fatigue/stress
management, and professionalism.
Q: Can you give us an example of situational awareness?
A: The operating room is a prime example of a complex, continually evolving
experience where situational awareness is of the utmost importance. The
human brain has a limited capacity to process all of the information available
to them, especially in the setting of a crisis happening during the surgery.
A surgeon must be able process the information wisely and react quickly.
Q: Can you describe how a surgeon practices decision-making?
A: With thousands of articles being published each year, it poses a considerable
challenge for the surgeon to remain up-to-date. Outcomes are optimized
when the right procedure is performed on the right patient, for the right
reason. To know and understand those three components takes diligence
and adherence to the principle of being a “lifelong learner.”
This helps the surgeon counsel patients as to the real risk-benefit ratio
of any given treatment.
Q: Can you explain communication and teamwork skills in a surgical setting?
A: Communication has been shown time and again to be a major factor in malpractice
claims, near-misses, and delays in diagnosis or treatment. Also, improved
outcomes for high volume operating rooms can be directly tied to the experience
and efficiency gained through the repetition of cases and tasks performed
by a team of professionals from a variety of disciplines who work and
communicate effectively, together.
Q: Describe why leadership and management skills are important for surgeons.
A: Doctors have historically held a privileged position in society. As respected
members of the community in which they serve, they frequently become leaders
and advocates at the individual, community, and national levels. They
are looked to for direction and guidance for the hospitals where they
work, and for the healthcare profession at large.
Q: Why is it important for surgeons to be good task managers?
A: Every day the surgeon must deal with numerous projects and tasks, all with
different deadlines. Keeping track of the innumerable responsibilities
can be tedious, but fulfilling duties, chiefly to the patient, in a timely
manner is key and critical to a successful practice.
Q: What are the repercussions of fatigue and stress among surgeons?
A: Surgeons can face a variety of illnesses if they don’t properly
manage fatigue and stress. The personal risk to the physician includes
issues such as depression, anxiety, sleep disturbance, substance misuse,
marital dysfunction, and suicide. Poor decision making, damaged working
relationships and medical errors are the professional components of burnout,
which is a widely recognized risk within the health profession.
Q: We would like to speak to you about professionalism as a spine surgeon.
Why is this such an important non-clinical skill?
A: It is a privilege to be a surgeon, and to be entrusted by the public with
inspiring hope, counseling and alleviating suffering. Practicing with
integrity and adherence to the ultimate goal of compassionate care with
respect for patient autonomy is crucial to improve patient care and elevating
About Dr. Joshua Schwind
Dr. Joshua Schwind is a board-eligible orthopedic surgeon at Hoag Orthopedic
Institute who is fellowship trained in orthopedic spine surgery. He has
published several articles in peer-reviewed journals and has co-authored
an instructional video in the Orthopedic Knowledge Online Journal, published
by the American Academy of Orthopedic Surgeons. Dr. Schwind is dedicated
to providing the highest standards in orthopedic spine care for all his patients.