September 22, 2025 • 34 mins
Dr. Kushagra Verma's journey reminds us that finding your calling often happens through unexpected rotations and powerful mentorships rather than childhood dreams.
What makes his approach to spine surgery truly distinctive is the blend of technical excellence with deep humanity. Dr. Verma describes his complex surgical work as an intricate three-dimensional puzzle that draws on his engineering background. Yet beyond the operating room, he's built a practice that prioritizes patient education, using 65-inch TVs to explain conditions and giving surgical patients his personal cell phone number to ease anxiety. This combination of technical precision and compassionate communication transforms lives affected by spine problems that can create "the same disability scores as people with terminal cancer."
Perhaps most remarkable is how Dr. Verma has structured his practice to reflect his values. He intentionally hires pre-health students aspiring to medicine and PA school, providing them with mentorship while simultaneously expanding access to care. His yearly medical missions to Africa to perform free scoliosis surgeries is "the best thing that I do," funded by the success of his private practice. Through candid discussion of both clinical and administrative challenges, Dr. Verma offers a blueprint for creating a sustainable medical career that resists burnout through purpose and meaningful relationships.
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To learn more about Dr. Verma and his office:
Instagram: @ascmd
Website: advanedspinecare.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Ashley (00:00):
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
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which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at shadow
me next, where we will reviewhighlights from this
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upcoming guests.
When you look at someone'scareer from the outside, it's
(01:06):
easy to think it was all plannedfrom the beginning, but Dr
Kushagra Verma's path as afellowship-trained orthopedic
spine surgeon was not linear.
He once thought he'd be anengineer and later imagined
delivering high-risk pregnancies, and yet finally found his
calling in the operating roomduring a pediatric spine
rotation.
(01:26):
What makes his story remarkable, though, isn't just the
technical complexity of his work.
It's the relationships thatanchor it, from mentors who
shaped his vision and studentshe now coaches into medicine, to
the children in Africa whoselives are transformed by his
volunteer surgeries.
Dr Verma reminds us thatmedicine is about persistence,
(01:49):
resilience and never taking nofor an answer.
We talk about the long road oftraining, what it means to run a
practice with both purpose andsustainability, and how the
power of mentorship can changenot only careers but entire
communities.
Please keep in mind that thecontent of this podcast is
(02:09):
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next with DrKushagra Verma.
(02:31):
Dr Verma, thank you so much forjoining me on Shadow Me Next
today.
This is going to be anabsolutely fantastic
conversation that I'm reallymotivated by, because of not
only what you do, but how you doit, so thanks for being here.
Dr. Kushagra Verma (02:46):
I appreciate it.
Ashley (02:47):
So let's start at the very beginning.
You went to medical school atNYU.
You are now a fellowshiptrained orthopedic spine surgeon
.
Is this the road that you hadplanned for yourself back when
you were eight, nine, 10 yearsold?
Dr. Kushagra Verma (03:00):
I zigged and zagged a little bit.
I was a good tinkerer as a kid.
I thought engineering was myway and I did pretty well in
high school, even won sciencefairs in engineering and got
into a good college for me.
And so I kind of redirected andwent into med school.
I took a year off, did someresearch actually at NYU, and
(03:27):
that's how I ended up gettinginto NYU, because I was there.
I always tell people you knowit's just show up, just be there
in person and doors open up.
And they kind of did that wayfor me.
I was applying to med schoolthere, I was doing research
there, they knew me, they likedme, so I got in.
And then in med school I thoughtI was going to do obstetrics,
(03:49):
actually high-risk pregnancies.
I always wanted to do thechallenging specialties, the
surgical ones.
You know that's kind of a toughspecialty for a guy to be in
these days and so I justcouldn't seem to envision myself
doing that.
So I was a little lost at theend of third year until my last
block of med school I didpediatric orthopedics and I saw
(04:10):
them do pediatric spine surgeryand immediately I looked at it I
was like, oh, this is thecoolest surgery.
This is what I want to doObviously had nothing lined up,
did no research, had no lettersof recommendation or anything.
So I decided to take a year offand I did research in scoliosis
and pediatric spine and it wasa great year.
I learned a lot.
I did a lot of research.
(04:31):
This is where I talk aboutmentorship was so valuable.
These like pretty well-knownsurgeons.
I'm still really close withsome of them.
I still am texting them.
You know they're my friends nowgoing on.
God, what was that?
2008.
So how many years is that?
17 years and um, it was justsuch a good relationship, you
(04:53):
know, like unlike anything I'dhad before that med school,
where I identify with theirpersonalities.
These were unique people thatcould do pretty risky surgery
and be pretty calm, you know,and it was just appealing to me
and I got into residency atJefferson.
I worked under Alex Vaccaro,who was a pretty well-known
(05:13):
spine surgeon and also, you know, a mentor.
And after that I went to UCSFfor fellowship, which was more
complex spine and scoliosis,some PEDs, some adult, and then
that finished up in 2016.
And then I moved to Seattlewhere I was a professor for a
couple of years and in Seattle alot of complex surgery.
(05:34):
But I really hated living inSeattle so I decided to move to
LA and kind of gradually startedmy own practice and now we
still embody a lot of that likeacademic feel in our private
practice.
We have a research component towhat we do.
We publish some papers.
Where you know, pretty activelyinvolved in outreach work, we
(05:55):
do a yearly trip to maybe notevery year to Africa for a
charity where I do freescoliosis surgery in Africa.
If anyone's interested indonating or supporting that
cause, you know they candefinitely reach out to us and I
even, like you know, recruit myother spine surgeon friends to
go with me.
(06:16):
And then you know our entirepractice.
You know we don't really hireon.
Indeed, I don't hiretraditional MAs, I hire people
out of college that are applyingto PA school or med school
because I really want to mentorpeople and for me mentoring is a
lot of chasing them around.
Did you get your applicationdone?
Yet Like coaching them.
I don't know how much mentoringis happening, how much
(06:37):
harassment is happening, but youneed a little push along the
way.
You got to get your applicationdone.
You got to check that box, yougot to take that test.
Along the way you got to getyour application done, you got
to check that box, you got totake that test.
It's a lot of stuff.
I remember it being just sotedious.
And I remember there was astudent that I mentored, a young
attending in Seattle.
His name's Casey and he was amed student.
(06:58):
They told him he couldn't getinto orthopedics and I said,
well, I'll take no for an answer.
And he did a bunch of research,wrote like 15 papers.
He got into orthopedicresidency.
We stayed friends.
Then I encouraged him to do hisfellowship down here in Orange
County and then they loved himthere.
Then he stayed on and nowbasically we're practicing 15
miles away from each other.
(07:18):
Whoa cool story and he's goingto go with me to Africa next
year.
So these relationships inhealthcare are, I think are
special, and the mentor menteerelationship is what keeps you
going, because healthcare is alittle bit of a mess in this
country and you, you genuinelywant to help people, but then
the system's a little broken andlong.
(07:40):
If it's med school, god, it'sso long.
And I have I'll be very honest,I have some trauma from some of
the parts of training.
It wasn't really that good foryour brain or your body or your
health to be up that many hoursworking, didn't go to the gym,
read healthy, all of thosethings.
I kind of look back.
I'm like, well, you know, nowI'm going to be even more
(08:01):
healthy than I might've beenbecause of that.
You know, even more healthythan I might have been because
of that, and I think it's justreally valuable.
It's one of the reasons Isigned up to do this podcast
right away I was like this isperfect for me.
Ashley (08:13):
We appreciate it, because I think your story is
just, it's so full, it's so fulland it's so important to me for
pre-health students to hearthat once you're in medicine, it
really it doesn't stop there,it just expands.
Honestly, it grows, things justgrow.
And I love how you weredescribing relationships,
(08:35):
because you talked aboutmentoring and about access and
about those personalrelationships in medicine.
But you also talk aboutresearch, a lot of research, and
that's a relationship with thecapital M part of medicine.
