Dr. Jim A. Youssef

From the minarets of Egypt to the mountains of the American West, Dr. Jim Youssef, founder of SpineColorado, has crafted an invigorating life indeed. Born in Minneapolis to parents who immigrated from Egypt, a young Jim Youssef was presented early on with several—just several—career options.

Medical Education

“Years ago my dad was working as the tax commissioner for the King of Saudi Arabia, while my mom was the first social worker in that country, ” says Dr. Youssef. “They met, married, and then proceeded to move around a lot because of his career. Our first stop in the U.S. was Wisconsin, where my sister was born, which was followed by Illinois, then Malibu, California. One day when I was in fourth grade, my mom and I sat down and wrote an essay on what I wanted to do with my life. In the Egyptian culture one is strongly encouraged to become a professor, a physician, or a member of the clergy…not a lot of options, really. But, we had a friend of the family who was a cardiothoracic surgeon, and who did a great job setting my arm when I broke it. I liked him, and respected what he was doing. Medicine—in some form—was going to be it for me.”

Before going forward, however, he stepped back in time, in a sense, to one of the world’s oldest schools. Dr. Youssef: “In 1985 I undertook a program of study at The University of Oxford in England. I chose Medicine and the Administration of Justice, a track which involved working in the prison system and learning about the profound differences in the American and British legal systems. It’s quite reformatory there, unlike most of our prisons in this country. Being able to attend the oldest college in the English-speaking world—complete with 12^th century dormitory—and without running water, was an absorbing experience. I knew that my future would entail a lot of the hard sciences, so I greatly appreciated the opportunity to study liberal arts for a time. And the structure of learning was very different, including the fact that we attended classes in the professors’ living rooms.”

Jim Youssef then moved from political science and the formality of England to Mendelian science and the relaxed atmosphere of California. “Throughout my education I had maintained a strong interest in biologics and molecular level science, and in fact was interested in becoming a pediatric immunologist and working with children who had AIDS. That shifted, however, when I got to know someone whose father was an orthopedic surgeon. I was allowed to observe his surgeries and saw that all of his patients turned the corner and got better. I could see that it would be quite an uplifting field.”

A youthful Jim Youssef entered the University of California, Irvine School of Medicine, only to be surrounded by his elders.

I was only 23 when I began medical school, whereas my classmates were an average age of 29, were married, and had children. I had a bit of growing up to do because I still thought I could party and do triathlons. The clinical experience was intense because we were at a county hospital and had the opportunity to both see and do a lot of different kinds of cases.

“In my fourth year I went to the University of California, San Francisco, where I did rotations in rheumatology, orthopedics, and pediatrics. During that time I got to know a visiting rheumatology fellow whose father was Chair of orthopedics at Oregon Health Sciences University in Portland. They were expanding their program to include a research post, and I was fortunate enough to get the position. While there I did genetic and molecular work, met my wife, and got married 10 months later. I was ill-suited for the constant rain in Oregon, however, so I interviewed at Dartmouth’s orthopedic residency program, and was accepted in 1992.”

The East Coast provided more agreeable weather, new lessons and piqued interests. Dr. Youssef: “In 1992 I left for the East Coast, and found Dartmouth to be a focused learning environment. There were only two residents a year, along with 18 attendings. Dr. Bill Abdu was one of the first people to introduce me to spine, while Dr. James Banta, a profound academician, stirred my interest in spinal deformities. Dr. James Murphy, a hand specialist, taught me the importance of being honest with regard to one’s mistakes. It was a very didactic, rigorous environment where we were expected to uphold the traditions of excellence, including wearing a tie—and no scrubs—on grand rounds. I did wear scrubs, however, when I participated in operating on Dr. C. Everett Koop, a Dartmouth alum who had his total knee done at our institution.”

The need to be near family then led Dr. Youssef back to the West Coast. “I selected the University of California, Davis for a spine fellowship in part because my father was ill and I wanted to be close to family. At the same time one of my children was diagnosed with a heart defect. When my dad passed away, my fellowship director, Dr. Dan Benson, was extremely supportive. He managed to continue to expect a lot out of me without being off putting.”

