Explorez tous les épisodes du podcast Lessons in Orthopaedic Leadership: An AOA Podcast

If orthopaedic surgeons stop showing up, who decides what our profession becomes? We sit down with Dr. Fred Azar, past president of the American Academy of Orthopaedic Surgeons, a longtime leader and current Department Chair at Campbell Clinic Orthopaedics, to talk about the future of organizational involvement in orthopaedic surgery and why it matters more than ever as healthcare grows more complex.

We get practical about the pressures surgeons feel right now: hospital employment, limited reimbursement for memberships, shrinking time, and the reality that many clinicians no longer want to “fly to learn.” Dr. Azar argues that the winning model is not meeting-based societies but connected knowledge networks where education, mentorship, data science, AI, and shared outcomes move fast and reach surgeons where they live. The standard for engagement changes too: it has to be meaningful, efficient, and clearly tied to impact for patients.

If you care about the future of musculoskeletal care, this is a conversation about unity, credibility, and showing up before someone else writes the rules. Subscribe for more, share this with a colleague, and leave a review with your take: what would make organizational involvement worth your time today?

Ballistic missiles overhead at 2 a.m. Surgeons back in the OR at sunrise. A city buying groceries and sending kids to school while medevacs arrive around the clock. That contrast is the setting for our conversation with Dr. Roman Hayda, Chief of Orthopaedic Trauma at Rhode Island Hospital and a retired US Army colonel who has traveled to Ukraine repeatedly to support frontline trauma hospitals.

We trace how his Ukrainian roots and military surgical career shaped a calling for war surgery, then zoom in on what makes the current conflict medically different. With contested airspace and relentless drone surveillance, traditional evacuation assumptions collapse. When you can’t fly a helicopter and you can’t safely drive into the kill zone, the “golden hour” becomes a moving target and the downstream impact shows up in limb salvage decisions, prolonged tourniquet times, infection risk, and a growing need for amputation care and complex reconstruction.

We also dig into leadership lessons for any orthopaedic surgeon considering humanitarian work: arrive with humility, listen first, adapt to limited resources, and treat teaching as a two-way exchange. Finally, we talk practical ways to help even if you never get on a plane, from donating external fixation resources to supporting reputable NGOs and advocating for sustained support.

Subscribe for more conversations on the future of orthopaedic surgery, share this with a colleague who cares about trauma systems and global surgery, and leave a review with your biggest takeaway or question.

“I’m fine” is one of the most expensive sentences in health care, because it can hide pain, lost function, fear, and stalled recovery. We talk with Dr. Judy Baumhauer, a national leader in orthopaedic surgery and outcomes measurement, about how patient-reported outcome measures (PROMs) give patients a real voice in their care and give clinicians a clearer signal about what’s working.

We get specific about PROMIS and why computer adaptive testing can measure physical function, pain interference, and even depression in just a few minutes, then trend those scores across an episode of care. Dr. Baumhauer explains how her team scaled PROMs from orthopaedics to a system-wide workflow, how results show up in the electronic health record, and why the numbers are most powerful when they spark a better conversation rather than replace one.

Then we zoom out to the future of value-based care in orthopaedics: CMS requirements, public reporting, bundled payments, and the risk of choosing the wrong instrument. We dig into why certain mandated surveys can blur pain and function, how comorbidities and ceiling effects can skew “improvement,” and why PROMIS crosswalks could help standardize reporting while lowering implementation costs.

If you care about patient-centered care, orthopaedic quality measurement, and where reimbursement is heading, subscribe, share this with a colleague, and leave a review with your take: should PROMIS become the default language for outcomes reporting?

The next wave in orthopaedic surgery isn’t just surgical technique it’s how care gets organized, measured, and paid for. We sit down with Dr. Aaron Chamberlain, senior medical director for Intermountain’s musculoskeletal clinical program, to unpack why vertically integrated healthcare systems can be a powerful engine for value-based care and what that means for surgeons who want to lead, not just react.

We talk candidly about “risk” and why taking on financial accountability can actually unlock better medicine: clearer incentives, tighter alignment with payers, and a sharper focus on outcomes across the full episode of care. Aaron shares how Intermountain uses deep data infrastructure, enterprise dashboards, and careful patient cohorting to reduce unwarranted variation and make cost and quality visible to clinicians. If you’ve ever wondered how an Epic-era analytics platform can change real-world practice patterns, you’ll hear the nuts and bolts.

You’ll also get a concrete care redesign example: shifting appropriate hand procedures from the hospital or surgery center into the clinic, then using shared savings to reward the extra work required to make the change safe and scalable. We connect that playbook to broader trends like bundled payments and the CMS TEAM model, and we close with leadership lessons that translate anywhere: keep physicians involved, stay close to the bedside, and “fall in love with the problem” before you pitch a solution.

If you found this useful, subscribe to the AOA Lessons in Leadership Podcast series, share the episode with a colleague, and leave a review with the value-based care question you’re wrestling with right now.

We sit down with Dr. Paul Anderson, a nationally recognized orthopaedic spine surgeon and longtime leader in bone health, to explain how bone fragility quietly drives pseudoarthrosis, hardware failure, periprosthetic fracture, and revision surgery across orthopaedics, including spine fusion, total hip and knee arthroplasty, shoulder procedures, and sports medicine repairs. Our goal is simple: help you make bone health optimization a normal part of elective surgical planning, not an extra task that never fits the schedule. 

