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Vital Signs

Mirza knew in his bones that DH was a good fit

By Jennifer Durgin

Sohail Mirza, intent here in the OR, is also intent on his new role as chair of ortho.

Dr. Sohail Mirza's recruitment to Dartmouth-Hitchcock began with a three-word e-mail: "Can we talk?" That was all Dr. James Weinstein, then chair of orthopaedics, wrote. Weinstein knew about Mirza's research in spine surgery outcomes and liked his approach to medicine. He'd also been a scientific reviewer for several of Mirza's National Institutes of Health grants. And, as editor of the journal Spine, Weinstein had published several of Mirza's papers.

Likewise, Mirza knew a lot about Weinstein. The leader of the $15-million Spine Patient Outcomes Research Trial, the nation's largest study of back pain, "Weinstein is the leading figure in changing orthopaedics," says Mirza. So when he got that brief e-mail, his first thought was "What trouble did I get into?"

Spine: Mirza soon learned that Weinstein was looking for someone to replace himself when he stepped down as chair to make more time for his role as director of the Dartmouth Institute for Health Policy and Clinical Practice. But Mirza, who specializes in cancer of the spine, was happy at the University of Washington, where he had trained and been on the faculty for 19 years. He had little desire to uproot his practice, his research, and his family for a position in rural New Hampshire.

That changed when he visited Dartmouth and attended the orthopaedics department's weekly meeting. "The entire faculty in orthopaedics and all of the residents were in the room," recalls Mirza, and they were "talking about clinical cases and asking big questions. What is the right treatment here? Does the patient know all the choices? I hadn't seen that [before]."

Lots: He found the emphasis on delivering the right care, not just on increasing clinical production, "very refreshing." Lots of institutions talk about patient-centered care, says Mirza, "but the way it was actually lived out in this institution was inspiring for me." So he joined the department in 2008 and became its chair in 2010.

Mirza wants to build on the foundation Weinstein left and do no less than "change the world of orthopaedics for the better," he says. That means measuring outcomes for every procedure, making sure all patients are informed about their choices, and developing systems that incorporate those practices efficiently and routinely.

The emphasis on delivering the right care was "very refreshing."

"Nobody has been able to do that," says Mirza. "The general assumption is that you can't do all these things and still run a busy practice that is successful as a business. . . . Our challenge is to show how it can be done."

Mirza is also working with neurology, radiation oncology, and palliative care to build an interdisciplinary spine cancer program—a service lacking in the region, he says, and thus "a huge opportunity." Another "huge opportunity" he sees is working under the leadership of Weinstein, who is now also copresident of DH; Dr. Wiley Souba, the new dean of DMS; and Dr. Jim Yong Kim, the president of Dartmouth College.

"I wouldn't have considered [moving] to any other place," says Mirza. "Only Dartmouth."

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