Mornings start early on most days, with hospital rounds starting well before 6:30am. We surgeons need to evaluate every patient that is in the hospital under our care prior to beginning the day's activities. Rounds consist of formulating an outline the day's recovery plan for each patient who is in the hospital (all have had surgery within the past few days), coordinating that plan with the nurses and therapists, checking in with the incredibly valuable medical consultants who also follow my patients, and taking some time for teaching our Spine Fellow, my Physician's Assistant, and the Orthopedic Surgery Resident who is on my Spine Service. Some days, we resemble a small covey of quail scurrying about the hospital.

Rounds are a candid report card on how my surgical intervention is working out for my patients. Patients tell me what is going well (nice nurse, great hospital food, pain gone, walking better, posture improved, etc) and what is not going well (hospital food, crabby nurse, pain pills, etc). Seeing patients every day in the hospital helps me to understand their needs, and make changes that will improve their hospital recovery. When I cannot be there, I count on one of my partners, residents, medical consultants, or PA's to function in the same way.

One particular patient I operated on recently had originally come to see me with severe back pain after an injury years ago. He had undergone physical therapy, pain management, and had undergone 3 prior spinal surgeries by others, including highly advertised "laser surgery". I had performed surgery on him to correct several areas that had not healed correctly, and to stand him up straight again. After just a few days in the hospital following major surgery, he was walking in the halls, eating regularly, and his pain was well controlled on pills. The catheters and IV's were out. He was ready to go home. I gave him my usual speech about returning to the office for follow-up in 2 weeks, checked that he had his pain pills, and reviewed his activity restrictions. He motioned me to stay at his bedside for a minute longer. Even though I knew what was coming, I never grow tired of it. What happened next is what makes all my work worthwhile. He took my hand in his, looked me in the eye, and said, "Doc, I can't thank you enough for all that you have done for me". I smiled, told him it was my pleasure to have him as a patient, and that I expected great things from him during and after his recovery.

These days, doctors have lost a great deal of autonomy over the care we provide our patients. Insurance company hassles, declining reimbursement, rising overhead costs, hospital bureaucracies, government meddling, Medicare and Medicaid regulations, the legal-lottery climate, and many other factors have negatively impacted the enjoyment all of us experience being doctors. Still, the reason I became a doctor many years ago was to have a substantial impact on improving the lives of people. That basic core desire and motivation has never left me. On rounds, the interaction with that one patient made my whole day. I love what I do, regardless of the third party distractions. On most days, I would rather be helping someone in surgery than golf. Maybe I need to see a doctor.