But you also talk aboutresearch, a lot of research, and
that's a relationship with thecapital M part of medicine.
And these are the things thatwe love so much and these are
things that why it's why wecontinue to do what we do.
We love people, we love formingthose relationships with them
(08:58):
and then we also love thescience behind it.
We love the research.
We love fixing things andsolving problems and identifying
those mysteries.
So that was just such a greatintroduction.
I am excited to talk about yourresearch.
I am excited to talk about yourrelationship with teaching and
how it has brought in a PA toyour practice, which is just, oh
(09:19):
, it sounds so fantastic the waythat you two work together, and
I really, really want to talkabout your charity work in
Africa because, well, for anystudents listening, I was a
student at one point and Ithought that it was what I was
going to do with medicine.
Right Is, I was going to takethe medicine I learned and just
change the world, and you'redoing that in a very, very
(09:39):
realistic way.
So we're getting to all that.
I can't wait to talk about it,but let's, let's first, let's
just talk about a day in yourlife, which I'm sure is very
multi-faceted.
Dr. Kushagra Verma (09:48):
It depends on the day.
Every day is a little different.
Our surgery days, you know, weget up I usually start my day at
five in the morning liftweights and exercise and get to
the OR and then, you know,depending on the day, like
yesterday we had a huge revisionthoracic forward and pelvis
revision, taking out hardware,putting in hardware, two liter
(10:09):
blood loss, five hour surgery.
That's one type of daySometimes we're doing, you know,
small procedures, outpatientsurgery.
The majority of what I tend todo on a daily basis is kind of
those kinds of cases Patients dowell.
And in spine surgery there's areally big revolution that's
happening where a lot oftraditional spine surgery is
(10:29):
being improved upon to the pointthat it's being done at surgery
centers, it's being doneoutpatient and it's not crap
surgery, it's good surgerythat's being done with small
incisions.
I'm always against, you know,doing outpatient surgery where
the surgery you're doing is kindof lousy but it's.
This is actually really goodsurgery but short recovery times
(10:50):
, great looking x-rays,improvement in the patient
experience.
So I'm interested in that sideof it and in the last five years
it's really been more abouttaking cases to the outpatient
setting.
Other days it's a lot of talking.
I don't mind doing this podcastbecause I probably, on like a
Wednesday, I've spent eighthours talking and listening, I
(11:11):
hope.
But I do a lot of consultationswith patients.
I ask them what's going on andI do a lot of teaching.
We have 65-inch TVs in ouroffice.
I pull up the imaging.
I say, look, this is theproblem.
This is not going to get betterwith an injection, or maybe it
will.
Or, you know, we got medicationor this is a diagnosis and this
is what the x-ray shows.
(11:32):
And we do it over and over andover.
And that's how I ended upteaching my staff.
If they're interested in spine,just a few days in my office
they'll learn how to read MRIsx-rays examine people.
Mris, x-rays examine people,talk to them, even know what the
different surgeries are,because it's pretty repetitive,
(11:52):
you know.
And then there's about a day aweek that I spend doing
administrative work.
I'm more involved, I think,than I've been in the past,
where I, you know, I havemarketers, help, you know, make
sure people know about ourpractice.
But I'll go out with themarketer and make sure they know
the doctor's availablesometimes.
But I'll go out with themarketer and make sure they know
the doctor's availablesometimes.
I will do various billingmeetings to see what's happening
(12:12):
with billing and insurance andcollections.
I'll meet with my bookkeeper.
I'll meet with my staff.
I'll meet with Calvin.
There's lots of things that wesort of are kind of on the to-do
list, as I say.
Well, we'll put it on the list.
We have an administrative day.
We tackle the list prettysystematically and that's how
we're able to drive the practiceforward.
We have four offices now.
We have this outreach trip thatwe're doing.
(12:35):
We have research that we'restill involved with, we're
mentoring students.
All of that sort of falls intothat administrative time.
Ashley (12:42):
Administrative things.
Thank you so much fordescribing that, because that's
not something we really talkabout a lot on the show, and I
think that it's so important fornot just pre-health students
but also for patients to hearand to understand that,
especially in private practice.
It is a business and I think wesay that a lot in terms of
(13:02):
making money and makingfinancial decisions, but it's
also running the business thatwe can continue seeing our
patients.
Dr. Kushagra Verma (13:09):
People think running a business is like a
bad word, like you're trying tomake money off people, and I
always want them to understandthat I have almost run this
practice into the ground acouple of times because I help
everyone that comes in the doorand not pay attention to the
numbers or what's happening.
And then you start looking atwhat actually came in and you're
like, oh my God, we went,almost went bankrupt.
(13:29):
We didn't collect anything.
And so if you care about yourpatients and your practice and
how you practice as a doctor orPA, you should care about the
engine, which is the practice,and I think it's important and
it's made me a better doctor,because for a while we were
running like a factory.
Just try to do as many patientsas possible, many consults as
(13:52):
possible.
Sometimes you're seeing toomany patients and it doesn't
really give you that excellentpatient experience.
As a clinician or PA, you'renot loving the experience of
seeing patients like that, andso we actually slow it down.
We really systematically look.
We're going to do a 30% of ourwork is going to be charity work
.
Who cares if we get paid or not?
(14:14):
We're going to do a certainpercentage of hopefully cases
where we do expect there to besome profit.
And then we're going to alsohave clinic percentage of,
hopefully, cases where we doexpect there to be some profit,
you know.
And then, uh, we're going toalso have clinic and a lot of
our clinic.
You know it's not reallyprofitable but we want to make
sure we do well enough on thesurgeries that I can spend an
hour and just chit chat withsomebody if I need to.
Who's anxious about surgery?
What makes me a better doctor?
(14:36):
But if we're so constricted, um, trying to just see as many
patients as possible, then itultimately erodes your
reputation, I think.
Ashley (14:47):
I want to talk about your Wednesdays real fast,
Talking and listening.
A lot happens on Wednesdays.
You perform these complex spinesurgeries and they can be
life-changing for patients, I'msure, but they're also
intimidating.
How do you approach thoseconversations with people who
are maybe very, very anxiousabout?
So this is the talking elementof your Wednesday what do you
(15:08):
say to them?
How do you give them comfort orreassurance?
Dr. Kushagra Verma (15:12):
You know, sometimes people are anxious and
there's nothing you can reallydo.
They have to just take time toprocess it and come to peace
with it.
So I usually give them theinformation in small doses.
You know, like I'll say, ohlisten, this is going to be
surgical, it's probably going tobe something big, but let's
have you come back with a familymember.
I want to go into some detail.
(15:33):
Other times it's somethingsmall, like hey, this is not
going to be a big surgery, thisis going to be an outpatient
procedure.
Most of the time when people areanxious, it's reassuring for
them to know that, listen, planA is going to be to avoid
surgery and we're going to dothis, this and this to try.
But if it doesn't work out,plan B is a minimally invasive
(15:55):
outpatient surgery and it's notsomething very technically
challenging, and I can show youon a model here what I do.
They actually are less anxious.
Every patient has my cell phonenumber, at least the surgical
patients.
So I'm having a lot of phonecalls with people afterwards and
then we never take anyone tosurgery until they've had
sufficient time to ask theirquestions, come to peace with it
(16:17):
, unless it's like a realemergency, you know, and that
happens sometimes, Um, but wereally, you know, and we've
created a lot of content.
If, if you know, people areinterested, they can follow us
on Instagram, advanced spinecare ASCmd.
They can also go to our websiteand we even have our own
Spotify podcast.
But I create a lot of contentto help relieve some of that
(16:39):
anxiety that I know people feel.
And I think information helps,but, on the flip side, sometimes
more information doesn't help.
If you were afraid of flyingand you had to sit down in the
cockpit with the pilot and goover all the switches, I'm not
sure it would make it better.
And now they'd say go in theback, have your cocktail.
(16:59):
So we try to strike a balancebetween those two.
