Cooperation to Help Improve Outcomes: Oversight Physicians and Neurophysiologists

Meet Adam DeBriae, Senior Neurophysiologist, and Anne Guyot, Oversight Physician with NuVasive Clinical Services (NCS). The two work together on approximately 10 cases per month, helping support surgeons in providing their best possible care for patients. Learn more about the working relationship of Oversight Physicians and Neurophysiologists (NPs) below, from the perspective of two of our own.

Can you describe your different roles and how they overlap during surgery?

AD: As NPs, we are on the front lines in the hospital working with our surgeons, meeting patients, placing electrodes and collecting patient-data in real time. We see and hear everything that is going on, which can prove vital when changes in our signals start to occur. Additionally, we have an Oversight Physician like Anne that is supervising the case remotely to provide interpretation of the collected data. We work together to identify areas of concern, troubleshoot any issues, and provide resolution (as best we can) to changes in our patients’ data.

AG: As the remote supervising physician, I provide auxiliary technical trouble shooting. On each case, I integrate known patient pathology in response to the changing dynamics during a surgery. As a physician, I also advise those in the room about the influence of ongoing issues on our responses.

How do you benefit from having one another’s support?

AG: While Adam provides the backbone of developing the patient responses, I holistically evaluate each case, ensuring we are doing everything we can to improve the responses. I integrate the patient history, vital signs, knowledge of the procedure and neurophysiology with patient safety as the goal. I am virtually standing behind Adam, and suggest interventions when we have changes in signals. In those crucial moments where every second counts, I can help in the operating room in ways that were unimaginable even 15 years ago.

How might a patient benefit from having an NP and an Oversight Physician?

AD: Having two sets of eyes on every case provides many advantages. First and foremost, NPs and Oversight Physicians are looking at the data from different perspectives. NPs keep a real-time chart of events from within the OR, while an Oversight Physician tracks surgical stages remotely—allowing for data assessment without OR distraction. When things don’t go as planned, the operating room can become chaotic with many tasks being asked of NPs simultaneously.

As remote workers, Oversight Physicians are seemingly immune to the “OR chaos” and can solely focus on evaluating data and providing immediate recommendations. This is vital, so the surgical team can come up with a plan quickly and efficiently to address changes.

AG: Patient safety is our main goal. Essentially, we are the patient’s support system in the operating room. I treat every patient as if they were family, and I feel it is my duty to the families in the waiting room to provide their loved ones with the best possible care. While a positional change may seem small, as a practicing neurologist, I’ve seen brachial plexopathies affect a patient’s ability to return to work and change their future. I believe we help make a difference in the patient’s quality life.

 What do you love about your roles?

AD: I love interacting with our patients and surgeons every day. During the preoperative period, it’s rewarding to talk with patients and families about our roles in intraoperative neuromonitoring (IOM), which helps provide reassurance and comfort in an otherwise nerve-wracking situation. Combine that with our talented team of oversight NPs and Oversight Docs, I love going to work for NCS every day!

AG: I love that I am able to work remotely and interact with so many team members across the country.

Follow along with more of our NCS Shareowners at #MeetTheNP, and learn more here.


NuVasive Clinical Services (a division within NuVasive, Inc.) is a leading provider of intraoperative neuromonitoring (IOM) services to surgeons and healthcare facilities, through the acquisitions of Impulse Monitoring, Biotronic NeuroNetwork, SafePassage, and others. Surgeons have enhanced surgical monitoring and oversight capabilities through neurophysiological data gathered via broadband transmission. IOM technology gives those in the operating room real-time insight into the nervous system, which can help surgeons reduce surgical risk by providing critical information and alerts throughout the procedure. This neural function monitoring helps decrease the chance of nerve damage to the patient and promotes patient safety during surgery. NuVasive Clinical Services is expected to serve more than 100,000 cases annually in the U.S. From over 530 highly trained neurophysiologists in the operating room, to technicians and scheduling staff available 24/7, NuVasive Clinical Services can help support physicians and hospitals to improve clinical outcomes.

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