Ladies and gentlemen, welcome back to another episode of Couple of Nukes. As always, I'm your host, Mr. Whiskey. And today we are going back into the world of healthcare. I know we dove into that subject a few times over the past few weeks, uh, but we're going in a different direction. We're not going to be focusing on medications today or biology, but about leadership, human connection and the importance of all of that when it comes to taking care of patients.
There is nothing worse than needing a surgery. dying, being sick, whatever it may be, whatever brings you to a doctor or a specialist. It can be a very scary time filled with anxiety, depression, and so many thoughts. And it is so important for our health care providers, whether nurses or doctors or surgeons, to provide excellent leadership that will trickle down to everyone else working with them.
And that will translate over to the patient feeling comfortable, Feeling relaxed and being able to properly and honestly communicate. And we're going to talk about all those roles and some examples in the real world of where we've seen that really lacking and where we've seen it excel. And we are here with Dr.
Cameron Roth to cover all of that today. Dr. Roth, would you please go ahead and introduce yourself for us? Thanks a lot for having me. My name is Cameron Roth. I'm one of the orthopedic surgeons here. I specialize in shoulder, elbow, and knee. Wrist and hand surgery. I work in mostly the Phoenix area. I live here in Scottsdale, Arizona, and I think everything that you just brought up are fantastic topics and hopefully We can do a good job synthesizing them for people and give people the information that they need so they can feel more comfortable when they're dealing with medical problems, whether it's personally with their family or friends.
So looking forward to it. Yeah. And it's important to remember that, uh, doctors and surgeons and anyone in the healthcare industry is also, uh, they're just people, right? So they're not always perfect. Right. And they have bad days too. Uh, Actually, you know, to be honest, we discussed this in a recent episode.
Most of y'all are working long hours, rotating hours, and, uh, dealing with people whose lives are falling apart. You know, it's just like, uh, you know, a firefighter said the other day about the firefighting industry, same for. Uh, you know, your days run on people's worst days, you know, so it can cause a lot of situations that are unique.
And one thing I want to go over, Dr. Roth, is anyone reading your bio online can see, uh, not only did you go to medical school and in other forms of college, but it mentions fellowship training quite a bit. that you're a fellowship trained doctor. What exactly does that mean? And how does that differentiate you from other doctors in the same field?
That's a great question. So, uh, fellowship is just an extra year, at least for orthopedic surgery. It's an extra year of what we call subspecialty training. So in orthopedics, you do, uh, five years of all orthopedic surgery. So you learn how to replace knees and hips, how to do spine surgery on children. Um, how to do hand surgery, shoulder surgery, et cetera.
And then, um, I chose to do an extra year of fellowship just focusing on shoulder, elbow, wrist, and hand surgery. Um, so in order to compete in work and really be an expert in your field, especially in a major city, in a major market, uh, that really gives you the extra skills, the extra year of practice, um, the extra medical and surgical knowledge to really, Um, take your, uh, skills and patient care to the next level.
So the example I always give is if you tear your ACL, which is a pretty common, uh, athletic or football injury that most people are familiar with, um, would you rather have your ACL? Repaired by a surgeon who does 100 to 200 ACLs a year or someone who does 10 to 12 a year. And I would think I'd want the guy who does it, who does it every day.
Um, so that gives me the opportunity to be more subspecialized. Yeah, definitely interesting. And I, Definitely wanted to clear that up. I think a lot of people hear the word fellowship and they instantly think that meant you went to like a religious organization, like Catholic doctrines, you know, kind of thing, so it's definitely interesting.
And, uh, you know, speaking of that, uh, I think we want to know a little bit about your backstory. What got you into this line of work? Uh, you know, there's a lot of different reasons to get into it. So what is your personal story in regard to that? I was lucky enough that my father was a. Physician and a big influence on my life.
And I, I think that's probably a common thread, um, with a lot of people in health care that one of their parents or one of their family members was in Madison. So my father pushed me into actually working in the hospital when I was in high school, cleaning the operating rooms, which is a pretty relatively low level.
Um, you know, a lot of grunt work, but, uh, you know, it opened my eyes to, you know, The team aspect of medicine patient care, I would see the gratitude on my father's patients faces. I loved working with the nursing staff and the operating room staff. And once I get involved with that, and then I was also a high school and college athletes, it sort of melded my.
