With common neurological disorders more prevalent among a growing and aging population and the demand for neurosurgeons driven by patient need, the number of practicing neurosurgeons is considered insufficient to meet the growing patient demand.
According to the American Board of Neurological Surgery, as of January 2012 there were approximately 3,689 practicing board-certified neurosurgeons in the United States, serving a population of more than 311 million people. That’s one neurosurgeon per 100,000 people. More recent analysis places the ratio at around 1:61,000.
“There are too few neurosurgeons compared to the number that are needed,” says Paul W. Hartzfeld, MD. “Each year there are more applicants to neurosurgery residency programs than there are openings. Because of the small number of available residencies, the training is very demanding and, once in practice, you are in high demand.”
Dr. Hartzfeld is one of only a handful of board-certified neurosurgeons in the Akron area. In January, he joined Western Reserve Hospital Physicians, Inc. (WRHPI). WRHPI offers a variety of care services with physicians and specialists in cardiology; pain management; endocrinology; diabetes and nutrition management and education; head, neck and plastic surgery; general surgery; gastroenterology; otolaryngology; orthopedics; urgent care — and now neurosurgery. Offices are located in Summit and Medina counties.
About Dr. Hartzfeld
Born and raised in Northeast Ohio, Dr. Hartzfeld attended Miami University in Oxford, Ohio, where he earned a BA degree in Psychology. After receiving an MD degree from the Medical College of Ohio in Toledo, he completed his internship, residency and fellowship training in Neurosurgery at Henry Ford Hospital in Detroit, Michigan.
“I knew as a child that I wanted to be a surgeon,” says Dr. Hartzfeld. “In undergraduate school, while majoring in psychology, what I liked best was neuropsychology and biopsychology. When I got to medical school, I initially considered orthopedics. But I quickly realized that I didn’t care how the bones were connected or how the ligaments moved the bone. What I really liked was the brain and how the nerves functioned, which then led me to become a neurosurgeon.”
Today, Dr. Hartzfeld is a member of the American Association of Neurological Surgeons. Board Certified in Neurosurgery in 2012, he has practiced in Summit, Stark and Medina counties.
Brain or Spine Surgeon?
Neurosurgery is a specialty dedicated to the medical and surgical treatment and management of conditions that affect the brain, spine and nervous system. While many patients only think of neurosurgeons as “brain surgeons,” the majority of operations performed by neurosurgeons are spine surgeries.
“Neurosurgeons perform both brain surgery and spine surgery and treat a variety of disorders and diseases that affect the nervous system,” says Dr. Hartzfeld. “Common spinal disorders that we treat include herniated discs; disc bulge/protrusion; spinal stenosis; spine fractures; back, neck, leg and arm pain often caused by spinal issues; and other degenerative diseases of the spine. From a cranial standpoint, diagnoses we treat include brain tumors, head injuries, and strokes.”
Both neurosurgeons and orthopedic surgeons perform spine surgery. But, according to Dr. Hartzfeld, there is a significant difference between a neurosurgeon versus an orthopedic surgeon doing spine surgery.
“The specialized training and the amount of training a neurosurgeon receives to be able to do spine surgery is longer, more intense and vastly superior to the training an orthopedic surgeon receives,” says Dr. Hartzfeld. “Neurosurgeons complete a full seven-year residency learning how to do brain and spine surgery. Orthopedic surgeons complete a five-year residency where they do maybe one to three months of spine surgery. If they choose to specialize in spine surgery, they then complete an additional one year of training following their residency.”
Clinical and Technological Advances
Dr. Hartzfeld is up-to-date on the most current surgical techniques and approaches and performs minimally invasive procedures whenever possible. “Depending on what the MRI shows and the work that needs to be done, my goal is always to keep the surgery as small as possible and the incision as small as possible while still achieving the desired outcome.”
During the last decade, significant clinical and technological advances have resulted in greatly improved patient outcomes for neurosurgical patients, according to Dr. Hartzfeld. “One of the major innovations during the last several years has been in the treatment of herniated discs,” he explains.
“Traditionally, if a patient had a herniated disc in their neck, we would remove the herniated disc and put a bone graft in and then fuse that segment. Now, current technology is available where we may be able to put in an artificial disc and not have to fuse it. This procedure maintains the patient’s mobility and range of motion and makes it less likely that they will develop a problem at a different disc juncture.”
In addition, he points out that these patients do not need to wear a cervical collar and usually are able to get back to their normal active lifestyle sooner.
Jennifer Tucholski, APRN-CNP, with Paul Hartzfeld, MD
Patient referrals to neurosurgeons largely come from family medicine or internal medicine doctors based on the results of diagnostic tests, such as an MRI. Dr. Hartzfeld considers the referring physician a member of the patient’s team and stresses the importance of keeping the referring physician informed.
“Once I’ve seen and evaluated the patient and developed a plan, the referring physician is notified of the diagnosis and recommended next steps in the patient’s care,” he says. “Whether we are going to do surgery or are recommending a non-invasive approach such as physical therapy or chiropractic care, the referring physician is always made aware of the patient’s diagnosis and next steps.”
Dr. Hartzfeld feels fortunate to be practicing in Northeast Ohio. “I was born in Akron, raised in Cuyahoga Falls, completed all of my education in Ohio, and have had the pleasure of practicing in my home town for the last seven years,” he says.
“I chose to join Western Reserve Hospital Physicians based on their diverse primary care physician network,” he adds. “I am looking forward to working with this highly expert group of physicians and expanding my practice.”
The medical office of Dr. Paul Hartzfeld and Western Reserve Hospital Neurosurgery is located at 701 White Pond Drive, Suite 300, Akron, OH 44320. For more information, call (330) 926-3322 or visit www.wrhpi.org.