{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":10.77,"endTime":13.35,"body":"Welcome to the"},{"speaker":"Charles Goldfarb","startTime":10.77,"endTime":13.35,"body":"upper hand, where Chuck and"},{"speaker":"Charles Goldfarb","startTime":13.35,"endTime":14.46,"body":"Chris talk Hand surgery."},{"speaker":"Chris Dy","startTime":14.79,"endTime":16.56,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":14.79,"endTime":16.56,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":16.56,"endTime":19.62,"body":"University in St. Louis here to"},{"speaker":"Chris Dy","startTime":16.56,"endTime":19.62,"body":"talk about all aspects of hand"},{"speaker":"Chris Dy","startTime":19.62,"endTime":21.48,"body":"surgery from technical to"},{"speaker":"Chris Dy","startTime":19.62,"endTime":21.48,"body":"personal."},{"speaker":"Charles Goldfarb","startTime":22.049,"endTime":24.329,"body":"Thank you for"},{"speaker":"Charles Goldfarb","startTime":22.049,"endTime":24.329,"body":"subscribing wherever you get"},{"speaker":"Charles Goldfarb","startTime":24.329,"endTime":25.229,"body":"your podcasts."},{"speaker":"Chris Dy","startTime":25.44,"endTime":27.63,"body":"And be sure to leave a"},{"speaker":"Chris Dy","startTime":25.44,"endTime":27.63,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":27.63,"endTime":28.17,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":28.409,"endTime":29.519,"body":"Oh, hey,"},{"speaker":"Charles Goldfarb","startTime":28.409,"endTime":29.519,"body":"Chris."},{"speaker":"Chris Dy","startTime":29.669,"endTime":31.679,"body":"Hey, Chuck, you"},{"speaker":"Chris Dy","startTime":29.669,"endTime":31.679,"body":"changed your Hey, Chris a little"},{"speaker":"Chris Dy","startTime":31.679,"endTime":31.859,"body":"bit."},{"speaker":"Charles Goldfarb","startTime":31.89,"endTime":33.45,"body":"I know just"},{"speaker":"Charles Goldfarb","startTime":31.89,"endTime":33.45,"body":"shaking it up."},{"speaker":"Chris Dy","startTime":33.719,"endTime":36.959,"body":"Yeah, okay. You know,"},{"speaker":"Chris Dy","startTime":33.719,"endTime":36.959,"body":"you probably got some some got"},{"speaker":"Chris Dy","startTime":36.959,"endTime":39.479,"body":"some grief from one of your many"},{"speaker":"Chris Dy","startTime":36.959,"endTime":39.479,"body":"fans."},{"speaker":"Charles Goldfarb","startTime":40.56,"endTime":42.93,"body":"No grief. As"},{"speaker":"Charles Goldfarb","startTime":40.56,"endTime":42.93,"body":"of the intro, I don't want to"},{"speaker":"Charles Goldfarb","startTime":42.93,"endTime":45.06,"body":"shake it up too much. Because"},{"speaker":"Charles Goldfarb","startTime":42.93,"endTime":45.06,"body":"this is our call sign."},{"speaker":"Chris Dy","startTime":45.36,"endTime":48.99,"body":"Have you and Jake been"},{"speaker":"Chris Dy","startTime":45.36,"endTime":48.99,"body":"signing autographs together now"},{"speaker":"Chris Dy","startTime":49.02,"endTime":51.87,"body":"like is that like a limited"},{"speaker":"Chris Dy","startTime":49.02,"endTime":51.87,"body":"edition basketball I can find"},{"speaker":"Chris Dy","startTime":51.87,"endTime":52.41,"body":"somewhere."