Enjoying ‘Hybrid’ Practice in a Hub and Spoke Model
Author: Taro Kaibara, MD
I am originally from Canada, having earned my BSc at McGill University, MSc at University of Western Ontario and MD the University of Toronto. I completed Neurosurgical Residency in Calgary, Alberta in 2002 and worked in private practice in Redding California for 3 years. In 2006, after completing a vascular/skull base fellowship with Drs. Heros and Morcos in Miami, I joined the Barrow Brain and Spine (BBS) practice at the Barrow Neurological Institute (BNI) in Phoenix, AZ. The BBS, as others, are developing a ‘hub and spoke’ model in an attempt to provide a high level of quality care for all neurosurgical problems over a large geographical area. This is achieved by focusing the management of certain high acuity, low volume pathologies at a ‘Hub’ (BNI), while treating more common pathologies throughout the community- based system (‘spokes’).
Over the years I have developed a broad range of clinical interests including in both cranial and spinal surgeries which has been fostered by this fairly unique opportunity to practice at both a ‘spoke’ hospital (Chandler Regional Medical Center, where I also serve as the medical director of neurosurgery) as well as at the BNI. Travel between sites can definitely can be time consuming. During any given week I will have a day of office and a day of surgery at both sites, often travelling to both sites on the same day to round on inpatients. However, they both provide their own unique experiences and challenges. Developing this community- based practice at Chandler Regional has been rewarding, as Neurosurgery was a brand new service line for the hospital. In a few short years, it has become a robust six surgeon group. Community practice allows one to sharpen clinical and surgical skills as well as benefit from a more direct interaction with physicians in the community from other specialties.
I also value my practice at the ‘Hub’(BNI) for many obvious reasons, including the presence of mentorship, clinical conferences, rounds, courses, etc., although none is more important than the interaction with and teaching of residents in the neurosurgery training program. A highlight of the training program is in preparing and competing in the annual neurosurgery charity softball tournament in NYC. My ‘hybrid’ practice allows me to maintain a broad experience and variety to my neurosurgical practice.
Things that people may not know about me: In college I played varsity hockey at McGill University for four years and baseball for University of Toronto for one season during medical school. Over the past several years, I have served as an Unaffiliated Neurotrauma Consultant at NFL games with the Arizona Cardinals and as a concussion consultant for college teams such as the Arizona State University hockey team. Outside of work I enjoy spending time with my wife and three daughters and stay active playing hockey, golf and baseball.