title: Spinal surgery: Who is in charge anyway?
abstract: BACKGROUND
  More and more, no one seems to be in charge of taking care of patients with spinal disease both before and after spine surgery. Yet, as spine surgeons, we should not have to direct basic medical clearance prior to surgery, or direct basic medical postoperative care.
  
  
  METHODS
  As we as spine surgeons did not complete medical residencies, why are we now being asked to take care of all postoperative issues in our patients undergoing spine surgery. As "captains of the ship," we are increasingly managing hypertension, diabetes, deep venous thrombosis/pulmonary embolism, and other basic medical issues.
  
  
  RESULTS
  Although our medical colleagues perform the preoperative clearance, too frequently they are not involved in the patients' follow-up treatment. Often, our medical colleagues are nowhere to be found after surgery for any of the postoperative problems; therefore, "tag" we are it. Nevertheless, this should not be the case.
  
  
  CONCLUSIONS
  So I ask again, who's in charge? Are we as spine surgeons now supposed to become the patients' primary care physicians, their pulmonologists, cardiologists, pain management specialists, much less their psychiatrists. Unfortunately, if we don't do this, no one else appears to be willing to step.
authors.affiliation: Department of Neuroscience, Winthrop University Hospital, Mineola, New York, USA.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Epstein
keywords: Medical clearance; no one in charge; postoperative care; preoperative care; spinal surgery