We start by clearing up a common trap: relying on a DEXA T-score alone. Dr. Anderson walks us through a more operational definition of clinical osteoporosis that combines bone mineral density, fragility fracture history, and the FRAX 10-year fracture risk calculator. That broader view catches the patients who “do not look osteoporotic” on paper but still have fragile bone and higher risk of poor outcomes after surgery. 

From there, we lay out a step-by-step workflow you can actually run in clinic: who to screen, when to order DEXA, how to use imaging clues like CT Hounsfield units, and why orthopaedic surgeons should feel confident interpreting DEXA quality and results. We also cover how to build referral pathways using fracture liaison services, how to think about antiresorptive vs anabolic medications, and what timing looks like when you decide to delay surgery to improve bone strength. 

If you want fewer failures, fewer fractures, and more predictable fixation, bone health has to be part of the plan. Subscribe and share this with a colleague.

Great leaders aren’t born in a boardroom—they’re forged in moments where stakes are high, information is messy, and people need clarity. That’s the lens we bring to a wide-ranging conversation with Dr. Mike Archdeacon, trauma surgeon and long-serving chair at the University of Cincinnati, on how to navigate leadership without losing the joy of clinical work.

We dig into the real mechanics of leading a modern orthopaedic department: building an executive committee that actually decides, giving vice chairs ownership, and using a predictable cadence to turn hot-button issues into shared choices. Mike breaks down a major communication miss during vendor consolidation and how he’d do it differently—define decision rights early, share constraints, and close the loop with a clear rationale. From AOA’s Chair Forum to intentional mentorship, we explore why peer spaces matter and how to spot and grow emerging leaders with targeted skill building in finance, conflict, philanthropy, and strategy.

If you care about orthopaedic leadership, succession planning, and the balance between the scalpel and the C-suite, this conversation offers a practical, human roadmap. Subscribe, share with a colleague who’s eyeing a leadership role, and leave a review telling us the one leadership habit you’re working on next.

Ready to Rethink How Orthopaedic Leaders are Made? We sit down with Rex C. Haydon, MD, PhD, FAOA, archaeologist turned musculoskeletal oncologist and Second President‑Elect of the American Orthopaedic Association—to trace the ABC Traveling Fellowship from its post‑war roots to its modern role as a launchpad for mid‑career transformation. Across five to six weeks and multiple continents, the fellowship pairs deep academic exchange with the kind of shared experience that forges lifelong mentors, collaborators, and friends. From resourceful solutions in international settings to the power of hosting fellows and paying forward the mentorship you received, this episode makes a compelling case for leaving your comfort zone to grow your career, your community, and your impact.

Fracture fixed, problem solved? Not even close. Dr. Andrea Spiker sits down with two orthopedic leaders, Dr. Marc Swiontkowski and Dr. Kyle Jeray, who helped turn a quiet crisis—osteoporosis-related fractures—into a national movement that’s changing how surgeons practice, teach, and lead.

You’ll hear the untold origin story of Own the Bone and why it succeeded where earlier efforts stalled: simple, reliable interventions, clear follow-up, and a registry that reveals what works. There’s a proven playbook, real people at the AOA ready to help, and shared best practices that make programs sustainable.

Owning bone health is an act of professionalism and empathy—treating the person behind the fracture and preventing the next one. If you’ve wondered how to move from “bone broke, me fix” to truly comprehensive care, this conversation gives you the history, the tools, and the push to start today.

Visit the JBJS Orthopaedic Forum to read Dr. Jeray’s presidential address: https://journals.lww.com/jbjsjournal/abstract/2025/11050/out_of_left_field__leadership_lessons_i_didn_t_see.18.aspx.

David Martin, MD, FAOA takes us on a profound exploration of orthopaedic board certification's past, present, and future landscape. As Executive Medical Director of the American Board of Orthopaedic Surgery (ABOS), Dr. Martin provides podcast host, Dr. Douglas Lundy, rare insights into how the certification process shapes both individual surgeons and the entire profession. Dr. Martin articulates a clear vision that balances competing priorities: "We need to increase the value of board certification and decrease the burden." This tension – maintaining rigorous standards while respecting surgeons' time constraints – drives the evolution of assessment methods. The podcast reveals how the ABOS approaches this challenge.

Whether you're a medical student considering orthopaedics, a resident preparing for boards, or an experienced surgeon maintaining certification, this conversation offers valuable perspective on why rigorous professional standards matter – not just for career advancement, but for patient safety and the profession's continued autonomy. Subscribe now to hear more thought-provoking discussions about the future of orthopaedic surgery.

What if the biggest breakthroughs in joint care are stalled not by science, but by budgets? We sit down with Dr. Josh Jacobs to trace the future of orthopaedic research across funding realities, scientific frontiers, and the mission to keep surgeon scientists in the game. It’s a candid look at how NIH indirect cuts, DOD reductions, and shifting hospital margins collide with the urgent need to tackle periprosthetic joint infection, chronic pain, and the rising burden of osteoarthritis.

Dr. Jacobs explains why NIAMS remains a vital engine for musculoskeletal research, how advocacy can reshape priorities, and why better grant quality—paired with clinically informed study sections—may be the fastest way to win a larger share of federal dollars. 

If you care about the future of joint replacement, surgeon scientist careers, and truly personalized musculoskeletal care, this conversation connects the policy dots with the lab and the OR. Subscribe, share with a colleague who writes grants, and leave a review with your take on where orthopedic research dollars should go next.

