Lessons in Orthopaedic Leadership: An AOA Podcast
Lessons in Orthopaedic Leadership: An AOA Podcast
The Global Landscape of Orthopaedic Care and Professional Advocacy: Insights from Felix H. “Buddy” Savoie, III, MD, FAOA
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, the esteemed 90th president of the American Academy of Orthopaedic Surgeons. 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.
Welcome to the AOA Future in Orthopedic Surgery podcast series. This AOA podcast series will focus on the future in orthopedic surgery and the impact on leaders in our profession. These podcasts will focus on the vast spectrum of change that will occur as the future reveals itself self. We will consider changes as they occur in the domains of culture, employment, technology, scope of practice, compensation and other areas. My name is Doug Lundy, host for this podcast series. Joining us today is Dr Buddy Savoie.
Speaker 2:Dr Savoie is an internationally renowned expert in areas of shoulder and elbow surgery, as well as sports medicine. He's the chairman of the Department of Orthopedics at the Tulane School of Medicine and the Ray J Haddad Professor of Orthopedic Surgery. In 2022, dr Savoy became the 90th president of the American Academy of Orthopedic Surgeons. He's also been president of the American Shoulder and Elbow Society, the Arthroscopy Association of North America, the Orthopedic Learning Center and the Louisiana Orthopedic Association. He served on the boards of ANA, the International Society of Arthroscopy, knee Surgery and Orthopedic sports medicine. He also serves as the sports medicine advisory committee of the Louisiana High School Athletic Association.
Speaker 2:Dr Savoie is board certified in orthopedic surgery and sports medicine. He's a graduate of the Louisiana State University School of Medicine in New Orleans. He completed his internship and residency at the University of Mississippi Medical Center in Jackson Mississippi. He added additional training and multiple fellowships in sports medicine and arthroscopy at the Medical College of Wisconsin, the Mayo Clinic, the AO International Fellowship in Basel, switzerland, the Orthopedic Research at Richmond, virginia, and at Fowler Kennedy Sports Medicine in London, ontario. Dr Savoie, thank you and welcome to the podcast series, sir.
Speaker 3:Thank you, Dr Lindy. It's an honor to be here.
Speaker 2:Well, buddy, you and I have known each other well.
Speaker 2:You are one of my favorite leaders in orthopedic surgery and, as you know and as we discussed on this series, we specifically target our discussions to areas that our speakers are specifically expert in. However, you have had a unique experience that few members of our profession have had, whereas you have sat on the perch the absolute pinnacle of arguably the most powerful orthopedic organization in the United States and in much of the world, in terms of seeing the entire spectrum, the entire scope of orthopedic surgery, both the good and the bad. So, instead of targeting in one specific area, we like in this podcast right here, just to look into the mind of Buddy Savoie. What was your perception of after sitting in that incredible position and now having a little bit over a year to reflect and consider what you learned, what you did in the middle of all that? Plus, you know you had to do the carousel afterwards. Where are we going as a profession? You take this anywhere. You need to take it, because your insight is going to be absolutely valuable.
Speaker 3:I think it's a great question and it's a wonderful concept to think about and usually when people ask me, I sort of ask if they want the good or the bad or really what I think, and so you sort of separate fact and impression. I will tell you that the most wonderful thing about serving the academy and serving our membership and then actually touring around the world is the many great physicians that we have. It's impressive how, across the world, orthopedics is just it's got to be the best medical subspecialty in the world and the people are caring, they really care about their patients, they want their patients to do well and for most of us you and I, doug, made the same way there's nothing that we wouldn't do for our patients. I mean, it's the extra mile, whatever we do. You know pay scale, all these other things just goes out the window with the joy of taking care of our patients, and that's refreshing.
Speaker 3:I can tell you that when I was president of the academy, there was a lot of passion amongst our membership about things that prevent that from happening, and you can argue right side, left side, up or down, however you want to do it, it doesn't make any difference because we all center on this patient care phenomenon and how to make sure that we can continue to do it. That being said, there are strong headwinds around the world which are quite impressive, and I gave a talk at the British Orthopedic Association on how to maintain excellence in a culture that demands mediocrity, and I think one of the things that the AOA is famous for is leadership, and I think that as we do these things, maintaining that focus on excellence as surgeons, excellence in patient care is going to be harder and harder. To sort of maintain that requirement. You have folks that are trying to standardize everything we do in our academies. Cpgs, clinical practice guidelines are really designed to help, but as these get sort of utilized by insurance companies and they use it to deny care rather than as a mechanism to create better care, that's a problem.
