{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":10.8,"endTime":13.62,"body":"Welcome to the"},{"speaker":"Charles Goldfarb","startTime":10.8,"endTime":13.62,"body":"upper hand where Chuck and Chris"},{"speaker":"Charles Goldfarb","startTime":13.62,"endTime":14.43,"body":"talk hand surgery."},{"speaker":"Chris Dy","startTime":14.81,"endTime":16.55,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":14.81,"endTime":16.55,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":16.55,"endTime":19.64,"body":"University in St. Louis here to"},{"speaker":"Chris Dy","startTime":16.55,"endTime":19.64,"body":"talk about all aspects of hand"},{"speaker":"Chris Dy","startTime":19.64,"endTime":21.47,"body":"surgery from technical to"},{"speaker":"Chris Dy","startTime":19.64,"endTime":21.47,"body":"personal."},{"speaker":"Charles Goldfarb","startTime":22.04,"endTime":24.32,"body":"Thank you for"},{"speaker":"Charles Goldfarb","startTime":22.04,"endTime":24.32,"body":"subscribing, wherever you get"},{"speaker":"Charles Goldfarb","startTime":24.32,"endTime":25.22,"body":"your podcasts"},{"speaker":"Chris Dy","startTime":25.46,"endTime":27.65,"body":"And be sure to leave a"},{"speaker":"Chris Dy","startTime":25.46,"endTime":27.65,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":27.65,"endTime":28.19,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":29.42,"endTime":30.17,"body":"Oh, hey,"},{"speaker":"Charles Goldfarb","startTime":29.42,"endTime":30.17,"body":"Chris."},{"speaker":"Chris Dy","startTime":30.29,"endTime":31.01,"body":"Hey, Chuck,"},{"speaker":"Charles Goldfarb","startTime":31.19,"endTime":32.0,"body":"how are you"},{"speaker":"Charles Goldfarb","startTime":31.19,"endTime":32.0,"body":"today?"},{"speaker":"Chris Dy","startTime":32.06,"endTime":33.35,"body":"I am well, how are"},{"speaker":"Chris Dy","startTime":32.06,"endTime":33.35,"body":"you?"},{"speaker":"Charles Goldfarb","startTime":33.72,"endTime":36.72,"body":"I'm doing"},{"speaker":"Charles Goldfarb","startTime":33.72,"endTime":36.72,"body":"very, very well. It's a little,"},{"speaker":"Charles Goldfarb","startTime":37.14,"endTime":42.0,"body":"you know, Today is November 15,"},{"speaker":"Charles Goldfarb","startTime":37.14,"endTime":42.0,"body":"then we're still in the midst of"},{"speaker":"Charles Goldfarb","startTime":42.0,"endTime":45.03,"body":"the pandemic and things are"},{"speaker":"Charles Goldfarb","startTime":42.0,"endTime":45.03,"body":"going in the wrong direction in"},{"speaker":"Charles Goldfarb","startTime":45.03,"endTime":47.37,"body":"St. Louis. I don't want to be a"},{"speaker":"Charles Goldfarb","startTime":45.03,"endTime":47.37,"body":"downer. So we don't want to talk"},{"speaker":"Charles Goldfarb","startTime":47.37,"endTime":48.27,"body":"too much about this."},{"speaker":"Chris Dy","startTime":48.0,"endTime":50.61,"body":"Yeah, you did open up"},{"speaker":"Chris Dy","startTime":48.0,"endTime":50.61,"body":"a couple of weeks ago with the"},{"speaker":"Chris Dy","startTime":50.64,"endTime":53.67,"body":"election and then pivoted"},{"speaker":"Chris Dy","startTime":50.64,"endTime":53.67,"body":"quickly into the podcasts or"},{"speaker":"Chris Dy","startTime":53.67,"endTime":56.61,"body":"into the into the pandemic. So"},{"speaker":"Chris Dy","startTime":53.67,"endTime":56.61,"body":"yeah, total win."},{"speaker":"Charles Goldfarb","startTime":57.27,"endTime":58.65,"body":"All right,"},{"speaker":"Charles Goldfarb","startTime":57.27,"endTime":58.65,"body":"well let's go, well let's stay"},{"speaker":"Charles Goldfarb","startTime":58.65,"endTime":62.67,"body":"happy here. No pandemic talk, no"},{"speaker":"Charles Goldfarb","startTime":58.65,"endTime":62.67,"body":"cancellation of elective surgery"},{"speaker":"Charles Goldfarb","startTime":62.67,"endTime":66.69,"body":"talk. We're gonna jump into our"},{"speaker":"Charles Goldfarb","startTime":62.67,"endTime":66.69,"body":"podcast without further ado."},{"speaker":"Chris Dy","startTime":67.17,"endTime":69.33,"body":"Well, yes. So there"},{"speaker":"Chris Dy","startTime":67.17,"endTime":69.33,"body":"are obviously many things to be"},{"speaker":"Chris Dy","startTime":69.33,"endTime":73.26,"body":"grateful for. And we're grateful"},{"speaker":"Chris Dy","startTime":69.33,"endTime":73.26,"body":"for our listeners for really"},{"speaker":"Chris Dy","startTime":73.29,"endTime":76.86,"body":"giving us energy as we do this."},{"speaker":"Chris Dy","startTime":73.29,"endTime":76.86,"body":"And this is one that, I have"},{"speaker":"Chris Dy","startTime":76.86,"endTime":80.25,"body":"some feedback that came from the"},{"speaker":"Chris Dy","startTime":76.86,"endTime":80.25,"body":"survey. It says here, thank you"},{"speaker":"Chris Dy","startTime":80.25,"endTime":83.55,"body":"for your efforts in producing"},{"speaker":"Chris Dy","startTime":80.25,"endTime":83.55,"body":"this podcast. Taking call as a"},{"speaker":"Chris Dy","startTime":83.55,"endTime":86.22,"body":"junior resident is one of the"},{"speaker":"Chris Dy","startTime":83.55,"endTime":86.22,"body":"more intimidating tasks that I"},{"speaker":"Chris Dy","startTime":86.22,"endTime":89.73,"body":"have undertaken. Knowing that"},{"speaker":"Chris Dy","startTime":86.22,"endTime":89.73,"body":"I've heard about something or"},{"speaker":"Chris Dy","startTime":89.73,"endTime":92.37,"body":"that I can put a name to"},{"speaker":"Chris Dy","startTime":89.73,"endTime":92.37,"body":"something help with, that helps"},{"speaker":"Chris Dy","startTime":92.37,"endTime":95.37,"body":"with many of my upper extremity"},{"speaker":"Chris Dy","startTime":92.37,"endTime":95.37,"body":"consults. I like hearing about"},{"speaker":"Chris Dy","startTime":95.37,"endTime":98.85,"body":"your experiences with diagnosis"},{"speaker":"Chris Dy","startTime":95.37,"endTime":98.85,"body":"and physical exam. For example,"},{"speaker":"Chris Dy","startTime":98.85,"endTime":101.31,"body":"it can hurt when mashing on"},{"speaker":"Chris Dy","startTime":98.85,"endTime":101.31,"body":"someone's scaphoid fossa, and"},{"speaker":"Chris Dy","startTime":101.31,"endTime":104.55,"body":"that's totally normal. If you're"},{"speaker":"Chris Dy","startTime":101.31,"endTime":104.55,"body":"mashing it probably will hurt."},{"speaker":"Charles Goldfarb","startTime":105.12,"endTime":108.09,"body":"I love the"},{"speaker":"Charles Goldfarb","startTime":105.12,"endTime":108.09,"body":"word mash. I love that."},{"speaker":"Chris Dy","startTime":108.12,"endTime":110.82,"body":"Oh, yeah. Oh, yeah."},{"speaker":"Chris Dy","startTime":108.12,"endTime":110.82,"body":"Well, thank you to the anonymous"},{"speaker":"Chris Dy","startTime":110.82,"endTime":112.98,"body":"person who filled out our survey"},{"speaker":"Chris Dy","startTime":110.82,"endTime":112.98,"body":"for obviously filling out the"},{"speaker":"Chris Dy","startTime":112.98,"endTime":115.83,"body":"survey and then also for giving"},{"speaker":"Chris Dy","startTime":112.98,"endTime":115.83,"body":"us that wonderful feedback, I"},{"speaker":"Chris Dy","startTime":115.83,"endTime":119.28,"body":"hope that your calls as a junior"},{"speaker":"Chris Dy","startTime":115.83,"endTime":119.28,"body":"resident go well, I remember"},{"speaker":"Chris Dy","startTime":119.28,"endTime":120.66,"body":"those days not so fondly."},{"speaker":"Charles Goldfarb","startTime":120.99,"endTime":123.66,"body":"Absolutely. I"},{"speaker":"Charles Goldfarb","startTime":120.99,"endTime":123.66,"body":"think mash is a southern term."},{"speaker":"Charles Goldfarb","startTime":123.66,"endTime":128.91,"body":"And I'm a southern boy. And I do"},{"speaker":"Charles Goldfarb","startTime":123.66,"endTime":128.91,"body":"like that it brings back shades"},{"speaker":"Charles Goldfarb","startTime":128.91,"endTime":129.93,"body":"of Alabama for me."},{"speaker":"Chris Dy","startTime":131.52,"endTime":133.68,"body":"Well, any good cases"},{"speaker":"Chris Dy","startTime":131.52,"endTime":133.68,"body":"recently, Chuck?"},{"speaker":"Charles Goldfarb","startTime":133.93,"endTime":136.69,"body":"You know, I've"},{"speaker":"Charles Goldfarb","startTime":133.93,"endTime":136.69,"body":"had a couple of interesting,"},{"speaker":"Charles Goldfarb","startTime":136.9,"endTime":144.31,"body":"similar cases, which are"},{"speaker":"Charles Goldfarb","startTime":136.9,"endTime":144.31,"body":"failures of CMC fusions in young"},{"speaker":"Charles Goldfarb","startTime":144.31,"endTime":148.15,"body":"patients. And so first of all,"},{"speaker":"Charles Goldfarb","startTime":144.31,"endTime":148.15,"body":"let me just say, because I, this"},{"speaker":"Charles Goldfarb","startTime":148.15,"endTime":151.54,"body":"is somewhat controversial. I'm a"},{"speaker":"Charles Goldfarb","startTime":148.15,"endTime":151.54,"body":"believer in the CMC fusion, I"},{"speaker":"Charles Goldfarb","startTime":151.54,"endTime":156.22,"body":"think it can be an outstanding"},{"speaker":"Charles Goldfarb","startTime":151.54,"endTime":156.22,"body":"option in the right patient. And"},{"speaker":"Charles Goldfarb","startTime":156.22,"endTime":158.86,"body":"for me, the right patient is a"},{"speaker":"Charles Goldfarb","startTime":156.22,"endTime":158.86,"body":"younger patient. And what does"},{"speaker":"Charles Goldfarb","startTime":158.86,"endTime":162.04,"body":"younger mean? I don't know, less"},{"speaker":"Charles Goldfarb","startTime":158.86,"endTime":162.04,"body":"than, younger than me, less than"},{"speaker":"Charles Goldfarb","startTime":162.04,"endTime":162.46,"body":"50"},{"speaker":"Chris Dy","startTime":162.46,"endTime":163.69,"body":"I was about to say."},{"speaker":"Charles Goldfarb","startTime":165.52,"endTime":168.52,"body":"It means"},{"speaker":"Charles Goldfarb","startTime":165.52,"endTime":168.52,"body":"someone who is you know, as my"},{"speaker":"Charles Goldfarb","startTime":168.52,"endTime":172.0,"body":"patients like to say, you know,"},{"speaker":"Charles Goldfarb","startTime":168.52,"endTime":172.0,"body":"I use my hands a lot. One of my"},{"speaker":"Charles Goldfarb","startTime":172.0,"endTime":175.66,"body":"favorite patient comments. Yes,"},{"speaker":"Charles Goldfarb","startTime":172.0,"endTime":175.66,"body":"thank you. We all do. But"},{"speaker":"Charles Goldfarb","startTime":175.66,"endTime":178.45,"body":"someone with intensive hand"},{"speaker":"Charles Goldfarb","startTime":175.66,"endTime":178.45,"body":"activities, especially. But I"},{"speaker":"Charles Goldfarb","startTime":178.45,"endTime":181.51,"body":"think it's a great option. Do"},{"speaker":"Charles Goldfarb","startTime":178.45,"endTime":181.51,"body":"you use the CMC fusion"},{"speaker":"Charles Goldfarb","startTime":181.51,"endTime":182.14,"body":"routinely?"},{"speaker":"Chris Dy","startTime":182.0,"endTime":184.73,"body":"I do, I tend to follow"},{"speaker":"Chris Dy","startTime":182.0,"endTime":184.73,"body":"the standard kinds of"},{"speaker":"Chris Dy","startTime":184.73,"endTime":188.69,"body":"indications, people younger than"},{"speaker":"Chris Dy","startTime":184.73,"endTime":188.69,"body":"Chuck, and people that do"},{"speaker":"Chris Dy","startTime":188.69,"endTime":191.66,"body":"heavier types of activities,"},{"speaker":"Chris Dy","startTime":188.69,"endTime":191.66,"body":"whether that's for work, or when"},{"speaker":"Chris Dy","startTime":191.66,"endTime":194.84,"body":"I ask them the types of hobbies"},{"speaker":"Chris Dy","startTime":191.66,"endTime":194.84,"body":"that they like to do. You know,"},{"speaker":"Chris Dy","startTime":194.84,"endTime":199.07,"body":"I know that, you know, the,"},{"speaker":"Chris Dy","startTime":194.84,"endTime":199.07,"body":"there are some studies"},{"speaker":"Chris Dy","startTime":199.07,"endTime":201.98,"body":"demonstrating that grip and"},{"speaker":"Chris Dy","startTime":199.07,"endTime":201.98,"body":"pinch can be quite well restored"},{"speaker":"Chris Dy","startTime":201.98,"endTime":208.22,"body":"after arthroplasty or, you know,"},{"speaker":"Chris Dy","startTime":201.98,"endTime":208.22,"body":"LRTI type options. But I do"},{"speaker":"Chris Dy","startTime":208.22,"endTime":210.95,"body":"think it makes a lot of sense in"},{"speaker":"Chris Dy","startTime":208.22,"endTime":210.95,"body":"the right patient, you know, the"},{"speaker":"Chris Dy","startTime":210.95,"endTime":214.22,"body":"non union rate is real. And"},{"speaker":"Chris Dy","startTime":210.95,"endTime":214.22,"body":"that's what scares me. You know,"},{"speaker":"Chris Dy","startTime":214.22,"endTime":217.37,"body":"so, in a paper coming out of"},{"speaker":"Chris Dy","startTime":214.22,"endTime":217.37,"body":"here even demonstrated that a"},{"speaker":"Chris Dy","startTime":217.37,"endTime":220.07,"body":"couple of years ago, so I mean,"},{"speaker":"Chris Dy","startTime":217.37,"endTime":220.07,"body":"how do you mitigate that risk?"},{"speaker":"Charles Goldfarb","startTime":220.87,"endTime":222.7,"body":"Before I"},{"speaker":"Charles Goldfarb","startTime":220.87,"endTime":222.7,"body":"answer the question, which is"},{"speaker":"Charles Goldfarb","startTime":222.76,"endTime":226.57,"body":"the important question. I give"},{"speaker":"Charles Goldfarb","startTime":222.76,"endTime":226.57,"body":"patients and I'd be interested"},{"speaker":"Charles Goldfarb","startTime":226.57,"endTime":229.81,"body":"to see what you tell patients, I"},{"speaker":"Charles Goldfarb","startTime":226.57,"endTime":229.81,"body":"tell patients, two things in"},{"speaker":"Charles Goldfarb","startTime":229.81,"endTime":233.26,"body":"warning about this procedure."},{"speaker":"Charles Goldfarb","startTime":229.81,"endTime":233.26,"body":"Number one, you will not be able"},{"speaker":"Charles Goldfarb","startTime":233.26,"endTime":236.29,"body":"to put your hand flat on the"},{"speaker":"Charles Goldfarb","startTime":233.26,"endTime":236.29,"body":"table. If you say that in"},{"speaker":"Charles Goldfarb","startTime":236.29,"endTime":240.07,"body":"advance, it's a non issue,"},{"speaker":"Charles Goldfarb","startTime":236.29,"endTime":240.07,"body":"because they can come close, but"},{"speaker":"Charles Goldfarb","startTime":240.07,"endTime":242.29,"body":"they can't quite get their hand"},{"speaker":"Charles Goldfarb","startTime":240.07,"endTime":242.29,"body":"flat on the table. And the"},{"speaker":"Charles Goldfarb","startTime":242.29,"endTime":245.26,"body":"second thing is even less of an"},{"speaker":"Charles Goldfarb","startTime":242.29,"endTime":245.26,"body":"issue. It can be tricky to put"},{"speaker":"Charles Goldfarb","startTime":245.26,"endTime":249.07,"body":"your hands in gloves. But other"},{"speaker":"Charles Goldfarb","startTime":245.26,"endTime":249.07,"body":"than that, I don't get"},{"speaker":"Charles Goldfarb","startTime":249.07,"endTime":250.48,"body":"complaints about this procedure."},{"speaker":"Chris Dy","startTime":251.95,"endTime":257.2,"body":"Do you think that it"},{"speaker":"Chris Dy","startTime":251.95,"endTime":257.2,"body":"takes a long time to get over"},{"speaker":"Chris Dy","startTime":257.26,"endTime":259.75,"body":"this surgery and we've talked"},{"speaker":"Chris Dy","startTime":257.26,"endTime":259.75,"body":"about the thumb CMC"},{"speaker":"Chris Dy","startTime":259.75,"endTime":265.15,"body":"arthroplasty, you know, LRTI in"},{"speaker":"Chris Dy","startTime":259.75,"endTime":265.15,"body":"various iterations, and perhaps"},{"speaker":"Chris Dy","startTime":265.15,"endTime":268.39,"body":"we don't tell people how long it"},{"speaker":"Chris Dy","startTime":265.15,"endTime":268.39,"body":"truly takes. You know, some"},{"speaker":"Chris Dy","startTime":268.39,"endTime":270.88,"body":"patients have told us six, nine"},{"speaker":"Chris Dy","startTime":268.39,"endTime":270.88,"body":"months and we usually tell them"},{"speaker":"Chris Dy","startTime":270.91,"endTime":273.43,"body":"three. So what do you tell"},{"speaker":"Chris Dy","startTime":270.91,"endTime":273.43,"body":"people about the recovery after"},{"speaker":"Chris Dy","startTime":273.46,"endTime":274.39,"body":"an arthrodesis?"},{"speaker":"Charles Goldfarb","startTime":274.42,"endTime":275.98,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":274.42,"endTime":275.98,"body":"one of the benefits of an"},{"speaker":"Charles Goldfarb","startTime":275.98,"endTime":279.91,"body":"arthrodesis. It is absolutely a"},{"speaker":"Charles Goldfarb","startTime":275.98,"endTime":279.91,"body":"faster recovery when compared to"},{"speaker":"Charles Goldfarb","startTime":279.91,"endTime":284.26,"body":"an LRTI. Now, you could argue"},{"speaker":"Charles Goldfarb","startTime":279.91,"endTime":284.26,"body":"that other trapeziectomy"},{"speaker":"Charles Goldfarb","startTime":284.29,"endTime":287.92,"body":"combined procedures, such as an"},{"speaker":"Charles Goldfarb","startTime":284.29,"endTime":287.92,"body":"internal brace may be a quicker"},{"speaker":"Charles Goldfarb","startTime":287.92,"endTime":291.88,"body":"recovery. But I think if you get"},{"speaker":"Charles Goldfarb","startTime":287.92,"endTime":291.88,"body":"to three months after a fusion,"},{"speaker":"Charles Goldfarb","startTime":292.0,"endTime":296.59,"body":"patients are generally healed,"},{"speaker":"Charles Goldfarb","startTime":292.0,"endTime":296.59,"body":"strength is recovered or nearly"},{"speaker":"Charles Goldfarb","startTime":296.59,"endTime":298.63,"body":"recovered and they're back to"},{"speaker":"Charles Goldfarb","startTime":296.59,"endTime":298.63,"body":"doing everything. So I think"},{"speaker":"Charles Goldfarb","startTime":298.63,"endTime":299.68,"body":"it's a pretty fast recovery."},{"speaker":"Chris Dy","startTime":299.74,"endTime":302.41,"body":"Now are you"},{"speaker":"Chris Dy","startTime":299.74,"endTime":302.41,"body":"immobilizing for six weeks after"},{"speaker":"Chris Dy","startTime":302.44,"endTime":304.87,"body":"the fusion to allow the fusion"},{"speaker":"Chris Dy","startTime":302.44,"endTime":304.87,"body":"body to set up?"},{"speaker":"Charles Goldfarb","startTime":305.47,"endTime":307.15,"body":"I'd probably"},{"speaker":"Charles Goldfarb","startTime":305.47,"endTime":307.15,"body":"go a little shorter than that."},{"speaker":"Charles Goldfarb","startTime":307.15,"endTime":311.47,"body":"But yes, I think the hardware"},{"speaker":"Charles Goldfarb","startTime":307.15,"endTime":311.47,"body":"and we'll get to that is part of"},{"speaker":"Charles Goldfarb","startTime":311.47,"endTime":316.9,"body":"the issue. And I do tend to go a"},{"speaker":"Charles Goldfarb","startTime":311.47,"endTime":316.9,"body":"little more slowly and don't get"},{"speaker":"Charles Goldfarb","startTime":316.9,"endTime":321.46,"body":"them into therapy too quickly."},{"speaker":"Charles Goldfarb","startTime":316.9,"endTime":321.46,"body":"Getting back to your question, I"},{"speaker":"Charles Goldfarb","startTime":321.46,"endTime":326.35,"body":"think the key elements to this"},{"speaker":"Charles Goldfarb","startTime":321.46,"endTime":326.35,"body":"procedure are one really getting"},{"speaker":"Charles Goldfarb","startTime":326.38,"endTime":330.91,"body":"good cancellous bone exposure."},{"speaker":"Charles Goldfarb","startTime":326.38,"endTime":330.91,"body":"And I did these two revisions in"},{"speaker":"Charles Goldfarb","startTime":330.91,"endTime":335.26,"body":"the last three weeks, and"},{"speaker":"Charles Goldfarb","startTime":330.91,"endTime":335.26,"body":"neither of them had complete"},{"speaker":"Charles Goldfarb","startTime":335.47,"endTime":336.91,"body":"cancellous bone exposure."