What happens when a respected orthopaedic chair steps away from the big title to get back to the OR, residents, and real day-to-day impact? We sit down with Dr. Keith Kenter to unpack a rare leadership arc—building an academic culture in Kalamazoo, navigating post-COVID administrative sprawl, and ultimately returning to Missouri to reclaim core values: teaching, operating, and mentoring. It’s a candid look at ego, identity, and the quiet power of influence without authority.

Dr. Kenter shares how he elevated scholarly activity, promoted faculty, and designed a longitudinal musculoskeletal education program, then watched his role expand across multiple surgical services until the clinical work he loved slipped out of reach. Family, foresight, and timing opened a door at Mizzou, where strong culture and deep bench strength offered collaboration, patient-first focus, and the daily satisfaction of training the next generation.

If the story resonates, follow the show, share with a colleague, and leave a review with your biggest “leading up” takeaway. Your feedback helps more clinicians find conversations that move our profession forward.

Want a real look at how independent orthopaedic groups thrive while hospitals buy up urgent cares, primary care, and the referral rails? Dr. Doug Lundy, AOA host, sits down with Dr. Kimmerly, president at Peachtree Orthopedics in Atlanta, to unpack how a 44-physician practice stays nimble, patient-centered, and profitable in a market dominated by large systems and complex EHR ecosystems. The story isn’t about being the biggest—it’s about building a vertically integrated experience that moves patients from access to outcome with speed and clarity.

If this resonated, follow the show, share it with a colleague who’s weighing independence vs employment, and leave a quick review with your biggest takeaway. Your feedback helps more surgeons find conversations that matter.

What if a health system could be massive and still feel local to every patient it serves? We sit down with Dr. MaCalus Hogan, chair of orthopedic surgery at UPMC, to unpack how a hybrid model—academic, community-employed, and private partners—can deliver scale without sameness. Dr. Hogan shares the leadership habits that shaped his path (mentorship, humility, listening first) and how those habits translate into practical decisions that align surgeons, hospitals, and health plans around value.

We pull back the curtain on horizontal integration—building trust and shared standards across regions—before moving into vertical integration that connects financing, bundles, post-acute care, and data. Dr. Hogan explains how UPMC leveraged CJR-era lessons to create surgeon-built programs for quality and cost, mirrored within a 4M+ member health plan. Expect clear insights on center-of-excellence designations, optimizing post-acute spend, and the realities of TEAMS participation. We also dig into consolidation with eyes wide open: comparing contracts, unlocking economies of scale, and reinvesting savings into community access points like ambulatory surgery centers and subspecialty services where patients actually live.

Looking 15–20 years ahead, Dr. Hogan argues the big will get bigger, but winners will collaborate, not copy-and-paste. Markets differ, payer mixes shift, and culture matters. The future favors systems that listen locally and act decisively—standardizing where it helps, flexing where it counts. If you care about orthopedic leadership, bundles, payer alignment, and how to grow without breaking what works, this conversation offers a grounded playbook.

Enjoy the episode? Follow, share with a colleague, and leave a review with your biggest takeaway—what’s one integration move your market needs next?

A new chair’s first year can feel like drinking from a fire hose—until the patterns emerge. Dr. Doug Lundy speaks with Dr. Jennifer Wolf, Chair of Orthopaedic Surgery and Rehabilitation Medicine at the University of Chicago, to unpack what truly shifts when your role becomes building others: the politics you don’t see until you’re in the seat, the communication cadence that keeps a department aligned, and the quiet decisions that make or break culture.

We also delve into the structural elements of leadership: when to appoint vice chairs, how to select division chiefs fairly and why an application process can reveal motivation more effectively than seniority. 

Whether you’re a surgeon aspiring to leadership or a chair refining your playbook, this conversation offers lessons on culture, structure, and strategy—delivered with humility and practical insight. Subscribe, share with a colleague ready to lead, and leave a review noting the one leadership practice you’d adopt tomorrow.

The future of orthopaedic practice won’t be won by the highest offer or the loudest brand—it’ll be won by groups that can bend without breaking. Dr. Doug Lundy sits down with Dr. Alex Vaccaro of Rothman to unpack how a true megagroup navigates shrinking CMS rates, anesthesia shortages, hiring wars, and private equity. 

Dr. Doug Lundy sits down with two leaders at the forefront of residency education: Dr. Tessa Balach, past chair of the Council of Orthopaedic Residency Directors (CORD), and Dr. Trent Guthrie, current CORD chair to discuss the future of Orthopaedic Education.

Their conversation explores the shift toward competency-based medical education in orthopaedic surgery.  Technology's transformative role in surgical education emerges as another focus of the discussion.

Regardless of your career stage, this discussion provides a crucial perspective on how orthopaedic training is evolving to meet tomorrow's challenges. 

Subscribe to stay updated on future episodes exploring leadership and innovation in orthopedic surgery!

Robotics emerges as another transformative force. While many surgeons remain skeptical, Dr. Chen makes a compelling case for why robotics will eventually become standard.

Perhaps most exciting is the potential to address periprosthetic joint infection (PJI)—what Dr. Chen calls "the holy grail" challenge in joint replacement. From implant coatings that prevent bacterial adhesion to novel technologies that disrupt biofilm formation, the future may include treatments that can eliminate infections without removing well-fixed implants.

