I’m delighted for the opportunity to write to you and give Dr. Wetzel a well-deserved break from the column. After a year of Zoom meetings with Dr. Wetzel and the SpineLine staff, I can tell you that my appreciation of NASS and SpineLine grew exponentially through socializing with these wonderful people in Chicago.

On that note, I hope that this column reflects the success of the recent NASS 39th Annual Meeting, particularly underscoring the importance of in-person meetings and fostering community feeling is good for our souls, our practices and our patients. Reaching back into Psychology 101, I would like to review a few questions about the concept of community feeling and then summarize some exciting new neuroscience describing our brain functioning during face-to-face (FTF) interactions as compared to video-conference (VC) meetings. I think we will agree that the justification for FTF meetings is now scientifically strong.

Community feeling (from the German word Gemeinschaftsgefühl) is a psychological concept first attributed to Alfred Adler in the first half of the 20th century.1 He conceived of this as “social interest” or interest in society now and in the future, including interest in what happens for future generations. To have community feeling is to think and act for the common good, and seeing others as comrades, each offering their own contributions to the community no matter how small or large.

The successful Chicago NASS meeting depended on contributions from organizers, industry partners, speakers, attendees, and many others. Interestingly, community feeling is not only important to successful organizations, but also to the individual. Alternatively, those without much community feeling tend to suffer more. More specifically, psychological literature notes that individuals who measure low in community feeling tend to be more self-centered, narcissistic, or anxious.1 They might find themselves constantly questioning their own place in the world and rating others’ worthiness.

Community feeling is to be humble and have the sense that we can all move forward together at our own pace regardless of the scale of our individual roles or belief systems, towards a common goal of betterment of our community for future generations.1 Social psychology studies indicate that community feeling is better for our health, elevates our self-esteem, improves happiness, and probably reduces burnout.2 This, of course, is better for our patients.

Community feeling is modifiable and in-person interaction is important. The COVID-19 pandemic illustrates the importance of this concept. When national meetings transitioned to VC from FTF meetings, neuroscientists around the world jumped on this as an opportunity to study brain function differences between FTF and VC interactions. Unsurprisingly, the contexts of our social encounters do matter, and VC meetings tend to be less productive and less satisfying in most instances.

More specifically, the research shows that compared to FTF meetings, VC generates lower levels of brain activity thought important for social arousal and social connectedness, including decreased “interbrain coupling” or coherence, which can be thought of as shared-attention or shared-goal-orientation.3 There are even different brain activation patterns when just observing a live face compared to the same face on a screen, even without a conversation or task to complete.4 While an inspiring speaker may be able to generate a blip of cortical activity in a VC setting, boring speakers are much better off seeking a FTF meeting whenever possible.

In terms of impacts on behavior and performance, loss of FTF encounters can impede scientific progress. Studies now provide empirical evidence that VC meetings have less conversational turn-taking across problem-solving, creative innovation, and social-emotional tasks.5,6 This leads to reductions in all of the following outcomes: creative-idea generation, subjective sense of cooperation, task performance, task fluency, activity absorption, and content retention.5,6

VC meetings are thought to trigger less social arousal because of heightened self-focused attention. My own distracted thoughts during recent Zoom meetings provide a nice example: why does my camera make me look so old and tired? Studies indicate that decreased attention system arousal also comes from inhibition of normal body movements when sitting in front of a camera, attempted interpretation of unnatural non-verbal cues from others, and the many other potential distractions during VC meetings (email, charting, family, etc).5

Interestingly, there is no difference in perceived individual performance between FTC and VC meetings.5 This reminds me of the many studies showing that drunk drivers are poor raters of their own driving impairment. In other words, most of us do not recognize the extent of our own cognitive-attentional impairment during Zoom meetings.

So, what are VC conferences good for? They are good for bringing people together when there is not a FTF alternative, can message important information to many people quickly (perhaps better than email blasts), and they can allow an efficient method for choosing between a few different options to pursue (ie, take votes).5 VC meetings also produce a smaller carbon footprint while getting more people “in the room.” FTF is simply better for creative, collaborative thought and generates more response attempts, more proposed ideas, more clarifications, more conversation, and in my opinion, more community feel.6

I think the research is compelling that we should strive to meet each other in person whenever possible and whenever idea generation or creative problem solving is needed. I greatly appreciate the boost in community feeling I gained from my time in Chicago. I look forward to seeing everyone again in Denver for the NASS 2025 Annual Meeting.

In This Issue:

Of course, if you were unable to make it this year’s meeting, SpineLine has you covered with several Annual Meeting Recap Articles, including summaries of the Presidential Symposium panel discussion, a summary of new technology and wearables, and the popular sessions on the use of Artificial Intelligence in Spine Surgery. We also get to hear from our newest NASS President, Scott Kreiner, in his first President’s Message. His first topic is fitting with his vast experience in leadership and outlines key components of successful spine practice management. I look forward to his leadership of NASS along with his natural blend of professionalism, humility and humor.

This issue’s Invited Review comes from Philip Louie and colleagues on the Professional Use of Social Media in Spine Surgery. I’m quite curious where the boundaries lie and if it’s possible to stay relevant without a social media presence. Albert Lee and Jonathan Grauer provide a very practical summary of a 2024 NASSJ paper by Narayanan et al, titled “Which North American Spine Society Disc Herniation Morphology Descriptors are Most Associated with Improvements in Clinical Outcomes After Microdiscectomy?” 7 I think you’ll appreciate the applicability of the conclusions from this paper and the review.

Jeff Stone provides another useful update on Clinical Decision Support for 2024 in the Coding section. Finally, I would also like to direct your attention to several important News updates listed in the table of contents.

Please enjoy this issue and thanks for your contribution to our spine community.