},{"speaker":"Chris Dy","startTime":336.0,"endTime":338.43,"body":"So you were still"},{"speaker":"Chris Dy","startTime":336.0,"endTime":338.43,"body":"looking at cartilage?"},{"speaker":"Charles Goldfarb","startTime":338.49,"endTime":340.14,"body":"I was still"},{"speaker":"Charles Goldfarb","startTime":338.49,"endTime":340.14,"body":"looking at cartilage or that"},{"speaker":"Charles Goldfarb","startTime":340.14,"endTime":342.48,"body":"subchondral bone, you know, when"},{"speaker":"Charles Goldfarb","startTime":340.14,"endTime":342.48,"body":"you take off the cartilage,"},{"speaker":"Charles Goldfarb","startTime":342.6,"endTime":345.27,"body":"sometimes you think you're done,"},{"speaker":"Charles Goldfarb","startTime":342.6,"endTime":345.27,"body":"but you're really not. You need"},{"speaker":"Charles Goldfarb","startTime":345.27,"endTime":348.6,"body":"that sub cortical bone gone. You"},{"speaker":"Charles Goldfarb","startTime":345.27,"endTime":348.6,"body":"need the yellow, hopefully"},{"speaker":"Charles Goldfarb","startTime":348.6,"endTime":352.26,"body":"yellow, cancellous bone which is"},{"speaker":"Charles Goldfarb","startTime":348.6,"endTime":352.26,"body":"just sitting there waiting to"},{"speaker":"Charles Goldfarb","startTime":352.26,"endTime":352.71,"body":"heal."},{"speaker":"Chris Dy","startTime":353.52,"endTime":357.93,"body":"What side was the was"},{"speaker":"Chris Dy","startTime":353.52,"endTime":357.93,"body":"the issue on? On the metacarpal"},{"speaker":"Chris Dy","startTime":357.93,"endTime":359.25,"body":"side or on the trapezium side?"},{"speaker":"Charles Goldfarb","startTime":359.49,"endTime":362.01,"body":"So on, there"},{"speaker":"Charles Goldfarb","startTime":359.49,"endTime":362.01,"body":"was a like a T plate use on one"},{"speaker":"Charles Goldfarb","startTime":362.01,"endTime":364.02,"body":"of these patients, there were"},{"speaker":"Charles Goldfarb","startTime":362.01,"endTime":364.02,"body":"staples used on one of these"},{"speaker":"Charles Goldfarb","startTime":364.02,"endTime":368.37,"body":"patients. And on both of them."},{"speaker":"Charles Goldfarb","startTime":364.02,"endTime":368.37,"body":"Preparation was okay, I wouldn't"},{"speaker":"Charles Goldfarb","startTime":368.37,"endTime":370.74,"body":"be overly critical the previous"},{"speaker":"Charles Goldfarb","startTime":368.37,"endTime":370.74,"body":"surgeon but it wasn't perfect on"},{"speaker":"Charles Goldfarb","startTime":370.74,"endTime":372.6,"body":"either one. And it was on both"},{"speaker":"Charles Goldfarb","startTime":370.74,"endTime":372.6,"body":"sides"},{"speaker":"Chris Dy","startTime":372.75,"endTime":374.52,"body":"On both sides. You"},{"speaker":"Chris Dy","startTime":372.75,"endTime":374.52,"body":"know, because I think that one"},{"speaker":"Chris Dy","startTime":374.52,"endTime":376.92,"body":"of the challenges is that"},{"speaker":"Chris Dy","startTime":374.52,"endTime":376.92,"body":"obviously metacarpal is a much"},{"speaker":"Chris Dy","startTime":376.92,"endTime":381.21,"body":"bigger bone. When you're doing"},{"speaker":"Chris Dy","startTime":376.92,"endTime":381.21,"body":"the the fusion surface"},{"speaker":"Chris Dy","startTime":381.21,"endTime":385.08,"body":"preparation. Trapezium I mean,"},{"speaker":"Chris Dy","startTime":381.21,"endTime":385.08,"body":"on some of these patients that"},{"speaker":"Chris Dy","startTime":385.08,"endTime":387.33,"body":"you may run out of bone pretty"},{"speaker":"Chris Dy","startTime":385.08,"endTime":387.33,"body":"quickly."},{"speaker":"Charles Goldfarb","startTime":387.78,"endTime":389.82,"body":"You can so"},{"speaker":"Charles Goldfarb","startTime":387.78,"endTime":389.82,"body":"it's so much easier to prepare"},{"speaker":"Charles Goldfarb","startTime":389.82,"endTime":392.22,"body":"the base of the metacarpal I"},{"speaker":"Charles Goldfarb","startTime":389.82,"endTime":392.22,"body":"like to create that in a little"},{"speaker":"Charles Goldfarb","startTime":392.22,"endTime":395.22,"body":"bit of a cone shape, and I try"},{"speaker":"Charles Goldfarb","startTime":392.22,"endTime":395.22,"body":"to create a little bit of a cup"},{"speaker":"Charles Goldfarb","startTime":395.22,"endTime":397.65,"body":"shape from the distal aspect of"},{"speaker":"Charles Goldfarb","startTime":395.22,"endTime":397.65,"body":"the trapezium, but the"},{"speaker":"Charles Goldfarb","startTime":397.65,"endTime":400.41,"body":"preparation of the trapezium is"},{"speaker":"Charles Goldfarb","startTime":397.65,"endTime":400.41,"body":"just more difficult and you need"},{"speaker":"Charles Goldfarb","startTime":400.41,"endTime":403.59,"body":"to be meticulous. I do add"},{"speaker":"Charles Goldfarb","startTime":400.41,"endTime":403.59,"body":"distal radius bone graft to most"},{"speaker":"Charles Goldfarb","startTime":403.59,"endTime":406.05,"body":"of these because it's right"},{"speaker":"Charles Goldfarb","startTime":403.59,"endTime":406.05,"body":"there and it's simple to get and"},{"speaker":"Charles Goldfarb","startTime":406.05,"endTime":409.59,"body":"it does fill in the any gaps you"},{"speaker":"Charles Goldfarb","startTime":406.05,"endTime":409.59,"body":"may have. And then the hardware"},{"speaker":"Charles Goldfarb","startTime":409.59,"endTime":413.91,"body":"you know, pins are fine. A"},{"speaker":"Charles Goldfarb","startTime":409.59,"endTime":413.91,"body":"typical plate like a T plates"},{"speaker":"Charles Goldfarb","startTime":413.91,"endTime":418.14,"body":"probably okay. There are"},{"speaker":"Charles Goldfarb","startTime":413.91,"endTime":418.14,"body":"specialized plates and I have no"},{"speaker":"Charles Goldfarb","startTime":418.14,"endTime":421.62,"body":"relationship with Medartis"},{"speaker":"Charles Goldfarb","startTime":418.14,"endTime":421.62,"body":"whatsoever. But they have a"},{"speaker":"Charles Goldfarb","startTime":421.62,"endTime":425.76,"body":"really nice plate design for CMC"},{"speaker":"Charles Goldfarb","startTime":421.62,"endTime":425.76,"body":"fusion, which I use in both of"},{"speaker":"Charles Goldfarb","startTime":425.76,"endTime":427.53,"body":"these last two cases. And it's a"},{"speaker":"Charles Goldfarb","startTime":425.76,"endTime":427.53,"body":"game changer."},{"speaker":"Chris Dy","startTime":427.78,"endTime":430.0,"body":"Yeah, I think you"},{"speaker":"Chris Dy","startTime":427.78,"endTime":430.0,"body":"know, beyond that specific"},{"speaker":"Chris Dy","startTime":430.0,"endTime":433.84,"body":"plate, having a two column type"},{"speaker":"Chris Dy","startTime":430.0,"endTime":433.84,"body":"plate is really important. And"},{"speaker":"Chris Dy","startTime":433.84,"endTime":437.65,"body":"obviously you want locking"},{"speaker":"Chris Dy","startTime":433.84,"endTime":437.65,"body":"options to see how much you can"},{"speaker":"Chris Dy","startTime":437.68,"endTime":440.23,"body":"you know, especially on the"},{"speaker":"Chris Dy","startTime":437.68,"endTime":440.23,"body":"trapezium, it's easy to run out"},{"speaker":"Chris Dy","startTime":440.23,"endTime":442.6,"body":"of real estate. Ever use a"},{"speaker":"Chris Dy","startTime":440.23,"endTime":442.6,"body":"headless compression screw?"},{"speaker":"Charles Goldfarb","startTime":443.23,"endTime":446.14,"body":"I've revised"},{"speaker":"Charles Goldfarb","startTime":443.23,"endTime":446.14,"body":"headless compression screw"},{"speaker":"Charles Goldfarb","startTime":446.14,"endTime":449.71,"body":"cases, I just don't buy that you"},{"speaker":"Charles Goldfarb","startTime":446.14,"endTime":449.71,"body":"have enough trapezium. I just"},{"speaker":"Charles Goldfarb","startTime":449.71,"endTime":451.96,"body":"find I think you can get away"},{"speaker":"Charles Goldfarb","startTime":449.71,"endTime":451.96,"body":"with it sometimes, but I think"},{"speaker":"Charles Goldfarb","startTime":451.96,"endTime":454.78,"body":"you can get burned with it"},{"speaker":"Charles Goldfarb","startTime":451.96,"endTime":454.78,"body":"sometimes as well, and sta- I'm"},{"speaker":"Charles Goldfarb","startTime":454.78,"endTime":458.32,"body":"not a stapler. I recognize some"},{"speaker":"Charles Goldfarb","startTime":454.78,"endTime":458.32,"body":"people love staples for four"},{"speaker":"Charles Goldfarb","startTime":458.32,"endTime":461.65,"body":"corner fusions. And for this,"},{"speaker":"Charles Goldfarb","startTime":458.32,"endTime":461.65,"body":"I'm not against it, but again,"},{"speaker":"Charles Goldfarb","startTime":461.65,"endTime":464.02,"body":"it has to be set up to succeed."},{"speaker":"Chris Dy","startTime":464.17,"endTime":468.67,"body":"Yeah. Well, so thank"},{"speaker":"Chris Dy","startTime":464.17,"endTime":468.67,"body":"you for sharing that. Chuck. If"},{"speaker":"Chris Dy","startTime":468.67,"endTime":472.36,"body":"there's anybody that wants to"},{"speaker":"Chris Dy","startTime":468.67,"endTime":472.36,"body":"put in any requests, you know,"},{"speaker":"Chris Dy","startTime":472.36,"endTime":474.67,"body":"for listener grab bag, feel free"},{"speaker":"Chris Dy","startTime":472.36,"endTime":474.67,"body":"to email us"},{"speaker":"Chris Dy","startTime":474.67,"endTime":477.07,"body":"handpodcast@gmail.com."},{"speaker":"Chris Dy","startTime":474.67,"endTime":477.07,"body":"Otherwise, you're gonna just"},{"speaker":"Chris Dy","startTime":477.07,"endTime":481.57,"body":"keep getting pearls from Chuck."},{"speaker":"Chris Dy","startTime":477.07,"endTime":481.57,"body":"And then of course, please go"},{"speaker":"Chris Dy","startTime":481.57,"endTime":483.76,"body":"and do our listener survey."},{"speaker":"Chris Dy","startTime":481.57,"endTime":483.76,"body":"You'll find the links on our"},{"speaker":"Chris Dy","startTime":483.76,"endTime":487.18,"body":"social media accounts on"},{"speaker":"Chris Dy","startTime":483.76,"endTime":487.18,"body":"Twitter, we're @hand podcast."},{"speaker":"Chris Dy","startTime":487.54,"endTime":490.03,"body":"And we'll also have it at our"},{"speaker":"Chris Dy","startTime":487.54,"endTime":490.03,"body":"our website,"},{"speaker":"Chris Dy","startTime":490.06,"endTime":496.09,"body":"theupperhandpodcast.wustl.edu."},{"speaker":"Chris Dy","startTime":490.06,"endTime":496.09,"body":"The chance to win the coffee"},{"speaker":"Chris Dy","startTime":496.09,"endTime":499.6,"body":"mug, the coveted coffee mug for"},{"speaker":"Chris Dy","startTime":496.09,"endTime":499.6,"body":"the December drawing is is"},{"speaker":"Chris Dy","startTime":499.6,"endTime":500.29,"body":"coming up."},{"speaker":"Charles Goldfarb","startTime":500.73,"endTime":503.19,"body":"It is and we"},{"speaker":"Charles Goldfarb","startTime":500.73,"endTime":503.19,"body":"are excited to draw hopefully a"},{"speaker":"Charles Goldfarb","startTime":503.19,"endTime":506.88,"body":"domestic listener. But hey,"},{"speaker":"Charles Goldfarb","startTime":503.19,"endTime":506.88,"body":"whatever it takes."},{"speaker":"Chris Dy","startTime":506.9,"endTime":508.31,"body":"I love the"},{"speaker":"Chris Dy","startTime":506.9,"endTime":508.31,"body":"international listeners. I don't"},{"speaker":"Chris Dy","startTime":508.31,"endTime":510.62,"body":"know about you. I love that."},{"speaker":"Chris Dy","startTime":508.31,"endTime":510.62,"body":"Thank you for anybody that's"},{"speaker":"Chris Dy","startTime":510.62,"endTime":513.68,"body":"listening to us across the"},{"speaker":"Chris Dy","startTime":510.62,"endTime":513.68,"body":"world. Chuck doesn't appreciate"},{"speaker":"Chris Dy","startTime":513.68,"endTime":514.25,"body":"you but I do."},{"speaker":"Charles Goldfarb","startTime":514.73,"endTime":517.49,"body":"I love you"},{"speaker":"Charles Goldfarb","startTime":514.73,"endTime":517.49,"body":"just like I love our domestic"},{"speaker":"Charles Goldfarb","startTime":517.49,"endTime":519.47,"body":"listeners. I just don't like"},{"speaker":"Charles Goldfarb","startTime":517.49,"endTime":519.47,"body":"mailing you mugs."},{"speaker":"Chris Dy","startTime":519.5,"endTime":520.94,"body":"Oh, come on."},{"speaker":"Charles Goldfarb","startTime":521.9,"endTime":522.44,"body":"Alright"},{"speaker":"Chris Dy","startTime":522.47,"endTime":524.48,"body":"The Grinch is already"},{"speaker":"Chris Dy","startTime":522.47,"endTime":524.48,"body":"here. It's not even December"},{"speaker":"Chris Dy","startTime":524.48,"endTime":524.72,"body":"yet."},{"speaker":"Charles Goldfarb","startTime":525.92,"endTime":530.09,"body":"So listen, so"},{"speaker":"Charles Goldfarb","startTime":525.92,"endTime":530.09,"body":"people ask partners ask why I"},{"speaker":"Charles Goldfarb","startTime":530.09,"endTime":535.16,"body":"like Twitter. I like Twitter"},{"speaker":"Charles Goldfarb","startTime":530.09,"endTime":535.16,"body":"because I have a medical Twitter"},{"speaker":"Charles Goldfarb","startTime":535.16,"endTime":536.84,"body":"and I have a personal Twitter"},{"speaker":"Charles Goldfarb","startTime":535.16,"endTime":536.84,"body":"and they're for very different"},{"speaker":"Charles Goldfarb","startTime":536.84,"endTime":540.8,"body":"purposes on my medical Twitter,"},{"speaker":"Charles Goldfarb","startTime":536.84,"endTime":540.8,"body":"I usually just listen or read"},{"speaker":"Charles Goldfarb","startTime":541.01,"endTime":544.1,"body":"and sometimes I get exposed to"},{"speaker":"Charles Goldfarb","startTime":541.01,"endTime":544.1,"body":"things that I would not"},{"speaker":"Charles Goldfarb","startTime":544.1,"endTime":548.39,"body":"otherwise be exposed to and our"},{"speaker":"Charles Goldfarb","startTime":544.1,"endTime":548.39,"body":"topic for today is exactly that."},{"speaker":"Charles Goldfarb","startTime":548.57,"endTime":552.83,"body":"So in 1999 in the journal"},{"speaker":"Charles Goldfarb","startTime":548.57,"endTime":552.83,"body":"clinical cancer research, which"},{"speaker":"Charles Goldfarb","startTime":552.83,"endTime":554.93,"body":"I honestly have never heard of"},{"speaker":"Chris Dy","startTime":555.11,"endTime":556.19,"body":"That doesn't get in"},{"speaker":"Chris Dy","startTime":555.11,"endTime":556.19,"body":"your mail box?"},{"speaker":"Charles Goldfarb","startTime":556.31,"endTime":558.62,"body":"It does not, I"},{"speaker":"Charles Goldfarb","startTime":556.31,"endTime":558.62,"body":"struggle to read the journal of"},{"speaker":"Charles Goldfarb","startTime":558.62,"endTime":559.19,"body":"Hand surgery"},{"speaker":"Chris Dy","startTime":559.19,"endTime":560.12,"body":"Come on QXread."},{"speaker":"Charles Goldfarb","startTime":562.88,"endTime":568.13,"body":"True, but a"},{"speaker":"Charles Goldfarb","startTime":562.88,"endTime":568.13,"body":"well known cancer researcher and"},{"speaker":"Charles Goldfarb","startTime":568.13,"endTime":573.62,"body":"department and university leader"},{"speaker":"Charles Goldfarb","startTime":568.13,"endTime":573.62,"body":"named Joseph Simone wrote an"},{"speaker":"Charles Goldfarb","startTime":573.62,"endTime":576.86,"body":"article called understanding"},{"speaker":"Charles Goldfarb","startTime":573.62,"endTime":576.86,"body":"academic medical centers,"},{"speaker":"Charles Goldfarb","startTime":576.92,"endTime":581.84,"body":"Simone's Maxims and when someone"},{"speaker":"Charles Goldfarb","startTime":576.92,"endTime":581.84,"body":"blurbed about it on Twitter, I"},{"speaker":"Charles Goldfarb","startTime":581.84,"endTime":584.69,"body":"was intrigued and intrigued"},{"speaker":"Charles Goldfarb","startTime":581.84,"endTime":584.69,"body":"enough to go pull the article"},{"speaker":"Charles Goldfarb","startTime":584.9,"endTime":586.97,"body":"and I shared it with Chris and"},{"speaker":"Charles Goldfarb","startTime":584.9,"endTime":586.97,"body":"we thought it would be an"},{"speaker":"Charles Goldfarb","startTime":586.97,"endTime":588.56,"body":"interesting article to discuss."},{"speaker":"Chris Dy","startTime":589.05,"endTime":591.06,"body":"First off before we"},{"speaker":"Chris Dy","startTime":589.05,"endTime":591.06,"body":"get into the article, I 100%"},{"speaker":"Chris Dy","startTime":591.27,"endTime":595.14,"body":"agree with you that I learn a"},{"speaker":"Chris Dy","startTime":591.27,"endTime":595.14,"body":"lot on Twitter from other"},{"speaker":"Chris Dy","startTime":595.14,"endTime":599.55,"body":"fields. And you know I pick up a"},{"speaker":"Chris Dy","startTime":595.14,"endTime":599.55,"body":"lot from the field of general"},{"speaker":"Chris Dy","startTime":599.55,"endTime":601.98,"body":"surgery because they're"},{"speaker":"Chris Dy","startTime":599.55,"endTime":601.98,"body":"obviously doing a lot of work on"},{"speaker":"Chris Dy","startTime":601.98,"endTime":604.41,"body":"social media. And there are a"},{"speaker":"Chris Dy","startTime":601.98,"endTime":604.41,"body":"lot of interesting concepts with"},{"speaker":"Chris Dy","startTime":604.41,"endTime":607.65,"body":"regards to leadership, and then"},{"speaker":"Chris Dy","startTime":604.41,"endTime":607.65,"body":"even some of the research topics"},{"speaker":"Chris Dy","startTime":607.65,"endTime":609.87,"body":"that we like to explore in terms"},{"speaker":"Chris Dy","startTime":607.65,"endTime":609.87,"body":"of new methodologies that you"},{"speaker":"Chris Dy","startTime":609.87,"endTime":611.76,"body":"can pick up on Twitter. So"},{"speaker":"Chris Dy","startTime":609.87,"endTime":611.76,"body":"that's one of the main reasons"},{"speaker":"Chris Dy","startTime":611.76,"endTime":614.73,"body":"why I like it. And I also"},{"speaker":"Chris Dy","startTime":611.76,"endTime":614.73,"body":"honestly will have learned"},{"speaker":"Chris Dy","startTime":614.73,"endTime":617.76,"body":"about, you know, big randomized"},{"speaker":"Chris Dy","startTime":614.73,"endTime":617.76,"body":"trials published in like the"},{"speaker":"Chris Dy","startTime":617.76,"endTime":621.6,"body":"Lancet based on Twitter. So,"},{"speaker":"Chris Dy","startTime":617.76,"endTime":621.6,"body":"kudos to everybody who's sharing"},{"speaker":"Chris Dy","startTime":621.63,"endTime":622.98,"body":"good stuff on Twitter. Thank"},{"speaker":"Chris Dy","startTime":621.63,"endTime":622.98,"body":"you."},{"speaker":"Charles Goldfarb","startTime":623.05,"endTime":625.54,"body":"Yeah. And the"},{"speaker":"Charles Goldfarb","startTime":623.05,"endTime":625.54,"body":"other thing I read a lot about"},{"speaker":"Charles Goldfarb","startTime":625.54,"endTime":627.88,"body":"on Twitter, and again, I've been"},{"speaker":"Charles Goldfarb","startTime":625.54,"endTime":627.88,"body":"exposed to interesting articles"},{"speaker":"Charles Goldfarb","startTime":627.88,"endTime":630.76,"body":"is in the field of field, I"},{"speaker":"Charles Goldfarb","startTime":627.88,"endTime":630.76,"body":"don't know if that's the right"},{"speaker":"Charles Goldfarb","startTime":630.76,"endTime":634.63,"body":"word, but diversity, inclusion"},{"speaker":"Charles Goldfarb","startTime":630.76,"endTime":634.63,"body":"and social justice, there is"},{"speaker":"Charles Goldfarb","startTime":634.63,"endTime":638.41,"body":"great work and that some of that"},{"speaker":"Charles Goldfarb","startTime":634.63,"endTime":638.41,"body":"gets propagated on Twitter. And"},{"speaker":"Charles Goldfarb","startTime":638.41,"endTime":641.98,"body":"it really helps to open my eyes"},{"speaker":"Charles Goldfarb","startTime":638.41,"endTime":641.98,"body":"in a way that in my normal daily"},{"speaker":"Charles Goldfarb","startTime":641.98,"endTime":644.05,"body":"life, I may not be exposed."