What makes a great orthopaedic leader? Dr. Alex Ghanayem, fresh off his term as the 137th President of the American Orthopaedic Association (AOA), shares candid reflections on leadership, legacy, and the future of orthopaedic surgery in this thought-provoking conversation with podcast host, Dr. Doug Lundy.
 
Dr. Ghanayem brings refreshing humility to his assessment of presidential leadership, emphasizing that the organization's strength lies in its committee members and chairs doing the essential work. His greatest satisfaction came not from personal accomplishment but from identifying emerging leaders who will guide orthopaedics through future challenges. 

Hear the advice that resonates far beyond orthopaedics: balance subspecialty expertise with broader engagement, develop interests outside medicine (like Dr. Ghanayem’s own wildlife photography), and recognize that leadership service provides returns far exceeding what you invest. 

Listen to discover how orthopaedic leadership principles might transform your own approach to medicine and career development.

Moving beyond typical discussions of value-based care, Dr. Mather reframes the entire conversation. "Value-based care is financial innovation to solve important healthcare problems," he explains. These problems extend far beyond cost control to address clinician burnout, prior authorization burdens, care gaps, declining profitability, and health equity. For surgeons planning their careers, understanding this broader context proves essential.

The discussion dives deep into why procedural bundles like CJR and BPCI have limitations despite their promise. "Bundles are a building block," Mather notes, explaining their volatility problems and how they've made value-based care appear to be a "joints and spine initiative" rather than engaging entire practices. He then explores the complex world of condition-based bundles, global risk, and capitation models, illustrating why the shift from fee-for-service feels like "entering a dark forest" for many surgeons.

Dr. Rick Wright explores the future of orthopaedic sports medicine, focusing on promising developments in cartilage replacement, meniscus substitution, ACL repair, and innovative rotator cuff treatments. His expert insights reveal how these advancements could transform patient care while addressing the economic realities of implementing cutting-edge treatments.

The healthcare workforce crisis is reshaping American medicine in profound ways that will impact both providers and patients for decades to come. In this eye-opening conversation, Dr. Thomas L Miller, Chief Medical Officer at the University of Utah, reveals how healthcare institutions are navigating the aftermath of what he calls "a bird's eye view of the future" following the pandemic-induced Great Resignation.

What happens when devastating cancer diagnoses transform into manageable chronic conditions? Dr. Terry Peabody, Chair of Orthopaedic Surgery at Northwestern University and past AOA president, takes us on a compelling journey through the evolving landscape of musculoskeletal oncology.

Dr. Peabody shares profound leadership wisdom gained from mentors who taught him that true leadership means "bringing people along with you, not pulling up the ladder." This philosophy has shaped his approach to both patient care and professional development throughout his distinguished career.

Whether you're a healthcare professional or someone whose life has been touched by cancer, this episode offers valuable insights into how leadership, technology, and compassion are shaping the future of orthopaedic oncology. 

The healthcare landscape is transforming at lightning speed, with consolidation reshaping how orthopaedic care is delivered across America. In this eye-opening conversation, Dr. David Jevsevar, CEO of OrthoVirginia, shares his unique perspective gained from navigating nearly every side of this complex equation—from private practice founder to hospital executive to leader of one of the nation's premier orthopaedic mega groups.

Whether you're contemplating your first practice or considering a job change, this conversation offers invaluable guidance from those who've successfully navigated multiple transitions. 

AOA Emerging Leader Aaron Brandt, MD, had a discussion with Antonia Chen, MD, FAOA, and Clayton Nuelle, MD, about transitioning jobs early in your career, and how to decide what your non-negotiables are for your workplace environment. 

What drives these transitions? As our guests reveal, it's often a combination of "push factors" moving you away from your current situation and "pull factors" drawing you toward new opportunities. Despite the statistic that over 50% of surgeons change their first job within three years, these transitions are rarely discussed openly, leaving many physicians feeling isolated when considering a move.

Both physicians share candid insights about creating personal lists of "negotiables" versus "non-negotiables" when evaluating both current and potential positions.  Both surgeons advocate for transparency with leadership when considering opportunities and leveraging mentorship networks to find positions aligned with your evolving career goals. They also discuss practical considerations like understanding contract terms around tail insurance, signing bonuses, and trailing collections before making any move.

Douglas W. Lundy, MD, MBA, FACS, FAOA, discussed the future of orthopaedic trauma with William T. Obremskey, MD, FAOA, Director of Orthopaedic Trauma at Vanderbilt University Medical Center. Dr. Obremskey shares his vision for the future of orthopaedic trauma surgery, focusing on reducing complications through advanced technologies and improved practices.

Perhaps most thought-provoking is Dr. Obremskey's perspective that some of the most impactful advances may not come from fancy technology at all—but from addressing underlying patient factors like smoking cessation and blood sugar control that dramatically affect healing outcomes. The future of trauma care involves both cutting-edge science and fundamental public health initiatives working in tandem.

Peter Murray, MD, FAOA, from the Mayo Clinic shares his groundbreaking insights on hand surgery and leadership. Discover how this unique specialty, sitting at the crossroads of general, plastic, and orthopaedic surgery, is not only evolving but also leading advancements in areas like wound management and peripheral nerve reconstruction. Dr. Murray sheds light on the exciting integration of genetic and regenerative medicine within hand surgery, emphasizing the growing demand for skilled surgeons in this dynamic field.