Advancing His Career and Starting New Initiatives

New opportunities at work also helped distract Dr. Youssef from the stress and worries in his personal life. “The fellows were accorded a significant amount of autonomy and had a large volume of cases, complete with three trauma helicopters. We saw a lot of deformity because we were adjacent to Shriners Hospital. The attending who ran the clinic left Davis, and Dr. Benson asked me to take over his position. This responsibility really elevated my level of practice, and looking back, I don’t think I could have accomplished all that I have without that experience.”

However, his next move left some friends and colleagues scratching their heads.

Looking to decompress after my training, I came to Durango, Colorado, thinking that I would leave after a couple of years. While a lot of people I knew thought it was career suicide, I was the first spine surgeon on the western slope of Colorado, and my life here has mushroomed into a prolific practice.

“My partners at the local hospital were very supportive, and I managed to put things into place that are unique in a rural area. I built my practice, SpineColorado, and under that ‘umbrella’ put all those who care for spine, including orthopedists, neurologists, neuropsychiatrists, physical therapists, and physiatrists. I built an active research department which has six FDA clinical trials underway at present. Also exciting is that I have been able to continue publishing and teaching, things which are rare in a private practice setting in a mountain town.”

Convinced that there was room for advancement in the field, in 2008 Dr. Youssef started the nonprofit Resources for Medical Education and Collaboration (RMEC) in order to drive innovation and support medical education. “Under the auspices of the RMEC I helped continue the Emerging Technologies Spine Education Summit Annual Meeting, which was initiated six years ago and now draws approximately 350 attendees. I then put into place other aspects of the RMEC, such as an internship program for premed students and an evidence based registries program.”

Dr. Youssef then wondered what a spine surgeon in France, perhaps puzzling over an XLIF procedure, might gain from near instant commentary by a colleague in, say, Detroit. “In 2000 I co-founded Syndicom, Inc., in order to create collaborative consultation environments for surgeons. It was obvious that while consulting on cases via email was possible, it was not a ‘live’ process and not especially collaborative. Our first effort, SpineConnect, is an online collaborative community involving 1500 spine surgeons in 40 countries who connect and share difficult and unusual cases. It has been so successful that we have now launched ArthrosplastyConnect and TraumaConnect.”

Highlighting one of special aspects of working in Durango, Dr. Youssef says, “We have a large population of Native Americans, with the Navajo nation only 20 miles down the road. Most of the people there do not speak English and have enormous health problems. Working with these folks, in addition to coming from immigrant parents and traveling frequently to Egypt, has really opened my eyes to what some people have and what others do not.”

Health Care Reform and a Healthy Family

Regarding the future of field, Dr. Youssef notes, “I am concerned about the current rush to create healthcare reform. Healthcare in this country has evolved over two centuries and has resulted in the most sophisticated technologies in the world. The problems are that we have a high rate of medical errors, along with high costs. But managing those issues should not be about taking money away from healthcare providers. We need to put more emphasis on reforming medical liability and put additional responsibility on the medical device companies for being more judicious about the delivery of new technology. There must also be a focused effort on high quality research, in particular as it concerns outcomes and evidence based medicine.”

“I am pleased, ” states Dr. Youssef, “that as a country we have a significant interest in maintaining our health. Those of us who have committed to the practice of medicine have an obligation to provide the best care we can without becoming mired in the issues of economic loss. Just recently I performed a seven hour intradural disc herniation and never once thought, ‘I’m not getting paid for this.’ Working in a small town sometimes means you are rewarded with a smile and a hug.”

These rewards are also waiting for him at home. “My wife and I have three children, a 14 year old son, a 12 year old daughter, and a 9 year old daughter, all of whom are freestyle skiers. Each weekend during the winter skiing is our life, with everyone piling into the car for the kids’ competitions around the state. My wife, Melissa, is very active in our community, and is Vice President of the local school board.”

We recently celebrated the one year anniversary of a stressful, but successful event in our lives. When my wife was 14 years old she underwent a scoliosis fusion. The fusion broke down about a year and a half ago, however, and she required surgery. We went to the medical board and insurance company and got permission for me to perform the surgery, along with my friend Dr. Darrel Brodke. It was the most intense thing I have ever done.

Dr. JimYoussef…having it all and grateful for it.