},{"speaker":"Charles Goldfarb","startTime":53.31,"endTime":55.77,"body":"If only I"},{"speaker":"Charles Goldfarb","startTime":53.31,"endTime":55.77,"body":"think both of our dreams were"},{"speaker":"Charles Goldfarb","startTime":55.8,"endTime":59.31,"body":"NBA and mine was shattered years"},{"speaker":"Charles Goldfarb","startTime":55.8,"endTime":59.31,"body":"ago. And his has been shattered"},{"speaker":"Charles Goldfarb","startTime":59.31,"endTime":60.12,"body":"more recently."},{"speaker":"Chris Dy","startTime":60.48,"endTime":62.46,"body":"It's crazy how"},{"speaker":"Chris Dy","startTime":60.48,"endTime":62.46,"body":"opposite the ends of the"},{"speaker":"Chris Dy","startTime":62.46,"endTime":66.45,"body":"spectrum we are with our kids,"},{"speaker":"Chris Dy","startTime":62.46,"endTime":66.45,"body":"because yesterday I took Rafi my"},{"speaker":"Chris Dy","startTime":67.08,"endTime":71.61,"body":"five year old down sledding down"},{"speaker":"Chris Dy","startTime":67.08,"endTime":71.61,"body":"a hill for the first time ever."},{"speaker":"Chris Dy","startTime":71.79,"endTime":74.58,"body":"And he loved it. He was"},{"speaker":"Chris Dy","startTime":71.79,"endTime":74.58,"body":"fearless. And it was you know, a"},{"speaker":"Chris Dy","startTime":74.58,"endTime":77.94,"body":"sizable kind of Hill. But it's"},{"speaker":"Chris Dy","startTime":74.58,"endTime":77.94,"body":"definitely a different"},{"speaker":"Chris Dy","startTime":77.94,"endTime":80.25,"body":"experience than having your"},{"speaker":"Chris Dy","startTime":77.94,"endTime":80.25,"body":"eldest in college."},{"speaker":"Charles Goldfarb","startTime":80.7,"endTime":83.43,"body":"You know, I'm"},{"speaker":"Charles Goldfarb","startTime":80.7,"endTime":83.43,"body":"taking a lot away from the"},{"speaker":"Charles Goldfarb","startTime":83.43,"endTime":86.79,"body":"pandemic. I'd like it to be"},{"speaker":"Charles Goldfarb","startTime":83.43,"endTime":86.79,"body":"over. But I know it's"},{"speaker":"Charles Goldfarb","startTime":86.79,"endTime":90.72,"body":"continuing. And one of the"},{"speaker":"Charles Goldfarb","startTime":86.79,"endTime":90.72,"body":"things is, and others have noted"},{"speaker":"Charles Goldfarb","startTime":90.72,"endTime":93.72,"body":"this on social media and"},{"speaker":"Charles Goldfarb","startTime":90.72,"endTime":93.72,"body":"different places. But the gift"},{"speaker":"Charles Goldfarb","startTime":93.72,"endTime":98.64,"body":"of spending time with our kids,"},{"speaker":"Charles Goldfarb","startTime":93.72,"endTime":98.64,"body":"has been really remarkable."},{"speaker":"Charles Goldfarb","startTime":98.64,"endTime":100.95,"body":"Jake's gonna have been home for"},{"speaker":"Charles Goldfarb","startTime":98.64,"endTime":100.95,"body":"four months in the middle of his"},{"speaker":"Charles Goldfarb","startTime":100.95,"endTime":104.13,"body":"junior year before he heads back"},{"speaker":"Charles Goldfarb","startTime":100.95,"endTime":104.13,"body":"in February. Even my girls, I"},{"speaker":"Charles Goldfarb","startTime":104.13,"endTime":106.74,"body":"mean, the limited social"},{"speaker":"Charles Goldfarb","startTime":104.13,"endTime":106.74,"body":"opportunities for both of them"},{"speaker":"Charles Goldfarb","startTime":106.74,"endTime":109.41,"body":"in high school. We've just spent"},{"speaker":"Charles Goldfarb","startTime":106.74,"endTime":109.41,"body":"a lot of family time together."