Explore the cutting-edge developments in orthopaedic fracture treatment, where traditional methods meet innovative techniques. Learn about the transformative role of PCR testing in diagnosing atypical infections and the evolution of treatments for distal radial fractures. From the effectiveness of Volar plates to the promising use of spanning wrist plates for older patients, our discussion highlights a pivotal shift towards less invasive, more adaptable solutions that hold the promise of better patient outcomes.

Finally, we turn our attention to the future of hand therapy and the evolving landscape of hand surgery education. The essential role of certified hand therapists is emphasized, along with emerging therapies like desensitization and mirror therapy. We also contemplate the training of future hand surgeons, where the balance between competency-based education and traditional residency models comes into play. Ending on a note of gratitude, we celebrate the camaraderie among orthopaedic professionals, acknowledging the AOA's support and relishing in 11 years of meaningful exchanges.

Charlie Saltzman, MD, a leader in foot and ankle surgery and former chair of the University of Utah’s Department of Orthopaedics, joins Douglas W. Lundy, MD, MBA, FACS, FAOA, to discuss the future of orthopaedic surgery. Dr. Saltzman shares insights on leadership, collective vision, and community engagement to create thriving teams and advance medical programs.

Join us as we discuss transformative innovations, from potential osteoarthritis treatments to trauma reduction via self-driving cars. Discover how advancements in bone healing and ankle replacements are shaping patient care and redefining the future of orthopaedics.

AOA Emerging Leader, Aaron Brandt, MD, sits down with Professor Bethany Adams (Villanova) and Mimi Peterson, MD (MGH), to discuss the power of allyship and privilege in orthopaedic surgery.  This discussion highlights the importance of DEI forums in fostering challenging yet vital conversations, supported by a three-year curriculum addressing allyship, DEI burnout, and the business aspects of DEI. Effective allyship is a continuous journey.

Explore strategies to drive DEI initiatives with limited resources, leveraging ERGs, collective allyship, and tools like reminder cards to turn intentions into actions. Learn how leaders can create environments where allyship thrives through shared learning and support.

Douglas W. Lundy, MD, MBA, FACS, FAOA, sits down with Hassan R. Mir, MD, MBA, FACS, FAOA to discuss the ethical dynamics and transformative potential of physician-industry relationships. Through his wealth of experience in leadership roles, Dr. Mir guides us through the intricacies of aligning personal passion with professional commitments in the medical field. He opens up about maintaining integrity through transparent, fair market value agreements, and how the "front page test" can serve as a guiding principle for ethical business interactions. Prioritizing patient care while cultivating meaningful industry partnerships stands at the forefront of our discussion, offering a blueprint for those navigating this complex landscape.

As we delve into the evolving roles of physicians as educators, advisors, and innovators within the industry, Dr. Mir sheds light on the balance needed for those aspiring to leadership positions. We explore how younger physicians can effectively engage with the industry through teaching, networking, and research, while also addressing ethical considerations and the importance of transparent disclosure practices. This episode is packed with insights on navigating the rewarding world of physician-industry engagement, the challenges national organizations face in maintaining funding, and the mutual benefits that arise from these vital partnerships. Join us in this compelling conversation to learn strategies for harnessing the potential of physician-industry collaborations.

Unlock the future of orthopaedic surgery as Arun Aneja, MD, PhD, a trailblazer in trauma surgery, unveils groundbreaking advancements in surgical implants. Explore how technology is reshaping the field with fourth-generation intramedullary nails and antibiotic-coated implants that promise to treat complex fractures and minimize complications. Discover the innovative biphasic plates designed to adapt dynamically to the healing needs of fractures, offering a glimpse into a more personalized approach to patient care. Dr. Aneja's pioneering insights reveal the transformative potential of these technologies, redefining the landscape of orthopaedic trauma surgery, one innovation at a time.

Delve into crucial topics such as antibiotic stewardship in orthopaedic procedures, where Dr. Aneja emphasizes the importance of responsible usage to combat resistance. Learn about the cutting-edge attachment of antibiotics to implants for sustained release and the use of growth factors to enhance bone healing. Consider the balance between the benefits of emergent technologies and their financial implications on healthcare systems. This episode serves as an enlightening journey through the latest orthopaedic innovations, offering listeners a detailed look into the exciting trajectory of trauma surgery and its future implications.

Unlock the future of orthopaedic surgery with our enlightening conversation featuring James L. Cook, DVM, PhD, OTSC, a pioneering expert in regenerative orthopaedics. Learn about the transformative potential of cutting-edge treatments, including the innovative combination of Hyaluronic Acid (HA) and Platelet-Rich Plasma (PRP) for joint health. Dr. Cook sheds light on the importance of evidence-based practices, regulatory challenges with mesenchymal stem cells, and the perils of unverified "stem cell" treatments. We emphasize the need for clear guidelines and insurance coverage to responsibly advance this promising field, ensuring patient safety and efficacy.

Discover the groundbreaking advancements in biologic joint regeneration, from the promising results of PRP and Bone Marrow Aspirate Concentrate (BMAC) to the future of biological grafts and tissue-engineered solutions. Dr. Cook discusses the necessity of standardization for consistent outcomes and highlights the crucial role of comprehensive care centers. We also delve into the financial considerations and insurance hurdles that patients face, stressing the importance of integrating these innovative treatments into mainstream orthopaedic care. Join us for an insightful exploration of how regenerative orthopaedics is poised to revolutionize patient care and the future of orthopaedic surgery.