Speaker 3:The academy needs data. The registries are important, but I think our colleagues justifiably so, fear that that data could be used against them. And you know, if you have a trauma registry and maybe everybody doesn't treat a broken femur the same way maybe you're held accountable, but in many ways it's good but threatening at the same time. So I think if we're going to have the discussion, there's a plethora of avenues to look at. I think, if we focus on this, how do we maintain excellence, how do we maintain excellence in training? How do we instill in our young physicians, who are residents or fellows, that desire and need to get better, when people are putting more and more rules in play that prevent that? So you know, I think that any of those topics we'd be willing to look at the reimbursement issues, the where you operate, how you operate, venture capital versus private groups, versus academics but because the same problem is across the board when you look at it.
Speaker 2:It's very refreshing to hear your initial comments on the quality of our colleagues across the planet and their motivations therein.
Speaker 3:Who, and then he and ann transitioned, and so wayne and michelle were fabulous, and you know the way the carousel works you drop somebody every time, so you just get to know a couple, start to enjoy them and then they drop off and then somebody else comes on. So we're losing wayne and michelle. We're thinking, well, this can't be as good. And then ann and greg van he's come on and we spent the year with them and I just came to the AOA meeting in St Louis, really mostly to see Greg and Ann.
Speaker 3:The meeting was great and the seminars were great and I enjoyed all that. But even Amy said, and my wife said, why are we going to this meeting? I said we're going to see Ann and Greg and our friends and she said you never do that. And I said, well, I'm doing it for this couple because not only is she a great leader and wonderful, but we had wonderful times together. So I admire her, I respect her, I think her opinions are marvelous and I learn something every time I talk to her. But just having she and Greg and sitting and visiting with Amy and I was one of the joyous experiences of the year. It was absolutely fantastic.
Speaker 2:That is fantastic, and Wayne's a sports guy like you, so it's good to be with Ann who does something. I mean she's, so that's completely different.
Speaker 3:Yeah, so it was great. I mean, we had a wonderful time, the folks were terrific, as always, and you know the difference in perspective and especially and when we would do talks together. She said, well, buddy represents just the regular membership in the United States and I represent the leadership. She said, well, buddy represents just the regular membership in the United States and I represent the leadership, and you know I don't disagree at all.
Speaker 3:I think that's true and my job as president of the academy is to take care of our folks in practice and let them be able to take care of their patients and anything that interfered with that. I think that's the academy's role to prevent that we're incredibly lucky that we have Adam Brueggemann and Wayne Johnson heading up our lobbying group.
Speaker 3:Adam's head of the Council on Advocacy and he's taking it in a whole different direction and Wayne's trying to get more money in the PAC. I mean we've got to build a lobby, we've got to protect our practice. Everybody knows and this will go to the pessimistic side if you deal with this you know our pay on CMS pay has been decreasing every year and they sit down and they have to do it and they cut budget based on our doctors. If you look over the last 21 years our pay scale has not just stayed flat, it's actually declined in terms of relative value and spending power and everything else where our expenses have gone up. And that was a deal cut 20 something 25, 30 years ago where they took physicians out of the cost of living increase. So we should right now you get paid on CMS about $32 in RVU. If you simply factor in cost of living over the last 21 years, that should be $68. And it got traded off.
Speaker 3:The AMA did that and they regret it as well.
Speaker 3:So it's not like oh, they're the enemy or anything, but Adam has been forging alliances with American College of Surgeons, like you and I did on the gun issue, so where we can lobby together, and then you and I and the OTA did that one, but it's more like OK, where does this look at With the AMA?
