What orthopedic leaders should avoid to be successful


Four orthopedic and spine surgeons recently connected with Becker's to discuss what leaders in their field should avoid to be successful. 

Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

Next question: What role should private equity play in the orthopedic industry?

Please send responses to Riz Hatton at rhatton@beckershealthcare.com by 5 p.m. CST Thursday, Feb. 16.

Editor's note: Responses have been lightly edited for length and clarity.

Steven Barnett, MD. Chief Medical Officer of Hoag Orthopedic Institute (Irvine, Calif.): 

1. Not putting the patient first in your decision-making. All new ideas, programs, operational changes and technology go through a prism of decision-making at Hoag Orthopedic Institute that asks, "How does this affect the patient?" Medical establishments and physicians can become engrossed in issue discussion and lose sight of the fact that patient care and outcomes come first.

2. Playing politics. High-functioning orthopedic surgeons can be a challenge to lead. Personal issues, friendships and long-standing traditions can affect your decision making. Consensus building is hard but can be achieved. Don't let petty politics sway your goals or strategies in doing what's right for your organization and the patient.

3. Not being transparent. Be a straight shooter. Tell colleagues bad news. Share good news. My goal always is to not have surprises down the road that I could have shared with my colleagues earlier. In the healthcare universe, there are always surprises that arise out of our control (such as COVID-19 or CMS decisions); therefore, be honest and transparent with your colleagues from the get-go.

4. Not paying attention to outcomes. Outcomes from our cases rule the world in our culture at HOI. We collect, measure and share outcome data on every patient case and physician, both internally and externally to our community. This focus creates an environment of accountability. Each surgeon follows his data and data from their colleagues. The subtle competition context of this data generates continuous quality improvement. Skills improve. Outcomes improve. Leading physicians gets easier because patient care and outcomes keep improving.

Nasser Heyrani, MD. Founder and President of Oak Tree Orthopedics (Corona, Calif.): One of my favorite quotes on leadership comes from Abraham Lincoln, who stated: "Nearly all men can stand adversity, but if you want to test a man's character, give him power."

As an orthopedic surgeon in a rapidly changing healthcare system with decreasing reimbursement rates and increasing administrative costs, this quote resonated with me.

Successful orthopedic surgeons in leadership roles must use the power that comes from an elevated position to advocate for their patients and profession. They should avoid resting on the laurels of the many years of hard work required to reach this position to keep up with the rapidly evolving orthopedic needs of their community.

Ehsan Jazini, MD. Spine Surgeon at the Virginia Spine Institute (Reston): The most important pitfall to avoid is giving up. Perseverance is the one quality of success for orthopedic leaders to reach their goals. Today, orthopedic leaders can become inundated with streams of demands that get them off track. Staying focused and persevering is vital to reaching the finish line.

Philip Louie, MD. Spine Surgeon at Virginia Mason Franciscan Health (Seattle):

1. Making decisions without patient care at the center. 

Amid the ongoing stresses of the current orthopedic landscape (short staffing, reimbursement cuts, backlog of patients) and the stresses of the position of leadership — the purpose and goal of all decisions need to be focused on how the safety, efficacy, and value of patient care can be improved. 

2. Bringing in junior partners that are all similar minded with similar skill sets. 

There has been an incredible amount of literature and training on the benefits of diversity in teams. Orthopedic surgery is no different. A diverse team can come up with new and innovative ideas that would not be possible if everyone was the same. Different perspectives often result in better decisions. These elements become amplified in the setting of caring for patient needs. Orthopedic care continues to change and grow, teams need to have the ability to grow with the field, and a diverse team will certainly be more nimble.

3. In a short-staffed world and budget restricted landscape, simply plugging holes without a focus on growth and opportunities. 

It's easy to focus on the immediate concerns and plug the seemingly endless leaks. In a field that prides itself on innovation, growth and a relentless pursuit in improving how we evaluate, treat and rehab our patients, leaders must keep their focus on the larger vision/mission. Urgent and temporizing decisions should all be pieces to a larger puzzle.

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