When Lisa Lattanza, MD, became chair of orthopedics and rehabilitation at New Haven, Conn.-based Yale School of Medicine, she set out to do something that has long been difficult in her field: intentionally reshape the culture of orthopedic surgery.
For decades, leadership in orthopedics followed a familiar model, the “triple threat” surgeon who excelled as a clinician, researcher and educator. But in today’s healthcare environment, Dr. Lattanza believes that model no longer reflects what departments truly need.
“It’s not really possible anymore to be all things to all people in the really complex climate of health care and education that we have today,” she said.
Instead, she argues, the success of a modern orthopedic program hinges on something less tangible, but far more consequential: culture.
A leadership shift rooted in culture
For Dr. Lattanza, leadership begins with trust and transparency, not just in strategy, but in everyday interactions across clinical care, education and research.
“What matters most in a leader is developing trust and transparency in all of the missions and everything that you do,” she said. That focus is deeply personal. Her decision to pursue a chair role was driven by a desire to change the environment she had experienced throughout her own training.
“One of the reasons that I wanted to become a chair was so that I would have the ability to impact at least one little corner of orthopedic surgery and create a different type of culture than what I was raised in,” she said.
That shift is also reflected in the evolving profile of leadership in orthopedics. While women remain underrepresented, their presence is growing, and with it, a different approach to leading teams.
“There is something about being a woman in this position that also just changes the tone and tenor of the culture,” Dr. Lattanza said.
Redefining how programs recruit talent
At Yale, that cultural transformation is most visible in how the department recruits and evaluates talent. Rather than prioritizing traditional metrics like test scores alone, Dr. Lattanza emphasizes qualities that are harder to quantify but critical to long-term success.
“Does it matter if you were the 99th percentile on the boards or the 79th? I don’t think it does,” she said. “Does it matter if you have integrity, grit and resilience and leadership capabilities? Yes, I think it absolutely does.”
That philosophy has produced measurable results. Yale’s orthopedic residency program is now 60% women and 40% underrepresented in medicine, far exceeding national averages.
But for Dr. Lattanza, those numbers are not the ultimate goal. They reflect a deeper shift toward belonging.
“It’s not a fitting in, it’s a true belonging,” she said.
That sense of belonging, she argues, is essential not only for workforce development, but also for patient care.
“We know that when the people providing care reflect the communities they serve, patient outcomes improve,” she said.
Retention — the missing piece of the puzzle
While much of the industry conversation focuses on recruitment, Dr. Lattanza believes retention is just as critical, and often overlooked.
“It’s not enough to get great people into your residency,” she said. “You also have to recognize that people learn differently and support them where they are.”
That approach requires a shift away from one-size-fits-all training models and toward more individualized support systems.
“It’s not about equality all the time. It’s about equity and giving people what they need to be successful,” she said.
For leaders, that means rethinking how success is defined, and how teams are supported across different stages of their careers.
Innovation that starts with people
Innovation is another defining pillar of Yale’s orthopedic program, but Dr. Lattanza is clear that it must be rooted in purpose, not novelty.
“Innovation spurs more innovation,” she said, describing how a single successful initiative can create momentum across an entire department.
Under her leadership, the department has launched new programs in areas like personalized medicine and applied engineering, while expanding capabilities in 3D surgical planning and complex reconstruction.
Many of these initiatives originate from individual surgeons’ passions, ideas that grow into programs with institutional support.
“It’s my duty to make sure that those things are supported and grow so that our patients can access these things,” she said.
Technology as a path to global access
For Dr. Lattanza, innovation is not just about differentiation, it is also a pathway to expanding access to care.
Advances in 3D planning, augmented reality and remote collaboration could allow surgeons to share expertise across geographic boundaries, bringing complex care to patients who might otherwise go without it.
“If we can figure out how to sit in a room here and guide someone in Africa, India or wherever through a procedure that they have not done before, then that is health equity,” she said.
While that vision is still evolving, it reflects a broader shift in how academic medicine can extend its reach beyond traditional settings.
Rethinking orthopedic education
As the field changes, Dr. Lattanza believes orthopedic education must evolve as well.
Traditional training models, she said, often assume uniformity among trainees, despite clear differences in how individuals learn and develop.
“We look at residency training like everybody is the same, even though a huge percentage of people do not learn that way,” she said.
At Yale, there is increasing emphasis on adapting training to meet individual needs, whether that means different pacing, teaching methods or support structures.
The goal is to produce surgeons who are not only technically skilled, but also deeply human in their approach to care.
“We know that the best surgeons are those that not only are technically excellent but also have human and interpersonal skills,” she said.
The toll of training — and the need for support
That human dimension extends to how Dr. Lattanza views the experience of becoming a surgeon.
“Surgical training is unbelievably difficult,” she said, noting the physical, emotional and social demands placed on trainees.
At the same time, physicians are expected to maintain composure and compassion under pressure, a tension that can take a toll over time.
“I know people who feel beat down by the system,” she said.
Addressing that challenge will require not only cultural change, but also more thoughtful use of technology and system-level support to reduce unnecessary strain on clinicians.
The decision that shapes everything
For leaders building orthopedic programs today, Dr. Lattanza’s advice is clear: Culture is the most important decision, and the one with the greatest long-term impact.
“The most important decision is to be really intentional about the culture of the program,” she said.
That decision shapes everything from recruitment and retention to innovation and patient care.
It also defines a leader’s legacy.
“My legacy will be the people I’ve impacted along the way, those whose careers I’ve helped shape or who’ve learned something from me,” she said.
In a field often focused on technical precision and clinical outcomes, Dr. Lattanza is making a broader case, that the future of orthopedics will be determined not just by what surgeons do, but by how they lead, support and develop the people around them.
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