Speaker 3:Prior authorization is a big deal for their doctors as well as for surgeons, so that becomes a big deal. And Adam has forged that path forward and it's been really good. We're still hoping that things like that, where we can lobby together, are very important. So it's nice to see that mechanism start to come into play. And then you know, traveling to almost every state in the union over the past few years and visiting with the doctors again, it's so reassuring how well they take care of folks. At the same time, they need to know that they have somebody which is the American Academy of Orthopedic Surgeons stressing the importance of their ability to take care of patients and to get all these other factors out of the way. So that makes you optimistic that maybe altogether not apart, but altogether we can move forward and fix some of the problems.
Speaker 2:So while you are on carousel and y'all go to England, Australia, New, Zealand what am I missing? Canada?
Speaker 3:South.
Speaker 2:Africa, South Africa. That's what I was missing. You got to see, and it's not just hearing about it or reading about it, you're actually in the culture, hanging out with their leadership, going to their meeting with their surgeons. Is there any insights that you gained on the future of orthopedic surgery just from that incredibly broad exposure across the English-speaking orthopedic associations?
Speaker 3:Yes, very interesting National Health Service. It's quite interesting. The doctors and even the patients that were working in that system and we in the US sort of downplayed a lot, but they actually were very supportive of their system. They thought that providing care across the board to everyone somewhat equally was good. They were very frustrated by the delays in care, about the ability to take care of folks being trumped sometimes by budget issues, and so it's a big deal for the government at that point. Patients are simply budget items and so you can go back and do that.
Speaker 3:Now the flip of it comes back to us as physicians are do we really need to be doing what we're doing, and are we doing the most cost-effective but efficient and best way to do it? So looking at the national health service in great britain, south africa system is very different. Canada excuse me, it's much like great britain, australia and new zealand very different. They have different methods but in general everybody is insured some way. But they also have the option except in great britain and canada to have private insurance and flip out of that system. And I think New Zealand and Australia's system, where you have a base national health system in this country, would sort of be Medicare for all, because the base system pays a decent amount. But you can always opt out for private insurance, for private insurance, and the thing I really liked about New Zealand system is that you are automatically in the national health system. At any given time you can opt out and get private insurance and the insurer has to give it to you. So you have home insurance, you have car insurance and you can go to these people and say I want to buy health insurance. You don't have to tell them it's because I just tore my rotator cuff and I need to have it fixed and I can't wait nine months for the National Health Service to fix it. I got to get back to work and they have to take you, they have to insure you, they have to pay for the whatever it is that you need and then but you have to stay and you pay the extra premium for a full year. You can't opt in for a month and opt out. So it's. I think it makes everything a bit more efficient when you can kind of go back and forth. It makes both sides better. So it's interesting looking at everyone and how they handle things. Delays in Canada and Great Britain are are in the UK are almost insurmountable it's a year to get a total hip or total knee done. And because it's a budget item enough.
Speaker 3:One of my favorite questions I think it was in Canada, because we opened the carousel up for questions and this gentleman surgeon in the audience raised his hand. He says well, my administrator and I are on exactly the same page about patient care and how do we make things happen. And so he got kind of sort of diffuse answers from a few people and I said you're not on the same page, You're not friends. You have to learn to speak his language To him. You are a budget cost item. Your patients are a budget cost item because at the end of the day he has to balance a spreadsheet. So to think that even though he may talk to you and be a really nice guy or girl and say, yeah, I'm really worried about your patients, At the end of the day he has to make his spreadsheet balance. So it's your job, if you want to take care of your patients, to learn how to speak spreadsheet mentality. Don't go to him and say I need these 10 things without showing him how it's going to be effective. If you can show him that if he invests some money in your patients or in your care, return on investment is going to be X and it'll fix a column in his spreadsheet to look better. Could be patient satisfaction, it could be efficiency of care.
Speaker 3:But that cost of care episode, which is where physicians lose out because we think of well, I have a broken bone, I'm going to fix a broken bone and then my part's done, I'm OK. But the budget? People are looking at it. While they're coming in, they're getting x-rays. This is an ER visit. Now you are in a CT scan, Now you are in an MRI scan. Then you do an operation and now you send them to therapy and anesthesia charged me a lot. They did a block and now they're still in therapy. My episode of care was very expensive and then you wonder why we don't get paid enough or other people don't, because we don't manage that whole episode of care.
