I often reflect on how difficult it must be for a patient to choose a spinal surgeon. Even more challenging, whether to trust a surgeon for the necessity of surgery. Very scary to be the patient with pain and not knowing what to do. I try to give options and ask patients to sleep on it. Only recommend surgery as emergency for very special clinical situations. I want them to know the fit between surgeon and patient’s trust must be mutual for surgery to proceed. I started giving patients’s my cell and home number ten years ago to increase my own personoal belief that surgery was a reasonable option. Obviously, this access exposes me and my whole personal world should results be less then expected. I thought about stopping this added stress as so many physicians thought this was “insane” to give home phone number knowing spinal surgery patients have upwards 20 percent not happy with their outcomes. Fortunately, patients have not abused and the added pressure makes me sure I fully inform and manage patient’s expectations. I find it so very rewarding to improve trust and communication,even when their are rough times after surgery. I hope to continue this service my entire professional career!