},{"speaker":"Chris Dy","startTime":644.41,"endTime":647.02,"body":"Yeah, it's always good"},{"speaker":"Chris Dy","startTime":644.41,"endTime":647.02,"body":"to have that extra exposure. So"},{"speaker":"Chris Dy","startTime":647.02,"endTime":649.81,"body":"let's get into discussing"},{"speaker":"Chris Dy","startTime":647.02,"endTime":649.81,"body":"Simone's Maxims. I think the"},{"speaker":"Chris Dy","startTime":650.38,"endTime":653.11,"body":"first Maxim that's listed here"},{"speaker":"Chris Dy","startTime":650.38,"endTime":653.11,"body":"is truly interesting. It's a"},{"speaker":"Chris Dy","startTime":653.11,"endTime":655.81,"body":"little awkward to have this"},{"speaker":"Chris Dy","startTime":653.11,"endTime":655.81,"body":"discussion in front of my vice"},{"speaker":"Chris Dy","startTime":655.81,"endTime":659.32,"body":"chair. But institutions don't"},{"speaker":"Chris Dy","startTime":655.81,"endTime":659.32,"body":"love you back."},{"speaker":"Charles Goldfarb","startTime":659.93,"endTime":661.7,"body":"So well, hold"},{"speaker":"Charles Goldfarb","startTime":659.93,"endTime":661.7,"body":"up, can I give a little"},{"speaker":"Charles Goldfarb","startTime":661.7,"endTime":662.18,"body":"background?"},{"speaker":"Chris Dy","startTime":662.21,"endTime":662.54,"body":"Sure"},{"speaker":"Charles Goldfarb","startTime":662.57,"endTime":664.64,"body":"You're, you"},{"speaker":"Charles Goldfarb","startTime":662.57,"endTime":664.64,"body":"want to jump into it. And I do,"},{"speaker":"Charles Goldfarb","startTime":664.64,"endTime":668.06,"body":"too, because it's super"},{"speaker":"Charles Goldfarb","startTime":664.64,"endTime":668.06,"body":"interesting. So this is an"},{"speaker":"Charles Goldfarb","startTime":668.06,"endTime":670.52,"body":"article and I think you can pull"},{"speaker":"Charles Goldfarb","startTime":668.06,"endTime":670.52,"body":"it for free. So anyone out there"},{"speaker":"Charles Goldfarb","startTime":670.52,"endTime":673.85,"body":"and we'll put a link in our in"},{"speaker":"Charles Goldfarb","startTime":670.52,"endTime":673.85,"body":"our show notes, there actually"},{"speaker":"Charles Goldfarb","startTime":673.85,"endTime":676.61,"body":"was a book written. So this"},{"speaker":"Charles Goldfarb","startTime":673.85,"endTime":676.61,"body":"article's from 1999, there was a"},{"speaker":"Charles Goldfarb","startTime":676.61,"endTime":680.33,"body":"book written in 2012, which I"},{"speaker":"Charles Goldfarb","startTime":676.61,"endTime":680.33,"body":"probably will buy, which is the"},{"speaker":"Charles Goldfarb","startTime":680.33,"endTime":683.93,"body":"same idea, but it's updated. So"},{"speaker":"Charles Goldfarb","startTime":680.33,"endTime":683.93,"body":"this is old. This is 21 years"},{"speaker":"Charles Goldfarb","startTime":683.93,"endTime":689.06,"body":"old. But it has absolutely stood"},{"speaker":"Charles Goldfarb","startTime":683.93,"endTime":689.06,"body":"the test of time. And the author"},{"speaker":"Charles Goldfarb","startTime":689.06,"endTime":692.51,"body":"just shares his thoughts about"},{"speaker":"Charles Goldfarb","startTime":689.06,"endTime":692.51,"body":"academic medical centers. And so"},{"speaker":"Charles Goldfarb","startTime":692.51,"endTime":695.48,"body":"some of you listening are like,"},{"speaker":"Charles Goldfarb","startTime":692.51,"endTime":695.48,"body":"Well, I'm not in academics, why"},{"speaker":"Charles Goldfarb","startTime":695.48,"endTime":698.3,"body":"should I keep listening? And I"},{"speaker":"Charles Goldfarb","startTime":695.48,"endTime":698.3,"body":"would just say that I think this"},{"speaker":"Charles Goldfarb","startTime":698.3,"endTime":701.66,"body":"is fascinating. You may listen"},{"speaker":"Charles Goldfarb","startTime":698.3,"endTime":701.66,"body":"to this conversation. And you"},{"speaker":"Charles Goldfarb","startTime":701.66,"endTime":704.75,"body":"may think, thank God, I'm not at"},{"speaker":"Charles Goldfarb","startTime":701.66,"endTime":704.75,"body":"an academic medical center. Or"},{"speaker":"Charles Goldfarb","startTime":704.75,"endTime":707.27,"body":"you may think, Hey, this still"},{"speaker":"Charles Goldfarb","startTime":704.75,"endTime":707.27,"body":"applies to me, because all of us"},{"speaker":"Charles Goldfarb","startTime":707.27,"endTime":710.48,"body":"deal in some form or fashion"},{"speaker":"Charles Goldfarb","startTime":707.27,"endTime":710.48,"body":"with bigger institutions today."},{"speaker":"Chris Dy","startTime":710.57,"endTime":712.67,"body":"Yeah, I think that's"},{"speaker":"Chris Dy","startTime":710.57,"endTime":712.67,"body":"100% relevant, and there are"},{"speaker":"Chris Dy","startTime":712.67,"endTime":715.97,"body":"going to be many listeners who"},{"speaker":"Chris Dy","startTime":712.67,"endTime":715.97,"body":"are saying, I'm glad I'm not"},{"speaker":"Chris Dy","startTime":715.97,"endTime":716.66,"body":"those guys."},{"speaker":"Charles Goldfarb","startTime":717.02,"endTime":717.44,"body":"So"},{"speaker":"Chris Dy","startTime":717.8,"endTime":719.54,"body":"But you'll probably"},{"speaker":"Chris Dy","startTime":717.8,"endTime":719.54,"body":"find some relevance for sure."},{"speaker":"Charles Goldfarb","startTime":719.0,"endTime":722.15,"body":"For sure. And"},{"speaker":"Charles Goldfarb","startTime":719.0,"endTime":722.15,"body":"I definitely did. So yeah, first"},{"speaker":"Charles Goldfarb","startTime":722.15,"endTime":727.46,"body":"of all, institutions don't love"},{"speaker":"Charles Goldfarb","startTime":722.15,"endTime":727.46,"body":"you back. And they're, that is"},{"speaker":"Charles Goldfarb","startTime":727.46,"endTime":729.59,"body":"the most important thing, I"},{"speaker":"Charles Goldfarb","startTime":727.46,"endTime":729.59,"body":"think, in this manuscript. I"},{"speaker":"Charles Goldfarb","startTime":729.59,"endTime":733.64,"body":"mean, it is really true. And the"},{"speaker":"Charles Goldfarb","startTime":729.59,"endTime":733.64,"body":"line that I like, which is,"},{"speaker":"Charles Goldfarb","startTime":733.67,"endTime":736.79,"body":"which is pretty clear, is that"},{"speaker":"Charles Goldfarb","startTime":733.67,"endTime":736.79,"body":"institutional leaders must make"},{"speaker":"Charles Goldfarb","startTime":736.79,"endTime":740.72,"body":"decisions that are not personal,"},{"speaker":"Charles Goldfarb","startTime":736.79,"endTime":740.72,"body":"but usually have positive or"},{"speaker":"Charles Goldfarb","startTime":740.72,"endTime":744.32,"body":"negative personal consequences."},{"speaker":"Charles Goldfarb","startTime":740.72,"endTime":744.32,"body":"So institutions have to think"},{"speaker":"Charles Goldfarb","startTime":744.32,"endTime":748.52,"body":"about the bigger picture. And I"},{"speaker":"Charles Goldfarb","startTime":744.32,"endTime":748.52,"body":"think it's really fair and fair"},{"speaker":"Charles Goldfarb","startTime":748.52,"endTime":750.71,"body":"or unfair, it's just it is what"},{"speaker":"Charles Goldfarb","startTime":748.52,"endTime":750.71,"body":"it is."},{"speaker":"Chris Dy","startTime":750.8,"endTime":754.43,"body":"One of the, you know"},{"speaker":"Chris Dy","startTime":750.8,"endTime":754.43,"body":"I, I think that this is a really"},{"speaker":"Chris Dy","startTime":754.43,"endTime":757.79,"body":"interesting part of the paper."},{"speaker":"Chris Dy","startTime":754.43,"endTime":757.79,"body":"And the sentence I underlined a"},{"speaker":"Chris Dy","startTime":757.79,"endTime":761.9,"body":"few sentences down is, one must"},{"speaker":"Chris Dy","startTime":757.79,"endTime":761.9,"body":"keep in mind that institutional"},{"speaker":"Chris Dy","startTime":761.9,"endTime":765.65,"body":"relationships are really with"},{"speaker":"Chris Dy","startTime":761.9,"endTime":765.65,"body":"persons who can and sometimes do"},{"speaker":"Chris Dy","startTime":765.65,"endTime":768.32,"body":"love you back. So if you think"},{"speaker":"Chris Dy","startTime":765.65,"endTime":768.32,"body":"about, you know, what you enjoy"},{"speaker":"Chris Dy","startTime":768.32,"endTime":772.31,"body":"about coming to work, and you"},{"speaker":"Chris Dy","startTime":768.32,"endTime":772.31,"body":"know, it's really the people as"},{"speaker":"Chris Dy","startTime":772.31,"endTime":775.28,"body":"opposed to saying I'm affiliated"},{"speaker":"Chris Dy","startTime":772.31,"endTime":775.28,"body":"with so and so institution,"},{"speaker":"Chris Dy","startTime":775.82,"endTime":778.13,"body":"because if, you know, if it was"},{"speaker":"Chris Dy","startTime":775.82,"endTime":778.13,"body":"just the institution without the"},{"speaker":"Chris Dy","startTime":778.13,"endTime":780.8,"body":"people, it would, it would be"},{"speaker":"Chris Dy","startTime":778.13,"endTime":780.8,"body":"probably an empty existence."},{"speaker":"Charles Goldfarb","startTime":781.26,"endTime":783.69,"body":"I that is"},{"speaker":"Charles Goldfarb","startTime":781.26,"endTime":783.69,"body":"exactly right. And I and I, one"},{"speaker":"Charles Goldfarb","startTime":783.69,"endTime":787.05,"body":"of the later points is that"},{"speaker":"Charles Goldfarb","startTime":783.69,"endTime":787.05,"body":"leadership matters. And I think"},{"speaker":"Charles Goldfarb","startTime":787.05,"endTime":789.87,"body":"if you have an effective leader,"},{"speaker":"Charles Goldfarb","startTime":787.05,"endTime":789.87,"body":"whether that's in your academic"},{"speaker":"Charles Goldfarb","startTime":789.87,"endTime":792.39,"body":"institution, your private"},{"speaker":"Charles Goldfarb","startTime":789.87,"endTime":792.39,"body":"practice, or whatever, then"},{"speaker":"Charles Goldfarb","startTime":792.39,"endTime":794.55,"body":"there are personal"},{"speaker":"Charles Goldfarb","startTime":792.39,"endTime":794.55,"body":"relationships. So we don't want"},{"speaker":"Charles Goldfarb","startTime":794.55,"endTime":797.94,"body":"to be too negative as we started"},{"speaker":"Charles Goldfarb","startTime":794.55,"endTime":797.94,"body":"the show by saying, I think it's"},{"speaker":"Charles Goldfarb","startTime":797.94,"endTime":801.21,"body":"just a reality, you know, you"},{"speaker":"Charles Goldfarb","startTime":797.94,"endTime":801.21,"body":"have to advocate for yourself,"},{"speaker":"Charles Goldfarb","startTime":801.42,"endTime":804.93,"body":"and understand institutional"},{"speaker":"Charles Goldfarb","startTime":801.42,"endTime":804.93,"body":"priorities. So Ryan Calfee"},{"speaker":"Charles Goldfarb","startTime":804.96,"endTime":808.2,"body":"recently suggested that I read"},{"speaker":"Charles Goldfarb","startTime":804.96,"endTime":808.2,"body":"the infinite game by Simon"},{"speaker":"Charles Goldfarb","startTime":808.2,"endTime":811.62,"body":"Sinek. And he's a business"},{"speaker":"Charles Goldfarb","startTime":808.2,"endTime":811.62,"body":"writer, he's written some really"},{"speaker":"Charles Goldfarb","startTime":811.62,"endTime":814.32,"body":"good stuff, I hadn't read this"},{"speaker":"Charles Goldfarb","startTime":811.62,"endTime":814.32,"body":"particular book, the infinite"},{"speaker":"Charles Goldfarb","startTime":814.32,"endTime":818.76,"body":"game, essentially, contrary, and"},{"speaker":"Charles Goldfarb","startTime":814.32,"endTime":818.76,"body":"this is a good read so far. It"},{"speaker":"Charles Goldfarb","startTime":818.76,"endTime":822.78,"body":"really contrasts the finite"},{"speaker":"Charles Goldfarb","startTime":818.76,"endTime":822.78,"body":"game, which is like a game of"},{"speaker":"Charles Goldfarb","startTime":822.78,"endTime":826.35,"body":"football. Or it could be Chuck"},{"speaker":"Charles Goldfarb","startTime":822.78,"endTime":826.35,"body":"Goldfarb's career versus the"},{"speaker":"Charles Goldfarb","startTime":826.38,"endTime":829.17,"body":"infinite game, which are games"},{"speaker":"Charles Goldfarb","startTime":826.38,"endTime":829.17,"body":"that are not won and lost and"},{"speaker":"Charles Goldfarb","startTime":829.17,"endTime":832.8,"body":"are played over a longer period"},{"speaker":"Charles Goldfarb","startTime":829.17,"endTime":832.8,"body":"of time. So institutions think"},{"speaker":"Charles Goldfarb","startTime":832.8,"endTime":836.7,"body":"about infinity, Chris and I, you"},{"speaker":"Charles Goldfarb","startTime":832.8,"endTime":836.7,"body":"know, because we're human,"},{"speaker":"Charles Goldfarb","startTime":836.7,"endTime":840.57,"body":"because this is our job think in"},{"speaker":"Charles Goldfarb","startTime":836.7,"endTime":840.57,"body":"a more finite way. So it's just"},{"speaker":"Charles Goldfarb","startTime":840.57,"endTime":841.83,"body":"a really interesting context."},{"speaker":"Chris Dy","startTime":842.08,"endTime":845.56,"body":"Yeah, I think that's a"},{"speaker":"Chris Dy","startTime":842.08,"endTime":845.56,"body":"good way to put it and, you"},{"speaker":"Chris Dy","startTime":845.56,"endTime":849.64,"body":"know, not being in a, any sort"},{"speaker":"Chris Dy","startTime":845.56,"endTime":849.64,"body":"of leadership role and not being"},{"speaker":"Chris Dy","startTime":849.64,"endTime":852.52,"body":"part of, you know, the bigger"},{"speaker":"Chris Dy","startTime":849.64,"endTime":852.52,"body":"thoughts of an institution and I"},{"speaker":"Chris Dy","startTime":852.52,"endTime":854.47,"body":"have a hard enough time, you"},{"speaker":"Chris Dy","startTime":852.52,"endTime":854.47,"body":"know, putting one foot in front"},{"speaker":"Chris Dy","startTime":854.47,"endTime":855.79,"body":"of the other on some of these"},{"speaker":"Chris Dy","startTime":854.47,"endTime":855.79,"body":"days, so."},{"speaker":"Charles Goldfarb","startTime":856.21,"endTime":858.94,"body":"Absolutely, I"},{"speaker":"Charles Goldfarb","startTime":856.21,"endTime":858.94,"body":"like this. What they called a"},{"speaker":"Charles Goldfarb","startTime":858.94,"endTime":862.42,"body":"variant of this maxim is that"},{"speaker":"Charles Goldfarb","startTime":858.94,"endTime":862.42,"body":"institutional reputations, and"},{"speaker":"Charles Goldfarb","startTime":862.42,"endTime":866.02,"body":"those of its departments and"},{"speaker":"Charles Goldfarb","startTime":862.42,"endTime":866.02,"body":"divisions change long after the"},{"speaker":"Charles Goldfarb","startTime":866.02,"endTime":869.74,"body":"time of their successes and"},{"speaker":"Charles Goldfarb","startTime":866.02,"endTime":869.74,"body":"failures, individual reputations"},{"speaker":"Charles Goldfarb","startTime":869.74,"endTime":872.41,"body":"change more quickly. And we've"},{"speaker":"Charles Goldfarb","startTime":869.74,"endTime":872.41,"body":"seen that in real life, and I'll"},{"speaker":"Charles Goldfarb","startTime":872.41,"endTime":876.04,"body":"be very personal here, is that"},{"speaker":"Charles Goldfarb","startTime":872.41,"endTime":876.04,"body":"our department, and I can"},{"speaker":"Charles Goldfarb","startTime":876.04,"endTime":879.13,"body":"thankfully say in the past, had"},{"speaker":"Charles Goldfarb","startTime":876.04,"endTime":879.13,"body":"a reputation for being somewhat"},{"speaker":"Charles Goldfarb","startTime":879.13,"endTime":883.87,"body":"malignant for residency"},{"speaker":"Charles Goldfarb","startTime":879.13,"endTime":883.87,"body":"training, and lo- it took a long"},{"speaker":"Charles Goldfarb","startTime":883.87,"endTime":887.71,"body":"time for that to go away. And"},{"speaker":"Charles Goldfarb","startTime":883.87,"endTime":887.71,"body":"that was a negative reputation."},{"speaker":"Charles Goldfarb","startTime":887.92,"endTime":890.83,"body":"And we had to work really hard."},{"speaker":"Charles Goldfarb","startTime":887.92,"endTime":890.83,"body":"We don't have that reputation"},{"speaker":"Charles Goldfarb","startTime":890.83,"endTime":893.5,"body":"anymore. We shouldn't have that"},{"speaker":"Charles Goldfarb","startTime":890.83,"endTime":893.5,"body":"reputation because we're not,"},{"speaker":"Charles Goldfarb","startTime":893.8,"endTime":896.47,"body":"but those kind of things for"},{"speaker":"Charles Goldfarb","startTime":893.8,"endTime":896.47,"body":"better or worse are hard to"},{"speaker":"Charles Goldfarb","startTime":896.47,"endTime":896.83,"body":"change."},{"speaker":"Chris Dy","startTime":897.07,"endTime":898.75,"body":"Well, how do you"},{"speaker":"Chris Dy","startTime":897.07,"endTime":898.75,"body":"change it then?"},{"speaker":"Charles Goldfarb","startTime":899.5,"endTime":902.8,"body":"I think It's A"},{"speaker":"Charles Goldfarb","startTime":899.5,"endTime":902.8,"body":"about, you know, reputations"},{"speaker":"Charles Goldfarb","startTime":902.8,"endTime":907.54,"body":"develop for a reason, and maybe"},{"speaker":"Charles Goldfarb","startTime":902.8,"endTime":907.54,"body":"not always fairly, presumably"},{"speaker":"Charles Goldfarb","startTime":907.54,"endTime":910.99,"body":"with a little bit at least some"},{"speaker":"Charles Goldfarb","startTime":907.54,"endTime":910.99,"body":"degree of truth. And so I think"},{"speaker":"Charles Goldfarb","startTime":910.99,"endTime":914.32,"body":"you first have to recognize"},{"speaker":"Charles Goldfarb","startTime":910.99,"endTime":914.32,"body":"that, you know, there is or"},{"speaker":"Charles Goldfarb","startTime":914.32,"endTime":918.34,"body":"potentially is an issue, correct"},{"speaker":"Charles Goldfarb","startTime":914.32,"endTime":918.34,"body":"the issue double down on"},{"speaker":"Charles Goldfarb","startTime":918.34,"endTime":921.25,"body":"correcting the issue. And then"},{"speaker":"Charles Goldfarb","startTime":918.34,"endTime":921.25,"body":"you have to be patient as hard"},{"speaker":"Charles Goldfarb","startTime":921.25,"endTime":922.06,"body":"as that may be."},{"speaker":"Chris Dy","startTime":922.27,"endTime":925.84,"body":"How long do you think"},{"speaker":"Chris Dy","startTime":922.27,"endTime":925.84,"body":"that it? You know, the, the arc"},{"speaker":"Chris Dy","startTime":925.84,"endTime":928.57,"body":"of time between when it was"},{"speaker":"Chris Dy","startTime":925.84,"endTime":928.57,"body":"recognized that, you know, we"},{"speaker":"Chris Dy","startTime":928.57,"endTime":933.22,"body":"have this reputation of being"},{"speaker":"Chris Dy","startTime":928.57,"endTime":933.22,"body":"malignant in residency training,"},{"speaker":"Chris Dy","startTime":933.85,"endTime":937.06,"body":"to when you feel like the page"},{"speaker":"Chris Dy","startTime":933.85,"endTime":937.06,"body":"turned? Like, how long did that"},{"speaker":"Chris Dy","startTime":937.06,"endTime":937.48,"body":"take?"},{"speaker":"Charles Goldfarb","startTime":938.89,"endTime":940.9,"body":"You may laugh"},{"speaker":"Charles Goldfarb","startTime":938.89,"endTime":940.9,"body":"at me and really think I'm old,"},{"speaker":"Charles Goldfarb","startTime":940.9,"endTime":944.98,"body":"but I would say 10 years. 