},{"speaker":"Charles Goldfarb","startTime":109.41,"endTime":112.8,"body":"And we've gotten into a routine,"},{"speaker":"Charles Goldfarb","startTime":109.41,"endTime":112.8,"body":"which is, you know, pretty good."},{"speaker":"Charles Goldfarb","startTime":112.8,"endTime":115.62,"body":"And I think we'll look back in"},{"speaker":"Charles Goldfarb","startTime":112.8,"endTime":115.62,"body":"20 years, hopefully and say,"},{"speaker":"Charles Goldfarb","startTime":115.62,"endTime":117.3,"body":"Wow, that was really an amazing"},{"speaker":"Charles Goldfarb","startTime":115.62,"endTime":117.3,"body":"time."},{"speaker":"Chris Dy","startTime":118.05,"endTime":121.14,"body":"Well, you know, like"},{"speaker":"Chris Dy","startTime":118.05,"endTime":121.14,"body":"you mentioned, when we had Amy"},{"speaker":"Chris Dy","startTime":121.14,"endTime":124.08,"body":"Moore on the program, you know,"},{"speaker":"Chris Dy","startTime":121.14,"endTime":124.08,"body":"that email from the dean saying,"},{"speaker":"Chris Dy","startTime":124.08,"endTime":126.18,"body":"you know, you're gonna remember"},{"speaker":"Chris Dy","startTime":124.08,"endTime":126.18,"body":"the people you spent these times"},{"speaker":"Chris Dy","startTime":126.18,"endTime":129.03,"body":"with, and I think that is a"},{"speaker":"Chris Dy","startTime":126.18,"endTime":129.03,"body":"silver lining that we can"},{"speaker":"Chris Dy","startTime":129.06,"endTime":131.91,"body":"capture. I mean, one thing I've"},{"speaker":"Chris Dy","startTime":129.06,"endTime":131.91,"body":"noticed about my own schedule is"},{"speaker":"Chris Dy","startTime":131.91,"endTime":135.99,"body":"how much less I'm traveling,"},{"speaker":"Chris Dy","startTime":131.91,"endTime":135.99,"body":"which in turn has led me to be,"},{"speaker":"Chris Dy","startTime":136.02,"endTime":138.45,"body":"you know, pretty busy"},{"speaker":"Chris Dy","startTime":136.02,"endTime":138.45,"body":"clinically, which I'm sure makes"},{"speaker":"Chris Dy","startTime":138.45,"endTime":142.2,"body":"you happy as our Executive Vice"},{"speaker":"Chris Dy","startTime":138.45,"endTime":142.2,"body":"Chair. But then also, it's it's"},{"speaker":"Chris Dy","startTime":142.2,"endTime":144.96,"body":"more time at home with the"},{"speaker":"Chris Dy","startTime":142.2,"endTime":144.96,"body":"family, which has been really,"},{"speaker":"Chris Dy","startTime":144.96,"endTime":147.6,"body":"really nice, you know, because,"},{"speaker":"Chris Dy","startTime":144.96,"endTime":147.6,"body":"you know, last year would have"},{"speaker":"Chris Dy","startTime":147.6,"endTime":149.58,"body":"been a year where I was kind of"},{"speaker":"Chris Dy","startTime":147.6,"endTime":149.58,"body":"globe trotting for the"},{"speaker":"Chris Dy","startTime":149.58,"endTime":153.6,"body":"government scholarship. And I"},{"speaker":"Chris Dy","startTime":149.58,"endTime":153.6,"body":"still can't even do that. This"},{"speaker":"Chris Dy","startTime":153.6,"endTime":156.51,"body":"year, well, not as of yet. And"},{"speaker":"Chris Dy","startTime":153.6,"endTime":156.51,"body":"probably not for at least six"},{"speaker":"Chris Dy","startTime":156.51,"endTime":157.17,"body":"months or so."