I answer the questions thatthey want answered, and in a lot
of detail, but sometimes, if Ifeel like they're getting more
and more anxious, I tell them tojust you know, take a little
break, you know, and and.
I let them know the differencebetween the complex spine
surgery, the dicey stuff Versusthe not dicey stuff, and I'll
(17:22):
let them know.
Okay, this one's a more riskysurgery.
These are the risks.
This is my experience and we'llhave longer, more detailed
conversations with thosepatients.
You just gotta be you, yeah,talk to people, yeah, tell them
what you know how to do, tellthem their experience and that
trust will come, I think, withtime.
Sometimes they're not ready tohear what you have to say.
Ashley (17:47):
I love that you give them the education, but then you
also give them the time and thespace to process that, which is
so important.
Okay, that's the talkingelement of Wednesdays.
Now the listening element andthis is something that you've
emphasized is giving patients astrong voice in their treatment
plans, and I'm sure I mean, howoften do you hear surgeons doing
that?
Right, that is, that seems veryunique.
Tell me a little bit about that.
Dr. Kushagra Verma (18:09):
People with spine problems.
When they're really complexthey have the same disability
scores as people with terminalcancer and their quality of life
is affected in such a severeway.
And in certain cases we cantake a disabled patient and make
them not disabled.
But sometimes it's a hugesurgery.
Other times we can takesomebody in severe pain and with
(18:30):
a relatively small surgerycompletely change their life.
But I have to figure out wherethey are a little bit.
I want to figure out is it painthat bothers you every day,
keeps you from doing things youlike to do?
Is it intolerable?
Is it keeping you from work?
Is it pain?
You know it doesn't get betterwith any non-surgical treatment.
(18:51):
You have to really feel likeyou know and understand your
surgeon, get to know them andyou really have to understand
the surgery.
And I mean that means youreally get it.
Okay, the bone has slipped outof place.
There's no way an injection isgoing to move it back into place
.
They've got to look at theimaging themselves.
They've got to look at a model,they've got to really see it
(19:12):
and then when all of thosepieces come together, they can
kind of make the decision.
I think Usually I give people abunch of information and they
probably feel like they'redrinking from a fire hose.
They're overwhelmed, they gohome and sometimes patients are
like well, thanks for theinformation, doc, I'm not ready.
I'm always like, that's fine,take your time, and then, like a
month later, they'll call meand they'll be like we're ready
(19:33):
now and they have to go throughwhatever process they're going
through to feel like they'rethere and I think you know I'm
half psychiatrist.
Because of that you know no twopeople are exactly the same.
Ashley (19:49):
No, which is the beauty of medicine, but it's also the
huge challenge of medicine, forsure.
I love listening to how you'reyou're educating your patients
and you're you're allowing themthat, like I said, and you're
allowing them that, like I said,that space to really understand
and learn and appreciate theircondition and what you're trying
(20:09):
to do.
Your love for teachingobviously doesn't just stop with
your patients.
You've already mentioned thatyou employ these incredible
pre-health students who arelooking towards becoming
physicians, pas and othermembers of the healthcare field.
You love to teach.
You brought on a PA into yourpractice.
Tell me how that has been,because I think so often when we
(20:30):
bring in another physician,it's a colleague.
When we bring in a PA, it'salso a colleague, but at the
same time as a PA.
Speaking as a PA, I amexpecting my supervising
physician to be a teacher firstand then a colleague second.
Is that your experience?
Dr. Kushagra Verma (20:47):
Yeah, I think I mean, a lot of teaching
is just done by observation.
You just spend time with me andeventually I vomit out all the
information I have that I'vepicked up over the years and you
sort of absorb it.
Information I have that Ipicked up over the years and you
sort of absorb it.
Um and so I think you know,just being in clinic, being in
(21:08):
surgery, you just get it.
But in the beginning I had a PAbefore Calvin moved to Hawaii,
and uh, he just, he just told mehe felt so overwhelmed in the
beginning and I said, well,that's okay, I feel overwhelmed,
you know.
And then in surgery he told methat he felt like everything was
moving in fast forward, that hewould go to do something and
(21:29):
I'd already done 10 steps inthat amount of time and he
couldn't understand why I wasmoving so fast.
And I, and I tried to explainto him.
I was like I've done this somuch that there's so much muscle
memory in what I do and I knowwhen the dicey parts of the case
are.
You don't know that.
I know that we're just exposingthe muscle off the spine.
We can go as fast as we want,but then other times I know to
(21:50):
sort of push your hand away andsay, okay, let me do this.
This is the dicey part, um, andthat just comes from watching.
I have watched a decade ofsurgery before I even really did
surgery and I used to hate it,to be honest.
I remember being like a medstudent and a resident and even
a fellow.
I did a lot of watching and Iremember being like man, I just
(22:14):
want to do the surgery.
And then, now that I'm on theother side and been operating
for 10 years, I love to watchpeople on the other side and
been operating for 10 years.
I love to watch people becauseyou'd be surprised, the more you
watch, the better you get.
You sort of watch somebodywho's really good, maybe when
you're a trainee, and then youhave that memory.
(22:34):
If you watch them enough, youhave it imprinted in your brain
how they did the surgery andthen magically, your hands just
recreate it five years later.
And it's true.
I remember my first year asattending.
It was in Seattle.
You know I'm operating.
Someone gave me the opportunityto see another surgeon who was
in private practice 15 years,huge volume of surgery.
(22:55):
I spent the day with him.
He just casually was like, yeah, we've got 10 cases.
I'm like what 10 cases?
And I watched him just blowthrough these cases with so much
efficiency and grace and I wasa first year surgeon then and I
think I came home the next dayand I was 30% faster.
Just watching him that one day.
(23:15):
I was just like what am I doingin surgery?
Why is this taking me so long?
And I think it's like that as aPA too.
I tell the PA this is going totake years for you to feel
comfortable, and that's okay.
Ashley (23:34):
There's nothing wrong with that and that's why I love
so much working with asupervising physician, because
there are still things Iregularly I encounter and I
think, well, this is what I'mthinking, but I know there's
something else there that I'mnot thinking, so I'm going to
run it by you to see what youhave to say.
And, of course, that's clinicOR.
You're absolutely right there.
He still surprises me withthings in the OR which is, oh,
it's just so much fun, and I amabsolutely swiping your phrase
(23:57):
the more you watch, the betteryou get, because, I mean, this
is shadow me.
Next, this is a podcastdirected at people to just
listen and watch and understandand learn about variety of areas
in medicine.
And it's so true the better youget, the more understanding you
have.
Dr. Kushagra Verma (24:12):
And I have all these moves and tricks where
people will ask me how did youlearn how to do this?
And I like flashback to the2016,.
Me in Africa doing a case on akid with 150 degree curve and
I'm like blotchy or whatever youknow.
Whatever it is, whoever theattending was that.
I just stared at, watched themput it together and it's true,
(24:36):
it's definitely like that.
In surgery, specifically spine,sometimes it's like you're
putting together an erector setof screws and rods and hooks,
especially some of the complexstuff.
It's from a brain stimulationstandpoint, I don't think
there's some of the complexstuff.
From a brain stimulationstandpoint, I don't think
there's anything better thancomplex spine.
It just really activates a partof your brain that likes to
solve problems,three-dimensional problems, and
(24:59):
if you're mechanically inclined,like I've always been because
I'm an engineer, I love to putscrews and rods and hooks
together.
I mean it's like playing Legos.
Ashley (25:13):
I was thinking that, as you were talking, that's
fabulous.
No, it's the ultimate puzzle.
I am so glad that you mentionedAfrica.
Let's talk about that.
Volunteerism in medicine issomething that I think people
just have such incrediblefeelings about and they're so
hopeful about, but oftentimesthey get drawn into their
careers and their current livesand and the burnout that's
occurring right now in medicineand et cetera and et cetera.
Tell us about what you're doingin Africa and then, how did you
(25:36):
first get involved and where?
