Special to MD Monthly
Over 14 years ago, Dr. Richard Francis, along with the help of his wife, Juanitta, opened Spine Associates so fellow Houstonians could benefit from the life-changing services offered by Dr. Francis and his staff.
Since then, Spine Associates has grown and with two clinics, one in Houston and one in Beaumont, Dr. Francis is quite a busy physician with an endless schedule from Monday through Saturdays. His passion for helping others, and the emphasis he places on the physician-patient relationship is refreshing and rewarding, to say the least.
Dr. Francis explains how his professional career evolved. “For a long time, I wanted to be an engineer. Later, I developed an interest in medicine as I learned more about it from students that preceded me in undergraduate school. When the time came to commit, I had a greater interest in pursuing medicine than I did engineering. I can’t underestimate the positive impact that my role models had on the choice of my profession. Above and beyond all of this, my mother had the greatest impact on me. She made me feel like the sun shone from my eyes and I could be anything I wanted to be. She even made my flaws feel worthwhile.”
His motto: “Whatever it takes; I’ll give you my best. I promise.”- Dr. Richard Francis
Born in Kingston, Jamaica, Dr. Richard Francis was 18 years old when he started medical school at the University of the West Indies in Jamaica. He received his medical degree at 22. During medical school, he was accepted as an elective student, and found his passion for orthopedic spine surgery at the University of Toronto Medical School in Ontario, Canada.
After receiving his medical degree, he was accepted to the Royal College of Surgeons of Edinburgh in Scotland. At 29, Dr. Francis was elected to the fellowship of the Royal College of Surgeons and by the age of 34, Dr. Francis had earned his specialty board certification in trauma and orthopaedic surgery.
Dr. Francis details his educational endeavors, and the path he followed to the Lone Star State. “I went to Wolmer’s Boys’ School in Jamaica and then studied medicine at the University of the West Indies. Following that, I moved to Edinburgh, Scotland, where I trained in general surgery and then orthopaedic surgery. Finally, I moved to Houston, Texas and trained in spine surgery at Baylor College of Medicine. At first, I taught spine surgery as an assistant professor at the University of Texas. After a few years, my wife Juanitta and I started Spine Associates. It is a private practice specializing in surgical and non-surgical treatment of the whole spine for adults and adolescents. I have special expertise in deformity, scoliosis, correction and the revision and reconstruction of failed spine surgery.”
Moving his family to Houston was certainly a change from where they lived prior to arriving in Texas. “One of my favorite memories of when I first came to Houston was having an opportunity to work and train in the Texas Medical Center in Houston…It’s the home of cardiac surgery, Nobel laureates and cutting-edge medical research as well as some of the world’s leading institutions such as the MD Anderson Cancer Center,” says Dr. Francis, adding that, “It is also home of such legends as Drs. Michael Debakey and Denton Cooley in cardiovascular surgery and Drs. Paul Harrington and Jessie Dickson in spine surgery. To see it, is to be blown away with the magnitude of its size and the excellence that is all around you.”
“There are fundamentals that assure success. We apply basic clinical skills for all patients.”- Dr. Richard Francis
Soon after relocating, Dr. Francis became an integral part of the medical excellence in Houston. For four years, he served as an assistant professor with the University of Texas, where he was responsible for training residents and fellows in the field of spinal surgery. In 2003, he founded Spine Associates, and at the age of 38 he was already considered one of the top performing, busiest and hardest working spine surgeons in Houston by his peers. His motto: “Whatever it takes; I’ll give you my best. I promise.” Dr. Francis’ motto is incorporated within the philosophy of Spine Associates. Their mission is simply to give each adult and child the best of themselves every time. Their goal is to get each person back to normal—physically, functionally and cosmetically.
Every patient is seen by Dr. Francis at every visit. New patients are seen within three days of calling. “We see patients on late evenings and weekends, if that’s what it takes,” says Dr. Francis. He is certainly not the norm for physicians these days. He goes above and beyond to ensure that all of his patients are examined and diagnosed correctly citing that the diagnosis is the most important aspect of all when treating his patients.
An accurate diagnosis can only be reached through a thorough examination by a specialist with experience and extensive training and is the only one that is going to be able to sort through the “noise” and find the root cause of the patient’s pain. Every patient receives a comprehensive exam which includes a review of the patient’s medical history, thorough physical examination, diagnostic testing if needed to confirm diagnosis and a detailed explanation of their condition and treatment options.
“There are fundamentals that assure success. We apply basic clinical skills for all patients. We take a detailed history of the problem, perform a thorough physical exam, and only then, employ appropriate imaging studies and testing to confirm a diagnosis. The most important thing in our whole approach is to obtain an accurate diagnosis. I increase the likelihood of that by taking responsibility for each of the above processes by seeing each and every patient myself at every appointment. If surgery is needed, it is actually the least challenging part,” Dr. Francis explains to MD Monthly.
Dr. Francis considers the patient’s age, lifestyle, career, health status and history in order to ascertain what the best form of treatment is. Once the diagnosis is confirmed, if surgery is needed, Dr. Francis explains, “Surgery is a skill that you practice and like most skills, you get better with time. When you do an operation, you want to do it perfectly once, then do it the same way every time.” The real challenge is making the correct diagnosis. Dr. Francis takes it from there, and ensures that his patients lead a better quality of life with non-surgical and, if necessary, surgical treatments, over time.
“We do spine surgery exclusively because we are specialists in that field, trained to a very high level to perform in this very demanding area. To continue to be the best, we must focus each day on advancing the specialty, following ongoing research in spine care and challenging ourselves to achieve good outcomes consistently. Deviating from this, to my mind, subtracts a bit from the package of excellence we always want to offer,” says Dr. Francis.
