Joe Hartman

IONM: Getting Started And Lessons Learned

My Neuromonitoring Story

The #1 question I get asked is “how do I get started in neuromonitoring.” The #2 question I get is “how did you get started in neuromonitoring?”

In my opinion, my admittedly boring, bookworm life makes for terrible entertainment. But enough people find value in hearing about it, I called uncle and decided to put it out there for the world to revel in. 

How I Got Into Intraoperative Neuromonitoring

Like almost everyone I’ve met in IONM, I had no idea that I would end up in this profession while in school. So let me start off by telling my “how did you get into this” story.

I started my healthcare studies in occupational therapy at the University of Florida. I was interested in working in the health industry but didn’t quite know what discipline yet. During my internships at a trauma rehab facility in Florida, I enjoyed my time to work with brain and spine trauma patients. It was rewarding seeing life altering changes with some of my patients. At other times, it was very discouraging to see little to no improvement. I left there knowing that I wanted to continue my education along those lines.

Since physical medicine was my interest, I decided to go to Parker University for chiropractic school instead of medical school. While there I continued to go along the neurology path. I later earned my diplomate in chiropractic neurology (DACNB) and did a sub-specialty in neurodiagnostic.

Later on, I was talking to a classmate of mine who was already in the IONM field for a year. We talked about what she was doing, and I began applying for jobs. It’s often hard to get that initial job in this field, but luckily PAS liked my background and agreed to hire/train me.

Twist And Turns In My Surgical Neurophysiology Career

And so I started my career as a surgical neurophysiologist. Here’s were I was at this point:

  • Familiarity With IONM 15% 15%
  • What I Thought I Knew 99% 99%
  • What I Did Know 12% 12%

Once I got over the initial shock of the OR environment, I decided that this was going to be a great career move for me. I really wanted to come out of the gates sprinting, so I made a concerted effort to learn every case type that I could. I lucked into a great training ground for someone looking for variety and I feel that was a key to my breadth of knowledge.

While I was happy getting all that exposure, I really wanted to have a true understanding of each modality as it pertained to the case types I was using it on. Access to that information was far less available than what I expected. Only a textbook here and there to read.

I would soon learn how competitive companies were with each other. Clinical training and education were held under lock and key. 

As I started to run into an academic roadblock, I ended up moving to Fl and working at an in-house facility. While the group was much smaller, I gained access to just about every publication that I wanted. And even though this facility did about 90% bread-and-butter cases + scoli’s, I was able to really gain depth of knowledge during my time spent there.

It was at this point in time that I started to realize I knew far less than what I thought I did. I began this website to help chronical my thoughts and help others along the way. It was my way of making sure I knew the material by extracting what’s in the literature and trying to explain it in a simple and useful manner.

After a couple years there and obtaining my D.ABNM in the process, I was offered a clinical manager position at SpecialtyCare. It was a really great opportunity for me, as I wanted to gain experience in management.

At the same time, I once again found myself in a broad spectrum of case types. It was here I was able to use the depth of knowledge gained tearing through the literature. I also wanted to gain some management knowledge, so I started my MBA (all paid for by SpecialtyCare… thanks guys!)

With this change in my career trajectory, I put this website on hold. 

A couple of years later, I was then offered a VP of clinical services position at Sentient Medical. To date, this was the most difficult professional decision I had to make. SpecialtyCare was growing fast and I felt I was growing with them. After much discussion with my wife, the experience was too great to pass up. So I had to say goodbye to a great thing for the unknown… just after my first kid was born.

This new position has allowed me to experience more of the business side of our industry along with greater management responsibilities.  It was at that time I was ready to once again opened up this website and share those experiences. You can see that point in time when I kicked off my “30 days of Neuromonitoring” series.

A Suprise That Suprised No One

It wasn’t long until the inevitable happened… SpecialtyCare bought the company I was working at. 

That next 6 month was a crazy time getting through the transition, but it was a great experience. If you’ve been on the purchasing or purchased end on those, you know what I mean. Just a lot of new stuff to learn and things to get done.

Sentient’s titles were different that SpecialtyCare’s, so that changed again. And so did some of the responsibilities. Where I was the VP of clinical services at a smaller company, I had one foot in the clinical camp and the other in the business camp. Pretty typical that you wear more hats at smaller companies. I transitioned into a Director of Operations role. With all the backend support that SpecialtyCare has, that means everyone has a more focused role. I still have clinical responsibilities, but the business and operations side is the meat of it these days.

And if you look at the dates of my blog post, you can almost see where my responsibilities shift in the types of post I’m writing. Interestingly enough, the non-clinical pieces are just as popular.

The Future Of This Website

While I am trying to keep this website true to my initial purpose — to pay it forward for all the help I’ve received along the way — I’m still tinkering with where the website is going to end up.

  • I had a forum – the area of this website with the most potential upside – but it bombed. Nothing but crickets. So that’s gone.
  • I had some rotating webinars for people to join. I got too lazy to keep up with it. Sorry.
  • I had some great hidden content for people who signed up to my list. Again, I never got around to it. I put some of it on the website though!
  • I had a place for new job postings. Not enough activity there to justify me spending time on it. Bye-bye. (Although if you’re interested in any jobs at SpecialtyCare, I do stay up to speed on those. Just shoot me an email or message me on LinkedIn).
  • I added an FAQ to help reduce the number of similar emails I get. If enough people are asking about it, and not everyone is emailing me about it, then it just made sense to save everyone some time.
  • I felt the website needed a facelift, so I did my own redesign. That’s probably not happening again any time soon.

I’m not sure what it will look like tomorrow, but I plan on having it up as long as I can. Below you can see some of the “bios” of persona’s I use in my post/videos for the sake of clarity.

BTW: if you would like to contribute an article, please reach out and we can discuss it.

The Crew


The Neuromonitoring Technician

The Neuromonitoring Technician

New to the field and ready to ask the questions most of us are already wondering. She’s here to learn, but her most important job is to show that it is OK to ask questions.
The Anesthesiologist

The Anesthesiologist

The art of anesthesia is a balancing act and IONM restrictions can throw a monkey wrench in that process. He wants to play nice at all time, but is here to lend some perspective in circumstances where standard protocol needs to be questioned.
The Surgical Neurophysiologist

The Surgical Neurophysiologist

The know it all DABNM. He seems to have an answer for everything or at least a strong opinion. (And yes, he looks like a cartoon version of me)
The Surgeon

The Surgeon

You’ll see him jump in from time-to-time to make sure you keep your monitoring feedback in the context of the case at hand. He’s interested in what’s happening, where, why and what is your level of confidence in what you’re reporting.
The Operating Room Nurse

The Operating Room Nurse

Been there forever and has seen it all. All except what we’re doing back there in the corner. He’s here to learn more about those little “squiggly” lines.
The Attorney

The Attorney

Not all lawyers are blood-suckers, but this one is the worst. He’s watching your every step to make sure you’re practicing at least above the standard of care. He hates this website, or any other resource that makes clinicians better.

Need Monitoring For Your Cases? Let’s Get Started >>>

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