What are the next steps withthis?
I'd love to hear this story.
Dr. Kushagra Verma (25:41):
Oh sure I, um, I I went to Africa as a med
student I was doing research,like I said, and there was a
surgeon that gave a talk at aconference about doing charity
surgery in West Africa at theFocus Hospital, professor
Belachi and I ran right up tohim after his talk I said,
please take me with you.
(26:02):
And he's like sure, oh wow, dida little Facebook fundraiser,
covered my flights, subletted myapartment out and there I was
with him and I didn't do anyoperating or anything like that,
but I helped out a little bitin clinic.
It was a great experience forme, cemented in my mind okay,
this is the type of surgeon I'mgoing to be.
I was a long way from it, but Iknew that's what I wanted.
(26:24):
And then I kept going back.
I went back in residency, I wentback in fellowship, organized
my own trips, same hospital, andthen I I've done some different
volunteer trips with otherpeople and I've gotten some
different experiences likedifferent countries.
It's kind of like traveling andthe value of traveling, but
like applied to your career, youknow it, it makes you a little
(26:47):
bit more resilient, surgeon.
I think it makes you a littlemore um, adaptable to different
situations, a little bit moreresistant to stress in the
operating room because you'vebeen in some other situations
that are a little wild.
You know, I've been in theoperating room where the power
went out and everything stoppedworking.
I've been oh my god, I've beenin the city room where the power
went out and everything stoppedworking.
(27:08):
I've been.
I've been in the city, you know, where we weren't even we
didn't have enough screws to putin the spine certain places.
One of the reasons I likeAfrica is it's, even though it's
an outreach hospital, the focushospital it's.
The quality of what we do isreally high and we're able to
produce data, research, publish,and so I think that's very
appealing for surgeons.
We don't want to go somewhereand then maybe do a
(27:28):
controversial surgery, badoutcome, something like that.
It wouldn't sit well with us.
So I trust this place and I'vebeen very loyal to it as a
result.
And then for many years I wouldsort of go on trips that were
organized and funded by a thirdparty, maybe by industry or by
(27:49):
another surgeon.
And this is the first year I'morganizing and funding the trip
myself, getting the surgeonstogether, getting the money to
the hospital, booking theflights, hotels, everything
we're doing, I mean and it's alot more gratifying.
I think you know I'm leadingthe whole thing and I'm bringing
my my surgeon friends a coupleof them are pretty affluent and
(28:12):
uh interested in this and I'mexcited to do it.
You know, um, and the cases wedo are very extreme.
You know the probably some ofthe most extreme pathology in
the world and, uh, it's, it'sgreat's great to be there and
the surgeons there are reallygood now over the years.
They're not surgeons that needa lot of training, but there's a
(28:35):
collaboration there that Ithink is really valuable and fun
.
So hopefully I get to continueto do it.
But I remember when I moved toLA I was with a group and I was
talking about doing outreachwork and they just couldn't
understand why I would dooutreach work and that was like
the first motivation for me tostart my own practice, like no,
we've got to have a practicewhere we could do whatever we
(28:56):
want.
And then there was a year wherewe were like just dying
financially.
You know, our billing was kindof a mess and I did not go on my
outreach trip.
And that was the motivation tobe like you know what?
I need to make sure I get ahandle on the administrative
side and the financial side ofthis practice so that I can do
the research, so that I can paymy PA and med students well and
(29:20):
have them not be overworked, sothat I can do the charity work.
So if you're feeling boggeddown with the administrative
side, I'd say listen, this iswhat gives you the freedom to
practice medicine the way youwant is taking the bull by the
horns.
Ashley (29:33):
We work so hard for what we do, and then you take
that success and you pour itright back in to more success in
just a little bit of adifferent way.
I mean correcting pediatricspinal deformities for children
in Africa.
Dr. Kushagra Verma (29:50):
it's just the coolest thing I remember.
I went on a trip with anothersurgeon, Tony Rinella, and he
was giving a speech and he saidit so simply.
He said this is the best thingthat I do, and that's exactly
how I feel.
I don't know that I do anythingthat's better than this.
Ashley (30:04):
You have built and established and continue to
succeed in this private practice.
You host students, you teach,you've published what?
Over 50 peer review articles.
Now I mean you travel to Africaand improve the lives of
children.
It's just fantastic to hear ofthese incredible success stories
(30:24):
.
Dr. Kushagra Verma (30:24):
I didn't do any of it alone.
Every paper had multipleco-authors on it.
You know I think beingcollaborative has always helped
me.
You know I there's a millionspine surgeons in town.
I try to make friends with allof them because there's, you
know I think I said this onanother podcast is every
surgeon's a little better atsomething.
You know.
Somebody might have a littlebetter skillset at minimally
(30:46):
invasive.
Somebody might be a little bitof a better deformity surgeon.
For a long time everyone was abetter businessman than me, you
know, and making friends withpeople in your specialty makes
you better the relationships.
Your career, I think, is moreresilient to being killed by
(31:06):
burnout.
Let's say, if you've gotfriends in what you do, right.
Ashley (31:10):
It's relationships.
It's like we talked about atthe beginning.
You started this career in arelationship as a research
undergrad student and then yousaid take me with you and that's
how you ended up in Africa.
And it's just.
Relationships are so important,Mentorships are so important.
So Dr Verma and I did not havea chance to discuss a quality
(31:35):
question, but he's about to giveus some really great feedback.
That would make a perfectinterview question, and that
question would be tell me abouta time you faced a setback in
your academic or clinicaljourney.
How did that push you forwardand what did you learn about
yourself in the process?
Let's see how Dr Verma posesand answers this question.
(31:55):
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Kushagra Verma (32:09):
I want to give you a few words of
motivation.
I was not the best student.
It was not all smooth sailingfor me.
There were a lot of roadblocks.
I didn't get into med school myfirst try.
I had to retake my MCAT.
I'm not a good test taker.
In residency it wasn't clear Iwould get into the fellowship I
wanted.
It wasn't clear I would getinto the residency I wanted
(32:30):
because I didn't have the besttest scores.
You just have to keep going.
You have to never take no foran answer.
If it's something you reallywant with your career, you have
to say well, this is what I'mgoing to do, and eventually the
doors will open.
The people around you will justbe like okay, well, he's not
(32:51):
going to go anywhere, he's goingto do this, and I think that's
really true.
I think I ended up here becauseI had a really clear vision in
med school, finally, like thisis exactly what I want to do,
and there was nothing that couldshake me from that.
And so I think that's the mostimportant thing for young people
.
They can get bogged down by thework, the rejection, the letters
of recommendation.
Bogged down by the work, therejection, the letters of
recommendation, the expense.
There's a lot of barriers, butif you just never take no for an
(33:13):
answer, you will end up whereyou want to be Maybe not the
path you thought you'd take, butyou will end up there.
Not everyone's going to openthe door up for you right away,
and so for everyone out there,just stay motivated.
I used to listen tomotivational videos on YouTube
in med school because I was downin the dumps my second year of
(33:33):
med school studying all the time, not doing well on tests.
So you know, try to staymotivated, stay positive.
Ashley (33:41):
Resilience and tenacity .
They are two things that are soundervalued and just absolutely
so important.
Dr Verma, thank you so much.
I appreciate you joining ustonight on Shadow Me Next.
Dr. Kushagra Verma (33:53):
Absolutely.
If anybody wants to learn moreAdvanced Spine Care, you can
come check us out on our website.
Ascmd is our Instagram and youcan also call our office if
you're in the SouthernCalifornia area 562-732-4578.
It was great chatting with you.
Ashley (34:10):
You too.
Thank you so much.
Dr. Kushagra Verma (34:12):
My pleasure.
Ashley (34:13):
Thank you so very much for listening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
Hello and welcome to Shadow Me Next, a podcast where
I take you into and behind thescenes of the medical world to
provide you with a deeperunderstanding of the human side
of medicine.