10"},{"speaker":"Charles Goldfarb","startTime":940.9,"endTime":944.98,"body":"years before it was not an issue"},{"speaker":"Charles Goldfarb","startTime":944.98,"endTime":948.31,"body":"that we felt like we had to say"},{"speaker":"Charles Goldfarb","startTime":944.98,"endTime":948.31,"body":"something about during residency"},{"speaker":"Charles Goldfarb","startTime":948.31,"endTime":950.83,"body":"interviews, and we were"},{"speaker":"Charles Goldfarb","startTime":948.31,"endTime":950.83,"body":"malignant. When I was a resident"},{"speaker":"Charles Goldfarb","startTime":950.83,"endTime":955.03,"body":"here, we were malignant. And"},{"speaker":"Charles Goldfarb","startTime":950.83,"endTime":955.03,"body":"again, we have doubled down it"},{"speaker":"Charles Goldfarb","startTime":955.03,"endTime":959.11,"body":"just, we were not malignant for"},{"speaker":"Charles Goldfarb","startTime":955.03,"endTime":959.11,"body":"many years before that"},{"speaker":"Charles Goldfarb","startTime":959.11,"endTime":960.01,"body":"reputation went away."},{"speaker":"Chris Dy","startTime":960.0,"endTime":963.27,"body":"Gotcha. Yeah,"},{"speaker":"Chris Dy","startTime":960.0,"endTime":963.27,"body":"reputations are, are hard to"},{"speaker":"Chris Dy","startTime":963.27,"endTime":966.69,"body":"adjust. And I think that, you"},{"speaker":"Chris Dy","startTime":963.27,"endTime":966.69,"body":"know, that's one of the"},{"speaker":"Chris Dy","startTime":966.69,"endTime":969.54,"body":"challenges of being a leader and"},{"speaker":"Chris Dy","startTime":966.69,"endTime":969.54,"body":"knowing when you have to change"},{"speaker":"Chris Dy","startTime":969.54,"endTime":971.76,"body":"something, but having the"},{"speaker":"Chris Dy","startTime":969.54,"endTime":971.76,"body":"patience and then having"},{"speaker":"Chris Dy","startTime":971.76,"endTime":974.16,"body":"constituents that are going to"},{"speaker":"Chris Dy","startTime":971.76,"endTime":974.16,"body":"be patient enough."},{"speaker":"Charles Goldfarb","startTime":974.58,"endTime":976.59,"body":"Right,"},{"speaker":"Charles Goldfarb","startTime":974.58,"endTime":976.59,"body":"absolutely. And you got to make"},{"speaker":"Charles Goldfarb","startTime":976.59,"endTime":978.45,"body":"sure you're heading in the right"},{"speaker":"Charles Goldfarb","startTime":976.59,"endTime":978.45,"body":"direction. And we'll get to some"},{"speaker":"Charles Goldfarb","startTime":978.45,"endTime":981.66,"body":"more of that. I like this next"},{"speaker":"Charles Goldfarb","startTime":978.45,"endTime":981.66,"body":"one, just because this"},{"speaker":"Charles Goldfarb","startTime":981.66,"endTime":984.09,"body":"definitely applies to anyone and"},{"speaker":"Charles Goldfarb","startTime":981.66,"endTime":984.09,"body":"everyone, it talks about"},{"speaker":"Charles Goldfarb","startTime":984.12,"endTime":987.66,"body":"institutional committees. But"},{"speaker":"Charles Goldfarb","startTime":984.12,"endTime":987.66,"body":"this applies to any committee"},{"speaker":"Charles Goldfarb","startTime":987.66,"endTime":992.49,"body":"one is on, any board one is on."},{"speaker":"Charles Goldfarb","startTime":987.66,"endTime":992.49,"body":"It consists of about 30% of"},{"speaker":"Charles Goldfarb","startTime":992.49,"endTime":995.7,"body":"members who will work at it,"},{"speaker":"Charles Goldfarb","startTime":992.49,"endTime":995.7,"body":"despite other pressures and"},{"speaker":"Charles Goldfarb","startTime":995.7,"endTime":1000.29,"body":"work, and 20%, who are idiots,"},{"speaker":"Charles Goldfarb","startTime":995.7,"endTime":1000.29,"body":"status seekers or troublemakers"},{"speaker":"Charles Goldfarb","startTime":1000.29,"endTime":1001.67,"body":"and the rest are somewhere in"},{"speaker":"Charles Goldfarb","startTime":1000.29,"endTime":1001.67,"body":"between."},{"speaker":"Chris Dy","startTime":1001.7,"endTime":1002.87,"body":"Yeah, I was going to"},{"speaker":"Chris Dy","startTime":1001.7,"endTime":1002.87,"body":"say what happened to the rest of"},{"speaker":"Chris Dy","startTime":1002.87,"endTime":1005.45,"body":"the people I was I read this"},{"speaker":"Chris Dy","startTime":1002.87,"endTime":1005.45,"body":"line a few times trying to"},{"speaker":"Chris Dy","startTime":1005.45,"endTime":1007.43,"body":"figure out what the other 50% of"},{"speaker":"Chris Dy","startTime":1005.45,"endTime":1007.43,"body":"people were"},{"speaker":"Charles Goldfarb","startTime":1007.49,"endTime":1010.82,"body":"They're just"},{"speaker":"Charles Goldfarb","startTime":1007.49,"endTime":1010.82,"body":"there. But I think the key point"},{"speaker":"Charles Goldfarb","startTime":1010.82,"endTime":1014.03,"body":"here, which really resonates"},{"speaker":"Charles Goldfarb","startTime":1010.82,"endTime":1014.03,"body":"with me, is that the line that"},{"speaker":"Charles Goldfarb","startTime":1014.03,"endTime":1017.39,"body":"most successful committees have"},{"speaker":"Charles Goldfarb","startTime":1014.03,"endTime":1017.39,"body":"hardworking Chairmen who prepare"},{"speaker":"Charles Goldfarb","startTime":1017.39,"endTime":1020.36,"body":"themselves and the members"},{"speaker":"Charles Goldfarb","startTime":1017.39,"endTime":1020.36,"body":"before the meeting, call"},{"speaker":"Charles Goldfarb","startTime":1020.36,"endTime":1023.21,"body":"meetings only when essential,"},{"speaker":"Charles Goldfarb","startTime":1020.36,"endTime":1023.21,"body":"and engage members in a"},{"speaker":"Charles Goldfarb","startTime":1023.21,"endTime":1024.5,"body":"productive manner."},{"speaker":"Chris Dy","startTime":1025.01,"endTime":1028.34,"body":"So how do you run an"},{"speaker":"Chris Dy","startTime":1025.01,"endTime":1028.34,"body":"effective meeting? Because I"},{"speaker":"Chris Dy","startTime":1028.34,"endTime":1031.01,"body":"think that that's something that"},{"speaker":"Chris Dy","startTime":1028.34,"endTime":1031.01,"body":"is really challenging to do."},{"speaker":"Charles Goldfarb","startTime":1032.35,"endTime":1035.02,"body":"Totally agree."},{"speaker":"Charles Goldfarb","startTime":1032.35,"endTime":1035.02,"body":"And I do think and first of all,"},{"speaker":"Charles Goldfarb","startTime":1035.02,"endTime":1038.5,"body":"I take pride, I run a lot of"},{"speaker":"Charles Goldfarb","startTime":1035.02,"endTime":1038.5,"body":"meetings now. And I think the"},{"speaker":"Charles Goldfarb","startTime":1038.5,"endTime":1043.33,"body":"first, the first and most"},{"speaker":"Charles Goldfarb","startTime":1038.5,"endTime":1043.33,"body":"important thing about being seen"},{"speaker":"Charles Goldfarb","startTime":1043.33,"endTime":1045.67,"body":"as somebody who runs an"},{"speaker":"Charles Goldfarb","startTime":1043.33,"endTime":1045.67,"body":"effective meeting, is finish"},{"speaker":"Charles Goldfarb","startTime":1045.67,"endTime":1048.94,"body":"your meeting on time, come hell"},{"speaker":"Charles Goldfarb","startTime":1045.67,"endTime":1048.94,"body":"or high water, finish your"},{"speaker":"Charles Goldfarb","startTime":1048.94,"endTime":1052.06,"body":"meeting on time, and people know"},{"speaker":"Charles Goldfarb","startTime":1048.94,"endTime":1052.06,"body":"that when I run a meeting, first"},{"speaker":"Charles Goldfarb","startTime":1052.06,"endTime":1055.96,"body":"of all, I do prepare, and I"},{"speaker":"Charles Goldfarb","startTime":1052.06,"endTime":1055.96,"body":"always have an outline for a"},{"speaker":"Charles Goldfarb","startTime":1055.96,"endTime":1060.28,"body":"meeting. And always keep your"},{"speaker":"Charles Goldfarb","startTime":1055.96,"endTime":1060.28,"body":"remarks short. And try not to"},{"speaker":"Charles Goldfarb","startTime":1060.28,"endTime":1064.3,"body":"just talk at the committee, but"},{"speaker":"Charles Goldfarb","startTime":1060.28,"endTime":1064.3,"body":"meaning is about Yes,"},{"speaker":"Charles Goldfarb","startTime":1064.3,"endTime":1067.33,"body":"communication to the committee."},{"speaker":"Charles Goldfarb","startTime":1064.3,"endTime":1067.33,"body":"But hopefully it's about getting"},{"speaker":"Charles Goldfarb","startTime":1067.33,"endTime":1070.09,"body":"back information from the"},{"speaker":"Charles Goldfarb","startTime":1067.33,"endTime":1070.09,"body":"committee. And so the"},{"speaker":"Charles Goldfarb","startTime":1070.09,"endTime":1072.49,"body":"preparation and the timeliness"},{"speaker":"Charles Goldfarb","startTime":1070.09,"endTime":1072.49,"body":"to me are the two most important"},{"speaker":"Charles Goldfarb","startTime":1072.49,"endTime":1072.73,"body":"things."},{"speaker":"Chris Dy","startTime":1072.76,"endTime":1074.77,"body":"Has it become that"},{"speaker":"Chris Dy","startTime":1072.76,"endTime":1074.77,"body":"much more challenging in the"},{"speaker":"Chris Dy","startTime":1074.77,"endTime":1075.82,"body":"pandemic environment?"},{"speaker":"Charles Goldfarb","startTime":1077.35,"endTime":1079.0,"body":"It is, the"},{"speaker":"Charles Goldfarb","startTime":1077.35,"endTime":1079.0,"body":"loss of the personal touch, I"},{"speaker":"Charles Goldfarb","startTime":1079.0,"endTime":1082.99,"body":"guess? The fact that you can"},{"speaker":"Charles Goldfarb","startTime":1079.0,"endTime":1082.99,"body":"call a meeting at any time is"},{"speaker":"Charles Goldfarb","startTime":1082.99,"endTime":1086.14,"body":"really challenging. But the"},{"speaker":"Charles Goldfarb","startTime":1082.99,"endTime":1086.14,"body":"fundamentals still apply."},{"speaker":"Chris Dy","startTime":1086.59,"endTime":1088.69,"body":"Yeah, I think it's I"},{"speaker":"Chris Dy","startTime":1086.59,"endTime":1088.69,"body":"think engagement is harder in"},{"speaker":"Chris Dy","startTime":1088.69,"endTime":1091.42,"body":"the current era. I mean I'm not"},{"speaker":"Chris Dy","startTime":1088.69,"endTime":1091.42,"body":"involved in nearly as many of"},{"speaker":"Chris Dy","startTime":1091.42,"endTime":1093.67,"body":"the leadership things as you are"},{"speaker":"Chris Dy","startTime":1091.42,"endTime":1093.67,"body":"in running meetings. But I think"},{"speaker":"Chris Dy","startTime":1093.67,"endTime":1097.42,"body":"that even trying to run my lab"},{"speaker":"Chris Dy","startTime":1093.67,"endTime":1097.42,"body":"meetings, you know, everybody,"},{"speaker":"Chris Dy","startTime":1097.42,"endTime":1100.45,"body":"because we're not present in the"},{"speaker":"Chris Dy","startTime":1097.42,"endTime":1100.45,"body":"same room, it's harder to be"},{"speaker":"Chris Dy","startTime":1100.48,"endTime":1103.63,"body":"present, you know, in a greater"},{"speaker":"Chris Dy","startTime":1100.48,"endTime":1103.63,"body":"sense, and getting people"},{"speaker":"Chris Dy","startTime":1103.63,"endTime":1107.14,"body":"engaged on zoom and saying, hey,"},{"speaker":"Chris Dy","startTime":1103.63,"endTime":1107.14,"body":"video on etc. Like, that's hard."},{"speaker":"Charles Goldfarb","startTime":1107.48,"endTime":1109.28,"body":"That is a"},{"speaker":"Charles Goldfarb","startTime":1107.48,"endTime":1109.28,"body":"really important point to me."},{"speaker":"Charles Goldfarb","startTime":1109.28,"endTime":1111.65,"body":"And it's interesting, our"},{"speaker":"Charles Goldfarb","startTime":1109.28,"endTime":1111.65,"body":"hospital and our department have"},{"speaker":"Charles Goldfarb","startTime":1111.65,"endTime":1114.77,"body":"different cultures, department"},{"speaker":"Charles Goldfarb","startTime":1111.65,"endTime":1114.77,"body":"meetings, almost everyone has"},{"speaker":"Charles Goldfarb","startTime":1114.77,"endTime":1118.64,"body":"their camera on. Hospital"},{"speaker":"Charles Goldfarb","startTime":1114.77,"endTime":1118.64,"body":"meetings, they don't I always"},{"speaker":"Charles Goldfarb","startTime":1118.64,"endTime":1122.03,"body":"put my camera on unless I really"},{"speaker":"Charles Goldfarb","startTime":1118.64,"endTime":1122.03,"body":"am not engaged. But that's the"},{"speaker":"Charles Goldfarb","startTime":1122.03,"endTime":1125.39,"body":"first that's the first do and"},{"speaker":"Charles Goldfarb","startTime":1122.03,"endTime":1125.39,"body":"the other part is be a be a good"},{"speaker":"Charles Goldfarb","startTime":1125.39,"endTime":1128.39,"body":"participant. And so it's so"},{"speaker":"Charles Goldfarb","startTime":1125.39,"endTime":1128.39,"body":"tempting to answer email when"},{"speaker":"Charles Goldfarb","startTime":1128.39,"endTime":1130.4,"body":"you're in a zoom meeting. And"},{"speaker":"Charles Goldfarb","startTime":1128.39,"endTime":1130.4,"body":"sometimes that's the right thing"},{"speaker":"Charles Goldfarb","startTime":1130.4,"endTime":1132.86,"body":"to do. Because it's just not a"},{"speaker":"Charles Goldfarb","startTime":1130.4,"endTime":1132.86,"body":"meeting that you need to be an"},{"speaker":"Charles Goldfarb","startTime":1132.86,"endTime":1137.15,"body":"active participant in. But I"},{"speaker":"Charles Goldfarb","startTime":1132.86,"endTime":1137.15,"body":"don't know, you And ideally,"},{"speaker":"Charles Goldfarb","startTime":1137.15,"endTime":1138.53,"body":"you're not multitasking."},{"speaker":"Chris Dy","startTime":1138.66,"endTime":1142.26,"body":"Yeah, I think that"},{"speaker":"Chris Dy","startTime":1138.66,"endTime":1142.26,"body":"it's it's much more tempting to"},{"speaker":"Chris Dy","startTime":1142.26,"endTime":1146.07,"body":"do that. In the current era. And"},{"speaker":"Chris Dy","startTime":1142.26,"endTime":1146.07,"body":"I'll be honest with you not to"},{"speaker":"Chris Dy","startTime":1146.07,"endTime":1148.11,"body":"for leadership stuff, but even"},{"speaker":"Chris Dy","startTime":1146.07,"endTime":1148.11,"body":"for like if there's a grand"},{"speaker":"Chris Dy","startTime":1148.11,"endTime":1151.02,"body":"rounds that I really need to I"},{"speaker":"Chris Dy","startTime":1148.11,"endTime":1151.02,"body":"want to watch and know that I'm"},{"speaker":"Chris Dy","startTime":1151.02,"endTime":1153.45,"body":"going to be tempted to do email"},{"speaker":"Chris Dy","startTime":1151.02,"endTime":1153.45,"body":"or something else, I actually"},{"speaker":"Chris Dy","startTime":1153.45,"endTime":1156.84,"body":"get on the exercise bike and"},{"speaker":"Chris Dy","startTime":1153.45,"endTime":1156.84,"body":"have my tablet pulled up in"},{"speaker":"Chris Dy","startTime":1156.84,"endTime":1159.09,"body":"front of me and just bike so I"},{"speaker":"Chris Dy","startTime":1156.84,"endTime":1159.09,"body":"have nothing else to do. Like my"},{"speaker":"Chris Dy","startTime":1159.09,"endTime":1162.0,"body":"hands aren't free that I can get"},{"speaker":"Chris Dy","startTime":1159.09,"endTime":1162.0,"body":"on my laptop and actually, like"},{"speaker":"Chris Dy","startTime":1162.0,"endTime":1163.41,"body":"try to do emails or whatever,"},{"speaker":"Chris Dy","startTime":1162.0,"endTime":1163.41,"body":"so."},{"speaker":"Charles Goldfarb","startTime":1163.68,"endTime":1166.38,"body":"Yeah, that is"},{"speaker":"Charles Goldfarb","startTime":1163.68,"endTime":1166.38,"body":"great. We had a great Grand"},{"speaker":"Charles Goldfarb","startTime":1166.38,"endTime":1169.26,"body":"Rounds last week, which was on"},{"speaker":"Charles Goldfarb","startTime":1166.38,"endTime":1169.26,"body":"microaggressions. It was really"},{"speaker":"Charles Goldfarb","startTime":1169.26,"endTime":1172.95,"body":"one of the best grand rounds in"},{"speaker":"Charles Goldfarb","startTime":1169.26,"endTime":1172.95,"body":"my 20 years at WashU. And I had,"},{"speaker":"Charles Goldfarb","startTime":1173.31,"endTime":1176.43,"body":"you know, many emails I needed"},{"speaker":"Charles Goldfarb","startTime":1173.31,"endTime":1176.43,"body":"to address, it was a fight not"},{"speaker":"Charles Goldfarb","startTime":1176.43,"endTime":1179.46,"body":"to multitask. And I'm so glad"},{"speaker":"Charles Goldfarb","startTime":1176.43,"endTime":1179.46,"body":"that I did and I got so much out"},{"speaker":"Charles Goldfarb","startTime":1179.46,"endTime":1181.53,"body":"of that grand rounds. I think"},{"speaker":"Charles Goldfarb","startTime":1179.46,"endTime":1181.53,"body":"whatever it takes for you to"},{"speaker":"Charles Goldfarb","startTime":1181.53,"endTime":1183.18,"body":"focus is you got to do it."},{"speaker":"Chris Dy","startTime":1183.0,"endTime":1185.82,"body":"I did that one for the"},{"speaker":"Chris Dy","startTime":1183.0,"endTime":1185.82,"body":"bike. I got more out of it"},{"speaker":"Chris Dy","startTime":1185.82,"endTime":1186.51,"body":"because of it."},{"speaker":"Charles Goldfarb","startTime":1186.51,"endTime":1187.86,"body":"Do you think"},{"speaker":"Charles Goldfarb","startTime":1186.51,"endTime":1187.86,"body":"it was it was as good as"},{"speaker":"Chris Dy","startTime":1188.19,"endTime":1189.12,"body":"I thought it was"},{"speaker":"Chris Dy","startTime":1188.19,"endTime":1189.12,"body":"fantastic."},{"speaker":"Charles Goldfarb","startTime":1189.15,"endTime":1191.28,"body":"Yeah, it was"},{"speaker":"Charles Goldfarb","startTime":1189.15,"endTime":1191.28,"body":"really good. All right."},{"speaker":"Charles Goldfarb","startTime":1191.46,"endTime":1195.42,"body":"leadership. Leadership does"},{"speaker":"Charles Goldfarb","startTime":1191.46,"endTime":1195.42,"body":"matter is the bold in the"},{"speaker":"Charles Goldfarb","startTime":1195.42,"endTime":1199.47,"body":"article. And I like that and I"},{"speaker":"Charles Goldfarb","startTime":1195.42,"endTime":1199.47,"body":"like one of the sentences that I"},{"speaker":"Charles Goldfarb","startTime":1199.47,"endTime":1203.31,"body":"underlined. Is that even though"},{"speaker":"Charles Goldfarb","startTime":1199.47,"endTime":1203.31,"body":"its effectiveness might not be"},{"speaker":"Charles Goldfarb","startTime":1203.31,"endTime":1204.54,"body":"apparent in the short term."},{"speaker":"Chris Dy","startTime":1204.75,"endTime":1210.3,"body":"Yes, I think that one"},{"speaker":"Chris Dy","startTime":1204.75,"endTime":1210.3,"body":"thing that I'm trying, I'm"},{"speaker":"Chris Dy","startTime":1210.3,"endTime":1213.57,"body":"starting to realize now, it's"},{"speaker":"Chris Dy","startTime":1210.3,"endTime":1213.57,"body":"leadership and the appearance of"},{"speaker":"Chris Dy","startTime":1213.57,"endTime":1216.84,"body":"leadership are two different"},{"speaker":"Chris Dy","startTime":1213.57,"endTime":1216.84,"body":"things. And I think that we,"},{"speaker":"Chris Dy","startTime":1217.17,"endTime":1219.81,"body":"each of us has different"},{"speaker":"Chris Dy","startTime":1217.17,"endTime":1219.81,"body":"expectations of what a leader"},{"speaker":"Chris Dy","startTime":1219.81,"endTime":1223.59,"body":"should, how they should act, and"},{"speaker":"Chris Dy","startTime":1219.81,"endTime":1223.59,"body":"what things should look like."},{"speaker":"Chris Dy","startTime":1224.73,"endTime":1228.21,"body":"And everybody interprets that"},{"speaker":"Chris Dy","startTime":1224.73,"endTime":1228.21,"body":"differently, which I think is it"},{"speaker":"Chris Dy","startTime":1228.21,"endTime":1231.27,"body":"makes it hard as a leader,"},{"speaker":"Chris Dy","startTime":1228.21,"endTime":1231.27,"body":"because you know, you you have,"},{"speaker":"Chris Dy","startTime":1231.87,"endTime":1235.65,"body":"you have to satisfy so many"},{"speaker":"Chris Dy","startTime":1231.87,"endTime":1235.65,"body":"different constituencies with"},{"speaker":"Chris Dy","startTime":1235.68,"endTime":1236.79,"body":"different expectations."