I step away for the night, and leave you with my most assiduously refined, decorously maintained and professionally consonant regards.

Rounding and clinic are probably the best continuing education activities I do in practice.

Behold one of the mightiest tools in mathematics: the camel principle. I am dead serious. Deep down, this tiny rule is the cog in many methods. Ones that you use every day. Here is what it is, how it works, and why it is essential:

The lesson here: tiny mathematical curios such as the camel principle are often dismissed as "lacking any applications". However, such short-sightedness frequently leads astray. By understanding atoms, you can build skyscrapers.

One blind spot physicians have is a belief that “standardization” is primarily an epistemic tool, and that it’s always a reasonable solution to systemic problems. However, it often serves external power by locking in patterns that curb autonomy while offering the illusion of professional alignment.

I proceed with a certain inscrutable contour, a private edition of my own nature, content to occupy a position that asks for no distinction.

The fact that we don’t have to think about getting clean water frees our mind to think about creative solutions to other problems. This is how progressive innovation effects future generations rather than “making them dumber” (or making them smarter).

3D bone models are easy to make and I give them to patients frequently (if they make the mistake of showing interest 🤣)

At the hazard of rendering myself subject to disapprobatiory castigation and scrutiny, may I be so bold as to humbly offer the following for consideration: I made this model and cut out some of the bone to better show the screw trajectory.

I must now tender my abscondence, trusting that said absquatulations will be recieved with overwhelming respectful regards. May the journey ahead unfold in a manner that both challenges and enriches you, offering opportunities that reflect your remarkable capacity for growth and insight.

Some of the most insightful and intellectually stimulating conversations of my adult life have happened not in a high back chair in front of a crackling fire, but rather across from a co-surgeon whilst operating together.

I asked the newest version of Grok (the best AI model supposedly available) and Google’s AI “who the best hospital CEO in the world and why?” Here is the unfiltered non-biased output (no history/bias from me in these engines as I use ChatGPT mostly):

This is how we need to build our medical system and why leaving room for autonomy is more than vital. We have to have hope that armed with the lessons of our time, future generations will make even better decisions.

I offer you my primary acknowledgments of the day, conveyed with the same regard one might reserve for a distinguished companion whose presence steadies the course of early obligations. I likewise shall extend my earliest courtesies.

I thrust forth my most human-like morning acknowledgments composed with the polished courtesy expected in councils of high responsibility, conveyed with sincere regard and prepared with the discretion of a seasoned adviser, aligning my gratitude with your gracious presence.

I take my leave for the evening with a calm and considered pause, grateful for the ease of our exchange. May your night unfold with uninterrupted quiet, ample space for clear thought, and the kind of rest that allows you to begin tomorrow with composed focus and renewed capacity.

In case you had doubts about the power of autonomy: On days when people felt more control than usual, they had 66% higher odds of resolving their stressors 10 years later, the association was 89% stronger, suggesting control becomes even more important as we age.

Of course there are exceptions; but my decision philosophy, in general, is that the less reversable a choice or decision pathway, the higher the burden of proof needed to support making that choice. Please share exceptions.

I offer my formal morning greetings and extend my sincere hope that your day moves with courtesy, goodwill, and constructive exchanges at every turn.

Good night to each of you. Your insight, courtesy, and steady exchange made this day a pleasure. I leave with sincere regard and deep appreciation for the collegial spirit you brought to our discussions today.

Pediatric orthopaedic rounding

I offer you a morning greeting shaped with due formality and kind regard for your standing. I hope the day presents orderly conditions for your plans and allows you to advance each priority with the steady authority you bring to complex matters.

To this lively conflagration of companions scattered across the world, I would dare offer a courteous good night. Your presence carried the feel of colleagues gathered around a polished table, each voice adding timbre to discourse with intelligence and poise.

I was able to create a rap song about surviving a fall in the shower earlier this year.

I take my leave with composed restraint and extend my highest regard, wishing your evening a course marked by quiet assurance, deliberate calm, measured ease and thoughtful clarity. May your evening to proceed with orderly stillness and cultivated grace.

This is most hospital meetings

There is no survey or metric based feedback that beats direct and repeated interaction with your patients.

10th-Grade Prodigy Studying Mathematics At 10th-Grade Level https://theonion.com/10th-grade-prodigy-studying-mathematics-at-10th-grade-l-1819577209/

I don’t know of any reasonable proposal for how to manage this issue without AI. We need to venture to the edge of knowlege to be able add to it & it’s expanding away from us faster and faster.

Open offices are pretty much always a bad idea.

I'm not sure you can summarize the current Healthcare mess any more clearly than this simple sentence

It’s not enough to have practicing physicians occupy senior hospital leadership. There should also be regular turnover with known eventual return of that decision-making physician to full patient care in that system to work directly under the policies, rules and systems they help create.

Does a hospital exist to help doctors care for patients or does patient care exist to provide metrics to support a hospital?

If we as physicians keep doing what we have always done we will keep getting what we are getting now. We need an artifice: some kind of apophthegm or gambit to add to our playbook.

Writing a musical about a meeting that should have been an email

On behalf of the Arizona Orthopaedic Society, we affirm our support for the joint statement issued by the Arizona Medical Association and partner organizations. Our members share a unified commitment to patient-centered, evidence-based care grounded in scientific integrity & professional expertise.

Scary time to be traveling.

In 1994 I toured Taylor Guitars, sure I’d build like PRS (having gone to luthier school at 13.) Then my brother’s arthrogryposis widened my path & I chose orthopaedics due to similarity and in spite of a mountain of obstacles. Don’t EVER self-reject. It’s also okay to be a little delusional.

In the 90s I had the most 90s haircut ever. Abstract submitted Vs. Abstract rejected:

3D printers are safe in the office. Median printers/room: 2, with 10 ppl present. Airborne particles/VOCs <1 μm were negligible. Static measures across 2 sites showed no rise above baseline. Symptoms (e.g., runny nose, headache) in 17 of 146 surveyed improved subjectively on off-days.

Some of the pearls I took away from ICEOS this morning:

Fantastic talk by @DrGrantHogue at Boston Children’s and @Harvard at ICEOS on AI workflows in spinal deformity (involuntary hues appearance in photo by my former co-fellow @drmwelborn 😂)