Looking for a Neurosurgeon? Ask About Specialization


Patients fare better when their surgeons are specialized. So says a new study published in the BMJ (formerly the British Medical Journal) and picked up by The Wall Street Journal.

We couldn’t agree more! In fact, the neurosurgeons at Columbia University Medical Center/NewYork-Presbyterian Hospital have known this for decades, and they’ve been specializing and sub-specializing just as long. Now the research is catching up: The BMJ study found that mortality rates can be reduced by as much as half when a specialist performs certain procedures.

Dr. Michael B. Sisti, the James G. McMurtry Associate Professor of Clinical Neurosurgery at Columbia, is pleased to see these conclusions. “This study is absolutely correct,” he says. “Specialized surgeons bring about the best outcomes. They also result in the patient spending the least amount of time in the hospital and in recovery.”

Columbia began using a model of surgical specialization back in the 1980s, when Dr. Bennett Stein became Chairman of the Neurosurgery Department. A classic-car enthusiast, Dr. Stein knew that you don’t take a classic European sports car to a general mechanic. Instead, you find an expert on that particular car.

Dr. Stein thought that what makes sense for specialized cars is even more true for the brain. Usually neurosurgeons perform a wide variety of surgical procedures in the brain and spinal column, on both children and adults. But Dr. Stein believed that a neurosurgeon who focused on, say, only cerebrovascular problems like aneurysms would become an expert at that type of surgery and would have better outcomes than a surgeon who might only perform a few of them a year.

He took this concept of specialization and used it to transform the practice of neurosurgery at Columbia. Dr. Stein has since retired, but current Chairman Dr. Robert Solomon has carried on his legacy.

“The neurosurgical world has become so complex, that it is not possible for a surgeon to be expert in all facets of neurosurgery. Sub-specialization allows a surgeon to perfect his or her skills by performing a single surgical procedure on an everyday basis and in high volume.
As well, specialists have a more detailed understanding of the disease process, and when to use surgery rather than more conservative approaches. These factors converge for better outcomes for the patient and elimination of unnecessary surgery.” –Columbia Neurosurgery Chairman Dr. Robert Solomon

The result of this approach is the team of hand-picked, sub-specialized neurosurgeons that Columbia is known for today. Click on the centers listed below to learn more about each specialty:

  • Brain Tumor Center
  • Cerebrovascular Center
  • Endovascular Center
  • Epilepsy Center
  • Gamma Knife Center
  • Movement Disorders Center
  • Neurosurgical Pain Center
  • Pediatric Neurosurgery Center
  • Peripheral Nerve Cancer Center
  • Peripheral Nerve Center
  • Pituitary Tumor Center
  • The Spine Hospital

The BMJ study confirms that this model of surgeon specialization is the way to go. The authors suggest that specialization is something patients and referring doctors should consider when choosing a surgeon. They encourage patients to ask prospective surgeons if they specialize or sub-specialize, and to choose a specialist when possible.

Learn more about Dr. Solomon at his bio page here.

Learn more about Dr. Stein here and here.

Image credit: © [WerbeFabrik] /pixabay

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