},{"speaker":"Charles Goldfarb","startTime":1236.9,"endTime":1238.4,"body":"So let's have"},{"speaker":"Charles Goldfarb","startTime":1236.9,"endTime":1238.4,"body":"a brief and we can use this"},{"speaker":"Charles Goldfarb","startTime":1238.4,"endTime":1241.13,"body":"article to help. Let's have a"},{"speaker":"Charles Goldfarb","startTime":1238.4,"endTime":1241.13,"body":"brief conversation about"},{"speaker":"Charles Goldfarb","startTime":1241.13,"endTime":1243.41,"body":"leadership. And I've mentioned"},{"speaker":"Charles Goldfarb","startTime":1241.13,"endTime":1243.41,"body":"this before, and we absolutely"},{"speaker":"Charles Goldfarb","startTime":1243.41,"endTime":1246.59,"body":"need to need to focus one"},{"speaker":"Charles Goldfarb","startTime":1243.41,"endTime":1246.59,"body":"episode. But Jim Collins writes"},{"speaker":"Charles Goldfarb","startTime":1246.59,"endTime":1249.62,"body":"so many great business books,"},{"speaker":"Charles Goldfarb","startTime":1246.59,"endTime":1249.62,"body":"but his description of"},{"speaker":"Charles Goldfarb","startTime":1249.62,"endTime":1251.66,"body":"leadership and what he called"},{"speaker":"Charles Goldfarb","startTime":1249.62,"endTime":1251.66,"body":"the level five leader was so"},{"speaker":"Charles Goldfarb","startTime":1251.66,"endTime":1255.59,"body":"important. And I think, to me,"},{"speaker":"Charles Goldfarb","startTime":1251.66,"endTime":1255.59,"body":"that probably is one of the most"},{"speaker":"Charles Goldfarb","startTime":1255.59,"endTime":1257.75,"body":"fundamental things, it's not"},{"speaker":"Charles Goldfarb","startTime":1255.59,"endTime":1257.75,"body":"specifically referenced in this"},{"speaker":"Charles Goldfarb","startTime":1257.75,"endTime":1260.78,"body":"article, but a leader who"},{"speaker":"Charles Goldfarb","startTime":1257.75,"endTime":1260.78,"body":"credits others, a leader who"},{"speaker":"Charles Goldfarb","startTime":1260.78,"endTime":1263.81,"body":"does not be need to be in the"},{"speaker":"Charles Goldfarb","startTime":1260.78,"endTime":1263.81,"body":"limelight, a leader who allows"},{"speaker":"Charles Goldfarb","startTime":1263.81,"endTime":1267.77,"body":"others to grow. Those to me are"},{"speaker":"Charles Goldfarb","startTime":1263.81,"endTime":1267.77,"body":"just so important."},{"speaker":"Chris Dy","startTime":1268.35,"endTime":1271.65,"body":"Yeah. So I mean, I"},{"speaker":"Chris Dy","startTime":1268.35,"endTime":1271.65,"body":"think that, you know, one of the"},{"speaker":"Chris Dy","startTime":1271.68,"endTime":1276.27,"body":"challenges as a leader, beyond"},{"speaker":"Chris Dy","startTime":1271.68,"endTime":1276.27,"body":"that is even, you know, do they"},{"speaker":"Chris Dy","startTime":1276.27,"endTime":1279.6,"body":"understand what the people they"},{"speaker":"Chris Dy","startTime":1276.27,"endTime":1279.6,"body":"are leading are going through?"},{"speaker":"Charles Goldfarb","startTime":1281.07,"endTime":1283.47,"body":"Yes,"},{"speaker":"Charles Goldfarb","startTime":1281.07,"endTime":1283.47,"body":"especially, I mean, this is, my"},{"speaker":"Charles Goldfarb","startTime":1283.47,"endTime":1286.59,"body":"gosh, I mean, we talk about this"},{"speaker":"Charles Goldfarb","startTime":1283.47,"endTime":1286.59,"body":"all the time for leadership in"},{"speaker":"Charles Goldfarb","startTime":1286.59,"endTime":1288.66,"body":"our department, you know, what"},{"speaker":"Charles Goldfarb","startTime":1286.59,"endTime":1288.66,"body":"we are going through in this"},{"speaker":"Charles Goldfarb","startTime":1288.66,"endTime":1293.22,"body":"pandemic is a stress to our work"},{"speaker":"Charles Goldfarb","startTime":1288.66,"endTime":1293.22,"body":"lives, our home lives, like"},{"speaker":"Charles Goldfarb","startTime":1293.22,"endTime":1295.44,"body":"we've never experienced, any of"},{"speaker":"Charles Goldfarb","startTime":1293.22,"endTime":1295.44,"body":"us have ever experienced. And"},{"speaker":"Charles Goldfarb","startTime":1295.44,"endTime":1298.47,"body":"it's really indescribable. And I"},{"speaker":"Charles Goldfarb","startTime":1295.44,"endTime":1298.47,"body":"don't know, when we will, you"},{"speaker":"Charles Goldfarb","startTime":1298.47,"endTime":1300.33,"body":"know, when the pandemic's over,"},{"speaker":"Charles Goldfarb","startTime":1298.47,"endTime":1300.33,"body":"we're still gonna be dealing"},{"speaker":"Charles Goldfarb","startTime":1300.33,"endTime":1304.29,"body":"with the ramifications of this"},{"speaker":"Charles Goldfarb","startTime":1300.33,"endTime":1304.29,"body":"time. And I think recognition of"},{"speaker":"Charles Goldfarb","startTime":1304.29,"endTime":1307.8,"body":"that, trying to address it, even"},{"speaker":"Charles Goldfarb","startTime":1304.29,"endTime":1307.8,"body":"though we may not have an"},{"speaker":"Charles Goldfarb","startTime":1307.8,"endTime":1310.47,"body":"answer. It's just really, really"},{"speaker":"Charles Goldfarb","startTime":1307.8,"endTime":1310.47,"body":"important."},{"speaker":"Chris Dy","startTime":1310.69,"endTime":1314.17,"body":"So my memory of"},{"speaker":"Chris Dy","startTime":1310.69,"endTime":1314.17,"body":"Collins's writings might be a"},{"speaker":"Chris Dy","startTime":1314.17,"endTime":1316.39,"body":"little bit off. But you know, he"},{"speaker":"Chris Dy","startTime":1314.17,"endTime":1316.39,"body":"talks about that level five"},{"speaker":"Chris Dy","startTime":1316.39,"endTime":1318.73,"body":"leader who has characteristics"},{"speaker":"Chris Dy","startTime":1316.39,"endTime":1318.73,"body":"that you described, but then"},{"speaker":"Chris Dy","startTime":1318.73,"endTime":1321.25,"body":"there's that level four leader"},{"speaker":"Chris Dy","startTime":1318.73,"endTime":1321.25,"body":"who leads because they want to"},{"speaker":"Chris Dy","startTime":1321.25,"endTime":1323.62,"body":"be in the spotlight, and they"},{"speaker":"Chris Dy","startTime":1321.25,"endTime":1323.62,"body":"may be a very effective leader."},{"speaker":"Chris Dy","startTime":1323.92,"endTime":1327.73,"body":"But what separates the person"},{"speaker":"Chris Dy","startTime":1323.92,"endTime":1327.73,"body":"who is out there for for this,"},{"speaker":"Chris Dy","startTime":1327.76,"endTime":1333.22,"body":"you know, for the limelight for"},{"speaker":"Chris Dy","startTime":1327.76,"endTime":1333.22,"body":"the bravado compared to a person"},{"speaker":"Chris Dy","startTime":1333.22,"endTime":1334.81,"body":"who is leading in the way that"},{"speaker":"Chris Dy","startTime":1333.22,"endTime":1334.81,"body":"you described."},{"speaker":"Charles Goldfarb","startTime":1335.39,"endTime":1338.21,"body":"I think, and I"},{"speaker":"Charles Goldfarb","startTime":1335.39,"endTime":1338.21,"body":"haven't read the book in many"},{"speaker":"Charles Goldfarb","startTime":1338.21,"endTime":1342.56,"body":"years. But I, the point to that"},{"speaker":"Charles Goldfarb","startTime":1338.21,"endTime":1342.56,"body":"I have taken away is that, you"},{"speaker":"Charles Goldfarb","startTime":1342.56,"endTime":1345.47,"body":"know, there is something lost if"},{"speaker":"Charles Goldfarb","startTime":1342.56,"endTime":1345.47,"body":"the leader has to be in the"},{"speaker":"Charles Goldfarb","startTime":1345.47,"endTime":1351.05,"body":"limelight, development of those"},{"speaker":"Charles Goldfarb","startTime":1345.47,"endTime":1351.05,"body":"beneath that person, shared"},{"speaker":"Charles Goldfarb","startTime":1351.05,"endTime":1354.89,"body":"accolades, there's just"},{"speaker":"Charles Goldfarb","startTime":1351.05,"endTime":1354.89,"body":"something lost if it's all about"},{"speaker":"Charles Goldfarb","startTime":1354.98,"endTime":1357.98,"body":"the leader. And again, as you"},{"speaker":"Charles Goldfarb","startTime":1354.98,"endTime":1357.98,"body":"said, you can be a very"},{"speaker":"Charles Goldfarb","startTime":1357.98,"endTime":1361.19,"body":"effective level four leader, but"},{"speaker":"Charles Goldfarb","startTime":1357.98,"endTime":1361.19,"body":"I don't think you can truly hit"},{"speaker":"Charles Goldfarb","startTime":1361.19,"endTime":1364.28,"body":"the high mark and business"},{"speaker":"Charles Goldfarb","startTime":1361.19,"endTime":1364.28,"body":"performance is correlated with"},{"speaker":"Charles Goldfarb","startTime":1364.28,"endTime":1367.07,"body":"those level five leaders. And I"},{"speaker":"Charles Goldfarb","startTime":1364.28,"endTime":1367.07,"body":"would certainly, you know, echo"},{"speaker":"Charles Goldfarb","startTime":1367.07,"endTime":1367.4,"body":"that."},{"speaker":"Chris Dy","startTime":1367.82,"endTime":1370.88,"body":"So one of the things"},{"speaker":"Chris Dy","startTime":1367.82,"endTime":1370.88,"body":"that Simone writes about in here"},{"speaker":"Chris Dy","startTime":1370.88,"endTime":1374.75,"body":"is that a leader should"},{"speaker":"Chris Dy","startTime":1370.88,"endTime":1374.75,"body":"articulate a consistent simple"},{"speaker":"Chris Dy","startTime":1374.75,"endTime":1378.86,"body":"public vision. And this vision"},{"speaker":"Chris Dy","startTime":1374.75,"endTime":1378.86,"body":"must be backed by public acts."},{"speaker":"Chris Dy","startTime":1379.76,"endTime":1383.45,"body":"And but it's sometimes smaller"},{"speaker":"Chris Dy","startTime":1379.76,"endTime":1383.45,"body":"acts that are more valuable. So"},{"speaker":"Chris Dy","startTime":1383.48,"endTime":1384.59,"body":"how do you interpret that?"},{"speaker":"Charles Goldfarb","startTime":1386.13,"endTime":1390.03,"body":"Leadership is"},{"speaker":"Charles Goldfarb","startTime":1386.13,"endTime":1390.03,"body":"complicated. And that concept of"},{"speaker":"Charles Goldfarb","startTime":1390.03,"endTime":1394.35,"body":"having a simple message is"},{"speaker":"Charles Goldfarb","startTime":1390.03,"endTime":1394.35,"body":"really important. And it may not"},{"speaker":"Charles Goldfarb","startTime":1394.35,"endTime":1396.66,"body":"be a message that is, like, Oh,"},{"speaker":"Charles Goldfarb","startTime":1394.35,"endTime":1396.66,"body":"my God, you know, you're not"},{"speaker":"Charles Goldfarb","startTime":1396.66,"endTime":1399.66,"body":"supposed to get tingles when you"},{"speaker":"Charles Goldfarb","startTime":1396.66,"endTime":1399.66,"body":"hear the message. But if it said"},{"speaker":"Charles Goldfarb","startTime":1399.66,"endTime":1403.62,"body":"over and over and over, I think"},{"speaker":"Charles Goldfarb","startTime":1399.66,"endTime":1403.62,"body":"it starts to resonate. And so,"},{"speaker":"Charles Goldfarb","startTime":1403.8,"endTime":1406.59,"body":"you know, making a difference in"},{"speaker":"Charles Goldfarb","startTime":1403.8,"endTime":1406.59,"body":"our community or making a"},{"speaker":"Charles Goldfarb","startTime":1406.59,"endTime":1410.01,"body":"difference in the lives of our"},{"speaker":"Charles Goldfarb","startTime":1406.59,"endTime":1410.01,"body":"patients, expanding our reach,"},{"speaker":"Charles Goldfarb","startTime":1410.01,"endTime":1411.96,"body":"those are kind of things that"},{"speaker":"Charles Goldfarb","startTime":1410.01,"endTime":1411.96,"body":"are pretty simple and easily"},{"speaker":"Charles Goldfarb","startTime":1411.96,"endTime":1416.94,"body":"understood. You know, you have a"},{"speaker":"Charles Goldfarb","startTime":1411.96,"endTime":1416.94,"body":"bigger vision statement and"},{"speaker":"Charles Goldfarb","startTime":1416.94,"endTime":1420.57,"body":"mission statement, but a very"},{"speaker":"Charles Goldfarb","startTime":1416.94,"endTime":1420.57,"body":"simplistic message, I agree is"},{"speaker":"Charles Goldfarb","startTime":1420.57,"endTime":1421.23,"body":"really important."},{"speaker":"Chris Dy","startTime":1421.0,"endTime":1423.94,"body":"Do you do you, do you"},{"speaker":"Chris Dy","startTime":1421.0,"endTime":1423.94,"body":"think that a lot of people yearn"},{"speaker":"Chris Dy","startTime":1423.94,"endTime":1427.54,"body":"for the big Jerry Maguire type"},{"speaker":"Chris Dy","startTime":1423.94,"endTime":1427.54,"body":"speech? That probably just dated"},{"speaker":"Chris Dy","startTime":1427.54,"endTime":1429.04,"body":"both of us when I made that"},{"speaker":"Chris Dy","startTime":1427.54,"endTime":1429.04,"body":"reference."},{"speaker":"Charles Goldfarb","startTime":1429.76,"endTime":1432.1,"body":"Oh, it's a"},{"speaker":"Charles Goldfarb","startTime":1429.76,"endTime":1432.1,"body":"classic isn't it? I think it is."},{"speaker":"Charles Goldfarb","startTime":1432.28,"endTime":1436.57,"body":"Um, yeah, but I don't know, I"},{"speaker":"Charles Goldfarb","startTime":1432.28,"endTime":1436.57,"body":"think you can be a super high"},{"speaker":"Charles Goldfarb","startTime":1436.57,"endTime":1439.48,"body":"level leader and not have that"},{"speaker":"Charles Goldfarb","startTime":1436.57,"endTime":1439.48,"body":"capacity. I mean, a good leader"},{"speaker":"Charles Goldfarb","startTime":1439.48,"endTime":1443.47,"body":"has to be forward facing and has"},{"speaker":"Charles Goldfarb","startTime":1439.48,"endTime":1443.47,"body":"to be able to, to rally the"},{"speaker":"Charles Goldfarb","startTime":1443.47,"endTime":1446.23,"body":"troops so to speak, but I don't"},{"speaker":"Charles Goldfarb","startTime":1443.47,"endTime":1446.23,"body":"know that it, you know, a"},{"speaker":"Charles Goldfarb","startTime":1446.23,"endTime":1450.49,"body":"department leader needs to be"},{"speaker":"Charles Goldfarb","startTime":1446.23,"endTime":1450.49,"body":"like a football coach. I mean,"},{"speaker":"Charles Goldfarb","startTime":1450.52,"endTime":1451.99,"body":"it would be great if we were."},{"speaker":"Chris Dy","startTime":1453.16,"endTime":1454.87,"body":"Maybe if you were paid"},{"speaker":"Chris Dy","startTime":1453.16,"endTime":1454.87,"body":"like a football coach."},{"speaker":"Charles Goldfarb","startTime":1454.43,"endTime":1460.37,"body":"True, true. I"},{"speaker":"Charles Goldfarb","startTime":1454.43,"endTime":1460.37,"body":"liked the concept that one of"},{"speaker":"Charles Goldfarb","startTime":1460.37,"endTime":1466.7,"body":"the flaws of choosing academic"},{"speaker":"Charles Goldfarb","startTime":1460.37,"endTime":1466.7,"body":"leaders in particular, is that"},{"speaker":"Charles Goldfarb","startTime":1467.0,"endTime":1470.69,"body":"it's based on a bygone era. And"},{"speaker":"Charles Goldfarb","startTime":1467.0,"endTime":1470.69,"body":"we'll get to some of the eras"},{"speaker":"Charles Goldfarb","startTime":1470.69,"endTime":1474.08,"body":"that I thought, era being era"},{"speaker":"Charles Goldfarb","startTime":1470.69,"endTime":1474.08,"body":"that are pointed out here, bu"},{"speaker":"Charles Goldfarb","startTime":1474.2,"endTime":1477.62,"body":"it writes choosing leaders i"},{"speaker":"Charles Goldfarb","startTime":1474.2,"endTime":1477.62,"body":"not a precise science, but i"},{"speaker":"Charles Goldfarb","startTime":1477.62,"endTime":1480.68,"body":"surprising how often managemen"},{"speaker":"Charles Goldfarb","startTime":1477.62,"endTime":1480.68,"body":"skills, interpersonal skills a"},{"speaker":"Charles Goldfarb","startTime":1480.68,"endTime":1483.59,"body":"d experience are undervalued."},{"speaker":"Charles Goldfarb","startTime":1480.68,"endTime":1483.59,"body":"I hope that's changing. becau"},{"speaker":"Charles Goldfarb","startTime":1483.59,"endTime":1485.75,"body":"e traditionally in big aca"},{"speaker":"Charles Goldfarb","startTime":1483.59,"endTime":1485.75,"body":"emic centers one thin"},{"speaker":"Charles Goldfarb","startTime":1485.75,"endTime":1491.03,"body":"was prioritized and that is NIH"},{"speaker":"Charles Goldfarb","startTime":1485.75,"endTime":1491.03,"body":"grants."},{"speaker":"Chris Dy","startTime":1488.98,"endTime":1489.31,"body":"Yeah."},{"speaker":"Charles Goldfarb","startTime":1490.27,"endTime":1493.06,"body":"I hope it's"},{"speaker":"Charles Goldfarb","startTime":1490.27,"endTime":1493.06,"body":"changing. I don't know if it is"},{"speaker":"Charles Goldfarb","startTime":1493.06,"endTime":1493.6,"body":"completely."},{"speaker":"Chris Dy","startTime":1493.87,"endTime":1495.94,"body":"Yeah, I think I think"},{"speaker":"Chris Dy","startTime":1493.87,"endTime":1495.94,"body":"there are some institutions that"},{"speaker":"Chris Dy","startTime":1495.94,"endTime":1500.02,"body":"are just going to be stuck in"},{"speaker":"Chris Dy","startTime":1495.94,"endTime":1500.02,"body":"needing you know, that that"},{"speaker":"Chris Dy","startTime":1500.02,"endTime":1503.32,"body":"marker of credibility. But I"},{"speaker":"Chris Dy","startTime":1500.02,"endTime":1503.32,"body":"think that that era probably has"},{"speaker":"Chris Dy","startTime":1503.32,"endTime":1507.46,"body":"passed where, you know, you can"},{"speaker":"Chris Dy","startTime":1503.32,"endTime":1507.46,"body":"rely on an NIH funded scientist"},{"speaker":"Chris Dy","startTime":1507.46,"endTime":1511.3,"body":"or clinician scientist to be,"},{"speaker":"Chris Dy","startTime":1507.46,"endTime":1511.3,"body":"you know, the the absolute best"},{"speaker":"Chris Dy","startTime":1511.3,"endTime":1513.67,"body":"person in these other domains"},{"speaker":"Chris Dy","startTime":1511.3,"endTime":1513.67,"body":"that you talk about that are"},{"speaker":"Chris Dy","startTime":1513.7,"endTime":1515.62,"body":"probably more important."},{"speaker":"Charles Goldfarb","startTime":1516.01,"endTime":1517.15,"body":"Right,"},{"speaker":"Charles Goldfarb","startTime":1516.01,"endTime":1517.15,"body":"absolutely."},{"speaker":"Chris Dy","startTime":1518.38,"endTime":1520.15,"body":"But there's one more"},{"speaker":"Chris Dy","startTime":1518.38,"endTime":1520.15,"body":"thing in this section, I thought"},{"speaker":"Chris Dy","startTime":1520.15,"endTime":1522.76,"body":"that was really interesting. I"},{"speaker":"Chris Dy","startTime":1520.15,"endTime":1522.76,"body":"mean, you know, in terms of the"},{"speaker":"Chris Dy","startTime":1522.76,"endTime":1526.93,"body":"critical skills, I mean, he"},{"speaker":"Chris Dy","startTime":1522.76,"endTime":1526.93,"body":"points out here scientific taste"},{"speaker":"Chris Dy","startTime":1526.96,"endTime":1529.48,"body":"versus accomplishment. And I"},{"speaker":"Chris Dy","startTime":1526.96,"endTime":1529.48,"body":"thought that was a really"},{"speaker":"Chris Dy","startTime":1529.48,"endTime":1533.02,"body":"intriguing part of it. I mean, a"},{"speaker":"Chris Dy","startTime":1529.48,"endTime":1533.02,"body":"keen sense of excellent versus"},{"speaker":"Chris Dy","startTime":1533.02,"endTime":1536.17,"body":"average science, as opposed to"},{"speaker":"Chris Dy","startTime":1533.02,"endTime":1536.17,"body":"the ability to run one's program"},{"speaker":"Chris Dy","startTime":1536.17,"endTime":1539.56,"body":"successfully. So if you're going"},{"speaker":"Chris Dy","startTime":1536.17,"endTime":1539.56,"body":"to be a leader, you know, a"},{"speaker":"Chris Dy","startTime":1539.56,"endTime":1542.62,"body":"department chair, does it matter"},{"speaker":"Chris Dy","startTime":1539.56,"endTime":1542.62,"body":"that you are a fantastic"},{"speaker":"Chris Dy","startTime":1542.62,"endTime":1546.58,"body":"scientist, or can you pick out"},{"speaker":"Chris Dy","startTime":1542.62,"endTime":1546.58,"body":"the people that are doing good"},{"speaker":"Chris Dy","startTime":1546.58,"endTime":1549.85,"body":"science and are going to advance"},{"speaker":"Chris Dy","startTime":1546.58,"endTime":1549.85,"body":"the field and get them on your"},{"speaker":"Chris Dy","startTime":1549.91,"endTime":1551.11,"body":"on your team and your"},{"speaker":"Chris Dy","startTime":1549.91,"endTime":1551.11,"body":"department?"