},{"speaker":"Charles Goldfarb","startTime":157.9,"endTime":159.79,"body":"Yeah, it's"},{"speaker":"Charles Goldfarb","startTime":157.9,"endTime":159.79,"body":"super interesting for those who"},{"speaker":"Charles Goldfarb","startTime":159.79,"endTime":163.18,"body":"travel for work, obviously, far"},{"speaker":"Charles Goldfarb","startTime":159.79,"endTime":163.18,"body":"beyond medicine. But, you know,"},{"speaker":"Charles Goldfarb","startTime":163.18,"endTime":165.52,"body":"I'm going to look forward to"},{"speaker":"Charles Goldfarb","startTime":163.18,"endTime":165.52,"body":"that first quote, unquote,"},{"speaker":"Charles Goldfarb","startTime":165.52,"endTime":169.39,"body":"normal meeting, and POSNA is"},{"speaker":"Charles Goldfarb","startTime":165.52,"endTime":169.39,"body":"still on the books for early"},{"speaker":"Charles Goldfarb","startTime":169.39,"endTime":174.01,"body":"May, I just do not believe it"},{"speaker":"Charles Goldfarb","startTime":169.39,"endTime":174.01,"body":"can happen, especially when with"},{"speaker":"Charles Goldfarb","startTime":174.01,"endTime":177.19,"body":"what is happening with this"},{"speaker":"Charles Goldfarb","startTime":174.01,"endTime":177.19,"body":"variant strain, or strains,"},{"speaker":"Charles Goldfarb","startTime":177.19,"endTime":182.23,"body":"plural. I, you know, when"},{"speaker":"Charles Goldfarb","startTime":177.19,"endTime":182.23,"body":"there's a normal meeting, and I"},{"speaker":"Charles Goldfarb","startTime":182.23,"endTime":185.02,"body":"think we're probably looking at"},{"speaker":"Charles Goldfarb","startTime":182.23,"endTime":185.02,"body":"2022. before that happens, it'll"},{"speaker":"Charles Goldfarb","startTime":185.02,"endTime":188.56,"body":"be fantastic. Getting back to"},{"speaker":"Charles Goldfarb","startTime":185.02,"endTime":188.56,"body":"once a month travel, which was"},{"speaker":"Charles Goldfarb","startTime":188.56,"endTime":193.45,"body":"sort of my routine feels really"},{"speaker":"Charles Goldfarb","startTime":188.56,"endTime":193.45,"body":"distant to me, and I don't know,"},{"speaker":"Charles Goldfarb","startTime":193.45,"endTime":195.37,"body":"it'll be interesting to see if"},{"speaker":"Charles Goldfarb","startTime":193.45,"endTime":195.37,"body":"we go back to the way things"},{"speaker":"Charles Goldfarb","startTime":195.37,"endTime":196.09,"body":"were done before."},{"speaker":"Chris Dy","startTime":196.36,"endTime":198.58,"body":"Well, it'll be nice"},{"speaker":"Chris Dy","startTime":196.36,"endTime":198.58,"body":"for some meetings not to have to"},{"speaker":"Chris Dy","startTime":198.58,"endTime":200.68,"body":"go in person. You know, I think"},{"speaker":"Chris Dy","startTime":198.58,"endTime":200.68,"body":"there are some committee"},{"speaker":"Chris Dy","startTime":200.68,"endTime":204.25,"body":"meetings where you do need the"},{"speaker":"Chris Dy","startTime":200.68,"endTime":204.25,"body":"camaraderie for certain things."