Discover the transformative changes on the horizon for orthopaedic coding and payment models with our esteemed guest, Dr. Adam Bruggeman. Covered are the new CMS-mandated procedural-based bundles, specifically the "team" bundle affecting 25% of US hospitals. Dr. Bruggeman sheds light on the financial and administrative hurdles these mandates bring and compares them to the cost-saving success of physician-led bundles.

Prepare yourself for an in-depth exploration of the evolving landscape of hospital-based healthcare bundles and their profound implications for orthopaedic surgeons. The conversation reveals how these new regulations might shift financial risks between hospitals and doctors, leading to a rare alignment of interests in opposing mandatory bundles. We also dive into the CMMI's push for value-based care and its potential impact on the sustainability of Medicare, putting a spotlight on the delicate balance of cost and care quality.

Join us as Dr. Bruggeman shares his expert views on the future of medical coding, particularly within the contexts of fee-for-service models and ambulatory surgery centers. From CPT and ICD-10 codes to the Resource-Based Relative Value Scale (RUC), we cover the complexities that define this space. We also discuss the slow shift towards value-based care and the promising, albeit underused, concept of condition-based bundles. This episode is packed with insights and foresight into the future of orthopaedic surgery and healthcare reimbursement models.

Can orthopaedic surgeons balance the demands of their profession while navigating complex healthcare systems? Join us as we explore this and more with our special guest, Felix H. “Buddy” Savoie, III, MD, FAOA. Dr. Savoie pulls back the curtain on the dedication required in orthopedic surgery, the challenges of maintaining high standards in patient care despite restrictive regulations, and how different operational models impact the quality of care provided. This isn't just about bones and joints—it's about the heart and soul surgeons pour into their work.

Learn more about global healthcare systems in Great Britain, South Africa, Canada, Australia, and New Zealand. Discover the strengths and pitfalls of national health services and why New Zealand's system stands out for its efficiency. Dr. Savoie sheds light on the significant delays in care in the UK and Canada, and underscores the critical importance of effective communication between physicians and administrators. His insights into rural healthcare challenges, medical training methodologies, and the role of budget constraints offer a well-rounded perspective on the global state of healthcare.

Looking ahead, we discuss the future landscape of orthopaedic surgery, from the evolution of Medicare reimbursements to the potential for employment models and unionization. Dr. Savoie emphasizes the urgent need for legislative changes to ensure sustainable medical practices, while also highlighting the importance of innovation and member engagement within professional healthcare organizations. Whether you're a medical professional or an enthusiast, this episode offers valuable insights into advocacy, the economics of practice, and the evolving field of orthopaedic surgery. Tune in to gain a comprehensive understanding of the future of healthcare from one of its leading voices.

Curious about how the future of orthopaedic surgery scholarly publications is shaping up? This episode features a deep dive with Marc F. Swiontkowski, MD, FAOA who provides an authoritative look at the challenges and opportunities facing the field. From the unintended consequences of open access mandates leading to a surge in subpar journals and paper mills, to the crucial rise in retracted manuscripts due to poor peer review, Dr. Swiontkowski explores every avenue. Also covered is the role of hybrid open access models and the complexities surrounding preprint servers, especially in the wake of the COVID-19 pandemic. This is an unmissable conversation that underscores the need for rigorous peer review and global cooperation to maintain the integrity of orthopaedic research.
 
In another compelling segment, the pitfalls and limitations of using large clinical databases and registries in medical research is assessed. Learn how missing data and skewed populations can skew your conclusions and why it’s crucial to approach these resources with a critical eye. The misuse of statistical methods by some researchers to chase positive associations without a clear research question, and how this can dilute scientific rigor is also discussed. Finally, how academic journals may inflate their impact factors and the transformative—and sometimes troubling—role of AI in academic publishing is explored. This episode is packed with invaluable insights for anyone vested in the future of orthopaedic surgery research and publications.

Unlock the future of orthopaedic residency training as Dr. Douglas W. Lundy sits down with Dr. J. Lawrence Marsh, a leading voice in the field and chair of the Department of Orthopedic Surgery at the University of Iowa Hospitals and Clinics. Dr. Marsh shares a treasure trove of insights on the paradigm shift from a time-based to a competency-based education system, already gaining momentum in countries like Canada, Australia, and the UK. Listen to Dr. Marsh's firsthand experience and wisdom on what these changes mean for the next generation of orthopaedic residents in the US and how they are set to revolutionize medical training.

Discover the intriguing challenges of granting more independence to exceptionally skilled surgical residents and how this can widen the competency gap between them and their peers. We explore the logistical and operational hurdles in transitioning to a competency-based training system and why a well-defined curriculum is critical. Organizations like the ACGME and orthopaedic boards are taking significant steps to implement this new framework, and we discuss the delicate balance needed to integrate competency-based attributes within the traditional time-based structure.

Stay ahead of the curve with the latest advancements in residency training, particularly through practice-based assessments and real-time evaluations using mobile technology. These innovations promise to significantly enhance skill acquisition and feedback, generating vast amounts of data to improve training standards. From basic models to cutting-edge VR simulations, we delve into the essential role of technology in preparing residents for complex surgical tasks. Finally, we contemplate the external forces driving rapid transformation in medical education, emphasizing the urgency for change within the next three years. Join us for an enlightening conversation that promises to reshape the future of orthopaedic education.