},{"speaker":"Charles Goldfarb","startTime":1551.38,"endTime":1554.23,"body":"Yeah, I would"},{"speaker":"Charles Goldfarb","startTime":1551.38,"endTime":1554.23,"body":"strongly argue that as important"},{"speaker":"Charles Goldfarb","startTime":1554.23,"endTime":1557.53,"body":"as it is for that department"},{"speaker":"Charles Goldfarb","startTime":1554.23,"endTime":1557.53,"body":"chair, to be a scientific"},{"speaker":"Charles Goldfarb","startTime":1557.53,"endTime":1560.98,"body":"leader, it is far more important"},{"speaker":"Charles Goldfarb","startTime":1557.53,"endTime":1560.98,"body":"that that chair, have the"},{"speaker":"Charles Goldfarb","startTime":1560.98,"endTime":1563.98,"body":"capacity to hire the right"},{"speaker":"Charles Goldfarb","startTime":1560.98,"endTime":1563.98,"body":"people. And that's what Richard"},{"speaker":"Charles Goldfarb","startTime":1563.98,"endTime":1567.94,"body":"Gelberman taught me, and taught"},{"speaker":"Charles Goldfarb","startTime":1563.98,"endTime":1567.94,"body":"all of us that recruitment, to"},{"speaker":"Charles Goldfarb","startTime":1567.94,"endTime":1572.47,"body":"me is the, excuse me the single"},{"speaker":"Charles Goldfarb","startTime":1567.94,"endTime":1572.47,"body":"most important skill that any"},{"speaker":"Charles Goldfarb","startTime":1572.47,"endTime":1573.25,"body":"Chairman needs."},{"speaker":"Chris Dy","startTime":1573.49,"endTime":1574.36,"body":"What about retention?"},{"speaker":"Charles Goldfarb","startTime":1575.02,"endTime":1577.69,"body":"Retention is"},{"speaker":"Charles Goldfarb","startTime":1575.02,"endTime":1577.69,"body":"the second most important."},{"speaker":"Chris Dy","startTime":1577.69,"endTime":1578.8,"body":"1A and 1B."},{"speaker":"Charles Goldfarb","startTime":1578.98,"endTime":1581.62,"body":"Yes. But if"},{"speaker":"Charles Goldfarb","startTime":1578.98,"endTime":1581.62,"body":"you if you create, you know, one"},{"speaker":"Charles Goldfarb","startTime":1581.62,"endTime":1584.2,"body":"of the things is just having a"},{"speaker":"Charles Goldfarb","startTime":1581.62,"endTime":1584.2,"body":"department where people feel"},{"speaker":"Charles Goldfarb","startTime":1584.2,"endTime":1587.35,"body":"like, wow, I'm in a department"},{"speaker":"Charles Goldfarb","startTime":1584.2,"endTime":1587.35,"body":"heading in the right direction,"},{"speaker":"Charles Goldfarb","startTime":1587.35,"endTime":1590.62,"body":"doing the right things. And"},{"speaker":"Charles Goldfarb","startTime":1587.35,"endTime":1590.62,"body":"while there will always be"},{"speaker":"Charles Goldfarb","startTime":1590.62,"endTime":1593.95,"body":"reasons for people to leave,"},{"speaker":"Charles Goldfarb","startTime":1590.62,"endTime":1593.95,"body":"reasons that you can't deal"},{"speaker":"Charles Goldfarb","startTime":1593.95,"endTime":1596.62,"body":"with, if you have a department"},{"speaker":"Charles Goldfarb","startTime":1593.95,"endTime":1596.62,"body":"heading in the right direction,"},{"speaker":"Charles Goldfarb","startTime":1596.83,"endTime":1600.19,"body":"where it feels good to be in the"},{"speaker":"Charles Goldfarb","startTime":1596.83,"endTime":1600.19,"body":"department, that takes care of a"},{"speaker":"Charles Goldfarb","startTime":1600.19,"endTime":1601.72,"body":"lot of the retention issues, I"},{"speaker":"Charles Goldfarb","startTime":1600.19,"endTime":1601.72,"body":"think."},{"speaker":"Chris Dy","startTime":1601.78,"endTime":1604.66,"body":"Well, that's one of"},{"speaker":"Chris Dy","startTime":1601.78,"endTime":1604.66,"body":"the reasons why I came here. And"},{"speaker":"Chris Dy","startTime":1604.66,"endTime":1608.56,"body":"one of the reasons why I stay is"},{"speaker":"Chris Dy","startTime":1604.66,"endTime":1608.56,"body":"that, you know I, no ties to St."},{"speaker":"Chris Dy","startTime":1608.56,"endTime":1611.71,"body":"Louis, no ties to Wash U, you"},{"speaker":"Chris Dy","startTime":1608.56,"endTime":1611.71,"body":"know, I was coming as a fellow"},{"speaker":"Chris Dy","startTime":1612.07,"endTime":1615.76,"body":"when I started looking at the"},{"speaker":"Chris Dy","startTime":1612.07,"endTime":1615.76,"body":"job. And to me, it was, this is"},{"speaker":"Chris Dy","startTime":1615.76,"endTime":1618.91,"body":"something special, this is"},{"speaker":"Chris Dy","startTime":1615.76,"endTime":1618.91,"body":"something where you can be a"},{"speaker":"Chris Dy","startTime":1618.91,"endTime":1622.54,"body":"part of something and you know,"},{"speaker":"Chris Dy","startTime":1618.91,"endTime":1622.54,"body":"one of the things that I want,"},{"speaker":"Chris Dy","startTime":1622.63,"endTime":1625.45,"body":"you know wish to preserve here"},{"speaker":"Chris Dy","startTime":1622.63,"endTime":1625.45,"body":"at Wash U is making sure that it"},{"speaker":"Chris Dy","startTime":1625.45,"endTime":1628.87,"body":"stays a special place so that it"},{"speaker":"Chris Dy","startTime":1625.45,"endTime":1628.87,"body":"brings more people here who want"},{"speaker":"Chris Dy","startTime":1628.87,"endTime":1631.72,"body":"to be part of that, regardless"},{"speaker":"Chris Dy","startTime":1628.87,"endTime":1631.72,"body":"of where they come from, and you"},{"speaker":"Chris Dy","startTime":1631.72,"endTime":1633.37,"body":"know, whether they have any ties"},{"speaker":"Chris Dy","startTime":1631.72,"endTime":1633.37,"body":"to the area."},{"speaker":"Charles Goldfarb","startTime":1633.64,"endTime":1635.41,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":1633.64,"endTime":1635.41,"body":"right, and you had to hit it on"},{"speaker":"Charles Goldfarb","startTime":1635.41,"endTime":1638.56,"body":"the head. That's why I'm here"},{"speaker":"Charles Goldfarb","startTime":1635.41,"endTime":1638.56,"body":"too before I probably said it a"},{"speaker":"Charles Goldfarb","startTime":1638.56,"endTime":1642.31,"body":"little bit wrong. In this paper,"},{"speaker":"Charles Goldfarb","startTime":1638.56,"endTime":1642.31,"body":"it says in recruiting, first"},{"speaker":"Charles Goldfarb","startTime":1642.31,"endTime":1645.7,"body":"class people recruit first class"},{"speaker":"Charles Goldfarb","startTime":1642.31,"endTime":1645.7,"body":"people, second class people"},{"speaker":"Charles Goldfarb","startTime":1645.7,"endTime":1650.41,"body":"recruit third class people. And"},{"speaker":"Charles Goldfarb","startTime":1645.7,"endTime":1650.41,"body":"again, the point is that you're"},{"speaker":"Charles Goldfarb","startTime":1650.41,"endTime":1652.87,"body":"going to make mistakes in the"},{"speaker":"Charles Goldfarb","startTime":1650.41,"endTime":1652.87,"body":"recruiting process, because it's"},{"speaker":"Charles Goldfarb","startTime":1652.87,"endTime":1656.74,"body":"imperfect. But you got to put in"},{"speaker":"Charles Goldfarb","startTime":1652.87,"endTime":1656.74,"body":"the effort and the time to get"},{"speaker":"Charles Goldfarb","startTime":1656.74,"endTime":1660.19,"body":"as much due diligence as you can"},{"speaker":"Charles Goldfarb","startTime":1656.74,"endTime":1660.19,"body":"to fill the department with the"},{"speaker":"Charles Goldfarb","startTime":1660.19,"endTime":1663.85,"body":"right kind of people. Because if"},{"speaker":"Charles Goldfarb","startTime":1660.19,"endTime":1663.85,"body":"you have people in the"},{"speaker":"Charles Goldfarb","startTime":1663.85,"endTime":1667.48,"body":"department who have one skill"},{"speaker":"Charles Goldfarb","startTime":1663.85,"endTime":1667.48,"body":"set or two skill sets, but"},{"speaker":"Charles Goldfarb","startTime":1667.48,"endTime":1671.89,"body":"really have other issues,"},{"speaker":"Charles Goldfarb","startTime":1667.48,"endTime":1671.89,"body":"interpersonal issues, or they"},{"speaker":"Charles Goldfarb","startTime":1671.89,"endTime":1674.62,"body":"put themselves first to the"},{"speaker":"Charles Goldfarb","startTime":1671.89,"endTime":1674.62,"body":"detriment of their partners,"},{"speaker":"Charles Goldfarb","startTime":1674.86,"endTime":1677.44,"body":"those kind of things can be deal"},{"speaker":"Charles Goldfarb","startTime":1674.86,"endTime":1677.44,"body":"breakers for the department."},{"speaker":"Chris Dy","startTime":1677.6,"endTime":1680.03,"body":"Yeah, and they may be"},{"speaker":"Chris Dy","startTime":1677.6,"endTime":1680.03,"body":"tremendous in other capacities."},{"speaker":"Chris Dy","startTime":1680.03,"endTime":1682.19,"body":"But you know, if they don't fit"},{"speaker":"Chris Dy","startTime":1680.03,"endTime":1682.19,"body":"well, and this comes up a little"},{"speaker":"Chris Dy","startTime":1682.19,"endTime":1685.79,"body":"bit later, you know, you know,"},{"speaker":"Chris Dy","startTime":1682.19,"endTime":1685.79,"body":"he thinks that the, the"},{"speaker":"Chris Dy","startTime":1685.79,"endTime":1690.65,"body":"philosophy of recruiting the"},{"speaker":"Chris Dy","startTime":1685.79,"endTime":1690.65,"body":"best athlete is a stupid"},{"speaker":"Chris Dy","startTime":1690.68,"endTime":1693.2,"body":"oversimplification in his words."},{"speaker":"Chris Dy","startTime":1690.68,"endTime":1693.2,"body":"And, you know, there have been"},{"speaker":"Chris Dy","startTime":1693.2,"endTime":1696.05,"body":"times where, you know, you're"},{"speaker":"Chris Dy","startTime":1693.2,"endTime":1696.05,"body":"like, wow, we should really get"},{"speaker":"Chris Dy","startTime":1696.05,"endTime":1699.65,"body":"this person because they look"},{"speaker":"Chris Dy","startTime":1696.05,"endTime":1699.65,"body":"like, they look amazing. But I"},{"speaker":"Chris Dy","startTime":1699.65,"endTime":1701.39,"body":"mean, are they gonna fit here?"},{"speaker":"Charles Goldfarb","startTime":1701.87,"endTime":1704.78,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":1701.87,"endTime":1704.78,"body":"right. And it is, you know, you"},{"speaker":"Charles Goldfarb","startTime":1704.78,"endTime":1709.19,"body":"want every partner to be"},{"speaker":"Charles Goldfarb","startTime":1704.78,"endTime":1709.19,"body":"perfect, you know, to be a great"},{"speaker":"Charles Goldfarb","startTime":1709.19,"endTime":1711.74,"body":"clinician to be, you know,"},{"speaker":"Charles Goldfarb","startTime":1709.19,"endTime":1711.74,"body":"that's the floor, you got to be"},{"speaker":"Charles Goldfarb","startTime":1711.74,"endTime":1714.65,"body":"a great clinician, but you also"},{"speaker":"Charles Goldfarb","startTime":1711.74,"endTime":1714.65,"body":"want to be a great researcher in"},{"speaker":"Charles Goldfarb","startTime":1714.65,"endTime":1719.69,"body":"whatever domain and a great"},{"speaker":"Charles Goldfarb","startTime":1714.65,"endTime":1719.69,"body":"educator and a leader. But if"},{"speaker":"Charles Goldfarb","startTime":1719.69,"endTime":1722.96,"body":"it's going to be to the"},{"speaker":"Charles Goldfarb","startTime":1719.69,"endTime":1722.96,"body":"detriment of others. I just"},{"speaker":"Charles Goldfarb","startTime":1722.96,"endTime":1725.15,"body":"don't know that it's worth it. I"},{"speaker":"Charles Goldfarb","startTime":1722.96,"endTime":1725.15,"body":"mean, I think it can be too"},{"speaker":"Charles Goldfarb","startTime":1725.15,"endTime":1725.66,"body":"much."},{"speaker":"Chris Dy","startTime":1725.78,"endTime":1727.73,"body":"Yeah, and chemistry is"},{"speaker":"Chris Dy","startTime":1725.78,"endTime":1727.73,"body":"obviously a very delicate thing."},{"speaker":"Chris Dy","startTime":1727.73,"endTime":1730.7,"body":"And you spend a long time"},{"speaker":"Chris Dy","startTime":1727.73,"endTime":1730.7,"body":"getting that chemistry just"},{"speaker":"Chris Dy","startTime":1730.7,"endTime":1733.34,"body":"right, and also establishing a"},{"speaker":"Chris Dy","startTime":1730.7,"endTime":1733.34,"body":"culture in which everybody can"},{"speaker":"Chris Dy","startTime":1733.34,"endTime":1736.16,"body":"thrive. And the last thing you"},{"speaker":"Chris Dy","startTime":1733.34,"endTime":1736.16,"body":"need is, you know, somebody"},{"speaker":"Chris Dy","startTime":1736.16,"endTime":1740.6,"body":"coming in and, and disrupting"},{"speaker":"Chris Dy","startTime":1736.16,"endTime":1740.6,"body":"that. And, you know, one of the"},{"speaker":"Chris Dy","startTime":1740.6,"endTime":1743.9,"body":"things that we often think about"},{"speaker":"Chris Dy","startTime":1740.6,"endTime":1743.9,"body":"is sports, you know, and not"},{"speaker":"Chris Dy","startTime":1743.9,"endTime":1746.78,"body":"sports medicine, but sports in"},{"speaker":"Chris Dy","startTime":1743.9,"endTime":1746.78,"body":"general, where you have the"},{"speaker":"Chris Dy","startTime":1746.81,"endTime":1750.68,"body":"disruptive hotshot wide receiver"},{"speaker":"Chris Dy","startTime":1746.81,"endTime":1750.68,"body":"who the coach decides to bring"},{"speaker":"Chris Dy","startTime":1750.68,"endTime":1753.47,"body":"in and you know, is that going"},{"speaker":"Chris Dy","startTime":1750.68,"endTime":1753.47,"body":"to work? Or is it not? And"},{"speaker":"Chris Dy","startTime":1754.4,"endTime":1756.11,"body":"chemistry is a really"},{"speaker":"Chris Dy","startTime":1754.4,"endTime":1756.11,"body":"challenging thing."},{"speaker":"Charles Goldfarb","startTime":1756.63,"endTime":1760.11,"body":"Absolutely. I"},{"speaker":"Charles Goldfarb","startTime":1756.63,"endTime":1760.11,"body":"want to mention one thing,"},{"speaker":"Charles Goldfarb","startTime":1760.11,"endTime":1762.9,"body":"before we go on, we still should"},{"speaker":"Charles Goldfarb","startTime":1760.11,"endTime":1762.9,"body":"talk about the job. But I like"},{"speaker":"Charles Goldfarb","startTime":1762.9,"endTime":1768.54,"body":"this line that in academic"},{"speaker":"Charles Goldfarb","startTime":1762.9,"endTime":1768.54,"body":"institution, muck flows uphill."},{"speaker":"Charles Goldfarb","startTime":1768.99,"endTime":1773.1,"body":"And I can absolutely state that"},{"speaker":"Charles Goldfarb","startTime":1768.99,"endTime":1773.1,"body":"I agree with that completely."},{"speaker":"Charles Goldfarb","startTime":1773.37,"endTime":1776.97,"body":"And whether whatever type of"},{"speaker":"Charles Goldfarb","startTime":1773.37,"endTime":1776.97,"body":"environment you are in, and"},{"speaker":"Charles Goldfarb","startTime":1776.97,"endTime":1779.79,"body":"whether it's a big issue or a"},{"speaker":"Charles Goldfarb","startTime":1776.97,"endTime":1779.79,"body":"little issue, I don't think it's"},{"speaker":"Charles Goldfarb","startTime":1779.79,"endTime":1782.16,"body":"practical in 2020, to think"},{"speaker":"Charles Goldfarb","startTime":1779.79,"endTime":1782.16,"body":"these things are going to go"},{"speaker":"Charles Goldfarb","startTime":1782.16,"endTime":1785.13,"body":"away. There's too much attention"},{"speaker":"Charles Goldfarb","startTime":1782.16,"endTime":1785.13,"body":"paid to interpersonal"},{"speaker":"Charles Goldfarb","startTime":1785.19,"endTime":1788.58,"body":"interactions, and there's too"},{"speaker":"Charles Goldfarb","startTime":1785.19,"endTime":1788.58,"body":"much attention to pay to all"},{"speaker":"Charles Goldfarb","startTime":1788.58,"endTime":1791.79,"body":"aspects of the care we provide."},{"speaker":"Charles Goldfarb","startTime":1788.58,"endTime":1791.79,"body":"And so I think the leaders have"},{"speaker":"Charles Goldfarb","startTime":1791.79,"endTime":1797.16,"body":"to get the facts. Get it get as"},{"speaker":"Charles Goldfarb","startTime":1791.79,"endTime":1797.16,"body":"many people on board as possible"},{"speaker":"Charles Goldfarb","startTime":1797.16,"endTime":1799.23,"body":"and address things rather than"},{"speaker":"Charles Goldfarb","startTime":1797.16,"endTime":1799.23,"body":"hope they disappear."},{"speaker":"Chris Dy","startTime":1799.32,"endTime":1802.62,"body":"Well, you know, you"},{"speaker":"Chris Dy","startTime":1799.32,"endTime":1802.62,"body":"have the unique experience of"},{"speaker":"Chris Dy","startTime":1802.62,"endTime":1805.53,"body":"taking over the number two spot"},{"speaker":"Chris Dy","startTime":1802.62,"endTime":1805.53,"body":"in the department what it's been"},{"speaker":"Chris Dy","startTime":1805.53,"endTime":1806.85,"body":"18 months now maybe?"},{"speaker":"Charles Goldfarb","startTime":1807.18,"endTime":1807.99,"body":"Going on,"},{"speaker":"Charles Goldfarb","startTime":1807.18,"endTime":1807.99,"body":"yeah."},{"speaker":"Chris Dy","startTime":1808.02,"endTime":1811.02,"body":"Yeah. And then in an"},{"speaker":"Chris Dy","startTime":1808.02,"endTime":1811.02,"body":"environment where there's a lot"},{"speaker":"Chris Dy","startTime":1811.02,"endTime":1812.91,"body":"of muck with COVID, so."},{"speaker":"Charles Goldfarb","startTime":1813.42,"endTime":1813.93,"body":"There is."},{"speaker":"Chris Dy","startTime":1813.96,"endTime":1816.06,"body":"A lot of challenges"},{"speaker":"Chris Dy","startTime":1813.96,"endTime":1816.06,"body":"there. I mean, has it has it"},{"speaker":"Chris Dy","startTime":1816.06,"endTime":1818.52,"body":"gotten that much harder in this"},{"speaker":"Chris Dy","startTime":1816.06,"endTime":1818.52,"body":"environment where muck is"},{"speaker":"Chris Dy","startTime":1818.52,"endTime":1819.06,"body":"everywhere?"},{"speaker":"Charles Goldfarb","startTime":1819.69,"endTime":1822.18,"body":"You know, I"},{"speaker":"Charles Goldfarb","startTime":1819.69,"endTime":1822.18,"body":"think it's tricky, because and I"},{"speaker":"Charles Goldfarb","startTime":1822.18,"endTime":1824.64,"body":"think this will resonate with"},{"speaker":"Charles Goldfarb","startTime":1822.18,"endTime":1824.64,"body":"the listeners, you don't want to"},{"speaker":"Charles Goldfarb","startTime":1824.64,"endTime":1828.36,"body":"be a leader that is constantly"},{"speaker":"Charles Goldfarb","startTime":1824.64,"endTime":1828.36,"body":"putting out fires, because"},{"speaker":"Charles Goldfarb","startTime":1828.36,"endTime":1831.27,"body":"that's no way to lead. And you"},{"speaker":"Charles Goldfarb","startTime":1828.36,"endTime":1831.27,"body":"shouldn't expend your energy"},{"speaker":"Charles Goldfarb","startTime":1831.27,"endTime":1836.22,"body":"doing that. And so that's either"},{"speaker":"Charles Goldfarb","startTime":1831.27,"endTime":1836.22,"body":"a reflection of challenging"},{"speaker":"Charles Goldfarb","startTime":1836.22,"endTime":1840.03,"body":"department personnel, a"},{"speaker":"Charles Goldfarb","startTime":1836.22,"endTime":1840.03,"body":"challenging culture, but somehow"},{"speaker":"Charles Goldfarb","startTime":1840.03,"endTime":1843.21,"body":"another, you know, the leader"},{"speaker":"Charles Goldfarb","startTime":1840.03,"endTime":1843.21,"body":"needs a vision of where the"},{"speaker":"Charles Goldfarb","startTime":1843.21,"endTime":1845.7,"body":"department should be going, and"},{"speaker":"Charles Goldfarb","startTime":1843.21,"endTime":1845.7,"body":"hopefully spending energy on"},{"speaker":"Charles Goldfarb","startTime":1845.7,"endTime":1849.3,"body":"that. not putting out fires. But"},{"speaker":"Charles Goldfarb","startTime":1845.7,"endTime":1849.3,"body":"yeah, we have a lot of fires."},{"speaker":"Charles Goldfarb","startTime":1849.48,"endTime":1849.84,"body":"Yeah,"},{"speaker":"Chris Dy","startTime":1849.9,"endTime":1851.94,"body":"Well then how do you,"},{"speaker":"Chris Dy","startTime":1849.9,"endTime":1851.94,"body":"so then who should be dealing"},{"speaker":"Chris Dy","startTime":1851.94,"endTime":1856.59,"body":"with fires? I mean, how do you?"