},{"speaker":"Chris Dy","startTime":204.73,"endTime":206.89,"body":"But there are other meetings,"},{"speaker":"Chris Dy","startTime":204.73,"endTime":206.89,"body":"which probably are better off"},{"speaker":"Chris Dy","startTime":206.89,"endTime":209.65,"body":"just, you know, accepting a"},{"speaker":"Chris Dy","startTime":206.89,"endTime":209.65,"body":"remote type platform and"},{"speaker":"Chris Dy","startTime":209.65,"endTime":214.3,"body":"everybody's so comfortable with,"},{"speaker":"Chris Dy","startTime":209.65,"endTime":214.3,"body":"with video now. You know, two of"},{"speaker":"Chris Dy","startTime":214.3,"endTime":216.82,"body":"the places I was supposed to go"},{"speaker":"Chris Dy","startTime":214.3,"endTime":216.82,"body":"on my government scholarship,"},{"speaker":"Chris Dy","startTime":216.85,"endTime":220.81,"body":"were Brazil and London and given"},{"speaker":"Chris Dy","startTime":216.85,"endTime":220.81,"body":"the COVID strains, I don't know"},{"speaker":"Chris Dy","startTime":220.81,"endTime":222.13,"body":"if I'm going anytime soon."},{"speaker":"Charles Goldfarb","startTime":222.55,"endTime":224.17,"body":"Well you can"},{"speaker":"Charles Goldfarb","startTime":222.55,"endTime":224.17,"body":"go but we may not welcome you"},{"speaker":"Charles Goldfarb","startTime":224.17,"endTime":224.74,"body":"back."},{"speaker":"Chris Dy","startTime":224.82,"endTime":226.62,"body":"Well, yeah, I'll have"},{"speaker":"Chris Dy","startTime":224.82,"endTime":226.62,"body":"to take a lot of time off of"},{"speaker":"Chris Dy","startTime":226.62,"endTime":227.94,"body":"work. When I come back."},{"speaker":"Charles Goldfarb","startTime":228.81,"endTime":230.58,"body":"It is the"},{"speaker":"Charles Goldfarb","startTime":228.81,"endTime":230.58,"body":"other interesting meeting, like"},{"speaker":"Charles Goldfarb","startTime":230.58,"endTime":234.24,"body":"I work with the American Board"},{"speaker":"Charles Goldfarb","startTime":230.58,"endTime":234.24,"body":"of orthopedic surgery. And we"},{"speaker":"Charles Goldfarb","startTime":234.24,"endTime":237.27,"body":"have an annual meeting about"},{"speaker":"Charles Goldfarb","startTime":234.24,"endTime":237.27,"body":"question development and the"},{"speaker":"Charles Goldfarb","startTime":237.27,"endTime":238.83,"body":"like. And this really young"},{"speaker":"Chris Dy","startTime":238.86,"endTime":240.75,"body":"Chuck is the mean guy"},{"speaker":"Chris Dy","startTime":238.86,"endTime":240.75,"body":"that writes the questions for"},{"speaker":"Chris Dy","startTime":240.75,"endTime":241.47,"body":"the board's guys."},{"speaker":"Charles Goldfarb","startTime":242.79,"endTime":245.13,"body":"I'm the guy"},{"speaker":"Charles Goldfarb","startTime":242.79,"endTime":245.13,"body":"who tries to put as many sports"},{"speaker":"Charles Goldfarb","startTime":245.13,"endTime":246.45,"body":"and congenital questions on"},{"speaker":"Charles Goldfarb","startTime":245.13,"endTime":246.45,"body":"there."},{"speaker":"Chris Dy","startTime":246.84,"endTime":249.12,"body":"I won- I wonder who"},{"speaker":"Chris Dy","startTime":246.84,"endTime":249.12,"body":"the first author on all the"},{"speaker":"Chris Dy","startTime":249.12,"endTime":249.69,"body":"papers."},{"speaker":"Charles Goldfarb","startTime":251.1,"endTime":253.74,"body":"Come on."