How is artificial intelligence revolutionizing orthopaedic surgery, and what can big data teach us about improving patient outcomes across different healthcare systems? In our latest episode, we feature insights from Dr. Wayne Sebastianelli, a leading expert in orthopaedics, as he discusses the transformative role of AI and big data in advancing orthopaedic care. Dr. Sebastianelli provides a comparative analysis of international big data registries, highlighting the differences between systems in the United Kingdom, New Zealand, and the United States, and the impact these systems have on patient care. We also explore the challenges of managing extensive data and the implications of different healthcare models on orthopaedic practices.
 
Leadership development and emotional intelligence are pivotal in ensuring the future success of orthopaedists. Listen as Dr. Sebastianelli shares his vision on balancing manpower and honing leadership skills within the field of orthopaedics. We dive into the collaborative efforts of the AOA, AAOS, and ABOS in addressing key issues like compensation and advocacy while emphasizing the critical role of AI in reducing administrative burdens. Dr. Sebastianelli's rich experiences and leadership roles offer valuable perspectives on preparing the next generation of practitioners. Join us for an enlightening conversation that celebrates Dr. Sebastianelli's contributions and looks ahead to the evolving landscape of orthopedic surgery.

Douglas W. Lundy, MD, MBA, FAOA, interviewed Jim Barber, MD who is an accomplished orthopaedic surgeon who practices in Douglas, Georgia. Dr. Barber shares his compelling journey, the various leadership roles he has embraced, and his experiences enriching a close-knit community despite the geographical limitations of a small town. His story illuminates the challenges and rewards of rural healthcare, showing how one dedicated individual can make a significant impact both locally and nationally.
 
Drs. Lundy and Barber tackle the evolving landscape of rural solo private practice, touching on the mounting pressures from insurance companies, the complexities of electronic medical records, and the growing need for larger teams. Dr. Barber offers his thoughts on state support programs, value-based care, and the pressures of consolidation, while reflecting on the changing dynamics of physician collegiality and scope of practice. Through innovative collaboration with local hospitals and Medicare shared savings programs, various pathways are explored for sustainability and the importance of staying positive and proactive in this challenging environment.

Aaron Brandt, MD, spoke with Anthony Catanzano, MD, a Pediatric Spine and Neuromuscular Surgeon at Duke University, and Erin Honcharuk, MD, a Pediatric Deformity Surgeon at Johns Hopkins University, to discuss the Board Certification Process and their methods for preparation.

While the boards can be a stressful process, all three orthopaedic surgeons emphasized that the examiners want to make sure that you are practicing safe medicine. Drs. Brandt, Honcharuk, and Catanzano highlighted the importance of using proper documentation, redacting all identifying data, and thoroughly reviewing the ABOS guidelines. Using proper documentation will set you and your patient up for future success. Throughout the conversation, they share valuable insights and personal stories about how mentors and colleagues played pivotal roles in their board preparation. Tune in for essential tips and advice to help you navigate this challenging process with confidence. 

Douglas W. Lundy, MD, MBA, FAOA, interviewed Karl Koenig, MD, FAOA, Executive Director and Adult Reconstruction Surgeon at Musculoskeletal Institute for the University of Texas at Austin, to discuss Shifts in Medicare. 

Dr. Koenig touched on the different views for Medicare shifting payment systems and managing budget issues. While America has spent large amounts of money on healthcare, Dr. Koenig believes the payment system needs to be adjusted to improve patient outcomes. It is discussed how Medicare is trying to move in a different direction by creating relationships between the specialists and Accountable Care Organizations (ACOs), so they can work together and achieve the same goals. Drs. Lundy and Koenig transitioned to a discussion on bundle payments; and explained the pros and cons for both physicians and patients. Overall, Dr. Koenig stated there are different views on Medicare, but the goal is to have the surgeons’ incentives be more aligned with the patients, to give them the best care possible.  

Alexander Aleem, MD, FAOA, interviewed Dr. Danny P. Goel, CEO of PrecisionOS, who currently practices in Vancouver, B.C. and is a Clinical Professor in the Department of Orthopedic Surgery at the University of British Columbia, to discuss the role of virtual reality training and surgical simulation in orthopaedics.

Virtual Reality (VR) training is impacting orthopaedics for both residents and educators. The ease of access and affordability of virtual reality education allows residents to practice and be better prepared in the OR, while also allowing the educators to assess the resident’s performance and teach them the best habits and actions to operate at the highest level. While typical training methods give haptic feedback to residents, virtual reality allows both haptic and real data feedback to assess competency. In addition to the different types of feedback that VR provides, it also can help foster mentorship both live or on demand, which helps promote a synchronous learning experience for the mentor and mentee. Dr. Goel expresses his excitement and optimism about the future role that VR and AI will play in the world of orthopaedics to provide the best training to future orthopaedic surgeons.

Dr. Aaron Brandt sat down with James R. Ficke, MD, FACS, FAOA, Department Chair of Johns Hopkins, and Joseph R. Hsu, MD, FAOA, Trauma and Deformity Surgeon at Carolinas Medical Center in Atrium Health in Charlotte, to discuss meaningful mentorship during early career. 

This conversation focuses on what they believe led them on a path to success, and how they have gotten the most out of both experiences – being a mentor and as a mentee. Their discussion communicates the importance of honesty and vulnerability when making relationships, and how this gives both parties the ability to trust one another. Throughout their chat, Drs. Brandt, Ficke, and Hsu, share numerous stories on how their relationships began, and the ways they were able to capitalize on being their genuine selves.  

