By: 15 September 2020
Surgeon in focus – Patrick Hill

Patrick Hill is a spine surgeon at DOCS Spine + Orthopaedics in Los Angeles. He is a fellowship trained orthopaedic spine surgeon, specialising in the application of minimally invasive surgery (MIS) for common and complex spinal conditions and ailments. Dr Hill’s clinical areas of interest consist of spinal ailments adult degenerative disc disease, cervical and lumbar disc herniation, spondylosis and reconstructive surgery for spinal deformity.


SSN: As a specialist in spine surgery, could you tell us more about your experience and training background in this field?

PH: My training background provided me with a wide variety of experiences and really prepared me to be able to tackle anything in the field of spine surgery, while still being able to specialise further in the areas I prefer, such as minimally invasive spine. My residency was at University of Southern California (USC), with a significant amount of time being spent at the LA County Hospital, which is one of the busiest trauma centres in the country. At that hospital the residents and fellows must become comfortable dealing with all types of pathology – trauma, infection, tumour, etc. There really is nothing that you are not exposed to as a resident there.

The training can be gruelling at times, but it really prepares you well for what you will face when you’re out on your own. After USC I went to the Hospital for Special Surgery (HSS) in New York for a year, where I was able to hone my skills to truly specialise in spine. At HSS, as with USC, there is a vast array of spine pathology. Fellows are well trained in all areas from the smallest, most minimally invasive techniques to large deformity corrections and everything in between. I am very fortunate that I was able to train there.


SSN: What drove you to choose surgery as a career – and spinal surgery in particular?

PH: When I first decided to go to medical school, I knew I wanted to be a surgeon, there really wasn’t any question. At first, I thought I was interested in cardiothoracic surgery, however once I spent time on the orthopaedic surgery rotation, it was clear that I had found my calling. Then once in residency at USC, I was able to work with several fantastic spine surgeons who opened my eyes to the entire field. By the time I had gone through all the different areas of orthopaedics in the first two years, I knew I would specialise in spine.


SSN: How has your working practice changed since the onset of the COVID-19 pandemic?

PH: Covid has affected all of us, especially early on during the months of April and May. A large percentage of the spine patient population are medicare patients, who coincidentally have been less likely to be willing to attend doctor visits or even enter medical facilities in general, given the increased risk for older patients and those with chronic medical conditions. As a direct result, I have seen my personal business take a hit. However, at DOCS Spine + Orthopedics, we have continued to adjust our protocols as we have learned more about the virus, which helps us mitigate the risks to both patients and staff – it’s been a valuable learning experience.


SSN: How does the future look for minimally invasive spine surgery and what impact will it have on patient experience?

PH: I think the future of minimally invasive spine is as bright as it’s ever been. Each year the technology improves, and we as surgeons are presented with newer techniques that can make surgery more efficient and safer. For instance, we now routinely use computer navigation that pairs with intraoperative low dose radiation CT scans, which allows us to accurately place screws into the spine through the skin (through very small incisions). We are also able to use this technology with robotics, which can increase accuracy even further. We now have access to a state-of-the-art robotics machine, and many different companies will have variations of robots in the next few years, so it will be exciting to see what is available in the next few years.


SSN: What’s the best part of your job?

PH: Without question it is helping my patients and making them better. When you see patients who are truly grateful that you have alleviated their pain or restored function, or simply made day-to-day life easier, it really is the most rewarding aspect of the job.


SSN: … and the worst?

PH: Call days in residency. Working for 28 hours straight, often with no sleep and minimal food, twice a week with 12-16 hour days the rest of the week can really beat you down over time. Most surgeons who have been through it all will say that it’s an important part of training and that everyone needs to do it, however I honestly think that having residents work 24+ hour call days should not continue to be a standard part of training programs. Your brain doesn’t work the same way at 3am that it does at 3pm.


SSN: What has been the highlight of your career so far?

PH: Winning the clinical fellows research award at HSS. My research while at USC was not as notable, and HSS is a research powerhouse, with around 250 publications from all the clinical fellows combined just during my year alone, so it was an unbelievable surprise for me to get to share the stage with Todd Albert, Surgeon in Chief, and accept that award.


SSN: If you weren’t a spine surgeon what would you be?

PH: Assuming I would have ample time and money to train year round, I would be a professional surfer. Ha ha, honestly if I had to go back and pick a different schooling or training I would have gone to business school and got an MBA. But I’m glad I don’t have to think about it much because if I could go back in time and change anything, I absolutely wouldn’t. I am very happy with my career.


SSN: What would you tell your 21-year-old self?

PH: Don’t be in a hurry. Don’t think too much about the future, but plan appropriately for it. Don’t dwell on the past either. Make sure that you are doing exactly what you need to be doing in that moment, and take things one step at a time. If you continue to do the right things, success will come, but it will not happen overnight. Spend far less money.


SSN: If you were Health Minister for the day what changes would you implement?

PH: I would work with the government to much better regulate or eliminate motorcycle accidents, possibly starting by eliminating lane splitting or outlawing motorcycles on freeways altogether. Motorcycle accidents cost our healthcare system literally billions upon billions of dollars each year due to the horrific injuries resulting in repeated tests, surgeries and lengthy ICU stays. We need to get better at limiting health care costs as time goes on, and identifying the biggest expenditures is an important place to start.


SSN: Away from the clinic and operating theatre – what do you do to relax?

PH: I love to be outdoors. I do like to surf, although I’m not very good. I love the beach and also the mountains, especially snowboarding in Mammoth, California. But it doesn’t always have to be something active – a good bottle of red wine with a movie, my girlfriend and our corgi is always a great night too!


SSN: How do you think the future looks in the field of spine surgery?

PH: I think the future of spine in general is as bright as the minimally invasive side of spine. The same is true for the entire field – as time goes on, our technology improves as well as our techniques. We also gain a better understanding as surgeons of what a patient’s true pathology is. What it is that is really causing their pain and how can we intervene to make them better. This understanding better allows us to select operative candidates and increases the likelihood that they will have positive outcomes.