I'm Ashley, a physicianassistant, medical editor,
clinical preceptor and thecreator of Shadow Me Next.
It is my pleasure to introduceyou to incredible members of the
(00:22):
healthcare field and uncovertheir unique stories, the joys
and challenges they face andwhat drives them in their
careers.
It's access you want andstories you need, whether you're
a pre-health student or simplycurious about the healthcare
field.
I invite you to join me as wetake a conversational and
personal look into the lives andminds of leaders in medicine.
(00:44):
I don't want you to miss asingle one of these
conversations, so make sure thatyou subscribe to this podcast,
which will automatically notifyyou when new episodes are
dropped, and follow us onInstagram and Facebook at shadow
me next, where we will reviewhighlights from this
conversation and where I'll giveyou sneak previews of our
upcoming guests.
When you look at someone'scareer from the outside, it's
(01:06):
easy to think it was all plannedfrom the beginning, but Dr
Kushagra Verma's path as afellowship-trained orthopedic
spine surgeon was not linear.
He once thought he'd be anengineer and later imagined
delivering high-risk pregnancies, and yet finally found his
calling in the operating roomduring a pediatric spine
rotation.
(01:26):
What makes his story remarkable, though, isn't just the
technical complexity of his work.
It's the relationships thatanchor it, from mentors who
shaped his vision and studentshe now coaches into medicine, to
the children in Africa whoselives are transformed by his
volunteer surgeries.
Dr Verma reminds us thatmedicine is about persistence,
(01:49):
resilience and never taking nofor an answer.
We talk about the long road oftraining, what it means to run a
practice with both purpose andsustainability, and how the
power of mentorship can changenot only careers but entire
communities.
Please keep in mind that thecontent of this podcast is
(02:09):
intended for informational andentertainment purposes only and
should not be considered asprofessional medical advice.
The views and opinionsexpressed in this podcast are
those of the host and guests anddo not necessarily reflect the
official policy or position ofany other agency, organization,
employer or company.
This is Shadow Me Next with DrKushagra Verma.
(02:31):
Dr Verma, thank you so much forjoining me on Shadow Me Next
today.
This is going to be anabsolutely fantastic
conversation that I'm reallymotivated by, because of not
only what you do, but how you doit, so thanks for being here.
Dr. Kushagra Verma (02:46):
I appreciate it.
Ashley (02:47):
So let's start at the very beginning.
You went to medical school atNYU.
You are now a fellowshiptrained orthopedic spine surgeon
.
Is this the road that you hadplanned for yourself back when
you were eight, nine, 10 yearsold?
Dr. Kushagra Verma (03:00):
I zigged and zagged a little bit.
I was a good tinkerer as a kid.
I thought engineering was myway and I did pretty well in
high school, even won sciencefairs in engineering and got
into a good college for me.
And so I kind of redirected andwent into med school.
I took a year off, did someresearch actually at NYU, and
(03:27):
that's how I ended up gettinginto NYU, because I was there.
I always tell people you knowit's just show up, just be there
in person and doors open up.
And they kind of did that wayfor me.
I was applying to med schoolthere, I was doing research
there, they knew me, they likedme, so I got in.
And then in med school I thoughtI was going to do obstetrics,
(03:49):
actually high-risk pregnancies.
I always wanted to do thechallenging specialties, the
surgical ones.
You know that's kind of a toughspecialty for a guy to be in
these days and so I justcouldn't seem to envision myself
doing that.
So I was a little lost at theend of third year until my last
block of med school I didpediatric orthopedics and I saw
(04:10):
them do pediatric spine surgeryand immediately I looked at it I
was like, oh, this is thecoolest surgery.
This is what I want to doObviously had nothing lined up,
did no research, had no lettersof recommendation or anything.
So I decided to take a year offand I did research in scoliosis
and pediatric spine and it wasa great year.
I learned a lot.
I did a lot of research.
(04:31):
This is where I talk aboutmentorship was so valuable.
These like pretty well-knownsurgeons.
I'm still really close withsome of them.
I still am texting them.
You know they're my friends nowgoing on.
God, what was that?
2008.
So how many years is that?
17 years and um, it was justsuch a good relationship, you
(04:53):
know, like unlike anything I'dhad before that med school,
where I identify with theirpersonalities.
These were unique people thatcould do pretty risky surgery
and be pretty calm, you know,and it was just appealing to me
and I got into residency atJefferson.
I worked under Alex Vaccaro,who was a pretty well-known
(05:13):
spine surgeon and also, you know, a mentor.
And after that I went to UCSFfor fellowship, which was more
complex spine and scoliosis,some PEDs, some adult, and then
that finished up in 2016.
And then I moved to Seattlewhere I was a professor for a
couple of years and in Seattle alot of complex surgery.
(05:34):
But I really hated living inSeattle so I decided to move to
LA and kind of gradually startedmy own practice and now we
still embody a lot of that likeacademic feel in our private
practice.
We have a research component towhat we do.
We publish some papers.
Where you know, pretty activelyinvolved in outreach work, we
(05:55):
do a yearly trip to maybe notevery year to Africa for a
charity where I do freescoliosis surgery in Africa.
If anyone's interested indonating or supporting that
cause, you know they candefinitely reach out to us and I
even, like you know, recruit myother spine surgeon friends to
go with me.
(06:16):
And then you know our entirepractice.
You know we don't really hireon.
Indeed, I don't hiretraditional MAs, I hire people
out of college that are applyingto PA school or med school
because I really want to mentorpeople and for me mentoring is a
lot of chasing them around.
Did you get your applicationdone?
Yet Like coaching them.
I don't know how much mentoringis happening, how much
(06:37):
harassment is happening, but youneed a little push along the
way.
You got to get your applicationdone.
You got to check that box, yougot to take that test.
Along the way you got to getyour application done, you got
to check that box, you got totake that test.
It's a lot of stuff.
I remember it being just sotedious.
And I remember there was astudent that I mentored, a young
attending in Seattle.
His name's Casey and he was amed student.
(06:58):
They told him he couldn't getinto orthopedics and I said,
well, I'll take no for an answer.
And he did a bunch of research,wrote like 15 papers.
He got into orthopedicresidency.
We stayed friends.
Then I encouraged him to do hisfellowship down here in Orange
County and then they loved himthere.
Then he stayed on and nowbasically we're practicing 15
miles away from each other.
(07:18):
Whoa cool story and he's goingto go with me to Africa next
year.
So these relationships inhealthcare are, I think are
special, and the mentor menteerelationship is what keeps you
going, because healthcare is alittle bit of a mess in this
country and you, you genuinelywant to help people, but then
the system's a little broken andlong.
(07:40):
If it's med school, god, it'sso long.
And I have I'll be very honest,I have some trauma from some of
the parts of training.
It wasn't really that good foryour brain or your body or your
health to be up that many hoursworking, didn't go to the gym,
read healthy, all of thosethings.
I kind of look back.
I'm like, well, you know, nowI'm going to be even more
(08:01):
healthy than I might've beenbecause of that.
You know, even more healthythan I might have been because
of that, and I think it's justreally valuable.
It's one of the reasons Isigned up to do this podcast
right away I was like this isperfect for me.
Ashley (08:13):
We appreciate it, because I think your story is
just, it's so full, it's so fulland it's so important to me for
pre-health students to hearthat once you're in medicine, it
really it doesn't stop there,it just expands.
Honestly, it grows, things justgrow.
And I love how you weredescribing relationships,
(08:35):
because you talked aboutmentoring and about access and
about those personalrelationships in medicine.
But you also talk aboutresearch, a lot of research, and
that's a relationship with thecapital M part of medicine.
But you also talk aboutresearch, a lot of research, and
that's a relationship with thecapital M part of medicine.
And these are the things thatwe love so much and these are
things that why it's why wecontinue to do what we do.
We love people, we love formingthose relationships with them
(08:58):
and then we also love thescience behind it.
We love the research.
