A Straight Arrow…
Don’t ask Neel Anand what he thinks if you don’t want straight answers.
“One problem in spine is the ongoing issue with incorrect diagnoses. So many surgeons want to rush to the OR when it comes to spine problems. They get attached to something on an X-ray or MRI, but what they see is not necessarily the problem. They’re operating on the MRI rather than the person. Be a doctor first.”
And his thoughts on the state of medical training?
“Some people have sufficient natural talent, and some do not. At a certain point, that is not trainable. And some young people are closed off, making it difficult to communicate your thought processes if the trainee is not able to widen his or her horizons and think beyond what they already know. Medicine is not 1+1=2. You have to be a detective in search of nuances.”
Not afraid to display his “personal gripe,” Dr. Anand told OTW, “There is too much focus on academic facts as well as technology. Robots, navigation, monitoring…there is no one asking the fundamental question, ‘Do we really need that?’ Is navigation going to change someone’s life? We don’t know. Any technology only makes a good surgeon better…it never makes a bad surgeon good.”
And, the next generation of spine/neurosurgeons?
“Orthopedic trainees must develop the ability to ‘think in a more critical fashion.’ People need to take time to analyze problems, asking themselves, ‘What could I have done to avoid this problem? Did I make the wrong diagnosis, do the wrong operation, etc. How exactly could I have done better?’”
“I spend an hour on every new patient and get to know them very well. And, for example, if someone comes back after surgery saying that they are still hurting and there is now pain down their leg, because I have interacted so much with them, I am better positioned to help them.”
“I had a patient who came to me following a lateral surgery. He was having pain down one leg and weakness in one foot. By then it was known that lateral surgery can cause weakness but that it typically improves on its own. But the orthopedic resident and internist didn’t realize that it was his foot that was weak, not his quads. The lumbar plexus is involved in transpsoas approaches and usually affects L3 or L4 nerve. In this instance it was L5 creating foot weakness, the issue being that the prior lateral surgery at L4-5 had pushed disc material into the spinal canal and squeezed the L5 nerve, creating the foot weakness. The patient needed a decompression. As surgeons, we shouldn’t be creating new problems for the patient! Knowing your patient allows you to recognize and correct a problem early on rather than later when someone is falling apart.”
Dr. Anand’s advice to younger surgeons? Don’t ignore a word of what a patient says…they are not making things up.
Oh, but that is A LOT of listening, you may think…I will get burned out if I listen to everything.
No, you will get burned out if you don’t do the right thing, says Dr. Anand.
“Don’t chase the money. Do the right thing you’ll never be wrong. You will have a peace of mind that you did your best. And if you don’t know something, ask and don’t be embarrassed.”
And what gives Neel Anand hope for the future of the spine? “I think the way we manage patients has changed immensely, and we have a better understanding of what we are doing. Technology—the right technology—will make things easier and will hopefully translate into better outcomes.”
Oh yes…Dr. Anand has a family. “My nineteen-year-old daughter is in her first year of college. My fifteen-year-old son is in 9th grade. As for me, to relax I try to spend whatever free time I have with my kids doing or accompanying them to activities they enjoy.”
Neel Anand, M.D.…for whom, every patient is a star.
I am probably one of those first patients. to have the non invasive surgery done by Dr. Anand sometime around 2003 or 2004. I recently had additional back surgery. Both were very successful. Dr Anand is very caring and kind. I always feel I am in good hands with him. My husband experienced some difficulty plus weakness in his legs so he saw his primary Dr., then saw a local orthopedic Dr. Who said he couldn’t see what was causing it. So we went to Dr.Anand and he said you have things wrong in your lower spine and in your neck, but you have no pain therefore I do not think you need surgery. Then he said you need to see a neurologist. How correct he was because my husband was subsequently diagnosed with ALS. How thankful we were that he did not have to have any unnecessary surgery which does happen to people who have unidentifiable ALS in the early stages. I am forever thankful to Dr. Anand.