Speaker 3:Orthopedics to win, we're going to have to manage the episode of care all of it. So that part of it was very intriguing and in every country that system was a problem. Rural health care is a problem. People don't want to go to practice in small towns. Australia. That's a devastating problem. How do you do emergency care in rural areas when you don't have a hospital, because people don't want to go to hospitals?
Speaker 3:Also another problem you know trainees.
Speaker 3:Are we training them the way we're supposed to train them, and are they getting to learn a lot?
Speaker 3:Now that the breadth of knowledge you need to learn in orthopedics is so big, how do we teach them every part of this, or should we be moving them into a more specialized training sooner? You know, in most of the other countries you finish med school and you just basically do general medical care for a couple of years and then you do general surgical care for a couple of years and then you move into your residency and then fellowship. So they're more experienced when they start, but the experience is not necessarily great. So there's a million things when you look around the world that some places could do better, and, having said that, they all look to the US to figure out where the path forward is, and so it's quite interesting and it's an awesome responsibility to know and to try to talk about this, and it was fun to talk about mistakes. We've made things we've given up that we shouldn't have and where we've ceded control, where we should be taking it back and how?
Speaker 2:to make it better. Did you get a sense of optimism, bullishness or pessimistic bearishness from the different societies, the different leaders in the carousels of the societies that you visited? So it's interesting In terms of the future, in terms of where we're going.
Speaker 3:No, it's great, so everybody's worried about it. Everybody looks at the downside. It's just like in our country, and we can talk about that in a little bit, if you want but, everybody's trying to make sure that we can take care of patients and they're concerned.
Speaker 3:They're concerned that we're not training a younger group of doctors like we should, that our younger colleagues don't necessarily have the same commitment that we did. And the most common thing is call. Our younger docs want to get paid for call. That's not unreasonable. But older folks are used to just having to take calls part of the job. But in any other profession if you have to work extra you get paid overtime. That's not an unreasonable thing for our young doctors to want that.
Speaker 3:I mean, work-life balance doesn't really apply to orthopedics very well and part of that is our own fault because we love what we do. But I will tell you that these younger doctors wanting Sundays off is not necessarily a bad thing. I mean, I grew up going to meetings, leaving on Friday after a full day of work and a full week of work and going to a meeting on Friday night, saturday, sunday, getting back home by 1030 or 11 o'clock, going right back to work on Monday, and it's kind of nice to be home on Sunday. So I think when you look at where people are thinking across the board, they worry about the future. They know that some of the changes are good, some are not as good, but in general, most people think we're going to be okay.
Speaker 3:The biggest question everyone has, and the biggest concern and it should be in this country too is how are we going to pay for care? Who's going to fund the bill to take care of folks? Because you're getting better treatments but those treatments are more expensive. You're getting more people that are retiring from the workforce. Who's going to take care of them? Do we have enough doctors to do that? Do we have enough trainees to do that? And most every country, just like ours, is either woefully or a little bit short on training and getting in the number of people you need to take care of folks.
Speaker 2:Fascinating. So that was the international side. You said you had some insights on the US side as well from that.
Speaker 3:So the pessimistic view of the US side is that by 2028, if nothing changes with CMS, and to our private practice colleagues and to our VC folks and our academic folks, everything ties into Medicare. So if you have a commercial insurance, you have Blue Cross, you have United, they're restricting you more and more but their payments are usually tied to Medicare. In 2028, if we can't change anything, the reimbursement for Medicare patients, the reimbursement for Medicare patients, which will account for probably 50% of our country by then, is going to cross your expense line. Our expenses stay the same and reimbursement continues to drop Right around 2028, that's going to cross and you will not be able to make a living seeing patients because the multiples are going to happen. So something has to change before then because there's no way to decrease your overhead enough and still take care of folks with that amount of reimbursement. So that's why the Academy and Adam are lobbying so hard to make that not happen.
Speaker 3:So the pessimistic view is that we can't get anything across. Congress restricts this, they decide doctors make too much money anyway and everybody goes to an employment model. Well, the plus side of an employment model is, if 85 percent of us are employed, we can unionize. We can unionize and demand a better wage, and we can tie it in. I'll take a couple of years I went 30 or 31 before that happens, and hopefully with good leadership. The problem then is you hold the government hostage to make a better pay and guess what they'll do? They'll outlaw the union, yeah, and then we're right back where we were, which no leverage at all in how to do it.
