Interviews with Entrepreneurs

Dr. David Hanscom, Orthopedic Spine Surgeon, Author, & Founder of the DOCC Project

The DOCC Project, or ‘Defined, Organized, Comprehensive Care’, is a structured rehabilitation program for spine pain.

What prompted you to start the DOCC Project?
Around 1990 I began experiencing burnout, which manifested itself as extreme anxiety.  By 1995 it had evolved into a full-blown obsessive -compulsive disorder.  I remained in this extreme state of anxiety until 2002. I was able to somewhat inadvertently pull out it using self-directed cognitive behavioral therapy through David Burn’s book, “Feeling Good”. I began to share this book with my patients with the idea that if I could not diminish their pain with surgery, I could at least give them some tools to cope with the pain. I also realized that lack of sleep would increase patients’ perception of pain. Between sharing the “Feeling Good” book with my patients and improving their sleep with medications, I noticed that their mood would improve and their pain would decrease. The DOCC project (Defined Organized Comprehensive Care) evolved into its current form after I did the Hoffman process in 2008. It is an in-house eight-day seminar that teaches you tools to develop alternate neurological pathways. The new pathways do not include pain. I have now consistently seen patients become pain free through engaging in the DOCC protocol. The one predictor of success is the degree of commitment.

I am also the surgeon patients see after they have had multiple failed back surgeries. It is clear that low back surgery for low back pain does not work and has a major potential downside risk of making the situation and pain much worse. If I do nothing more than slow down the rate of unnecessary surgeries I will have considered my efforts worthwhile.

There is no typical day in the life of an entrepreneur. Please share with us a sample of your day, start to finish.
My day usually starts between 5:30AM to 6:00AM and ends between 7PM to 9PM.  My surgery days range from six to twelve hours two days a week. The surgery and clinic days are non-stop with about a fifteen minute break for lunch.

My projects include:

  • 50-60 hour/week spine practice
  • Co-chairman of the spine surgery fellowship
  • Musculoskeletal consultant for Premera (Blue Cross of Washington)
  • Program chair of the Puget Sound Spine Interest Group
  • Various phases of writing four books: two on chronic pain, one on anxiety as the basis of all mental health issues, and finally applying athletic performance principles to surgery
  • Development of an educational website for chronic pain
  • Running a committee improving the delivery  of spine care

I work out in the gym three to four hours per week. I try to play golf once a week. My wife is actively working on slowing me down and I have to agree with her.

Enjoy every part of what you do each day & it won’t feel like work. Look at adversity as a challenge and why you are in the game. It is an opportunity for personal growth.

What was the best advice you received when you started your career?
Enjoy today-today!! Your peace of mind must become relatively independent of your external circumstances.  You then can create whatever life you desire and have the energy to do so.  I received the advice early on in my career and stuck with it for about five years.  I slipped away from it and have re-engaged the last three years.  Take what you have today and just do it.

Given the current economic climate, what has been your strategy for building awareness of your business for short term and long-term growth?
I am committed to doing the best job humanly possible for the patient right in front of me.  Slowly as I have observed numerous successes with my patients going to pain free, they have spread the word of the concepts.  My website for the DOCC Project is a self-directed resource that is steadily gaining traction. I also network frequently with my peers.  My next target is to collect data to document the successes and also learn what part of the process is the most effective.  I am hoping to fold  the DOCC project into a non-profit organization that is a resource for others to start for-profit business based on the concepts.

What is your proudest achievement as an accomplished entrepreneur?
I have spent my life imposing my view of reality on everyone else.  To be successful as an entrepreneur it is critical to be aware of the needs of those around you.  I have had the privilege of “waking up” and truly being able to listen. It is not only more effective it is much more interesting to see life through the eyes of others.

How do you achieve balance in your life?
I have not been successful with that.  My goal is to be fully engaged with whatever I am doing at the present moment. Balance is a huge struggle and I am redoubling my efforts in 2012 to attain a small amount of balance.

Your top 3 book recommendations?

  • ‘[amazon_link id="0380810336" target="_blank" container="" container_class="" ]Feeling Good[/amazon_link]‘ by David Burns
  • ‘[amazon_link id="006251721X" target="_blank" container="" container_class="" ]Forgive for Good[/amazon_link]‘ by Fred Luskin
  • ‘[amazon_link id="0609806939" target="_blank" container="" container_class="" ]Parent Effectiveness Training[/amazon_link]‘ by Thomas Gordon: This is still the one book that has had the greatest impact on me.
  • ‘[amazon_link id="0142000280" target="_blank" container="" container_class="" ]Getting Things Done[/amazon_link]‘ by David Allen:  He proposes a simple but elegant way of getting and staying organized. Every task longer than two minutes is defined as a project. Every project is broken down to the “one next step.”  It has allowed me to juggle many balls at once and not become overwhelmed. My brother introduced me to the concept about 10 years ago. He went from a middle manager to a vice president of his company within three years after implementing his strategies.  It is a game-changer.

What are your most rewarding charitable involvements?
In the midst of a full-time practice my work with the DOCC project is my way of giving back. Working with patients who have no hope and watch them get a full and rich life back is incredibly rewarding.

Who has influenced your career the most?

