Getting any idea approved in corporate medicine is just a matter of bringing it up over and over until an executive decides that they came up with the idea.

"The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom." -Isaac Asimov

Orthopaedic trainees: remember the value of training is to practice making decisions that will be subjected to scrutiny. Get good at that by making as many decisions as you can and subject them to as much scrutiny as possible.

There are too many conferences. So what’s next?

Congratulations to the Barrow Neurological Institute neurosurgery residents! We can’t wait to work with you when you come through Phoenix Children's on your spine rotation!

Update: Here are All 14 of the new incoming orthopaedic interns who matched today and who will be rotating through Phoenix Children’s Hospital with us! Welcome to Orthopaedics! @vegasorthobros @mayoazortho @uaphxortho @uazorthoresidency

Congratulations to all the new residents who matched to the Arizona programs today! We look forward to seeing you all on your pediatric orthopaedic rotations!

Anyone who looks down on you for asking for advice isn’t someone you should approach again. It’s unlikely they have cultivated the respect for getting advice that lends them to growth so any advice you get from them has high odds of being stagnant.

Had a great discussion tonight with all of Arizona State Medical Society leadership to discuss pressing issues that impact healthcare in AZ. Good things are coming!

Stop pushing the narrative that expensive schools are somehow better.

Facts alone aren’t very influential because they exist in clouds of probability while influence attaches emotion to an opinion on those probabilities and then confidently expressing that interpretation in determinative concrete and actionable ways; even if wrong.

The plantaris muscle is a small, thin muscle in the posterior compartment of the leg Read: wikism.org/Plantaris_Mu... #Anatomy #ATC #SportsMedicine #Orthopedics #Radiology #PhysicalTherapy #AthleticTraining #Rehab #InjuryPrevention #Physio #SportsInjury #SportsRehab #PhysioTherapy #Meded #FOAMed

"See one, do one, teach one" is for skills. For mistakes, it is: "Make one, admit it immediately, never make it again."

The Stance Rule: When handed a retractor, immediately adopt a stance you can hold for 2 hours. If you are leaning or twisting, you will be in agony in 15 minutes.

"Never implant a stranger." (Avoid putting hardware/prosthetics in a patient you haven't thoroughly vetted yourself.)

What are your favorite quotes or aphorisms as a surgeon? A few of mine: - “When you do things right, people won't be sure you've done anything at all.”

Beware

We validated our remodeling equation and presented at AAOS! Should be good to use for those interested for distal radius. pediatricorthopaedics.unicornplatform.page/testmark/

What it's really like to write a paper

If you’re a journal and send a “call for papers” just to me with a suggested subject: please don’t also link it to a predatory payment page to submit. The entire journal publishing industry is predatory in 2026. This has to stop.

Jefferson Mays is a gift.

“I got no nothing against God. ‘S just that the pious keep puttin’ the devil in charge.”

This is what it feels like talking to a doc to doc to do a prior auth in 2026

Reflect thoughtfully and intentionally about every encounter. Predict. Check your work. Follow-up. Mismatch between expectation & observation forces an internal adjustment. Surgeons who repeatedly search for those mismatches and then confront the discomfort will likely recalibrate faster.

We validated our remodeling equation and presented at AAOS! Should be good to use for those interested for distal radius. pediatricorthopaedics.unicornplatform.page/testmark/

I find my first lucid interval invariably occupied by a cordial orientation of my attention in your direction, a kind of secular benediction upon the nascent hours.

n=28. Fatigue ↑ across blocks t222=6.95,p=3.94e-11. High effort acceptance ↓ t138=-9.18,p=5.65e-16; reward acceptance ↑ t222=8.96,p=1.36e-16. Fatigue shifted choices to easier reward opts: beta=-0.349,p=3.24e-4; relevance: fatigue may favor default/low effort decisions.

How it feels as a surgeon to pass the liability-transfer module final test after only 3 attempts.

Modules, mandated CME and other formalized programs don’t really act as professional development nor continuing education - instead they cause performative or compliance-driven behavior.

n=27; acc 97.3%; median RT 634ms. Breaks ↓RT 37ms overall, 6.48%. 28s vs 12s: RT gain 7.9% vs 5.1%, post-break RT 639 vs 647ms, but TOT slope steeper after 28s (p=.02). Recovery↔later decline: r=-.86/-.69. Ortho: short frequent breaks may keep output steadier.

N=50; congruent tgt faster vs incongruent 1341 vs 1716 ms, t49=9.23. Gain cue bias > loss cue bias: DeltaRT 483 vs 267 ms, t49=2.76, p=.004, d=.54. Incongruent info -> AI/DACC/PPC/IFG/SMA activation, stronger after optimistic cues. confirming optimistic data is picked over disconfirming pessimistic.

28 studies/2006-2021 from 5010 records; 17/28 RCTs. MMAT: 17/28 scored ≥75, 5/28=100. Exergames 12/28, CVG 9/28. Console 13/28, PC 9/28. Play time 2 min-15 h; mean 6.6 sessions. Stress/anxiety often ↓, but action/sports titles sometimes ↑ stress.

47-study meta-analysis mapped metacog network; meta-d’/d’=1 = perfect self-monitoring, 0.8 = 80% evidence access. High performers > low in metacog ctl. Training data mixed; offline self-reflection looks strongest. plan. doubt it. refine it. then cut.

n=14, age 20.7. 2 fMRI sessions +3 training sessions. Accuracy ≥95%. RT ↓ pre→post: F=11.58 p=.011; seq<pseudo F=17.88 p=.004; dual slower F=13.38 p=.008. Dual task cost 61ms→11ms. Prefrontal+caudate activation ↓ after practice ⇒ rehearsal preserves OR bandwidth.

I am a module warrior.

How bacteria feel when I wash out a hip joint open with a suction tip on the end of the cysto tubing:

If someone can vote for Phoenix Children’s this year in US news rankings for reputation, it would be helpful to give our orthopaedic team resources to take even better care of patients and do more researcher.

The brilliant Keith Baldwin MD @southNJscoli was at #AAOS2026, & asked a seemingly simple question that I think is actually by far the most important question that nobody is asking about AI: “What does AI do with missing data?” www.upoj.org/wp-content/u... pmc.ncbi.nlm.nih.gov/articles/PMC...

Please take a minute and purchase this great book by my partner Random Hall MD www.amazon.com/Performance-...

An actually great talk by AS at AAOS

If you’re free at noon and in New Orleans - Join the Arizona Orthopaedic society today at 12pm CST in lobby of the Courtyard Marriott 300 Julia St New Orleans, LA 70130 maps.apple/p/fzpvw1qcLH... (this is a last minute location change as our reserved venue, Jazz City Cafe was unexpectedly closed).

Me trying to find a conference room