Love for getting people back to doing what they love and, um, also working in that team environment and hopefully acting in a life of giving back to others to the best of my ability. So it's a pretty regular story for most, most medical professionals and maybe most orthopedic surgeons, but, you know, it worked for me and I'm very lucky to be where I am today.
Yeah. And I think it's so interesting just studying human behavior, how, uh, 50 percent of the other time in your case, uh, people in your position would have been like, I hate this work. I hate being pushed into this industry by my parents. I'm never going to do anything like this. Uh, so it's either one way or the other.
And I guess it really depends also what you see when you're there. And you mentioned seeing some great things. So your surgeries in particular, yeah. Is it mostly preventative or is it responsive? So you get a lot of like sports injuries, uh, car crash injuries, or is this just routine aging kind of stuff where you do all of the above?
Majority of my surgeries are what you would call elective surgeries. So over time people, uh, get injured. So, uh,
We have a lot of tennis and pickleball overhead activity of hitting the tennis racket or the pickleball racket their shoulder gets sore after a while and Uh, these are more chronic injuries that eventually over time may need to be addressed whether that's surgically or non surgically Right people also develop arthritis.
So you're familiar with knee arthritis or hip arthritis So people can develop shoulder arthritis elbow arthritis wrist arthritis And those are you know when the patient decides that they've had enough You Of the pain and dysfunction, then they'll choose to have surgery. Of course, we do have non elective surgeries or urgent or emergent surgeries due to trauma.
So, broken bones, people, people getting in accidents, people getting hit by cars and other incidents, which are not elective and sometimes they just need to be done in order to get people back to their best possible function. Right. Now, we talked about earlier, we kind of hinted at leadership and teamwork, and you mentioned teamwork.
And so, what role does that play in your life right now? Everything we do is a team. I'm just one person. And patient care, I think what you realize early in medical training is that patient care is incredibly team oriented. So one patient who's in the hospital as as Um, you know, maybe one faculty or attending physician overseeing all their care, but there'll be multiple residents helping with the patient, multiple nurses helping with the patient, multiple, multiple nursing assistants.
There's people who clean the room. There's people who stock the room. There's people who bring the patient food. There's people who transport the patient around the hospital. There's patient who do, there's people who do imaging for the patient. So there's 15, 20, 25 people who are just helping for one patient and you multiply that by all the patients in the hospital.
It's incredible. So even if, even if you show up to the outpatient clinic just to see the doctor, Hey, my shoulder hurts, my elbow hurts. You know, my medical assistant is absolutely integral to making, um, sure that the patient has the best possible experience. Um, um, I have someone who helps me take notes, you know, documenting everything that goes on in the visit, working with the extra paperwork.
Um, and that doesn't even speak of the, the teamwork in the operating room. I'm just one person. I wouldn't be able to successfully do surgery on a patient if it weren't for the anesthesiologist or the anesthesia team, the scrub techs, the other nurses in the room, sometimes other surgeons in the room who are incredibly helpful, whether they're there or whether I've actually run my plan by them before the surgery.
So everything we do is a team effort, truly. Yeah, and you know, that's all of it staffing side. And then also just you and the patient are your own separate team. And then you have not just the patient, but their family, their friends, everyone who's asking questions is concerned. So there's a lot of social interaction.
And I'm curious, do you feel like, you know, medical school kind of addresses is. Those aspects, those skills that aren't necessarily, you know, medical knowledge and education, but you're talking about communication, you know, empathy, explaining stuff properly, comforting, or do you feel like that's kind of what you, you learn it on the job kind of trial by fire?
I think it's both. That's actually a great question. I think medical school, maybe the past decade has really put an emphasis on. empathy, compassion, and medical literacy. So understanding that my medical knowledge and a patient's medical knowledge are quite different in being able to equilibrate the conversation so everybody can understand what's going on.
Transparency in medicine, which I'm a big advocate of. I'm trying to give the patients the information at a base level and providing everyone with as much information as possible. They can make informed decisions. I think training, at least in medical school, has Done a much better job of that. But at the end of the day, it is a complete On the job experience.