Speaker 3:More simple thing is get everybody to contribute to the PAC. Start talking to your congressmen and your senators and just explain this to them in a simple term that they can understand that I'm not going to be able to take care of your constituents. Your constituents are the people that vote for you. I am their doctor, I'm your doctor. If you can help me throw me a bone here and help us out a little bit, then we can keep taking care of these people because those people vote.
Speaker 3:But if I start saying that my congressman doesn't want me to get paid to take care of you and I can't afford to take care of you anymore, or I'd love to see you as a patient, but I can only see X number of people a day because that's the only time frame they let me do it. You know it'll be six months before I can tend to be broken ankle. That's a problem. So it'd be very interesting to see. I tend to be on the optimistic side. I think orthopedic surgeons especially are very creative and will figure out a way to take care of people. But it's not like we're not fighting headwinds. That would be nice not to have Right right.
Speaker 2:Now, a big function or purpose or mission of the AAOS is education. Where do you see academy education moving as we move into the future?
Speaker 3:So what I hope to see, and I ended up dealing with some crises when I was president of the academy. But one of my goals was first.
Speaker 3:One was patient care, to make it easier for our guys and girls to take care of patients. But the second one was to try to improve our educational outlook, so to speak. And I think the academy does best when we do things with our specialist societies and I think that that comes out the best when we partner with. If we want to do a shoulder course, partner with shoulder and elbow surgery, make it very fair for them, don't just take over the course and run it. You know, do a give and take kind of thing where everybody, if the course makes money, you make a little bit of money, if it loses money, you lose a little bit of money. But I think partnering with our subspecialty societies to provide education is going to be critically important. The second thing is I think we need to tailor those educational offerings to the position where they are. I think that in this day and age, you know you and I learn by getting a cadaver and going and dissecting it out, figuring out what's going on, going to the library to read a book With our young doctors it's at the palm of their hand. You ask them a question, they can look it up right there on their phone and give you five references in a minute, so that part of it is quicker. They also learn by video more so than by anything else, and I think, changing that educational platform into augmented reality, virtual reality, where they have goggles and they have some haptics in their hands, it's not like going to find a simulator to work with. They're going to have it right there, just like you and I are talking on the laptop. It'll be the same thing. They're going to be able to do that and you'll do really well, and I think education will go that way. I think you'll see a lot of partnerships. I think you'll see a lot more augmented reality.
Speaker 3:I think that that's going to, unfortunately, maybe allow some standardization, but I do think the people that are coming into orthopedics will be just as creative in how they design new solutions for patients as we were, you know, 40 years ago. I think all this is going to get better and better because we have great people. They're very smart, they learn very quickly and I think there's more knowledge at their fingertips and it's easier to access. So I think that increasing knowledge is going to be much bigger. My biggest fear is that we standardize it across the world, and I would not like to see that. I want to see creativity. I think creativity breeds new things which the world and I would not like to see that. I want to see creativity. I think creativity breeds new things which help people, and I think that's probably better than having everybody know the same thing at the same time.
Speaker 2:Speaking of which and you kind of segued right into that what about innovation? I know the AOS has, I know, under the council on quality and research, innovation is kind of baked in that to a degree. What do you see innovation headed in as we move into the future?
Speaker 3:So innovation by definition is not going to be with a big organization.
Speaker 3:Innovation is one individual coming up with a new solution. You and I have done that for many years. Where a patient comes in, they have a problem current stuff's not available for it. Let me design something that I can use Now. My problem is that I did that for probably 25 years and just gave it away to companies so that they could. All I wanted to do is make me a toy. I would say I need this, and they would make it and not get it, not make it work, and that would be fine. And then next thing I see it's on a, on pamphlets or somebody. They're doing all that stuff to make it work. So, but I think innovation doesn't do that way.
Speaker 3:Now, what the academy can do, what the arthroscopy association is doing, I'm sure the trauma association is they'll have areas where you can bring some an idea in.