},{"speaker":"Chris Dy","startTime":1851.94,"endTime":1856.59,"body":"How do you find the right"},{"speaker":"Chris Dy","startTime":1856.68,"endTime":1859.89,"body":"structure to do that? Because"},{"speaker":"Chris Dy","startTime":1856.68,"endTime":1859.89,"body":"it's something that you"},{"speaker":"Chris Dy","startTime":1859.89,"endTime":1862.53,"body":"obviously don't want to spend"},{"speaker":"Chris Dy","startTime":1859.89,"endTime":1862.53,"body":"too much energy on. But there"},{"speaker":"Chris Dy","startTime":1862.53,"endTime":1864.24,"body":"can be some delicate things to"},{"speaker":"Chris Dy","startTime":1862.53,"endTime":1864.24,"body":"delegate there."},{"speaker":"Charles Goldfarb","startTime":1864.48,"endTime":1866.04,"body":"Yeah, I don't,"},{"speaker":"Charles Goldfarb","startTime":1864.48,"endTime":1866.04,"body":"I don't know that you can"},{"speaker":"Charles Goldfarb","startTime":1866.04,"endTime":1868.5,"body":"delegate a lot of that. I think"},{"speaker":"Charles Goldfarb","startTime":1866.04,"endTime":1868.5,"body":"that's exactly right. Our"},{"speaker":"Charles Goldfarb","startTime":1868.5,"endTime":1871.77,"body":"department is going through a"},{"speaker":"Charles Goldfarb","startTime":1868.5,"endTime":1871.77,"body":"phase where we are transitioning"},{"speaker":"Charles Goldfarb","startTime":1871.77,"endTime":1874.14,"body":"to an increased role for"},{"speaker":"Charles Goldfarb","startTime":1871.77,"endTime":1874.14,"body":"division chiefs, just because"},{"speaker":"Charles Goldfarb","startTime":1874.14,"endTime":1877.92,"body":"we've gotten so big. But that's"},{"speaker":"Charles Goldfarb","startTime":1874.14,"endTime":1877.92,"body":"not easy. That's not an easy"},{"speaker":"Charles Goldfarb","startTime":1877.92,"endTime":1880.38,"body":"change. And so I still think"},{"speaker":"Charles Goldfarb","startTime":1877.92,"endTime":1880.38,"body":"department leadership has to own"},{"speaker":"Charles Goldfarb","startTime":1880.38,"endTime":1882.84,"body":"a lot of this. But it's again,"},{"speaker":"Charles Goldfarb","startTime":1880.38,"endTime":1882.84,"body":"it goes back to getting the"},{"speaker":"Charles Goldfarb","startTime":1882.84,"endTime":1885.9,"body":"right people on the bus with a"},{"speaker":"Charles Goldfarb","startTime":1882.84,"endTime":1885.9,"body":"with a culture, and a vision"},{"speaker":"Charles Goldfarb","startTime":1885.9,"endTime":1888.78,"body":"that resonates and people who"},{"speaker":"Charles Goldfarb","startTime":1885.9,"endTime":1888.78,"body":"really see things the same way"},{"speaker":"Charles Goldfarb","startTime":1888.78,"endTime":1891.36,"body":"to the greatest, you know,"},{"speaker":"Charles Goldfarb","startTime":1888.78,"endTime":1891.36,"body":"degree possible?"},{"speaker":"Chris Dy","startTime":1891.54,"endTime":1894.3,"body":"How hard is it to"},{"speaker":"Chris Dy","startTime":1891.54,"endTime":1894.3,"body":"drive home vision to people? I"},{"speaker":"Chris Dy","startTime":1894.3,"endTime":1896.46,"body":"mean, does this need to be"},{"speaker":"Chris Dy","startTime":1894.3,"endTime":1896.46,"body":"something where you know, you"},{"speaker":"Chris Dy","startTime":1896.46,"endTime":1899.97,"body":"have retreats of the sorts,"},{"speaker":"Chris Dy","startTime":1896.46,"endTime":1899.97,"body":"obviously, in a socially"},{"speaker":"Chris Dy","startTime":1899.97,"endTime":1903.09,"body":"distanced manner or remote kind"},{"speaker":"Chris Dy","startTime":1899.97,"endTime":1903.09,"body":"of thing? But I mean, is that"},{"speaker":"Chris Dy","startTime":1903.09,"endTime":1905.79,"body":"the best way to drive vision"},{"speaker":"Chris Dy","startTime":1903.09,"endTime":1905.79,"body":"home to people? Or is it through"},{"speaker":"Chris Dy","startTime":1905.79,"endTime":1908.28,"body":"other ways? Is it one on one"},{"speaker":"Chris Dy","startTime":1905.79,"endTime":1908.28,"body":"meetings and that kind of thing?"},{"speaker":"Charles Goldfarb","startTime":1908.36,"endTime":1911.63,"body":"I think we had"},{"speaker":"Charles Goldfarb","startTime":1908.36,"endTime":1911.63,"body":"a retreat. I don't know how long"},{"speaker":"Charles Goldfarb","startTime":1911.63,"endTime":1914.93,"body":"it's been at least a year ago,"},{"speaker":"Charles Goldfarb","startTime":1911.63,"endTime":1914.93,"body":"maybe it was last January. And I"},{"speaker":"Charles Goldfarb","startTime":1914.93,"endTime":1918.17,"body":"got so much positive feedback,"},{"speaker":"Charles Goldfarb","startTime":1914.93,"endTime":1918.17,"body":"everyone gripes about finding"},{"speaker":"Charles Goldfarb","startTime":1918.17,"endTime":1921.05,"body":"four hours on a Saturday to sit"},{"speaker":"Charles Goldfarb","startTime":1918.17,"endTime":1921.05,"body":"and talk about something that"},{"speaker":"Charles Goldfarb","startTime":1921.05,"endTime":1923.57,"body":"doesn't directly affect their"},{"speaker":"Charles Goldfarb","startTime":1921.05,"endTime":1923.57,"body":"clinical lives. But it was a"},{"speaker":"Charles Goldfarb","startTime":1923.57,"endTime":1925.7,"body":"great, well you know it was"},{"speaker":"Charles Goldfarb","startTime":1923.57,"endTime":1925.7,"body":"great. And I think we were"},{"speaker":"Charles Goldfarb","startTime":1925.7,"endTime":1928.46,"body":"planning to have more of those."},{"speaker":"Charles Goldfarb","startTime":1925.7,"endTime":1928.46,"body":"I think that's great. And it's"},{"speaker":"Charles Goldfarb","startTime":1928.46,"endTime":1932.51,"body":"just the constant messaging, and"},{"speaker":"Charles Goldfarb","startTime":1928.46,"endTime":1932.51,"body":"and signaling, kind of who we"},{"speaker":"Charles Goldfarb","startTime":1932.51,"endTime":1935.36,"body":"are, throught the type of"},{"speaker":"Charles Goldfarb","startTime":1932.51,"endTime":1935.36,"body":"conferences we have. It's just,"},{"speaker":"Charles Goldfarb","startTime":1935.51,"endTime":1938.75,"body":"it's kind of all of leadership"},{"speaker":"Charles Goldfarb","startTime":1935.51,"endTime":1938.75,"body":"actions, whether they are"},{"speaker":"Charles Goldfarb","startTime":1938.75,"endTime":1943.1,"body":"allowed or not send a message,"},{"speaker":"Charles Goldfarb","startTime":1938.75,"endTime":1943.1,"body":"all the choices we make send"},{"speaker":"Charles Goldfarb","startTime":1943.1,"endTime":1946.04,"body":"messages, and those messages are"},{"speaker":"Charles Goldfarb","startTime":1943.1,"endTime":1946.04,"body":"heard, whether we think they're"},{"speaker":"Charles Goldfarb","startTime":1946.04,"endTime":1949.64,"body":"being heard or not. You know,"},{"speaker":"Charles Goldfarb","startTime":1946.04,"endTime":1949.64,"body":"one thing, this article talks"},{"speaker":"Charles Goldfarb","startTime":1949.64,"endTime":1952.67,"body":"about job changes. And one of"},{"speaker":"Charles Goldfarb","startTime":1949.64,"endTime":1952.67,"body":"the things in academics is we"},{"speaker":"Charles Goldfarb","startTime":1952.67,"endTime":1955.01,"body":"are constantly fighting the"},{"speaker":"Charles Goldfarb","startTime":1952.67,"endTime":1955.01,"body":"perception that the grass is"},{"speaker":"Charles Goldfarb","startTime":1955.01,"endTime":1958.1,"body":"greener. The grass is greener in"},{"speaker":"Charles Goldfarb","startTime":1955.01,"endTime":1958.1,"body":"private practice, or the grass"},{"speaker":"Charles Goldfarb","startTime":1958.1,"endTime":1961.91,"body":"is greener in another job, and"},{"speaker":"Charles Goldfarb","startTime":1958.1,"endTime":1961.91,"body":"especially in COVID, because"},{"speaker":"Charles Goldfarb","startTime":1961.91,"endTime":1964.46,"body":"we're dealing with, you know,"},{"speaker":"Charles Goldfarb","startTime":1961.91,"endTime":1964.46,"body":"financial issues, which are"},{"speaker":"Charles Goldfarb","startTime":1964.46,"endTime":1968.36,"body":"real, and huge. And now, as we"},{"speaker":"Charles Goldfarb","startTime":1964.46,"endTime":1968.36,"body":"potentially are walking into"},{"speaker":"Charles Goldfarb","startTime":1968.36,"endTime":1970.46,"body":"another shutdown, those issues"},{"speaker":"Charles Goldfarb","startTime":1968.36,"endTime":1970.46,"body":"are going to raise their ugly"},{"speaker":"Charles Goldfarb","startTime":1970.46,"endTime":1974.24,"body":"head again, and the grass is not"},{"speaker":"Charles Goldfarb","startTime":1970.46,"endTime":1974.24,"body":"greener. You know, for us, we"},{"speaker":"Charles Goldfarb","startTime":1974.24,"endTime":1977.21,"body":"are very, you know, I try to"},{"speaker":"Charles Goldfarb","startTime":1974.24,"endTime":1977.21,"body":"share this message. I know for a"},{"speaker":"Charles Goldfarb","startTime":1977.21,"endTime":1980.69,"body":"fact, by looking at different"},{"speaker":"Charles Goldfarb","startTime":1977.21,"endTime":1980.69,"body":"private practice jobs in our"},{"speaker":"Charles Goldfarb","startTime":1980.69,"endTime":1983.36,"body":"community and academic jobs"},{"speaker":"Charles Goldfarb","startTime":1980.69,"endTime":1983.36,"body":"around the country, we have it"},{"speaker":"Charles Goldfarb","startTime":1983.36,"endTime":1986.66,"body":"really good, but it goes back to"},{"speaker":"Charles Goldfarb","startTime":1983.36,"endTime":1986.66,"body":"your question, how do you make"},{"speaker":"Charles Goldfarb","startTime":1986.66,"endTime":1988.67,"body":"people truly understand and"},{"speaker":"Charles Goldfarb","startTime":1986.66,"endTime":1988.67,"body":"appreciate that?"},{"speaker":"Chris Dy","startTime":1989.39,"endTime":1990.92,"body":"Well, I hope you have"},{"speaker":"Chris Dy","startTime":1989.39,"endTime":1990.92,"body":"the answer to that, because"},{"speaker":"Chris Dy","startTime":1990.92,"endTime":1993.29,"body":"you're probably gonna have to"},{"speaker":"Chris Dy","startTime":1990.92,"endTime":1993.29,"body":"use some of that skill and"},{"speaker":"Chris Dy","startTime":1993.29,"endTime":1997.25,"body":"muscle in the coming months, you"},{"speaker":"Chris Dy","startTime":1993.29,"endTime":1997.25,"body":"know, with, you know, the"},{"speaker":"Chris Dy","startTime":1997.25,"endTime":2000.82,"body":"financial aspects are going to"},{"speaker":"Chris Dy","startTime":1997.25,"endTime":2000.82,"body":"be turned upside down, probably."},{"speaker":"Chris Dy","startTime":2001.27,"endTime":2005.89,"body":"And, you know, that's where a"},{"speaker":"Chris Dy","startTime":2001.27,"endTime":2005.89,"body":"lot of people's true colors show"},{"speaker":"Chris Dy","startTime":2005.89,"endTime":2007.9,"body":"is when you know, you're dealing"},{"speaker":"Chris Dy","startTime":2005.89,"endTime":2007.9,"body":"with that kind of thing."},{"speaker":"Charles Goldfarb","startTime":2007.0,"endTime":2010.66,"body":"It is for"},{"speaker":"Charles Goldfarb","startTime":2007.0,"endTime":2010.66,"body":"sure. All right. So we've been"},{"speaker":"Charles Goldfarb","startTime":2010.66,"endTime":2013.84,"body":"going at this for quite a while,"},{"speaker":"Charles Goldfarb","startTime":2010.66,"endTime":2013.84,"body":"I would like to and we can talk"},{"speaker":"Charles Goldfarb","startTime":2013.84,"endTime":2016.54,"body":"about a few more issues. But I"},{"speaker":"Charles Goldfarb","startTime":2013.84,"endTime":2016.54,"body":"think one of the most powerful"},{"speaker":"Charles Goldfarb","startTime":2016.54,"endTime":2022.09,"body":"parts about this was the section"},{"speaker":"Charles Goldfarb","startTime":2016.54,"endTime":2022.09,"body":"entitled success. And I like it"},{"speaker":"Charles Goldfarb","startTime":2022.09,"endTime":2025.27,"body":"because I'm a history buff. But"},{"speaker":"Charles Goldfarb","startTime":2022.09,"endTime":2025.27,"body":"why don't we just alternate, and"},{"speaker":"Charles Goldfarb","startTime":2025.27,"endTime":2029.8,"body":"basically, Simone described,"},{"speaker":"Charles Goldfarb","startTime":2025.27,"endTime":2029.8,"body":"essentially four overlapping"},{"speaker":"Charles Goldfarb","startTime":2029.8,"endTime":2035.14,"body":"eras relevant to academia. And"},{"speaker":"Charles Goldfarb","startTime":2029.8,"endTime":2035.14,"body":"it's really interesting. So the"},{"speaker":"Charles Goldfarb","startTime":2035.14,"endTime":2041.47,"body":"first is the the Oslerian era"},{"speaker":"Charles Goldfarb","startTime":2035.14,"endTime":2041.47,"body":"from 1900 to 1945. And this is"},{"speaker":"Charles Goldfarb","startTime":2041.47,"endTime":2045.76,"body":"when medicine had a long way to"},{"speaker":"Charles Goldfarb","startTime":2041.47,"endTime":2045.76,"body":"go. And leadership was dominated"},{"speaker":"Charles Goldfarb","startTime":2045.76,"endTime":2049.69,"body":"and I quote, by diagnostic"},{"speaker":"Charles Goldfarb","startTime":2045.76,"endTime":2049.69,"body":"skills, anatomic and clinical"},{"speaker":"Charles Goldfarb","startTime":2049.69,"endTime":2053.47,"body":"pathology, and public health."},{"speaker":"Charles Goldfarb","startTime":2049.69,"endTime":2053.47,"body":"There weren't a lot of academic"},{"speaker":"Charles Goldfarb","startTime":2053.47,"endTime":2056.77,"body":"positions. They weren't paid"},{"speaker":"Charles Goldfarb","startTime":2053.47,"endTime":2056.77,"body":"particularly well. But those"},{"speaker":"Charles Goldfarb","startTime":2056.77,"endTime":2061.33,"body":"clinicians, were giants and were"},{"speaker":"Charles Goldfarb","startTime":2056.77,"endTime":2061.33,"body":"respected. And they set the,"},{"speaker":"Charles Goldfarb","startTime":2061.45,"endTime":2064.24,"body":"they set the standard and"},{"speaker":"Charles Goldfarb","startTime":2061.45,"endTime":2064.24,"body":"institutions that had those"},{"speaker":"Charles Goldfarb","startTime":2064.24,"endTime":2068.17,"body":"physicians really became the"},{"speaker":"Charles Goldfarb","startTime":2064.24,"endTime":2068.17,"body":"place to seek medical care."},{"speaker":"Chris Dy","startTime":2068.35,"endTime":2070.63,"body":"Well, I mean this, it"},{"speaker":"Chris Dy","startTime":2068.35,"endTime":2070.63,"body":"says here, this was the era of"},{"speaker":"Chris Dy","startTime":2070.63,"endTime":2074.56,"body":"the medical renaissance man or"},{"speaker":"Chris Dy","startTime":2070.63,"endTime":2074.56,"body":"person, superb clinician,"},{"speaker":"Chris Dy","startTime":2074.56,"endTime":2077.08,"body":"investigator and teacher often"},{"speaker":"Chris Dy","startTime":2074.56,"endTime":2077.08,"body":"well read."},{"speaker":"Charles Goldfarb","startTime":2077.36,"endTime":2079.37,"body":"Yeah, and it"},{"speaker":"Charles Goldfarb","startTime":2077.36,"endTime":2079.37,"body":"was a man. Yeah, I mean, yeah,"},{"speaker":"Charles Goldfarb","startTime":2079.4,"endTime":2082.28,"body":"we had a hard time saying that"},{"speaker":"Charles Goldfarb","startTime":2079.4,"endTime":2082.28,"body":"yesterday. Yeah. It's"},{"speaker":"Charles Goldfarb","startTime":2082.28,"endTime":2084.62,"body":"fascinating, fascinating. What"},{"speaker":"Charles Goldfarb","startTime":2082.28,"endTime":2084.62,"body":"was the next era?"},{"speaker":"Chris Dy","startTime":2084.65,"endTime":2088.88,"body":"So the NIH rapid"},{"speaker":"Chris Dy","startTime":2084.65,"endTime":2088.88,"body":"growth era, 1945 to 1970. And"},{"speaker":"Chris Dy","startTime":2088.91,"endTime":2092.12,"body":"that saw the NIH when it was the"},{"speaker":"Chris Dy","startTime":2088.91,"endTime":2092.12,"body":"premier place in the country to"},{"speaker":"Chris Dy","startTime":2092.12,"endTime":2095.66,"body":"train, not just to do research,"},{"speaker":"Chris Dy","startTime":2092.12,"endTime":2095.66,"body":"but people went to the NIH to"},{"speaker":"Chris Dy","startTime":2095.66,"endTime":2100.31,"body":"train and then it when when"},{"speaker":"Chris Dy","startTime":2095.66,"endTime":2100.31,"body":"there was a diaspora of people"},{"speaker":"Chris Dy","startTime":2100.31,"endTime":2104.78,"body":"who left the NIH centers, it"},{"speaker":"Chris Dy","startTime":2100.31,"endTime":2104.78,"body":"really demonstrated the value of"},{"speaker":"Chris Dy","startTime":2104.78,"endTime":2107.93,"body":"the NIH in pushing the envelope"},{"speaker":"Chris Dy","startTime":2104.78,"endTime":2107.93,"body":"in terms of research and"},{"speaker":"Chris Dy","startTime":2107.93,"endTime":2109.31,"body":"particularly funding."},{"speaker":"Charles Goldfarb","startTime":2109.91,"endTime":2112.49,"body":"Yet and it"},{"speaker":"Charles Goldfarb","startTime":2109.91,"endTime":2112.49,"body":"says here, NIH grantees became"},{"speaker":"Charles Goldfarb","startTime":2112.52,"endTime":2117.89,"body":"kings. And there's still some of"},{"speaker":"Charles Goldfarb","startTime":2112.52,"endTime":2117.89,"body":"that today, but not to the not"},{"speaker":"Charles Goldfarb","startTime":2117.89,"endTime":2118.79,"body":"to the same degree."},{"speaker":"Chris Dy","startTime":2118.96,"endTime":2121.12,"body":"Well, you didn't"},{"speaker":"Chris Dy","startTime":2118.96,"endTime":2121.12,"body":"finish the sentence here. So it"},{"speaker":"Chris Dy","startTime":2121.12,"endTime":2124.15,"body":"says they became kings often"},{"speaker":"Chris Dy","startTime":2121.12,"endTime":2124.15,"body":"allowed to distain clinical or"},{"speaker":"Chris Dy","startTime":2124.15,"endTime":2126.31,"body":"teaching duties because they"},{"speaker":"Chris Dy","startTime":2124.15,"endTime":2126.31,"body":"were an important source of"},{"speaker":"Chris Dy","startTime":2126.31,"endTime":2128.56,"body":"prestige and dollars for the"},{"speaker":"Chris Dy","startTime":2126.31,"endTime":2128.56,"body":"institution"},{"speaker":"Charles Goldfarb","startTime":2129.32,"endTime":2132.26,"body":"It's true, and"},{"speaker":"Charles Goldfarb","startTime":2129.32,"endTime":2132.26,"body":"there are some holdovers that we"},{"speaker":"Charles Goldfarb","startTime":2132.26,"endTime":2136.25,"body":"see still older, almost always"},{"speaker":"Charles Goldfarb","startTime":2132.26,"endTime":2136.25,"body":"older. And again, they are all"},{"speaker":"Charles Goldfarb","startTime":2136.25,"endTime":2141.8,"body":"men that still walk around with"},{"speaker":"Charles Goldfarb","startTime":2136.25,"endTime":2141.8,"body":"that mentality, but it's become"},{"speaker":"Charles Goldfarb","startTime":2141.8,"endTime":2142.58,"body":"a dying breed."},{"speaker":"Chris Dy","startTime":2142.63,"endTime":2144.85,"body":"Yeah, and I've heard,"},{"speaker":"Chris Dy","startTime":2142.63,"endTime":2144.85,"body":"I've had, you know, several"},{"speaker":"Chris Dy","startTime":2144.85,"endTime":2148.27,"body":"people of different generations"},{"speaker":"Chris Dy","startTime":2144.85,"endTime":2148.27,"body":"tell me that, you know, once"},{"speaker":"Chris Dy","startTime":2148.27,"endTime":2151.0,"body":"that happens for you, it is a"},{"speaker":"Chris Dy","startTime":2148.27,"endTime":2151.0,"body":"big leverage point, like, you"},{"speaker":"Chris Dy","startTime":2151.0,"endTime":2153.7,"body":"know, in terms of, you know, I"},{"speaker":"Chris Dy","startTime":2151.0,"endTime":2153.7,"body":"know that there are people, even"},{"speaker":"Chris Dy","startTime":2153.7,"endTime":2156.73,"body":"in our institution that have"},{"speaker":"Chris Dy","startTime":2153.7,"endTime":2156.73,"body":"used it to, you know, you know,"},{"speaker":"Chris Dy","startTime":2156.73,"endTime":2159.49,"body":"shop around a bit, and they talk"},{"speaker":"Chris Dy","startTime":2156.73,"endTime":2159.49,"body":"a little bit about looking at"},{"speaker":"Chris Dy","startTime":2159.49,"endTime":2160.72,"body":"jobs and stuff in here, but."