So when you're counseling, uh, patients or patients, families on what you correctly mentioned are a lot of the time, the worst days in our lives, that's where you really get your experience. But you know, at least we've been taught and at least we've discussed how to be empathetic. We've practiced how to be empathetic, how to deal with difficult patients, how to deal with upset family members.
So I think it's a combination of both, but it's something that should continue to be talked about and continue to be emphasized over and over. And we also mentioned not just communication between you and the family and the patients, but also other personnel that are staffed at, you know, the office. And so sometimes maybe there's a disagreement over how a surgery should be done or other stuff in terms of whether it's medication or whatever it may be, doctor to doctor, doctor to nurse.
How have you seen those handled? Uh, both good and bad. I was going to say they can be handled in both good and bad, uh, both good and bad ways. You know, unfortunately there is somewhat of a Hierarchy whether that's right or wrong in these health care settings where usually the physician sits on tops So as a physician your role is you can either take that communication in two ways You can either take it more of a direct Dictatorial authoritative approach where you say, uh, you know, whatever I say goes, whether it's right or wrong.
Um, maybe somewhat similar to the military, although I, I, you know, have extremely limited knowledge about that. And you could probably speak more to that versus a more democratic approach saying, Hey, I think, uh, I'm going, I think this is what we should do. Um, based on my knowledge and expertise and experience.
Does anybody have any other thoughts? Does anyone have any comments or suggestions or alternatives? Um, because it's really a group. It's really a group discussion. Um, I usually try to take the more democratic approach because, um, you know, that empowers people and then people want to speak up if something actually does go wrong.
And, uh, you mentioned kind of how it's been shifting over the years in a more positive direction, more emphasis, and I totally agree. In fact, my neighbor, he's an older gentleman, he got a couple surgeries for cancer removal, and he had some issues with some of the nurses, just, um, he said, you know, seven of them were great, and two of them were kind of, you know, Rude.
And, uh, he actually let the review on Google and, uh, send in a complaint to the, their, their office and they responded instantly, you know, what exactly was wrong, give us names and times, how can we fix this and prevent this? So I think they're doing a great job at responding to that on top of everything they have now, uh, everywhere.
You're seeing a bigger push and emphasis on that kind of stuff. So it's great. And when it comes to communicating with the patients, you know, do you find it better to approach it just, you know, kind of bluntly and honestly, When it comes to the seriousness of an injury of a surgery or team sugar coat it a little bit, because when it comes to medical stuff, I mean, me personally, I think it's best to be transparent.
Uh, and I would say not necessarily sugar coat it, but definitely focus on some positive points, you know, post surgery, uh, but I know everyone has a different tactic. Some people try to twist it a little bit, make it sound really nice. Not bad. And other people are like, look, this is the reality of it. And you and your family need to be prepared for this.
I think in my experience, it's probably more beneficial to be more straightforward and blunt, um, in a good or bad way. I think setting expectations is a very difficult part of practicing medicine. Um, and setting expectations with patients and their families, what really to expect from, if we're talking about surgery, what to expect from surgery, because surgery, unfortunately is not a quick fix.
Um, bad things can have bad things can happen. We can always make you worse. Um, And I wouldn't offer anything to you if I didn't think it was going to help you. But sometimes people have very complex issues that have a lot of steps to try to address. And It can be very difficult to manage people's feelings and emotions as they go along this journey.
Um, so I think being straightforward and honest and transparent with people gives them the knowledge and gives them the ability and power To choose what they want to do so they know that when they're choosing to move forward with the procedure that they have been able to ask all the questions that they've wanted to ask.
They've gotten the most honest, straightforward answers. Maybe they've talked to other providers, which I would totally recommend and encourage. But beating around the bush and sugarcoating things will only get you in trouble, I think. Right, because then they get these expectations, which we actually talked in a couple weeks ago in an episode with Repeatedly Dead Fred.
He's a man who died 50 times and, uh, came back 50 times and had a bunch of botched surgeries, and it was a mind blowing episode. And, uh, we talked about how That's unbelievable. Yeah, I mean, he's a miracle case. And we were talking about the medical industry, and one of the things we mentioned, which is so true, is that Everyone wants to be a special exception case, like most of the surgeries go this way, or there's this, and people want to be like, well, doctor, could you, I know you, you don't really do it this way, but you do it for me, you know, or, and of course, everyone's going to say, but, but they're sick, or they really need.