We love fixing things andsolving problems and identifying
those mysteries.
So that was just such a greatintroduction.
I am excited to talk about yourresearch.
I am excited to talk about yourrelationship with teaching and
how it has brought in a PA toyour practice, which is just, oh
(09:19):
, it sounds so fantastic the waythat you two work together, and
I really, really want to talkabout your charity work in
Africa because, well, for anystudents listening, I was a
student at one point and Ithought that it was what I was
going to do with medicine.
Right Is, I was going to takethe medicine I learned and just
change the world, and you'redoing that in a very, very
(09:39):
realistic way.
So we're getting to all that.
I can't wait to talk about it,but let's, let's first, let's
just talk about a day in yourlife, which I'm sure is very
multi-faceted.
Dr. Kushagra Verma (09:48):
It depends on the day.
Every day is a little different.
Our surgery days, you know, weget up I usually start my day at
five in the morning liftweights and exercise and get to
the OR and then, you know,depending on the day, like
yesterday we had a huge revisionthoracic forward and pelvis
revision, taking out hardware,putting in hardware, two liter
(10:09):
blood loss, five hour surgery.
That's one type of daySometimes we're doing, you know,
small procedures, outpatientsurgery.
The majority of what I tend todo on a daily basis is kind of
those kinds of cases Patients dowell.
And in spine surgery there's areally big revolution that's
happening where a lot oftraditional spine surgery is
(10:29):
being improved upon to the pointthat it's being done at surgery
centers, it's being doneoutpatient and it's not crap
surgery, it's good surgerythat's being done with small
incisions.
I'm always against, you know,doing outpatient surgery where
the surgery you're doing is kindof lousy but it's.
This is actually really goodsurgery but short recovery times
(10:50):
, great looking x-rays,improvement in the patient
experience.
So I'm interested in that sideof it and in the last five years
it's really been more abouttaking cases to the outpatient
setting.
Other days it's a lot of talking.
I don't mind doing this podcastbecause I probably, on like a
Wednesday, I've spent eighthours talking and listening, I
(11:11):
hope.
But I do a lot of consultationswith patients.
I ask them what's going on andI do a lot of teaching.
We have 65-inch TVs in ouroffice.
I pull up the imaging.
I say, look, this is theproblem.
This is not going to get betterwith an injection, or maybe it
will.
Or, you know, we got medicationor this is a diagnosis and this
is what the x-ray shows.
(11:32):
And we do it over and over andover.
And that's how I ended upteaching my staff.
If they're interested in spine,just a few days in my office
they'll learn how to read MRIsx-rays examine people.
Mris, x-rays examine people,talk to them, even know what the
different surgeries are,because it's pretty repetitive,
(11:52):
you know.
And then there's about a day aweek that I spend doing
administrative work.
I'm more involved, I think,than I've been in the past,
where I, you know, I havemarketers, help, you know, make
sure people know about ourpractice.
But I'll go out with themarketer and make sure they know
the doctor's availablesometimes.
But I'll go out with themarketer and make sure they know
the doctor's availablesometimes.
I will do various billingmeetings to see what's happening
(12:12):
with billing and insurance andcollections.
I'll meet with my bookkeeper.
I'll meet with my staff.
I'll meet with Calvin.
There's lots of things that wesort of are kind of on the to-do
list, as I say.
Well, we'll put it on the list.
We have an administrative day.
We tackle the list prettysystematically and that's how
we're able to drive the practiceforward.
We have four offices now.
We have this outreach trip thatwe're doing.
(12:35):
We have research that we'restill involved with, we're
mentoring students.
All of that sort of falls intothat administrative time.
Ashley (12:42):
Administrative things.
Thank you so much fordescribing that, because that's
not something we really talkabout a lot on the show, and I
think that it's so important fornot just pre-health students
but also for patients to hearand to understand that,
especially in private practice.
It is a business and I think wesay that a lot in terms of
(13:02):
making money and makingfinancial decisions, but it's
also running the business thatwe can continue seeing our
patients.
Dr. Kushagra Verma (13:09):
People think running a business is like a
bad word, like you're trying tomake money off people, and I
always want them to understandthat I have almost run this
practice into the ground acouple of times because I help
everyone that comes in the doorand not pay attention to the
numbers or what's happening.
And then you start looking atwhat actually came in and you're
like, oh my God, we went,almost went bankrupt.
(13:29):
We didn't collect anything.
And so if you care about yourpatients and your practice and
how you practice as a doctor orPA, you should care about the
engine, which is the practice,and I think it's important and
it's made me a better doctor,because for a while we were
running like a factory.
Just try to do as many patientsas possible, many consults as
(13:52):
possible.
Sometimes you're seeing toomany patients and it doesn't
really give you that excellentpatient experience.
As a clinician or PA, you'renot loving the experience of
seeing patients like that, andso we actually slow it down.
We really systematically look.
We're going to do a 30% of ourwork is going to be charity work
.
Who cares if we get paid or not?
(14:14):
We're going to do a certainpercentage of hopefully cases
where we do expect there to besome profit.
And then we're going to alsohave clinic percentage of,
hopefully, cases where we doexpect there to be some profit,
you know.
And then, uh, we're going toalso have clinic and a lot of
our clinic.
You know it's not reallyprofitable but we want to make
sure we do well enough on thesurgeries that I can spend an
hour and just chit chat withsomebody if I need to.
Who's anxious about surgery?
What makes me a better doctor?
(14:36):
But if we're so constricted, um, trying to just see as many
patients as possible, then itultimately erodes your
reputation, I think.
Ashley (14:47):
I want to talk about your Wednesdays real fast,
Talking and listening.
A lot happens on Wednesdays.
You perform these complex spinesurgeries and they can be
life-changing for patients, I'msure, but they're also
intimidating.
How do you approach thoseconversations with people who
are maybe very, very anxiousabout?
So this is the talking elementof your Wednesday what do you
(15:08):
say to them?
How do you give them comfort orreassurance?
Dr. Kushagra Verma (15:12):
You know, sometimes people are anxious and
there's nothing you can reallydo.
They have to just take time toprocess it and come to peace
with it.
So I usually give them theinformation in small doses.
You know, like I'll say, ohlisten, this is going to be
surgical, it's probably going tobe something big, but let's
have you come back with a familymember.
I want to go into some detail.
(15:33):
Other times it's somethingsmall, like hey, this is not
going to be a big surgery, thisis going to be an outpatient
procedure.
Most of the time when people areanxious, it's reassuring for
them to know that, listen, planA is going to be to avoid
surgery and we're going to dothis, this and this to try.
But if it doesn't work out,plan B is a minimally invasive
(15:55):
outpatient surgery and it's notsomething very technically
challenging, and I can show youon a model here what I do.
They actually are less anxious.
Every patient has my cell phonenumber, at least the surgical
patients.
So I'm having a lot of phonecalls with people afterwards and
then we never take anyone tosurgery until they've had
sufficient time to ask theirquestions, come to peace with it
(16:17):
, unless it's like a realemergency, you know, and that
happens sometimes, Um, but wereally, you know, and we've
created a lot of content.
If, if you know, people areinterested, they can follow us
on Instagram, advanced spinecare ASCmd.
They can also go to our websiteand we even have our own
Spotify podcast.
But I create a lot of contentto help relieve some of that
(16:39):
anxiety that I know people feel.
And I think information helps,but, on the flip side, sometimes
more information doesn't help.
If you were afraid of flyingand you had to sit down in the
cockpit with the pilot and goover all the switches, I'm not
sure it would make it better.
And now they'd say go in theback, have your cocktail.
(16:59):
So we try to strike a balancebetween those two.
I answer the questions thatthey want answered, and in a lot
of detail, but sometimes, if Ifeel like they're getting more
and more anxious, I tell them tojust you know, take a little
break, you know, and and.
I let them know the differencebetween the complex spine
surgery, the dicey stuff Versusthe not dicey stuff, and I'll
(17:22):
let them know.
