By Jane Ehrhardt

Daniel Kim, MD, MSc, with Andrews Sports Medicine & Orthopaedic Center, became one of only three spine surgeons in the nation to be chosen as a Fellow in the 2024 SMISS Traveling Fellowship Program. “It’s a big honor because most of the previous fellows are typically from very prestigious fellowships and academic positions,” Kim says. “I’m humbled to be in such good company.”

The Society for Minimally Invasive Spine Surgery selects the Fellows from applicants among their more than 500 members. The immersive two-week program takes the Fellows to visit three prestigious medical institutions across the country.

“This is an opportunity to get hands-on experience and see how things are done at three of the leading spine facilities in the country,” says Kim, a complex and minimally invasive spine surgeon with Andrews Sports Medicine. “More importantly, this allows me to bring a national standard, if not international standard—like tip-of-the-spear type stuff—to our patients here in Birmingham.”

The travelling fellowship begins at the Hospital for Special Surgery. The private, orthopedic-only hospital in New York City consistently ranks as the No. 1 orthopedic hospital in the United States and in the world. “People fly in from all over the world on a routine basis,” Kim says. “It’s kind of like the Mayo Clinic of orthopedics.”

Kim’s focus will be on the big picture of handling minimally invasive spine cases. “I’m looking at everything that might impact a better long-term outcome from the minute the patients enter the clinic building,” he says. “That encompasses anything from data handling to patient care to recovery procedures and staff workflows. It’s only for a few days at each place, but you get an idea from just being there.

“The next stop will be Washington University, an academic hospital in St. Louis. That’s where modern spinal deformity was revolutionized in the last few decades with Dr. Lawrence Lenke. They have a lot of thought leaders on both the neurosurgical and orthopedic side.”

Because Washington University is set among a diverse population, it will present the Fellows with different insights into producing the same top-tier outcomes as the Hospital for Special Surgery does for affluent patients. “Wash U has the record, name-brand recognition and the power to attract the top-insured population in their area, and yet it’s still an academic and tertiary care institution where they get people from all walks of life,” Kim says.

After two days in St. Louis, the Fellows travel to Virginia Mason Franciscan Health

in Seattle. “The spine program at Virginia Mason has always been good,” Kim says. “Also, it has recently had an influx of some of the leading younger spine surgeons across the country, and they’ve been pushing the needle on value-based medicine and value spine care. The value-based focus on how to maximize outcomes and limit costs involves a new perspective on decision making and care of spinal cases. In regards to value-based care, we need to ask ourselves how we make durable decisions for our patients, and be good stewards in terms of waste, along with applying the best practices in terms of value to the hospital or insurance company and to the patients. That’ll be interesting to see how they navigate their surgeries and their patient care with that in mind.”

While at each institution, the Fellows will not only interact with expert faculty but share cases and observe procedures. “I’ll be learning from some of the top spine surgeons in the minimally-invasive world,” Kim says. “I want to learn how they make their surgical decisions and what enhances their outcomes in the pre- and post-operative phases that we’re not already utilizing in our practice; things like different nutrition profiles or different indicators or testing we can do preoperatively to enhance outcomes.”

From the surgical observations, Kim sees benefits in simply watching how they set up their OR and what equipment they have. “I want to find any details we can add to our techniques to enhance our outcomes, and basically emulate the best,” he says.

“The value of the Fellowship won’t be about learning a procedure. We’re already performing most of the industry-leading advanced technology and technique procedures here in Birmingham, like AI-assisted robotic surgeries and endoscopic spine surgeries. I’m just trying to hone and perfect the craft. I mean, the devil’s in the details of everything.”