Typically, spine surgeons have a PA or another assistant see their patients in clinic, and will only consult with the surgeon if surgery is required. This approach is not conducive to Spine Associates’ beliefs, and makes for long hours on clinic days where Dr. Francis sees a multitude of patients. Clinics are held on Tuesdays, Thursdays and every other Saturday, starting at 6:30 a.m. and ending at 9:00 p.m. Dr. Francis gives his all and never strays from his standards.
Offering services from sciatica treatment and robotic assisted spine surgery, to adult stem cell therapy, artificial disc replacement and electro-diagnostic testing, Dr. Francis and his team make sure his patients have an array of options.
Their goal is to get each person back to normal—physically, functionally and cosmetically.
When a patient comes to see Dr. Francis, they are typically in pain, and need appropriate treatment, quickly. Verifying a diagnosis requires diagnostic studies such as X-rays, MRI, CT, EMG/NCV’s and diagnostic injections. Having these services within the practice allows the team to facilitate these requests sooner, so the patient is able to get their treatment plan, even on the same day as the initial appointment. This is extremely helpful for Spine Associates’ international and out-of-state patients.
“Fundamentally, most spine conditions can be treated non-surgically with conservative tools. These tools include physical therapy, spinal injections, medication management, weight loss and physical conditioning. We always offer these options first. It is the right thing to do from a medical point of view. We must always respect the magnitude of surgery on a person’s life and be judicious in offering it. Quite likely, an individual who is presented with spine surgery as an option will be facing this kind of event for the first time in their life. It’s a big deal,” explains Dr. Francis, adding that, “The proper place for surgery is in situations where there is failure of conservative care, neurologic risk of injury, spinal instability, or pain refractory to all other reasonable forms of treatment.”
At the core of Dr. Francis’ philosophy is the fundamental belief that the connection with patients and their families is crucial to the entire medical process. While talking with him, he explained just how important this connection is throughout patient care. “As a physician, we are in a sense wedded to the patient. The treatments that we give and recommend will affect the patient for the rest of their life. It is essential to have a good relationship with my patients to get the best results possible and to get them the results they deserve,” says Dr. Francis. This belief of patient connection served as the foundation in the development of the Spine Associates Patient Ambassador Program. The first official Patient Ambassador was recruited 2 years ago after Dr. Francis realized the need for patients considering surgery to be connected with those who had already been through the life-changing experience. “We know that when people a faced with a challenging decision of going forward with spine surgery, which many people fear, they get a lot of comfort from speaking with their doctor that they have a lot of respect for. But, perhaps more importantly, is to connect with people have had the identical procedure and can give a firsthand account on what they experienced. Now they are no longer depending on just what their doctor has said, but they are also relying on what real-life people have said.” The Patient Ambassador Program now has over 300 Ambassadors and actively connects patients on a daily basis.
Jodie Schaefer, a Patient Ambassador from Victoria, Texas states, “Addressing the issue of spine surgery can be lonely and frightening. It is gratifying to be able to share positive experiences with new patients.” Trisha Barnes has also found her niche as a Patient Ambassador, “I will never forget the feeling of being told I need surgery and the fear that comes along with it. Seeing others that have had successful surgeries really helped me and I would love to be able to help others with my story.”
“I can’t underestimate the positive impact that my role models had on the choice of my profession.”- Dr. Richard Francis
On the other side of the spectrum, his staff and colleagues give us more insights on Dr. Francis, and his practices. Regina Williams—R.T., R, M, CT, ARRT—lead CT technologist says, “Observing his passion, dedication, and relentless strive for truly wanting to improve a patient’s quality of life is inspiring. I’ve never worked with another physician in my 18 year career that has exhibited his pursuit of excellence and precision in the care his patients receive.”
Jody Plumb-Gonzalez who has been working with Dr. Francis for the past 9 years shares her insights. “He’s definitely an outlier in complex spinal surgery. I’ve heard this same opinion shared by a number of his peers. As his executive assistant, I have an opportunity to see both sides of Dr. Francis and after 9 years, I am still amazed by the passion and drive that he has. I’ve never met anyone like him. The man trained himself to fully function on only four hours of sleep! I see a man with deep multi-faceted intelligence and incredible skill and creativity. If only he could figure out a way to clone himself.”
Safety and precision are cornerstones of successful surgical treatment and correction of spinal deformities. Dr. Francis was among the first to use Mazor Robotics technology in the US, and has a series of approximately 500 cases over the past 5 years – making him one of the most experienced surgeons in the use of the technology, worldwide. In 2017, Spine Associates acquired the Mazor X™ – the latest advancement in robotic surgery with real-time 3D navigation. At the time of writing, Spine Associates is one of four surgical teams in the United States equipped with this advanced technology.
“My life sometimes feels as if it’s being lived under a lucky star. Either that, or I am the beneficiary of God’s continuous blessings. I choose to believe the latter,” says Dr. Francis, adding that, “My whole career has been a journey of chasing dreams and now actually living those dreams. I am a spine surgeon, a husband and a father to four beautiful children; Chloe, Shannon, Zachary and Samantha.”
Spine Associates will always be ahead of the curve when it comes to the practice of spine medicine. They have made it their goal to stay on the forefront of technology, while maintaining a personal connection with patients and their families. Dr. Francis concludes, “We continue to differentiate ourselves purely on the basis of doing spinal surgery. I see us as always trying to be leaders in applying new technologies that give benefits, not just technologies that are done for the sake of doing something different, but that bring added benefits to our patients.”
For more information about Dr. Richard Francis and his clinic, please visit myspineassociates.com.