Speaker 3:I know with the arthroscopy association, ray thal has done some of this for them, where you raise very creative he designed uh, not the first, not the same curve for for arthroscopy Brilliant guy. But you can bring an idea in and Ray can help you and maybe they'll give you a little seed grant to bring this up into where it's available for commercial use and you get to keep your percentage, and the Academy has an innovation lab that will help you kind of at least show you the ropes. Nobody's trying to steal the ideas. We're just trying to create that pathway. We have an innovation area at Tulane for the same thing. So I think those kinds of things can happen if you already have the idea and you see a need. So the creativity comes in and just trying to take care of your patients seeing something that maybe the current equipment, technology, something doesn't fit, that's always going to be an individual person saying I need something better and that person will make it happen and organizations can help that.
Speaker 2:But I don't think as an organization you're going to create new innovation in general, Speaking of organizations, every organization I'm aware of the Academy, the Specialty Societies, the State Orthopedic Associations, the ACS put them all together, it doesn't matter. Every one of them are feeling the impact of member apathy and disengagement. You and I are reading off the same script in terms of what we would say on that. But what is the future? And a lot of people blame it with hospital employment. Right, if I'm hospital, if I'm employed by the hospital, then I'm insulated, they think, from a lot of the advocacy issues that you, like you, talked about before, which you and I both know they're not. It's just there. They are to a degree insulated, but the pain is going to be just as real. But getting back to the whole idea of our professional organizations, what's the future of our professional organizations and what can we expect from the AOA, the AOS, specialty societies, the state orthopedic societies, in the next 10 to 15 years? I think they have to justify relevance.
Speaker 3:I think it's really difficult and you have to hit home to that. It's interesting traveling around the States and with some of the controversial issues that usually started with someone upset saying I'm gonna drop my academy membership because of this and on the one hand.
Speaker 3:I'm saying thank you for calling, love, talking to you. I appreciate your passion. Let's go through this and see if we can perhaps meet a common ground Now. I will tell you by the end of the year. Having two or three calls almost every night with someone who is upset kind of wears you down a bit. So you're still trying to make things work out for the best and I think the hard part for every organization is going to be to show relevance to where that individual practitioner is in practice. What can you do that makes them feel that membership in your organization is important? We can talk all day about having advocacy, and it's very important, and you've got to have a seat at the table or you'll be the food on the table. But by the same token, we've got to reach out to our guys and girls. You know, private practice or someone that's employed by a hospital in Allentown, pennsylvania, may have something totally different. It's the job of the academy to reach out to him or her and have things available that will help their practice, show them what's going on, and that's really tough because how to contact them and how to make it worthwhile and not just another email to delete or another text message or another you know spam phone call that you know invest in timeshare. That makes it really difficult, and so to get someone's attention and keep it is important.
Speaker 3:What the academy has done and most societies have done is to reach out to med students and start talking to them early about the importance of this and what you should do as a student to help the profession that you hope to join. So if you're a med student and you want to do orthopedics, what do you do as a med student to make sure that when you're an orthopedic resident, your practice is still going to be good? If you're a resident, what are you going to do now to make sure that your practice, whatever practice it is, stays good? So where's that importance? And I think we do a poor job. I'm sure you do a great job, but I think at Tulane we could sure do a much better job of teaching basic economics of practice to our residents. Now you could also argue that part of that is they're not interested. They're trying to learn how to, you know, learn the anatomy and how to operate and how to do stuff. By the same token, we seem to keep it in play that this is very important.
Speaker 3:I think it's embarrassing that 12 to 15 percent of our membership across the country contribute to the PAC. That's embarrassing, right. I mean trial lawyers have 100 percent commitment and contribution and, having said that, we're the second largest PAC on Capitol Hill. Only anesthesiologists are above us, and not by much. So even with that small percentage, we still do a good job.
Speaker 3:But I think talking to these people about and making it personal, and making it personal and that's where our organizations have got to hit things, because that's where we're going to run into trouble. No matter what practice you're in, if you're in a hospital practice, what you get paid is going to be based on the private guys out in town. That's it. And if those private guys go away, you have nothing to base your practice on other than what the hospital administrator decides he wants to pay you. And rest assured, they'll have numbers, they'll have all the data and they can say people across the board do this. You got to have that data too. We you know if you belong to the Academy, if you belong to AOA, you belong to AOSSM. Maybe you can get that data and use it to argue your position. I think that's critically important.