  • Dr. Paul Brand is the first orthopedic surgeon to ignore the stigma associated with leprosy and learn exactly what was going on.  He was the one who learned that it was the lack of protective sensation that caused the structure of the skeleton to disintegrate.  He then applied the principles to diabetes and revolutionized the treatment of diabetic foot ulcers.  He was the kindest most well intentioned person that I have ever had the pleasure of knowing. At age 90 he had not slowed down at all.
  • Nelson Mandela—his ability to come out of a true victim role and give back is one of the most inspiring stories I have ever heard.  I consider his attitude on a daily basis and have a picture of him in my office.  I don’t really know what a bad day is compared to his experience.
  • Joey Gauld—he is the founder of the Hyde schools.  He is about 50 years ahead of his time developing an educational high school that emphasizes character over achievement.  He had the courage early on in his career to step off of the treadmill and follow his dream.  He epitomizes the power of commitment.  My stepdaughter attended the school her junior and senior year of high school. The whole family was involved and it was transformative.  He then did the Hoffman process at age 80 and inspired my wife, me, and my son to go through it. I cannot put into words the power of these two institutions.

What is your advice for someone interested in entrepreneurship?
Consider doing the Hoffman Process. It is an eight-day in-house process that creates an intense awareness of the patterns that run your life.  From birth to age 12 you are simply downloaded by your environment.  The entire rest of your life consists of either adopting or rejecting these initial patterns.  You cannot connect with your authentic self until you can see and clear these patterns.  Instead of “stimulus-response” it is “stimulus-choice of response.” The process gave me clarity and focus that I never imagined possible.  None of the projects I am bringing to life would be possible without having learned the tools that I learned in the Hoffman process. Harvard School of Public Leadership has sent many of their graduates through Hoffman.  I have been a laser beam the day I walked out of there and have not deviated since. About a dozen of my friends have done the process with the same consistent transformative outcome.

Learn how to handle stress in your life.  The number one predictor of success in my opinion is your ability to handle stress. You cannot be successful unless you are willing to take risks and accept failure.  Again, Hoffman is a major resource in learning these skills.  It is not stress that drains your energy.  It is your reaction to it.

Dr. Hanscom’s Bio
Dr. Hanscom is a board certified orthopedic surgeon specializing in complex spine problems in all areas of the spine. He has expertise in adult and pediatric spinal deformities such as scoliosis and kyphosis. A significant part of his practice is devoted to performing surgery on patients who have had multiple prior spine surgeries. He works for Swedish Neuroscience Specialists with eight neurosurgeons and a physiatrist.

He is the founder of the “DOCC” project. It stands for “Defined, Organized, Comprehensive, Care.” This is a structured rehabilitation protocol for spine pain, which involves improving sleep, managing stress, engaging in long-term conditioning, obtaining adequate pain control with aggressive medication management, and educating the patient so as to regain control of their decision making. Surgery is considered in the overall context of the rehabilition effort and is only performed on specific structural problems. He is working with Swedish Hospital in Seattle, WA to improve access to structured non-operative care.

He is the founder of the Puget Sound Spine Interest group, which was formed in 1987. It is a non-profit educational group, which provides a regional forum for physicians to share ideas regarding optimum spine care.

“Awake at the Wound” is a process, which brings athletic performance principles into the operating room. He co-founded the program with his golf-instructor, David Elaimy, in 2006. David Elaimy is also a performance coach who has been giving golf-based performance seminars in the financial sector for over fifteen years.

Current Positions:

  • Orthopedic Spine Surgeon, Seattle Neuroscience Specialists with Swedish Medical Center in Seattle, WA.
  • Orthopedic Consultant for Premera (Blue Cross/LifeWise of WA, OR, AK)
  • Director of the Swedish Neuroscience Specialists spine fellowship, Seattle, WA
  • DOCC Implementation Committee Swedish Medical Center, Seattle, WA
  • Member of Best Doctors of America

His medical degree is from Loma Linda University in 1979. His residency training began with internal medicine in Spokane, WA from 1979-1981. Orthopedic surgery training was at the University of Hawaii from 1981-1984. He did an orthopedic trauma fellowship at UC Davis in Sacramento, CA. His spinal deformity fellowship was completed in Minneapolis, MN at Twin Cities Scoliosis Center in 1986.

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There are 4 comments .

Dr. D.Devanand —

Respected Sir,
I have completed my Orthopedic training in India in a prestigious Institute and stood as a topper in the examinations conducted.
I have worked with three Spine surgeons in India for the last two years. I have completed my SSHRI fellowship in spine at Ahmedabad , Gujarat , India.
For the last 1 year I am performing Spine surgeries independently more of trauma and Degenerative work. I have operated over 80 cases in the last 8 months.
I have special interest in Spine surgery and want to improve my clinical and Surgical skills by working in a reputed centers like yours.
It will be a great opportunity for me to be selected as a spine fellow at your Institute.
Kindly consider my application for spine fellowship.

Thank you,

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Dear Dr. Devanand, I don’t visit this spot and just saw your note. We would be interested in talking to you. However, we are only accepting fellows that have a US license and can obtain staff privileges. If you have some other way of obtaining funding let me know. Thanks for your interest. David Hanscom

Reply »

The DOCC seems like a great project. Since this post, have you seen a lot of success?

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