I had the amazing opportunity to sit down with a generational icon of Orthopaedics, Dr. Jon "JP" Warner. Dr. Warner is the chief of the MGH (Boston) Shoulder Service, a professor at Harvard Medical School, and a top researcher, innovator, and investor (eg: he helped create VuMedi - the most popular platform for virtual surgical education). He founded the Codman Shoulder Society (http://codmansociety.org/), an open forum for discussion of upper-extremity cases, business-x-medicine articles, and global collaboration.
This enlightening conversation covers an incredible range of topics, which I will attempt to detail below. See website for full show notes & sponsor links. Personally, I found that reading Porter's "Redefining Healthcare" and reading blog posts featuring articles by Ioannidis and Krummel, are a great start. Enjoy!
MD Consultants: mdconsultants.ca code ORTHOPOD15
MCAT Prep 101: prep101.com/casting code 350CASTINGPOD
Timestamps:
2:30-4:40: Building a "brand" - how to make yourself externally desirable (eg: titles, affiliations..).
4:45-9:15: His journey to becoming a shoulder surgeon. His framework for making decision relies on analytics and intution, detailed in Simon Sinek's "Start with Why".
9:30-11:30: Critiques of the state of Orthopaedic Surgery research: relying on fragile data and Level 4 evidence to answer uninteresting questions.
11:30-12:30: Cites Paul Grammont as an example of true innovation, "thinking outside the box" requires taking what exists and building something unique, rather than simply regurgitating.
12:30-15:15: Discussing the Stanford Biodesign Innovation program, his biggest regret (prioritizing resume building over innovation).
15:15-18:30: Issues in American healthcare: rising costs are a symptom of misaligned value. "Kaiserization of American Healthcare", where doctors are commoditized and made into pawns (UPMC is a classic case study).
18:30-20:30: Wonderful tour of the greatest Orthopaedic innovators and a common theme: they all exist outside the mainstream institutions.
20:30-22:00: Major Canadian innovations include the Tenet Spider-Arm, Dr. Danny Goel's PrecisionOS.
22:00-23:45: AI will revolutionize Orthopaedics by doing what we can do better and faster.
24:45-27:15: Defining value in healthcare: Codman found that measuring costs, treatments, outcomes, “true costs” was the key.
27:15-31:30: The crucible of medicine: Surgeons get paid to operate, and they do not get paid if they do not operate.
31:30-36:15: Case study: Martini Prostate Cancer group in Germany.
36:15-37:30: Having transparency of outcomes is the most important thing. Key outcomes for patients include reoperation and infection rates.
37:30-39:45: Most US Orthopaedic Programs don’t measure or post PROMs. Hypothesizes that it is due to not wanting to expose themselves.
39:45-40:45: Limitations of Registry data.
40:45-43:15: Canadian fellows and their penchance for innovation.
43:15-45:15: Number one piece of advice to trainees: find a mentor, someone who will help you succeed.
45:15-52:00: Legacy building, what is a worthy legacy, creating the Codman Shoulder Society
Links:
(https://hbr.org/2013/10/the-strategy-that-will-fix-health-care)
(https://journals.lww.com/jbjsjournal/Fulltext/2007/02000/The_Reverse_Total_Shoulder_Prosthesis__The_New_Kid.1.aspx)
(https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124)