Career Path

“Don’t It Always Seem to Go, That You Don’t Know What You’ve Got Till It’s Gone”

I have recently been thinking about this old Joni Mitchell song. I tried to retire last year and succeeded in stopping clinical practice after 30 great years of hand surgery. For better or worse, I ended up immediately running against 7 other people (including 2 other doctors) for an open Georgia State Senate seat. The seat became vacant due to…
Patient Communication

Chief Complaints

One of my senior partners tells a story where he is called out of a patient room to take an urgent phone call. The patient in the room was in his mid-60s and had spent the last 15 minutes describing the 10/10 severity of his lateral epicondylitis symptoms. On the phone was a former fellow, now practicing in a remote…
Community

Mentoring in Orthopaedics

Over 3,000 years ago, Odysseus entrusted his friend Mentor to educate and guide his son Telemachos when he left to fight in the Trojan War (Homer. Odyssey, Book II). Thus, was the birth of the word ‘mentor,’ which has evolved to mean trusted advisor, friend, teacher, and wise person. I have had the tremendous opportunity to mentor dozens of undergraduate…
Education

Absolute vs Relative Risk Reduction: Number Needed to Treat in Hand Surgery

I recently read Overdosed America: The Broken Promise of American Medicine by John Abramson.  The story of the COX-2 inhibitor, Vioxx, is one of the prime examples used in the book to show how pharmaceutical marketing and publication bias can result in disastrous outcomes for the public.  However, the part of the book that I found most interesting was when…
Community

You Get What You Celebrate

It is a well-known business principle that “you get what you measure.” Any of us involved in pay-for-performance and complying with the various hospital metrics can relate to that. But recently I heard an interesting variation on this theme. On his podcast “The Tim Ferriss Show”, Tim Ferriss interviewed Frank Blake, former CEO of Home Depot. Blake’s version was “You…
Education

Life Long Learning

In a field of medicine such as hand surgery, although some fundamental entities stay the same (pathology, anatomy, etc), there are inevitable changes and advancements as time passes.  Even if the underlying anatomy remains unchanged, a surgical approach may be refined over time to hopefully improve outcomes and minimize time and risk. New technology and implants are constantly being proposed,…
Community

Do you have an action plan?

My last JHS Focus post introduced the Waterline model as a guide to providing clarity regarding the root causes of team conflict and/or underperformance. I suggested that, more often than not, a system or process issue may be the basis for the problem even though we, as emotionally driven team members, may attribute underperformance to an individual or to an…
Work/Life Balance

“New Year’s” Resolutions

Unlike residency and fellowship, which are typically divided into discrete rotations or blocks; the passage of time in practice seems to flow in a relatively unobstructed fashion. Certainly the long winter drags on and business inevitably picks up as summer arrives,  indicating the change of season.  But, without distinct check points throughout the year, it is easy to forget to…