Healthcare organizations spend millions trying to recruit surgeons, expand market share and build national reputations. Felix “Buddy” Savoie III, MD, thinks many of them start in the wrong place.
Before growth, he argues, comes identity. Before recruiting physicians. Before opening new locations. Before pursuing partnerships. An orthopedic program has to decide who it wants to be.
“I think the biggest thing is establishing a culture and an identity for your program,” Dr. Savoie told Becker’s. “You really need to be true to your own environment and your own roots, and have an idea of what you envision your program to be.”
Few orthopedic leaders have had more opportunities to test that philosophy. An internationally recognized shoulder and elbow surgeon, former president of the American Academy of Orthopaedic Surgeons and longtime chair of New Orleans-based Tulane University’s department of orthopaedics, Dr. Savoie helped rebuild the department after Hurricane Katrina and transform it into a nationally recognized destination for orthopedic care, education and sports medicine.
Looking back, he does not credit that success to a strategic plan or recruitment campaign. He credits culture.
Building a program around who you are
When Dr. Savoie arrived at Tulane after Hurricane Katrina, the challenge was larger than restoring a department. The institution was rebuilding itself. That meant making decisions not only about staffing and resources, but about identity. What would the department stand for? Who would it serve? What kind of surgeons would thrive there?
Under the leadership of then-chair Raoull Rodriguez, MD, the department developed a culture centered on collaboration, mentorship and shared purpose. The experience reinforced a lesson Dr. Savoie still believes many healthcare leaders overlook. Successful organizations are rarely copies of one another.
“Building a program in New Orleans is different than building one in Dallas or New York City,” he said. “You have to be true to your own environment.” Too often, he said, organizations become distracted by what peer institutions are doing instead of focusing on the strengths of their own communities, patient populations and physicians.
The best programs understand who they are. And who they are not.
Why surgeons choose to stay
At a time when orthopedic recruitment has become increasingly competitive, compensation often dominates the conversation. Dr. Savoie does not dismiss its importance. But he believes the physicians who build long careers within an organization are usually motivated by something deeper.
“If financial security is your main goal, private practice may be the best place to go,” he said. Academic medicine offers a different proposition. The opportunity to teach. To mentor. To conduct research. To help shape the next generation of surgeons.
“If you like teaching, and it’s worth giving up a little bit of salary so you have the opportunity to pass on your expertise, then this is a good place for you,” he said.
For leaders, the challenge is not convincing every surgeon to want the same career. It is finding surgeons whose personal goals align with the mission of the institution. Over the years, Dr. Savoie has watched talented physicians leave academic medicine for private practice opportunities.
He never viewed those departures as failures. Rather, he saw them as evidence that different physicians are seeking different things. The key is ensuring the fit is right from the beginning.
The profession’s two families
One area where orthopedic culture has evolved significantly, Dr. Savoie said, is how younger surgeons think about balance. He is not particularly fond of the phrase “work-life balance.” Instead, he offers a different framework.
“I tell younger surgeons that you essentially have two families,” he said. One family exists at home. The other exists inside the hospital.
“It’s your patients. It’s your nurses. It’s your assistants. It’s the person sitting at the front desk. It’s the radiology tech. It’s the folks in the operating room.”
The challenge is not choosing one over the other. It is honoring both.
Dr. Savoie believes younger physicians have helped push the profession in a healthier direction. Early in his career, extensive travel, weekend meetings and constant professional obligations were often viewed as expected sacrifices.
Today’s surgeons are more intentional about protecting time with their families. “I think that’s a wonderful thing,” he said. One of the most meaningful support systems Tulane developed came not from physicians but from their spouses.
For years, Dr. Savoie’s wife, Amy, organized monthly dinners for spouses and partners of orthopedic residents and faculty. The goal was simple: create a community for people navigating the unique demands of life alongside a surgeon.
The program eventually paused during Dr. Savoie’s AAOS presidency before being revived by the spouse of a younger faculty member. To him, the lesson is obvious. Culture extends far beyond the people wearing white coats.
How reputations are really built
Tulane’s orthopedic department routinely attracts patients from well beyond Louisiana. Dr. Savoie does not believe reputation is built through advertising. He believes it is built through contribution.
For nearly four decades, he has traveled extensively to teach courses, lecture at conferences and train surgeons around the world. The purpose was never referrals. It was multiplication.
“If you can make a surgeon a little bit better, think of all the people that surgeon will impact because you helped them,” he said. That idea has shaped much of his career. A surgeon may directly treat thousands of patients. A teacher can influence the care of hundreds of thousands. Over time, those professional relationships create trust.
When difficult cases arise, surgeons often seek advice from people they respect. Sometimes they keep the patient. Sometimes they refer the patient. Either way, reputation grows from expertise, generosity and service to the specialty.
“You don’t get that patient population without a certain level of expertise,” Dr. Savoie said.
The test of every partnership
As hospitals, health systems and physician groups continue pursuing affiliations, acquisitions and partnerships, Dr. Savoie believes many leaders ask the wrong first question.
They focus on what each side gains. He believes healthcare requires a different lens.
“Win-win is actually a real thing,” he said. But in medicine, he argues, two winners are not enough.
“The partners have to understand that at the end of the day, making patient care better is actually why we’re doing this,” he said. The physicians should benefit. The organization should benefit. Most importantly, the patient should benefit.
“The patients have to be No. 1,” he said. “That’s why we’re all here.”
The advice he’d give every orthopedic leader
After decades leading departments, national societies and educational initiatives, Dr. Savoie still returns to the same principle. Before building a program, leaders must decide who they want to be.
Only then can they determine whether the institution, the community and the people around them support that vision.
“If you know your identity, then you’re probably going to succeed and be happy,” Dr. Savoie said. “If you don’t know who you are and don’t have a basis in fact about what you’re doing, then it’s not going to work.”
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