Yeah, everyone getting the surgery, you know, really needs to be fixed and stuff. And, uh, I think, yeah, when you're sugarcoating it on top, kind of setting up, maybe kind of leading them on. And then they, we all saw this mentality of, you know, how could this happen to me? And, you know, I'm going to be different so it can lead to disaster.
And one of the things, since we're talking about communication and then just bad things happening, you know, what would be your advice, Dr. Roth, for You know, like I said, y'all are humans. Sometimes there are mistakes, right? Y'all are highly trained professionals, but anything can happen. Uh, you know, like you said, every person is different.
Some cases are more complicated than others, and not just for surgeons, but for nurses, for doctors, for anyone out there who makes a mistake, whether it's during an operation or just somewhere in the healthcare industry, and it has a pretty significant effect. I mean, there's so much pressure there. And it can send them home in tears, there's so much pressure that can cave in, maybe even pushes people to the edge of self harm or suicidal ideation.
What would be your advice for coping with all the stress and pressure of people's lives being on the line, not just their life, maybe in terms of life and death, but their lifestyle in general? So, how, are you asking? How we as medical professionals cope with the stress. Yeah. Like what, what would be your advice for, you know, all those medical professionals who have made mistakes or are dealing with all that stress?
It's such a demanding job. Like, how do you deal with that? That's a very, that's a tough question. I think there's probably a couple avenues for that. I think if something. Bad happens to you. Professionally, you make a mistake. Something bad happens to a patient, which happens to all of us. Um, it's happened to me and I lose sleep over it.
I think talking to your mentors and your partners and your colleague. Um, and asking them their advice and hey, hey, doctor, whoever, um, you know, what happened? What did you do? What happened to you after this happened earlier in your career? What was your experience in learning from what they did? Because all of us at some point, unfortunately, we'll make a mistake and, and, you know, a patient will not do as well as we want under our care.
And that's the reality of the situation. Um, but learning from others, um, so what I do is I, you know, I, I talked to my mentors. I talked to the people more experienced than I am, but I also have personal coping mechanisms. So that would be, you know, exercise, mindfulness, meditation, reading, um, you know, staying away from my phone and things like that, always trying to get better.
So, reviewing what happened. In the past, um, trying to take notes, mental and actually written notes on, on if I encountered this issue in the future, what I can do. And then when facing a patient with the complication, you can't brush it under the rug because it will always come back and find you. So you meet it head on, you acknowledge the complication to the patient, their family, and you say, I'm with you this entire time.
And I'm going to do everything in my power to. Help get you the best possible result whether that's with me whether that's with someone else and I am a hundred percent committed to the Best possible care I can give you. Yeah, and I think it's important Uh, if it's not with you, right, because sometimes if you have to redo something or go again, the patient might request someone else just because of what happened, and I think it's important as the medical practitioner to understand that it's not necessarily a personal thing, it's not that you're irredeemable, right, they're just being cautious, and I think as soon as you have another patient, maybe you'll get over it, or like you said, it might be something that keeps you up for a while, but it's important to know that, you know, it's, Doesn't make you irredeemable, right?
They're just being cautious. And I, I preach to the patient side. There's a lot of ego. Yeah, I, I preach to the patient side, you know, uh, empathy, right? Again, that they're, they're humans, right? People make mistakes. It's especially when you're doing, like you said, sometimes hundreds of surgeries. I mean, there's bound to be some kind of mess up and, uh, think everyone is so hot to try to just sue someone.
They just, you know, love quick cash. And, uh, sometimes it's over something minor that doesn't affect your overall lifestyle. Right. And it's like, now you're trying to screw someone out of their life. When they didn't really mess up yours, you know, it was just a small mistake that maybe delayed something or, you know, was just a hindrance.
So it's important to be empathetic and patient on both sides. And Dr. Roth, I'm really curious. I know it's just a little side pivot discussion, but you talked about like having people taking notes while you're going over everything. And do you see AI replacing those kinds of jobs? Do you, do you think that'll be all right?
Or do you think it's so important to have it? Actual people working in the healthcare industry, especially with sensitive. human topics like this that require so much emotion as we've said already. There's, there's a lot of documentation that goes into medical care. So documenting the patient visit, documenting exactly what goes on almost every minute of a patient's hospital stay, what goes on in the operating room and afterwards.