Okay, this one's a more riskysurgery.
These are the risks.
This is my experience and we'llhave longer, more detailed
conversations with thosepatients.
You just gotta be you, yeah,talk to people, yeah, tell them
what you know how to do, tellthem their experience and that
trust will come, I think, withtime.
Sometimes they're not ready tohear what you have to say.
Ashley (17:47):
I love that you give them the education, but then you
also give them the time and thespace to process that, which is
so important.
Okay, that's the talkingelement of Wednesdays.
Now the listening element andthis is something that you've
emphasized is giving patients astrong voice in their treatment
plans, and I'm sure I mean, howoften do you hear surgeons doing
that?
Right, that is, that seems veryunique.
Tell me a little bit about that.
Dr. Kushagra Verma (18:09):
People with spine problems.
When they're really complexthey have the same disability
scores as people with terminalcancer and their quality of life
is affected in such a severeway.
And in certain cases we cantake a disabled patient and make
them not disabled.
But sometimes it's a hugesurgery.
Other times we can takesomebody in severe pain and with
(18:30):
a relatively small surgerycompletely change their life.
But I have to figure out wherethey are a little bit.
I want to figure out is it painthat bothers you every day,
keeps you from doing things youlike to do?
Is it intolerable?
Is it keeping you from work?
Is it pain?
You know it doesn't get betterwith any non-surgical treatment.
(18:51):
You have to really feel likeyou know and understand your
surgeon, get to know them andyou really have to understand
the surgery.
And I mean that means youreally get it.
Okay, the bone has slipped outof place.
There's no way an injection isgoing to move it back into place
.
They've got to look at theimaging themselves.
They've got to look at a model,they've got to really see it
(19:12):
and then when all of thosepieces come together, they can
kind of make the decision.
I think Usually I give people abunch of information and they
probably feel like they'redrinking from a fire hose.
They're overwhelmed, they gohome and sometimes patients are
like well, thanks for theinformation, doc, I'm not ready.
I'm always like, that's fine,take your time, and then, like a
month later, they'll call meand they'll be like we're ready
(19:33):
now and they have to go throughwhatever process they're going
through to feel like they'rethere and I think you know I'm
half psychiatrist.
Because of that you know no twopeople are exactly the same.
Ashley (19:49):
No, which is the beauty of medicine, but it's also the
huge challenge of medicine, forsure.
I love listening to how you'reyou're educating your patients
and you're you're allowing themthat, like I said, and you're
allowing them that, like I said,that space to really understand
and learn and appreciate theircondition and what you're trying
(20:09):
to do.
Your love for teachingobviously doesn't just stop with
your patients.
You've already mentioned thatyou employ these incredible
pre-health students who arelooking towards becoming
physicians, pas and othermembers of the healthcare field.
You love to teach.
You brought on a PA into yourpractice.
Tell me how that has been,because I think so often when we
(20:30):
bring in another physician,it's a colleague.
When we bring in a PA, it'salso a colleague, but at the
same time as a PA.
Speaking as a PA, I amexpecting my supervising
physician to be a teacher firstand then a colleague second.
Is that your experience?
Dr. Kushagra Verma (20:47):
Yeah, I think I mean, a lot of teaching
is just done by observation.
You just spend time with me andeventually I vomit out all the
information I have that I'vepicked up over the years and you
sort of absorb it.
Information I have that Ipicked up over the years and you
sort of absorb it.
Um and so I think you know,just being in clinic, being in
(21:08):
surgery, you just get it.
But in the beginning I had a PAbefore Calvin moved to Hawaii,
and uh, he just, he just told mehe felt so overwhelmed in the
beginning and I said, well,that's okay, I feel overwhelmed,
you know.
And then in surgery he told methat he felt like everything was
moving in fast forward, that hewould go to do something and
(21:29):
I'd already done 10 steps inthat amount of time and he
couldn't understand why I wasmoving so fast.
And I, and I tried to explainto him.
I was like I've done this somuch that there's so much muscle
memory in what I do and I knowwhen the dicey parts of the case
are.
You don't know that.
I know that we're just exposingthe muscle off the spine.
We can go as fast as we want,but then other times I know to
(21:50):
sort of push your hand away andsay, okay, let me do this.
This is the dicey part, um, andthat just comes from watching.
I have watched a decade ofsurgery before I even really did
surgery and I used to hate it,to be honest.
I remember being like a medstudent and a resident and even
a fellow.
I did a lot of watching and Iremember being like man, I just
(22:14):
want to do the surgery.
And then, now that I'm on theother side and been operating
for 10 years, I love to watchpeople on the other side and
been operating for 10 years.
I love to watch people becauseyou'd be surprised, the more you
watch, the better you get.
You sort of watch somebodywho's really good, maybe when
you're a trainee, and then youhave that memory.
(22:34):
If you watch them enough, youhave it imprinted in your brain
how they did the surgery andthen magically, your hands just
recreate it five years later.
And it's true.
I remember my first year asattending.
It was in Seattle.
You know I'm operating.
Someone gave me the opportunityto see another surgeon who was
in private practice 15 years,huge volume of surgery.
(22:55):
I spent the day with him.
He just casually was like, yeah, we've got 10 cases.
I'm like what 10 cases?
And I watched him just blowthrough these cases with so much
efficiency and grace and I wasa first year surgeon then and I
think I came home the next dayand I was 30% faster.
Just watching him that one day.
(23:15):
I was just like what am I doingin surgery?
Why is this taking me so long?
And I think it's like that as aPA too.
I tell the PA this is going totake years for you to feel
comfortable, and that's okay.
Ashley (23:34):
There's nothing wrong with that and that's why I love
so much working with asupervising physician, because
there are still things Iregularly I encounter and I
think, well, this is what I'mthinking, but I know there's
something else there that I'mnot thinking, so I'm going to
run it by you to see what youhave to say.
And, of course, that's clinicOR.
You're absolutely right there.
He still surprises me withthings in the OR which is, oh,
it's just so much fun, and I amabsolutely swiping your phrase
(23:57):
the more you watch, the betteryou get, because, I mean, this
is shadow me.
Next, this is a podcastdirected at people to just
listen and watch and understandand learn about variety of areas
in medicine.
And it's so true the better youget, the more understanding you
have.
Dr. Kushagra Verma (24:12):
And I have all these moves and tricks where
people will ask me how did youlearn how to do this?
And I like flashback to the2016,.
Me in Africa doing a case on akid with 150 degree curve and
I'm like blotchy or whatever youknow.
Whatever it is, whoever theattending was that.
I just stared at, watched themput it together and it's true,
(24:36):
it's definitely like that.
In surgery, specifically spine,sometimes it's like you're
putting together an erector setof screws and rods and hooks,
especially some of the complexstuff.
It's from a brain stimulationstandpoint, I don't think
there's some of the complexstuff.
From a brain stimulationstandpoint, I don't think
there's anything better thancomplex spine.
It just really activates a partof your brain that likes to
solve problems,three-dimensional problems, and
(24:59):
if you're mechanically inclined,like I've always been because
I'm an engineer, I love to putscrews and rods and hooks
together.
I mean it's like playing Legos.
Ashley (25:13):
I was thinking that, as you were talking, that's
fabulous.
No, it's the ultimate puzzle.
I am so glad that you mentionedAfrica.
Let's talk about that.
Volunteerism in medicine issomething that I think people
just have such incrediblefeelings about and they're so
hopeful about, but oftentimesthey get drawn into their
careers and their current livesand and the burnout that's
occurring right now in medicineand et cetera and et cetera.
Tell us about what you're doingin Africa and then, how did you
(25:36):
first get involved and where?
What are the next steps withthis?
I'd love to hear this story.
Dr. Kushagra Verma (25:41):
Oh sure I, um, I I went to Africa as a med
student I was doing research,like I said, and there was a
surgeon that gave a talk at aconference about doing charity
surgery in West Africa at theFocus Hospital, professor
Belachi and I ran right up tohim after his talk I said,
please take me with you.