},{"speaker":"Charles Goldfarb","startTime":2160.87,"endTime":2162.64,"body":"Yeah, for"},{"speaker":"Charles Goldfarb","startTime":2160.87,"endTime":2162.64,"body":"Absolutely, it's still mat-"},{"speaker":"Charles Goldfarb","startTime":2162.64,"endTime":2166.54,"body":"don't get me wrong, it's still"},{"speaker":"Charles Goldfarb","startTime":2162.64,"endTime":2166.54,"body":"matters a lot. And NIH dollars"},{"speaker":"Charles Goldfarb","startTime":2166.54,"endTime":2169.51,"body":"matter far more than other"},{"speaker":"Charles Goldfarb","startTime":2166.54,"endTime":2169.51,"body":"dollars. I mean, DOD dollars are"},{"speaker":"Charles Goldfarb","startTime":2169.51,"endTime":2174.28,"body":"great, just not the same. The"},{"speaker":"Charles Goldfarb","startTime":2169.51,"endTime":2174.28,"body":"next era, the third era was the"},{"speaker":"Charles Goldfarb","startTime":2174.28,"endTime":2179.71,"body":"medicare/medicaid era, from 1965"},{"speaker":"Charles Goldfarb","startTime":2174.28,"endTime":2179.71,"body":"to 1990. And this saw academic"},{"speaker":"Charles Goldfarb","startTime":2179.71,"endTime":2184.39,"body":"structures, I'm sorry, sorry. So"},{"speaker":"Charles Goldfarb","startTime":2179.71,"endTime":2184.39,"body":"academic centers restructure to"},{"speaker":"Charles Goldfarb","startTime":2184.39,"endTime":2187.93,"body":"increase the newly available"},{"speaker":"Charles Goldfarb","startTime":2184.39,"endTime":2187.93,"body":"clinical revenues, that allowed"},{"speaker":"Charles Goldfarb","startTime":2187.93,"endTime":2191.5,"body":"cost shifting, to support"},{"speaker":"Charles Goldfarb","startTime":2187.93,"endTime":2191.5,"body":"research and teaching. And so"},{"speaker":"Charles Goldfarb","startTime":2191.59,"endTime":2195.43,"body":"this is when academic medical"},{"speaker":"Charles Goldfarb","startTime":2191.59,"endTime":2195.43,"body":"centers became clinical hubs."},{"speaker":"Charles Goldfarb","startTime":2195.61,"endTime":2199.09,"body":"And it became important to treat"},{"speaker":"Charles Goldfarb","startTime":2195.61,"endTime":2199.09,"body":"lots of patients to bring in"},{"speaker":"Charles Goldfarb","startTime":2199.09,"endTime":2202.45,"body":"money to support the other"},{"speaker":"Charles Goldfarb","startTime":2199.09,"endTime":2202.45,"body":"missions. And while this era"},{"speaker":"Charles Goldfarb","startTime":2202.45,"endTime":2203.92,"body":"allegedly ended in 1990,"},{"speaker":"Chris Dy","startTime":2204.97,"endTime":2206.08,"body":"I'd argue it's still"},{"speaker":"Chris Dy","startTime":2204.97,"endTime":2206.08,"body":"going on,"},{"speaker":"Charles Goldfarb","startTime":2206.08,"endTime":2208.6,"body":"absolutely,"},{"speaker":"Charles Goldfarb","startTime":2206.08,"endTime":2208.6,"body":"still going on. And still super"},{"speaker":"Charles Goldfarb","startTime":2208.6,"endTime":2212.35,"body":"important to what we do,"},{"speaker":"Charles Goldfarb","startTime":2208.6,"endTime":2212.35,"body":"although then we have the final"},{"speaker":"Charles Goldfarb","startTime":2212.35,"endTime":2212.8,"body":"era,"},{"speaker":"Chris Dy","startTime":2213.85,"endTime":2217.27,"body":"The for-profit era,"},{"speaker":"Chris Dy","startTime":2213.85,"endTime":2217.27,"body":"and, you know, the dominant"},{"speaker":"Chris Dy","startTime":2217.27,"endTime":2219.85,"body":"forces with the greatest impact"},{"speaker":"Chris Dy","startTime":2217.27,"endTime":2219.85,"body":"on their missions for good or"},{"speaker":"Chris Dy","startTime":2219.85,"endTime":2222.52,"body":"ill, are Managed Care Health"},{"speaker":"Chris Dy","startTime":2219.85,"endTime":2222.52,"body":"Systems and the pharmaceutical"},{"speaker":"Chris Dy","startTime":2222.52,"endTime":2225.94,"body":"and biotech industries. You"},{"speaker":"Chris Dy","startTime":2222.52,"endTime":2225.94,"body":"know, I'd argue for these two"},{"speaker":"Chris Dy","startTime":2225.94,"endTime":2228.46,"body":"eras that we've described, the"},{"speaker":"Chris Dy","startTime":2225.94,"endTime":2228.46,"body":"medicare/medicaid era and the"},{"speaker":"Chris Dy","startTime":2228.46,"endTime":2232.57,"body":"for-profit era, you know, our"},{"speaker":"Chris Dy","startTime":2228.46,"endTime":2232.57,"body":"salaries are paid by our"},{"speaker":"Chris Dy","startTime":2232.57,"endTime":2234.88,"body":"clinical care, not by anything"},{"speaker":"Chris Dy","startTime":2232.57,"endTime":2234.88,"body":"else, you know, it's the care"},{"speaker":"Chris Dy","startTime":2234.88,"endTime":2239.68,"body":"that we provide. And when I was"},{"speaker":"Chris Dy","startTime":2234.88,"endTime":2239.68,"body":"looking at positions, and I"},{"speaker":"Chris Dy","startTime":2239.71,"endTime":2242.53,"body":"wanted to spend a substantial"},{"speaker":"Chris Dy","startTime":2239.71,"endTime":2242.53,"body":"amount of time doing research"},{"speaker":"Chris Dy","startTime":2242.53,"endTime":2245.35,"body":"more than most, it was"},{"speaker":"Chris Dy","startTime":2242.53,"endTime":2245.35,"body":"essentially, you know, many"},{"speaker":"Chris Dy","startTime":2245.35,"endTime":2247.63,"body":"people said, Alright, that's,"},{"speaker":"Chris Dy","startTime":2245.35,"endTime":2247.63,"body":"that's your call, because that's"},{"speaker":"Chris Dy","startTime":2247.63,"endTime":2251.17,"body":"a financial liability for you."},{"speaker":"Chris Dy","startTime":2247.63,"endTime":2251.17,"body":"And, you know, we don't want you"},{"speaker":"Chris Dy","startTime":2251.17,"endTime":2253.48,"body":"costing us money, but you know,"},{"speaker":"Chris Dy","startTime":2251.17,"endTime":2253.48,"body":"you're gonna lose some money,"},{"speaker":"Chris Dy","startTime":2253.48,"endTime":2256.63,"body":"too. And I think that that's the"},{"speaker":"Chris Dy","startTime":2253.48,"endTime":2256.63,"body":"way that most people look at"},{"speaker":"Chris Dy","startTime":2256.63,"endTime":2260.5,"body":"research nowadays, is that it's"},{"speaker":"Chris Dy","startTime":2256.63,"endTime":2260.5,"body":"a personal choice. It is, you"},{"speaker":"Chris Dy","startTime":2260.5,"endTime":2263.17,"body":"know, there's a lot of"},{"speaker":"Chris Dy","startTime":2260.5,"endTime":2263.17,"body":"opportunity cost economically"},{"speaker":"Chris Dy","startTime":2263.71,"endTime":2266.32,"body":"for that. And, you know, that's"},{"speaker":"Chris Dy","startTime":2263.71,"endTime":2266.32,"body":"a decision you have to make, and"},{"speaker":"Chris Dy","startTime":2266.32,"endTime":2267.73,"body":"how do you prioritize it in your"},{"speaker":"Chris Dy","startTime":2266.32,"endTime":2267.73,"body":"life?"},{"speaker":"Charles Goldfarb","startTime":2268.2,"endTime":2271.17,"body":"It is, it's"},{"speaker":"Charles Goldfarb","startTime":2268.2,"endTime":2271.17,"body":"really tough, it's tough for"},{"speaker":"Charles Goldfarb","startTime":2271.17,"endTime":2275.01,"body":"departments, you know,"},{"speaker":"Charles Goldfarb","startTime":2271.17,"endTime":2275.01,"body":"department can support some"},{"speaker":"Charles Goldfarb","startTime":2275.37,"endTime":2278.97,"body":"clinical research positions. But"},{"speaker":"Charles Goldfarb","startTime":2275.37,"endTime":2278.97,"body":"ultimately, the department has"},{"speaker":"Charles Goldfarb","startTime":2278.97,"endTime":2281.88,"body":"to be financially viable. And"},{"speaker":"Charles Goldfarb","startTime":2278.97,"endTime":2281.88,"body":"the deans and the leaders of"},{"speaker":"Charles Goldfarb","startTime":2281.88,"endTime":2285.84,"body":"these academic institutions"},{"speaker":"Charles Goldfarb","startTime":2281.88,"endTime":2285.84,"body":"understand that. And so it's a"},{"speaker":"Charles Goldfarb","startTime":2285.84,"endTime":2288.66,"body":"balance right. And certainly at"},{"speaker":"Charles Goldfarb","startTime":2285.84,"endTime":2288.66,"body":"our institution, we do"},{"speaker":"Charles Goldfarb","startTime":2288.9,"endTime":2292.86,"body":"absolutely prioritize changing"},{"speaker":"Charles Goldfarb","startTime":2288.9,"endTime":2292.86,"body":"the field of orthopedics through"},{"speaker":"Charles Goldfarb","startTime":2292.86,"endTime":2296.31,"body":"research. But Washington"},{"speaker":"Charles Goldfarb","startTime":2292.86,"endTime":2296.31,"body":"University also realizes you"},{"speaker":"Charles Goldfarb","startTime":2296.31,"endTime":2298.41,"body":"have to be clinically productive"},{"speaker":"Charles Goldfarb","startTime":2296.31,"endTime":2298.41,"body":"to help pay the bills."},{"speaker":"Chris Dy","startTime":2299.01,"endTime":2301.29,"body":"Yes, becoming even"},{"speaker":"Chris Dy","startTime":2299.01,"endTime":2301.29,"body":"more challenging in current"},{"speaker":"Chris Dy","startTime":2301.29,"endTime":2302.13,"body":"environments right?"},{"speaker":"Charles Goldfarb","startTime":2302.3,"endTime":2304.34,"body":"That is true."},{"speaker":"Charles Goldfarb","startTime":2302.3,"endTime":2304.34,"body":"And the you know, the article"},{"speaker":"Charles Goldfarb","startTime":2304.34,"endTime":2307.88,"body":"ends with the statement that"},{"speaker":"Charles Goldfarb","startTime":2304.34,"endTime":2307.88,"body":"academic medicine is a noble"},{"speaker":"Charles Goldfarb","startTime":2307.88,"endTime":2311.78,"body":"calling. And certainly, I think"},{"speaker":"Charles Goldfarb","startTime":2307.88,"endTime":2311.78,"body":"you and I agree with that. It's"},{"speaker":"Charles Goldfarb","startTime":2311.78,"endTime":2314.75,"body":"funny, when I was a resident"},{"speaker":"Charles Goldfarb","startTime":2311.78,"endTime":2314.75,"body":"here at Washington University,"},{"speaker":"Charles Goldfarb","startTime":2315.11,"endTime":2319.16,"body":"one of my attendings said to me,"},{"speaker":"Charles Goldfarb","startTime":2315.11,"endTime":2319.16,"body":"you know, always remember, this"},{"speaker":"Charles Goldfarb","startTime":2319.16,"endTime":2324.2,"body":"is a job, this is just a job."},{"speaker":"Charles Goldfarb","startTime":2319.16,"endTime":2324.2,"body":"And while that is the opposite"},{"speaker":"Charles Goldfarb","startTime":2324.2,"endTime":2327.11,"body":"end of the spectrum of being a"},{"speaker":"Charles Goldfarb","startTime":2324.2,"endTime":2327.11,"body":"noble calling, sometimes that I"},{"speaker":"Charles Goldfarb","startTime":2327.11,"endTime":2329.24,"body":"mean, obviously, it's still"},{"speaker":"Charles Goldfarb","startTime":2327.11,"endTime":2329.24,"body":"residence, it's been 25 years"},{"speaker":"Charles Goldfarb","startTime":2329.24,"endTime":2332.06,"body":"and I still remember that"},{"speaker":"Charles Goldfarb","startTime":2329.24,"endTime":2332.06,"body":"statement. And I have to remind"},{"speaker":"Charles Goldfarb","startTime":2332.06,"endTime":2335.81,"body":"myself sometimes that it is"},{"speaker":"Charles Goldfarb","startTime":2332.06,"endTime":2335.81,"body":"still a job. But I think of the"},{"speaker":"Charles Goldfarb","startTime":2335.81,"endTime":2339.23,"body":"life I lead of work being you"},{"speaker":"Charles Goldfarb","startTime":2335.81,"endTime":2339.23,"body":"know, my work, taking care of"},{"speaker":"Charles Goldfarb","startTime":2339.23,"endTime":2341.36,"body":"patients and hopefully changing"},{"speaker":"Charles Goldfarb","startTime":2339.23,"endTime":2341.36,"body":"the field of orthopedics, it's"},{"speaker":"Charles Goldfarb","startTime":2341.36,"endTime":2344.75,"body":"more than a job, but there's"},{"speaker":"Charles Goldfarb","startTime":2341.36,"endTime":2344.75,"body":"still, that still some what"},{"speaker":"Charles Goldfarb","startTime":2344.78,"endTime":2345.5,"body":"rings true."},{"speaker":"Chris Dy","startTime":2345.75,"endTime":2347.46,"body":"You know, and when,"},{"speaker":"Chris Dy","startTime":2345.75,"endTime":2347.46,"body":"you know, the challenges that"},{"speaker":"Chris Dy","startTime":2347.46,"endTime":2349.59,"body":"when it's more than a job it"},{"speaker":"Chris Dy","startTime":2347.46,"endTime":2349.59,"body":"becomes a slippery slope,"},{"speaker":"Chris Dy","startTime":2349.77,"endTime":2353.28,"body":"because all of your identity"},{"speaker":"Chris Dy","startTime":2349.77,"endTime":2353.28,"body":"becomes tied to how things are"},{"speaker":"Chris Dy","startTime":2353.28,"endTime":2357.09,"body":"going at work at times. And I"},{"speaker":"Chris Dy","startTime":2353.28,"endTime":2357.09,"body":"think that, you know, obviously,"},{"speaker":"Chris Dy","startTime":2357.09,"endTime":2360.12,"body":"some of us do it better than"},{"speaker":"Chris Dy","startTime":2357.09,"endTime":2360.12,"body":"others in terms of, I don't"},{"speaker":"Chris Dy","startTime":2360.12,"endTime":2362.76,"body":"think the right word is"},{"speaker":"Chris Dy","startTime":2360.12,"endTime":2362.76,"body":"compartmentalizing, but"},{"speaker":"Chris Dy","startTime":2362.76,"endTime":2365.79,"body":"integrating things better."},{"speaker":"Chris Dy","startTime":2362.76,"endTime":2365.79,"body":"Because, you know, let's be"},{"speaker":"Chris Dy","startTime":2365.79,"endTime":2368.49,"body":"real, physician suicide is a"},{"speaker":"Chris Dy","startTime":2365.79,"endTime":2368.49,"body":"real problem, and mental health"},{"speaker":"Chris Dy","startTime":2368.49,"endTime":2371.97,"body":"issues in physicians are real"},{"speaker":"Chris Dy","startTime":2368.49,"endTime":2371.97,"body":"problems. And I think that if we"},{"speaker":"Chris Dy","startTime":2372.45,"endTime":2378.48,"body":"tie our entire lives to our"},{"speaker":"Chris Dy","startTime":2372.45,"endTime":2378.48,"body":"calling, job, profession, you"},{"speaker":"Chris Dy","startTime":2378.48,"endTime":2381.66,"body":"know, you have a string of tough"},{"speaker":"Chris Dy","startTime":2378.48,"endTime":2381.66,"body":"outcomes, and that can really"},{"speaker":"Chris Dy","startTime":2381.66,"endTime":2382.08,"body":"sting."},{"speaker":"Charles Goldfarb","startTime":2382.59,"endTime":2384.87,"body":"For sure. And"},{"speaker":"Charles Goldfarb","startTime":2382.59,"endTime":2384.87,"body":"you know, the burnout is also"},{"speaker":"Charles Goldfarb","startTime":2384.87,"endTime":2387.3,"body":"the expression that obviously"},{"speaker":"Charles Goldfarb","startTime":2384.87,"endTime":2387.3,"body":"you and I've talked about before"},{"speaker":"Charles Goldfarb","startTime":2387.3,"endTime":2390.24,"body":"and it's so incredibly relevant."},{"speaker":"Charles Goldfarb","startTime":2387.3,"endTime":2390.24,"body":"So you have to achieve balance"},{"speaker":"Charles Goldfarb","startTime":2390.24,"endTime":2393.72,"body":"and it is a noble calling, but"},{"speaker":"Charles Goldfarb","startTime":2390.24,"endTime":2393.72,"body":"you can't forget the other stuff"},{"speaker":"Charles Goldfarb","startTime":2393.72,"endTime":2396.78,"body":"because remember how we started"},{"speaker":"Charles Goldfarb","startTime":2393.72,"endTime":2396.78,"body":"this that academic institutions"},{"speaker":"Charles Goldfarb","startTime":2396.78,"endTime":2401.01,"body":"don't love you back. Anyways,"},{"speaker":"Charles Goldfarb","startTime":2396.78,"endTime":2401.01,"body":"for those of you who have not"},{"speaker":"Charles Goldfarb","startTime":2401.01,"endTime":2404.67,"body":"heard of this, again, we'll put"},{"speaker":"Charles Goldfarb","startTime":2401.01,"endTime":2404.67,"body":"the reference in our show notes."},{"speaker":"Charles Goldfarb","startTime":2404.7,"endTime":2407.64,"body":"It's worth the read. If you're"},{"speaker":"Charles Goldfarb","startTime":2404.7,"endTime":2407.64,"body":"in academics, if you're not in"},{"speaker":"Charles Goldfarb","startTime":2407.64,"endTime":2409.92,"body":"academics, I think it's just"},{"speaker":"Charles Goldfarb","startTime":2407.64,"endTime":2409.92,"body":"really interesting and well"},{"speaker":"Charles Goldfarb","startTime":2409.92,"endTime":2410.25,"body":"said."},{"speaker":"Chris Dy","startTime":2410.58,"endTime":2412.71,"body":"Yeah, thank you for"},{"speaker":"Chris Dy","startTime":2410.58,"endTime":2412.71,"body":"pointing it out and for for"},{"speaker":"Chris Dy","startTime":2412.71,"endTime":2416.1,"body":"sharing it, and I look forward"},{"speaker":"Chris Dy","startTime":2412.71,"endTime":2416.1,"body":"to perhaps learning some more"},{"speaker":"Chris Dy","startTime":2416.1,"endTime":2417.48,"body":"lessons from the updated"},{"speaker":"Chris Dy","startTime":2416.1,"endTime":2417.48,"body":"version."},{"speaker":"Charles Goldfarb","startTime":2417.96,"endTime":2419.91,"body":"Absolutely."},{"speaker":"Charles Goldfarb","startTime":2417.96,"endTime":2419.91,"body":"All right. Great to see you as"},{"speaker":"Charles Goldfarb","startTime":2419.91,"endTime":2420.39,"body":"always"},{"speaker":"Chris Dy","startTime":2420.42,"endTime":2421.35,"body":"Do it again next time."},{"speaker":"Charles Goldfarb","startTime":2422.4,"endTime":2424.41,"body":"Hey, Chris,"},{"speaker":"Charles Goldfarb","startTime":2422.4,"endTime":2424.41,"body":"that was fun. Let's do it again"},{"speaker":"Charles Goldfarb","startTime":2424.41,"endTime":2424.92,"body":"real soon."},{"speaker":"Chris Dy","startTime":2425.19,"endTime":2427.71,"body":"Sounds good. Well, be"},{"speaker":"Chris Dy","startTime":2425.19,"endTime":2427.71,"body":"sure to check us out on Twitter"},{"speaker":"Chris Dy","startTime":2427.95,"endTime":2430.11,"body":"@handpodcast. Hey, Chuck, what's"},{"speaker":"Chris Dy","startTime":2427.95,"endTime":2430.11,"body":"your Twitter handle?"},{"speaker":"Charles Goldfarb","startTime":2430.47,"endTime":2433.32,"body":"Mine is"},{"speaker":"Charles Goldfarb","startTime":2430.47,"endTime":2433.32,"body":"@congenitalhand. What about you?"},{"speaker":"Chris Dy","startTime":2433.47,"endTime":2436.86,"body":"Mine is @ChrisDyMD"},{"speaker":"Chris Dy","startTime":2433.47,"endTime":2436.86,"body":"spelled d y. And if you'd like"},{"speaker":"Chris Dy","startTime":2436.86,"endTime":2440.67,"body":"to email us, you can reach us at"},{"speaker":"Chris Dy","startTime":2436.86,"endTime":2440.67,"body":"handpodcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":2441.3,"endTime":2443.43,"body":"And remember,"},{"speaker":"Charles Goldfarb","startTime":2441.3,"endTime":2443.43,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":2443.43,"endTime":2444.51,"body":"get your podcast"},{"speaker":"Chris Dy","startTime":2444.57,"endTime":2446.76,"body":"And be sure to leave a"},{"speaker":"Chris Dy","startTime":2444.57,"endTime":2446.76,"body":"review, that helps us get the"},{"speaker":"Chris Dy","startTime":2446.76,"endTime":2447.15,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":2447.54,"endTime":2449.85,"body":"Special thanks"},{"speaker":"Charles Goldfarb","startTime":2447.54,"endTime":2449.85,"body":"to Peter Martin for the amazing"},{"speaker":"Charles Goldfarb","startTime":2449.85,"endTime":2453.93,"body":"music. And remember, keep the"},{"speaker":"Charles Goldfarb","startTime":2449.85,"endTime":2453.93,"body":"upper hand. Come back next time."}]}