Douglas W. Lundy, MD, MBA, FAOA, discussed generational shifts and worldview changes in orthopaedics with Lisa Lattanza, MD, FAOA, Chair of Department of Orthopaedics and Rehabilitation at Yale School of Medicine. 

Dr. Lattanza sees a lot of similarities between the residents of today, and those during her time of residency. Although there are generational differences in technology and practices, there are many positive changes that allow orthopaedic surgeons to become competent and successful in their practice. Young faculty prefers to have a culture that supports their professional and personal lives, allowing them to develop their leadership skills and become a working member of society. 

Some of the major differences between generations are the faster adaptation to technology and the increased effort to support diversity amongst the orthopaedic profession. Both factors allow for orthopaedic surgeons to become better poised to solve issues in medicine, use more forward thinking, and expand their leadership to a more inclusive culture. 

Douglas W. Lundy, MD, MBA, FAOA, spoke with Scott Porter, MD, FAOA, Orthopaedic Oncologist and Vice Chair of Operations in the Department of Orthopaedics at Prisma Health, Greenville, South Carolina, to discuss how changes in compensation will affect access to patient care in the future. 

Throughout the discussion, the concepts of rationing healthcare, bundling, and the future of compensation models are evaluated. Dr. Porter explains that compensation affects physician behavior which directly impacts access to patient care. The limitation or creation of access to patient care is created by the physician, while rationing healthcare is only due to overconsumption.

Dr. Porter describes his ideal situation for future patient care, which involves a way to fund a healthcare account owned by the patient. This can be used as a means to pay for healthcare in the future, which can also be gifted and transferred to others. 

In conclusion, Dr. Porter states that it is not a matter of whether changes in compensation will affect access to patient care, but how it will influence access.

Deana Mercer, MD, FAOA, Professor at the University of New Mexico at Albuquerque and Hand and Upper Extremity Surgeon, spoke with Douglas W. Lundy MD, MBA, FAOA, to discuss the misogynistic culture of the orthopaedic specialty. Dr. Mercer explains the changing norms of society and how young orthopaedic surgeons can adjust their views to succeed. Rather than focusing on diversity, biases, and difficulties, orthopaedic departments need to give women the tools to succeed, build their confidence, and empower them to be successful orthopaedic surgeons. Dr. Mercer believes that all prospective orthopaedic surgeons need to engage, challenge others, and be a part of the discussion. 

Dr. Alex Jahangir, MD, FAOA, an Orthopaedic Trauma Surgeon at Vanderbilt University Medical Center, spoke with Dr. Douglas W. Lundy, MD, MBA, FAOA, about the governmental influence on change of culture in orthopaedics.

Dr. Jahangir shared his experience as the Chair of the Board of Health and the COVID-19 Taskforce, during the global pandemic. Taking on this government position allowed Dr. Jahangir to see what matters most to the community of Nashville regarding Health and Safety. He found that physicians need to build relationships with patients so they can have trust in the methods that doctors advocate for. A sense of trust and transparency between government officials and the community are also a necessity to address everyone’s issues. Dr. Jahangir is optimistic about the future of orthopaedics and believes that establishing good relationships and civil discourse are an investment in the successful future of the orthopaedic profession.  

Drs. Douglas W. Lundy, MD, MBA, FAOA and Aaron Brandt, MD, sat down with Dr. Matthew R. Schmitz, MD, FAOA to discuss the development of two new Lessons in Leadership Podcast Series. Dr. Lundy discussed his intention to interview different leaders on the topic of the future in orthopaedics. This primarily involves changes in culture, employment, and technology—factors that have a major effect on the careers of orthopaedic surgeons. Dr. Brandt indicates that different leaders will be interviewed on the best ways to develop skills early in their practice. This includes addressing the importance of meaningful mentorships, finding success at your first job, and being as productive and efficient as possible. By interviewing these leaders about their early career best practices, Dr. Brandt’s goal is to give young orthopaedic surgeons valuable and relevant information as they evolve in their practice. 

Matthew R. Schmitz, MD, FAOA, sat down with the Chief of Surgery at the University of Pennsylvania, Neil P. Sheth, MD, FAOA, to discuss ways that young orthopaedic surgeons can be efficient early in their practice. Throughout their conversation, they articulate three key points to being efficient: managing your attention and energy, finding a work-life balance, and using your time wisely by creating good habits. Not only do they share their tips on finding efficiency early in your career, but they provide real life examples of how they implemented these points in their own lives. 

AOA President, Ann Van Heest, MD, FAOA, connected with Australian Orthopaedic Association (AOA) Past President, Dr. Chris Morrey, to discuss their new programs that have been put into place to diversify the orthopaedic specialty, how the AOA is trying to improve healthcare in regional/rural areas, and how they implemented competency based training into their healthcare system. The Australian Orthopaedic Association is hopeful that the future of orthopaedics will continue to improve by training a diverse, competent fleet of surgeons. to provide equitable healthcare. 

AOA President Ann Van Heest, MD, FAOA, connected with New Zealand Orthopaedic Association (NZOA) President, Haemish Crawford, FRACS, to discuss the structure of orthopaedics in New Zealand, the status of the workforce, and the best way to provide value to young orthopaedic surgeons. The discussion led to an in-depth conversation about the challenges New Zealand orthopaedic surgeons are dealing with, including a lack of healthcare providers, inability to find employment after training, and the lack of resources needed to create a better infrastructure.