Comfort with data and comfort with change. The half-life of what we “know” keeps shrinking, and the surgeons who thrive will be the ones who can read the evidence critically rather than follow the loudest voice or the slickest rep. Beyond that, learn the business and the technology. You don’t have to start a company, but understanding how implants, economics, and reimbursement actually work makes you a better advocate for your patients and a much harder person to sell to. Technical skill is table stakes—judgment, adaptability, and a healthy dose of skepticism are what separate good surgeons from great ones.

Founding ThinkFirst of Northern Nevada. Since 2011, the program has reached more than 21,000 students with injury-prevention education. As a spine surgeon, you spend your career repairing damage after the fact—ThinkFirst was a way to get upstream of it. The operations are what I’m known for, but keeping a teenager out of my operating room in the first place is the work I’m proudest of.

I came to NASS the way most people do—for the education—but I stayed for the people. Spine is one of the few places in medicine where surgeons, interventionalists, researchers, and industry sit in the same room and argue productively about what actually works, and NASS is where that conversation happens honestly. What has kept me engaged is the chance to give back through teaching and committee work. Helping shape how the next generation is trained and credentialed has been far more rewarding than any single talk I’ve given.