And there already are artificial applications and, and devices that can Uh, record our conversations in the clinic and transcribe, uh, uh, clinic notes. So I, I definitely think the transcription part and the paperwork part will likely continue to be consumed by artificial intelligence. But in terms of who is actually meeting with the patient and offering their expertise, I think that's only a human to human.
Uh, interaction who is doing the surgery. I think it'll be a human. I mean, we have robotic help in orthopedics, but it's not as it's not like AI. With Will Smith or um, you know, it's it's nothing like that. It's um, uh, it's really just an assist We have 3d planning But again, and it's the surgeon and the staff who's really taking care of the patient Yeah, it's really interesting to see how that's gonna move forward.
I know In a previous episode with Dr. Fred Moss, or he calls himself the undoctor, but we discussed how you could technically go to AI and say, Hey, I have these symptoms X, Y, Z, and it'll be like, most likely you have a B. C. But with. You know, they call it hallucinations with A. I. S. given out misinformation with not really being able to.
And it's curious if A. I. S. are going to be able to read honesty or not, because, like we talked about, especially when it comes to mental health and, uh, it comes down to patients being honest about their symptoms, uh, for a proper diagnosis. So definitely an interesting shift to see that. But we've talked about leadership, about emotional intelligence and all of that stuff in the workplace.
Dr. Roth, was there anything else you want to share with us before we sign off here? Well, I just, I think Dr. Moss actually makes a really, really, uh, interesting and good point because I don't really know anything about artificial intelligence, to be honest. I sort of just stay in my Sphere here. Um, and I think, and I think it's, it's incredibly helpful for, uh, productivity.
So bulk productivity, so paperwork, documentation, et cetera. I don't know. And again, I don't know anything about this, but how are we going to replace the true human empathy and compassion and connection that we all feel for each other and that we're all trying to impart on to each other? Um, Because listening to a patient's story and drawing that story out of people and drawing it out of their family members is truly the art of medicine.
And I'm not sure if we're ever going to get, I don't know, and we may, um, but that's what's truly special. About the physician patient relationship, and I think that's what's special just about being human I mean you you and I are speaking right now. One of us is doing neither of us are robots To my knowledge and we're able.
Yeah, exactly to our knowledge and and we're able to have a You know, an interesting nuanced intellectual discussion that maybe some AI algorithm loses track at some point because we know what it's like to be human and we know what it's like to ourselves be in medical trouble or have a family member in medical trouble.
So you truly know the correct questions to ask, and I truly can tell you based on my experience with other humans. What it's like, what it feels as a human to be with other people on the worst day of their lives. And I, that's, that's hard to, that's hard to take away. And I, that's what makes, that's what makes all of this so special.
Yeah, I agree. And another thing too, is we talked about how complicated people's personal situations can be just even physically and biologically. And with AI, it's evidence based, it's past based, right? So as of right now, AI won't be like, Hey, we could try this crazy theoretical thing to fix you, right?
Whereas humans can come together and say, okay, this is a complication we've never seen before. What can we do to fix it? Right? And also just You know, if we had self, it could get to the point one day and I hope this never happens where there's just a self serve station on, on every corner and you go up to it, you put in your ailments and symptoms and it spits out a medicine, uh, that will get abused so much.
Uh, yeah. They have drug addicts everywhere. That scares me. Yeah. That scares me because you, you, Miss the, the experience of, of being evaluated by a professional. Now, I think I could use AI to say, Hey, I have this very chronic, rare. You know, condition that a patient showed up with. Can I use the AI to bring up all the case reports in the past 50 years of how people have dealt with that?
And suddenly I have a treasure trove of information that I can read through and learn about and prepare for their care. But if people just expect medical care to be a drive through or like a Jiffy Lube where you just sort of go in and they, you know, fill your, fill your They check your oil, and they fill your, your fluid, and they bump up your tires, and that's not what medicine is.
Medicine is a true human experience. And all of us in medical care are doing everything in our power to do what we can to provide people the best possible outcome, no matter what field you're in, because that's, that's why we do it. And artificial intelligence completely removes all of that from the equation.
