Secrets of a Top-Performer — Dr. Michael Haglund, Neurosurgeon

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Dr. Michael Haglund, of Duke Health in North Carolina, recently appeared in The Raleigh News and Observer. The Observer story showed that Dr. Haglund earned an MPIRICA Quality Score of 720, for three spinal fusion procedures. This makes him the single-highest scoring provider of these procedures in the country.

This is an extraordinary achievement. We caught up with Dr. Haglund to see what insight he might have to offer. He shared what, in his view, contributes to his success.

A Spirit of Service

Where we spoke to Dr. Haglund is especially revealing. He spoke to us on his cellphone — from Entebbe International Airport, in the East African country of Uganda.

Outside his work in North Carolina, Dr. Haglund is also co-director of the Duke East African Neurosurgery Training Program. Since 2007, Dr. Haglund’s efforts have helped thousands of Ugandan patients, brought $11 million-worth of equipment to Ugandan hospitals, and doubled the number of available neurosurgeons in the country. He received the American Association of Neurological Surgeons’ Humanitarian Award in 2015.

He sees this work as part of his vocational calling, and it’s this spirit of service that animates his efforts — both in Uganda and in Raleigh.

As a born-again Christian, Dr. Haglund cites scripture to clarify his sense of duty. “You can find it in Luke 12:48,” he said. “‘From everyone who has been given much, much will be demanded; and from the one who has been entrusted with much, much more will be asked.’ I’ve been given a lot. I consider myself very fortunate to be doing what I do. That’s what motivates me to give back.”

The Name on the Front of the Jersey

Dr. Haglund doubled-down on this humility when he described what actually happens in the OR.

“It’s not about me being a rockstar,” he said. “It’s the name on the front of the jersey, not the back, that makes the difference.”

He believes that he owes a great deal of his success to his team. His scrub-techs, for example, have an uncanny understanding for what he needs in the middle of a procedure. “I hardly need to speak when I’m operating,” he said, “I hold out my hand, and Lawrence [Davis, scrub-tech] or Valerie [Anakaroyne, scrub tech] has the correct instrument ready.”

The seamless work in the background allows Dr. Haglund to enter a state of Flow. With total concentration, he’s able to complete procedures efficiently and effectively.

“We all prioritize efficiency. If I can shave an hour off procedural time for a cervical fusion, that’s one hour less of esophageal stress, that’s one less hour under anesthesia. These things substantially reduce risk for the patient. None of that would be possible if we didn’t work so well together in the OR.”

Post-Op Follow-Up

But the efforts toward quality don’t stop with the OR. Dr. Haglund is careful to emphasize — thorough follow-up is essential.

In this regard, Dr. Haglund literally walks the walk. He estimates that he checks in on his post-op patients about four times per day, each.

“Getting in there so often gives you an eye for the little things,” Dr. Haglund says. “That’s the real value of it. You develop a real gut-level understanding for their progression through the hours after surgery. You can spot problems and intervene proactively before they become more serious. ”

As humble as ever, though, he also insists that he doesn’t do the follow-up work on his own:

“I’m blessed with an outstanding nurse at Duke University, Sara Williams. She makes herself available to patients in an extraordinary way. She answers their questions, and makes sure they understand what they’re supposed to be doing in recovery. We have great residents and PAs at Duke University Hospital and we also have two nurse practitioners at Duke Raleigh, Tina Dennis and Lorie Desmarais, and my Physician’s Assistant, Rosa Jou-Zhang that closely follow patient progress after surgery. The patients feel at ease, comfortable with their care — that helps with their compliance, which ultimately means a better recovery.”

Institutional Support

Dr. Haglund’s warm regard extends to his entire hospital, too.

“First of all, I have to give them [Duke Raleigh Hospital] credit for making sure I have the same team with me, every time,” he said.  “It gave us that time to get to know each other. Now we’re very close. I consider these people family.”

He also commends the Duke Health system for its commitment to quality improvement. “Quality improvement is built into our training. The hospital is constantly generating data-driven, measurable, repeatable goals, in areas like infection control or rounding. There’s no complacency here. The efforts never stop.”

THE TAKEAWAY

Over and over again, Dr. Haglund deflected the credit for his work. He insisted that he owes much of his success to his team, and in this he makes an important point. No surgeon succeeds in a vacuum. It takes robust systems of support, in the OR and beyond, to achieve and maintain high-quality surgical outcomes.

But this shouldn’t diminish Dr. Haglund’s achievements. Whether at Duke-Raleigh, Duke University Hospital, or Mulago Hospital in Uganda, his outcomes speak to his extraordinary compassion, skill, and attention to detail.