Strengthening the physician team at DISC Sports & Spine Center in California (“DISC”), two new partners have recently joined the practice. Dr Neel P Shah is an orthopaedic spine surgeon specialising in minimally invasive surgery, and Dr Puja Shah is an interventional pain management specialist with a holistic focus on wellness. Husband and wife, they share a fierce dedication to individualised patient care, one they will continue to hone under the vision of DISC founding director, Dr Robert S Bray. Here, we chat to Dr Neel P Shah about his work in orthopaedics
OPN: As a specialist in spine surgery, could you tell us more about your experience and training background in this field?
NS: Spine surgery has evolved to become a subspecialty. Traditionally, the work around nerves and the spinal cord was undertaken by neurosurgeons, and the work to fuse segments, place hardware and correct deformity and/or instability of the spine was done by orthopods. Over time, they have merged and both orthopaedic surgeons and neurosurgeons do all segments of spinal surgery.
I was lucky to have great training experiences during medical school, residency and fellowship. This makes me comfortable tackling any kind of pathology that comes my way. I completed a very hands-on residency in orthopaedic surgery at Rutgers New Jersey Medical School, which is a level 1 trauma centre where we saw every kind of orthopaedic pathology. After this, I was fortunate to complete a fellowship in spine surgery at the New England Baptist Hospital, where I was able to train with both orthopaedic surgeons and neurosurgeons. Here, I learned traditional open techniques of spine surgery as well as the latest in minimally invasive surgery. Given the sheer volume of spine surgery that occurs at the New England Baptist Hospital in Boston, I felt comfortable and confident becoming an attending spine surgeon.
OPN: What drove you to choose surgery as a career – and orthopaedic spine surgery in particular?
NS: Ever since I was a kid, I wanted to be a doctor, and not because my parents pushed me to become one (haha). I saw how my mother’s healing touch truly impacted her patients and tried to emulate the compassion and empathy I witnessed her give her patients. My father was an engineer and a self-proclaimed Mr Fix-It-All, which allowed me to develop a true joy of working with my hands. Along with my love of sports and being active, this naturally led me to orthopaedic surgery.
While in residency, I realised spine surgery was the field of orthopaedics I gravitated towards. I really enjoy the puzzle that is spine surgery.
In essence, there are four main principles of spine surgery: 1. Take pressure off the nerves and/or the spinal cord (decompression); 2. Correct or address any instability (stabilisation); 3. Correct or address any deformity; and 4. Preserve motion if possible (this is an emerging part of spine surgery). This sounds very simple, but there are many different ways to attack each of these principles with their own risks and benefits, and putting these pieces of the puzzle together for individual patients is a process that I truly enjoy.
OPN: As we head in 2021, it is clear that the healthcare industry has been greatly impacted by this year’s events, what has been the greatest impact within the orthopaedic and spinal surgery industry?
NS: This year has been eye-opening. In regards to healthcare and orthopaedics, I think it has really accelerated how healthcare will look in the future. I believe this will lead us to improve patient care and lower healthcare costs. It is showing us how the traditional hospital model is inefficient.
Elective surgery has slowly been moving to the outpatient setting, and the pandemic has only shown us the value of moving out of the hospital in terms of elective surgery. At DISC Sports & Spine Center, we have been able to increase the volume of outpatient spine surgery during a pandemic, as patients want to avoid the hospital. We have, with appropriate safety measures, been able to continue treating patients with spinal issues. Outpatient surgery has shown better outcomes and lower costs to the system.
Additionally, telemedicine has really been thrown onto the main stage. Both providers and patients seem to appreciate the convenience of telemedicine. Before the pandemic, payors (insurance companies) were hesitant to reimburse physicians for doing work via telemedicine. They have begrudgingly started reimbursing us during the pandemic, and we hope they will continue to allow us to provide care virtually once we’re on the other side of the pandemic.
OPN: What’s the best part of your job?
NS: It would have to be each and every patient that I am lucky enough to treat. I enjoy the process of properly working with a patient and solving their individual puz