Speaker 2:John Gill did a phenomenal job as PAC chair, following Stu. I mean, he all, both of those guys were just absolutely knocking it out of the park, and probably the best person that I can think of to follow either of the either one of them is Wayne Johnson, who is continuing to carry the torch, so you're pretty good yourself, though. Yeah Well, thank you, but to your point, adam reinvented the whole council and has really taken it in a strong direction.
Speaker 3:He is truly brilliant. I got to say Kevin Bozick gave me his name and we appointed him and he said it's a really smart guy. And I talked to him I'm like, wow, this guy is sharp I mean I'd like to be in practice with him. We went back into private practice and went away from this. He'd be a guy to work with.
Speaker 2:We actually interviewed him on this series he'd be a guy to work with.
Speaker 3:We actually interviewed him on this series, uh.
Speaker 2:So that's pretty great, brilliant guy and he's truly amazing. I think his will come out before this one. If not, people will be wondering what I'm talking about. But two questions. I'm gonna throw through curveballs they're not hardballs with curveballs at you. So you've done it all. You have you've done it all a young buddy, savoie. Let's do some kind of jujitsu thing and make you pop back out when you're 30 years old, just finishing your sports fellowship and, if I recall, when your first practice in private practice in Mississippi yeah, I actually went to University of Mississippi in academics for a couple years and then I came to Louisiana and then came, then went to Jackson and stayed there 25 years and then came down to New Orleans after Hurricane Katrina.
Speaker 3:That's right, that's right.
Speaker 2:So a brand new buddy Savoie coming out of sports medicine fellowship. Knowing what you know now, what advice would you give that young buddy Savoie for his career?
Speaker 3:that young buddy Savoie for his career.
Speaker 1:I think the best advice is what my dad told me when you get when I got started and he said you know, there's always going to be smarter, more brilliant.
Speaker 3:There'll be people out there that are just really good at what they do. But the one thing you can control, you can control effort. And so I, from my grandfather, from my great-grandfather everybody we grew up on a farm Farmers know how to work hard and you worry about things a lot and you worry about the weather and things you can't control. So I think if I was coming out, I would just say stay true to yourself. You know, take really good care of your patients. Every patient is treat them like your mom, your father. You know, make sure that you're taking care of them as best you can and if there's something you can do, don't say, well, that's too hard or it's I'm too tired or I don't have enough energy to do it. You got to make it happen and I think if you do that, everything else works out great.
Speaker 3:I mean, I never started off to be president of anything. I just want to take care of my folks and it seemed like volunteering and doing the things that we ended up doing allowed that to happen. And you know, I was incredibly blessed and lucky where those things that were important to me in patient care also were important to other people, and so by doing the things I've done, I've helped them take care of more people and made it easier for them, and I think that's all we can do. All we can do is take care of each other. So I would tell me, maybe don't quite get so carried away with how much fun you're having operating, doing from six in the morning until midnight, three days a week In as many cases.
Speaker 3:Probably not reasonable in this day and age anyway, but it was then. But I think that I think just make sure you maintain your focus on patient care. Everybody gets sidetracked at times, and the times I regret, looking back over the last 40 years, are the times where I went in a different direction, where taking care of my patients didn't come first. Family didn't come first. You know, my church and my God didn't come first and they have to come first, and then after that, you know, the rest of the stuff can happen.
Speaker 2:Very, very well said. Everybody needs to listen to that. Well, Dr Savoie, thank you so much. It's been an absolute pleasure talking with you about the future in orthopedic surgery from a position that very few people ever get to sit at. It's a hard earned position, it's well-deserved, but y'all being very close to the presidential line when I was on the council on advocacy y'all work tirelessly hard and get beat up pretty good in that position. So appreciate your efforts as Academy president and we appreciate you being on the podcast series today, sir. Well, it's been my honor.
Speaker 2:Doug, thank you so much and y'all stay tuned for other editions of the future and orthopedic surgery podcast series. Thank you.