That's why we do it. Yeah, and you know what's really interesting is that Dr. Moss and I were talking about One thing too is we live in a day and age where people are looking to have something wrong with them Oh, we talked about influencers online Purposely acquiring a vast amount of disorders to get paid more or better Be sexier, you know, whatever it is, because our society is messed up or they want something wrong with them to excuse their behavior, to have excuses, to not do this, to not do that.
And the AI, you know, if we're talking about that human connection is just going to say. Okay, that's what you're telling me is wrong with you. Here's what's wrong with you. Whereas if you go and talk to an actual person, they might say, Hey, look, there isn't anything wrong with you. What you're feeling is normal, you know?
And sometimes that's what a person needs is to hear that they're not alone or that what they're going through is normal. And With this human connection, you can have that. Whereas with the AI, you're just going to say, okay, yeah, there's, here's, what's probably wrong with you and here's the probable, you know, solution to it, and you're going to just be furthering that issue.
So I think it's very interesting. Uh, it's funny you said the, uh, the oil change. I think it would be like the bank, you know, you just got that tube and it just shoots down and you open it up and here's your, you know, your dose of medicine, uh, but I think it's so important to have that human connection, like you said, and I want to connect with all the people listening here right now, Dr.
Roth specifically. Anyone listening who is on the fence about going into the medical industry for whatever reason there's a hundred reasons to go in There's a hundred reasons not to right if they're on the fence. Dr. Roth, what would you say to them? I think you should do it. I mean if you truly want to spend your life Trying to better others lives and medicine isn't obviously the only way to do that There's thousands of ways you could do that.
I put Medicine, you can, you can truly connect. It's a very special connection with people and their families. And you learn the deepest, darkest aspects of, of people's lives and what makes them tick. And you can really do a lot of good in the world, not only domestically, but internationally. Um, you meet people of all shapes and sizes of all ages of all ethnicities and backgrounds, and it's, it's.
You know, race, creed, religion, politics. It's completely absent because you just look at it, you treat everyone equally and you treat everyone with respect. Because we're all in the same game together. We all look the same on the inside, pretty much. Um, so if that's really what you want to do, then yeah, I would say absolutely go for it.
I would never discourage anyone from pursuing a career in medicine. That's what my dad told me. It changed my life. And from this, if I can get one person to go into a medical career, then I think we've won. Yeah, yeah, yeah. And medicine being, it could be therapy, it could be physical therapy, it could be surgery, it could be, you know, all those different practices fall into that.
And yeah, ladies and gentlemen, you know, there are days where you lose people, and there are days where you get a crayon drawn picture. And I thank you now. So, you know, but at the end of the day, whether something bad happens or something good happens. You tried and you helped and you put in effort to make a change.
And it's a job where it's one of the few jobs where you can actually change people's lives every single day. And every time you put in effort. So I think it's so beautiful. And I think this episode really captured the human connection aspect of it. Because when people think hospital, they think doctor's office, they think cold, sterile, you know, they don't want to be there.
And yeah, of course you don't want to be there. But. But there are people like Dr. Roth who do want to be there so that they can help you. So I think this was a great episode and I'm really glad you came on, Dr. Roth, and to share all of this and to have this connection with us. No, I, I appreciate your time, but the doctor's office and the hospital are not the fuzziest places.
I totally understand that. And sometimes that's just the nature of the scientific sterility, but we're trying. Every single day to do what we can to, to help you be better. And that's, and we are human though. So, and we're all human and we're on this together. I really appreciate your time and I think you're doing an incredible service speaking about a variety of topics.
I've listened to a bunch of your shows, and I think you speak on a wide array of topics and especially given your background, um, very helpful to a lot of people. So, um, you're giving back in the same way that we're all helping. So, you know, Keep up the good work. I appreciate that. Yeah. And ladies and gentlemen, Dr.
Roth and his information and website will be in the description below. So be sure to check it out. And if you're in the Arizona area or you feel like traveling, uh, to go get some wrist, shoulder, hip, or whatever surgery it may be, uh, he's your guy over there in Arizona for the time being, so be sure to check him out.
And, you know, share this episode with whoever needs it, whether it's someone thinking about pursuing a career in this industry, someone who's had a bad experience, someone who's had a good experience, be sure to share it. And, uh, hopefully we can all help each other learn something. But Dr. Roth, again, thank you so much for coming on the show.
No, I appreciate your time.