(26:02):
And he's like sure, oh wow, dida little Facebook fundraiser,
covered my flights, subletted myapartment out and there I was
with him and I didn't do anyoperating or anything like that,
but I helped out a little bitin clinic.
It was a great experience forme, cemented in my mind okay,
this is the type of surgeon I'mgoing to be.
I was a long way from it, but Iknew that's what I wanted.
(26:24):
And then I kept going back.
I went back in residency, I wentback in fellowship, organized
my own trips, same hospital, andthen I I've done some different
volunteer trips with otherpeople and I've gotten some
different experiences likedifferent countries.
It's kind of like traveling andthe value of traveling, but
like applied to your career, youknow it, it makes you a little
(26:47):
bit more resilient, surgeon.
I think it makes you a littlemore um, adaptable to different
situations, a little bit moreresistant to stress in the
operating room because you'vebeen in some other situations
that are a little wild.
You know, I've been in theoperating room where the power
went out and everything stoppedworking.
I've been oh my god, I've beenin the city room where the power
went out and everything stoppedworking.
(27:08):
I've been.
I've been in the city, you know, where we weren't even we
didn't have enough screws to putin the spine certain places.
One of the reasons I likeAfrica is it's, even though it's
an outreach hospital, the focushospital it's.
The quality of what we do isreally high and we're able to
produce data, research, publish,and so I think that's very
appealing for surgeons.
We don't want to go somewhereand then maybe do a
(27:28):
controversial surgery, badoutcome, something like that.
It wouldn't sit well with us.
So I trust this place and I'vebeen very loyal to it as a
result.
And then for many years I wouldsort of go on trips that were
organized and funded by a thirdparty, maybe by industry or by
(27:49):
another surgeon.
And this is the first year I'morganizing and funding the trip
myself, getting the surgeonstogether, getting the money to
the hospital, booking theflights, hotels, everything
we're doing, I mean and it's alot more gratifying.
I think you know I'm leadingthe whole thing and I'm bringing
my my surgeon friends a coupleof them are pretty affluent and
(28:12):
uh interested in this and I'mexcited to do it.
You know, um, and the cases wedo are very extreme.
You know the probably some ofthe most extreme pathology in
the world and, uh, it's, it'sgreat's great to be there and
the surgeons there are reallygood now over the years.
They're not surgeons that needa lot of training, but there's a
(28:35):
collaboration there that Ithink is really valuable and fun
.
So hopefully I get to continueto do it.
But I remember when I moved toLA I was with a group and I was
talking about doing outreachwork and they just couldn't
understand why I would dooutreach work and that was like
the first motivation for me tostart my own practice, like no,
we've got to have a practicewhere we could do whatever we
(28:56):
want.
And then there was a year wherewe were like just dying
financially.
You know, our billing was kindof a mess and I did not go on my
outreach trip.
And that was the motivation tobe like you know what?
I need to make sure I get ahandle on the administrative
side and the financial side ofthis practice so that I can do
the research, so that I can paymy PA and med students well and
(29:20):
have them not be overworked, sothat I can do the charity work.
So if you're feeling boggeddown with the administrative
side, I'd say listen, this iswhat gives you the freedom to
practice medicine the way youwant is taking the bull by the
horns.
Ashley (29:33):
We work so hard for what we do, and then you take
that success and you pour itright back in to more success in
just a little bit of adifferent way.
I mean correcting pediatricspinal deformities for children
in Africa.
Dr. Kushagra Verma (29:50):
it's just the coolest thing I remember.
I went on a trip with anothersurgeon, Tony Rinella, and he
was giving a speech and he saidit so simply.
He said this is the best thingthat I do, and that's exactly
how I feel.
I don't know that I do anythingthat's better than this.
Ashley (30:04):
You have built and established and continue to
succeed in this private practice.
You host students, you teach,you've published what?
Over 50 peer review articles.
Now I mean you travel to Africaand improve the lives of
children.
It's just fantastic to hear ofthese incredible success stories
(30:24):
.
Dr. Kushagra Verma (30:24):
I didn't do any of it alone.
Every paper had multipleco-authors on it.
You know I think beingcollaborative has always helped
me.
You know I there's a millionspine surgeons in town.
I try to make friends with allof them because there's, you
know I think I said this onanother podcast is every
surgeon's a little better atsomething.
You know.
Somebody might have a littlebetter skillset at minimally
(30:46):
invasive.
Somebody might be a little bitof a better deformity surgeon.
For a long time everyone was abetter businessman than me, you
know, and making friends withpeople in your specialty makes
you better the relationships.
Your career, I think, is moreresilient to being killed by
(31:06):
burnout.
Let's say, if you've gotfriends in what you do, right.
Ashley (31:10):
It's relationships.
It's like we talked about atthe beginning.
You started this career in arelationship as a research
undergrad student and then yousaid take me with you and that's
how you ended up in Africa.
And it's just.
Relationships are so important,Mentorships are so important.
So Dr Verma and I did not havea chance to discuss a quality
(31:35):
question, but he's about to giveus some really great feedback.
That would make a perfectinterview question, and that
question would be tell me abouta time you faced a setback in
your academic or clinicaljourney.
How did that push you forwardand what did you learn about
yourself in the process?
Let's see how Dr Verma posesand answers this question.
(31:55):
Keep in mind that there's moreinterview prep, such as mock
interviews and personalstatement review over on
shadowmenextcom.
There you'll find amazingresources to help you as you
prepare to answer your ownquality questions.
Dr. Kushagra Verma (32:09):
I want to give you a few words of
motivation.
I was not the best student.
It was not all smooth sailingfor me.
There were a lot of roadblocks.
I didn't get into med school myfirst try.
I had to retake my MCAT.
I'm not a good test taker.
In residency it wasn't clear Iwould get into the fellowship I
wanted.
It wasn't clear I would getinto the residency I wanted
(32:30):
because I didn't have the besttest scores.
You just have to keep going.
You have to never take no foran answer.
If it's something you reallywant with your career, you have
to say well, this is what I'mgoing to do, and eventually the
doors will open.
The people around you will justbe like okay, well, he's not
(32:51):
going to go anywhere, he's goingto do this, and I think that's
really true.
I think I ended up here becauseI had a really clear vision in
med school, finally, like thisis exactly what I want to do,
and there was nothing that couldshake me from that.
And so I think that's the mostimportant thing for young people
.
They can get bogged down by thework, the rejection, the letters
of recommendation.
Bogged down by the work, therejection, the letters of
recommendation, the expense.
There's a lot of barriers, butif you just never take no for an
(33:13):
answer, you will end up whereyou want to be Maybe not the
path you thought you'd take, butyou will end up there.
Not everyone's going to openthe door up for you right away,
and so for everyone out there,just stay motivated.
I used to listen tomotivational videos on YouTube
in med school because I was downin the dumps my second year of
(33:33):
med school studying all the time, not doing well on tests.
So you know, try to staymotivated, stay positive.
Ashley (33:41):
Resilience and tenacity .
They are two things that are soundervalued and just absolutely
so important.
Dr Verma, thank you so much.
I appreciate you joining ustonight on Shadow Me Next.
Dr. Kushagra Verma (33:53):
Absolutely.
If anybody wants to learn moreAdvanced Spine Care, you can
come check us out on our website.
Ascmd is our Instagram and youcan also call our office if
you're in the SouthernCalifornia area 562-732-4578.
It was great chatting with you.
Ashley (34:10):
You too.
Thank you so much.
Dr. Kushagra Verma (34:12):
My pleasure.
Ashley (34:13):
Thank you so very much for listening to this episode of
Shadow Me Next.
If you liked this episode or ifyou think it could be useful
for a friend, please subscribeand invite them to join us next
Monday, as always.
If you have any questions, letme know on Facebook or Instagram
Access.
You want stories you need?
You're always invited to shadowme next.
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