},{"speaker":"Charles Goldfarb","startTime":251.1,"endTime":253.74,"body":"Anyways, those meetings in"},{"speaker":"Charles Goldfarb","startTime":253.74,"endTime":256.86,"body":"person are dynamic and"},{"speaker":"Charles Goldfarb","startTime":253.74,"endTime":256.86,"body":"interesting. And the people in"},{"speaker":"Charles Goldfarb","startTime":256.86,"endTime":260.01,"body":"the room are fantastic. I'm"},{"speaker":"Charles Goldfarb","startTime":256.86,"endTime":260.01,"body":"going to do one, I think next"},{"speaker":"Charles Goldfarb","startTime":260.01,"endTime":263.55,"body":"week or the week after,"},{"speaker":"Charles Goldfarb","startTime":260.01,"endTime":263.55,"body":"virtually, and I just can't"},{"speaker":"Charles Goldfarb","startTime":263.55,"endTime":266.37,"body":"imagine it's gonna be very"},{"speaker":"Charles Goldfarb","startTime":263.55,"endTime":266.37,"body":"satisfying. And so that kind of"},{"speaker":"Charles Goldfarb","startTime":266.37,"endTime":268.95,"body":"meeting while it could be done"},{"speaker":"Charles Goldfarb","startTime":266.37,"endTime":268.95,"body":"over zoom, I don't know that it"},{"speaker":"Charles Goldfarb","startTime":268.95,"endTime":271.11,"body":"should be over zoom. So those"},{"speaker":"Charles Goldfarb","startTime":268.95,"endTime":271.11,"body":"are all things we have to work"},{"speaker":"Charles Goldfarb","startTime":271.11,"endTime":271.44,"body":"out."},{"speaker":"Chris Dy","startTime":271.74,"endTime":273.93,"body":"Yeah. So what's been"},{"speaker":"Chris Dy","startTime":271.74,"endTime":273.93,"body":"going on in your clinical"},{"speaker":"Chris Dy","startTime":273.93,"endTime":276.24,"body":"practice anything any good cases"},{"speaker":"Chris Dy","startTime":273.93,"endTime":276.24,"body":"recently."},{"speaker":"Charles Goldfarb","startTime":276.99,"endTime":279.93,"body":"I have had a"},{"speaker":"Charles Goldfarb","startTime":276.99,"endTime":279.93,"body":"really interesting case. And"},{"speaker":"Charles Goldfarb","startTime":279.93,"endTime":283.74,"body":"it's interesting, not only"},{"speaker":"Charles Goldfarb","startTime":279.93,"endTime":283.74,"body":"because of the case, but because"},{"speaker":"Charles Goldfarb","startTime":283.74,"endTime":287.97,"body":"of an epiphany I had during the"},{"speaker":"Charles Goldfarb","startTime":283.74,"endTime":287.97,"body":"case and to some this may sound"},{"speaker":"Charles Goldfarb","startTime":288.54,"endTime":291.03,"body":"lame to others it may sound"},{"speaker":"Charles Goldfarb","startTime":288.54,"endTime":291.03,"body":"interesting, but I'll just share"},{"speaker":"Charles Goldfarb","startTime":291.03,"endTime":296.07,"body":"so yesterday I had my first what"},{"speaker":"Charles Goldfarb","startTime":291.03,"endTime":296.07,"body":"I consider fully normal day"},{"speaker":"Charles Goldfarb","startTime":296.07,"endTime":300.09,"body":"since before Thanksgiving, in"},{"speaker":"Charles Goldfarb","startTime":296.07,"endTime":300.09,"body":"that I was operating in our own"},{"speaker":"Charles Goldfarb","startTime":300.09,"endTime":303.51,"body":"operating rooms, I had my usual"},{"speaker":"Charles Goldfarb","startTime":300.09,"endTime":303.51,"body":"two rooms, and it was a"},{"speaker":"Charles Goldfarb","startTime":303.51,"endTime":305.97,"body":"pediatric day. So I did some"},{"speaker":"Charles Goldfarb","startTime":303.51,"endTime":305.97,"body":"congenital in the morning and I"},{"speaker":"Charles Goldfarb","startTime":305.97,"endTime":309.09,"body":"transition to some teenage or"},{"speaker":"Charles Goldfarb","startTime":305.97,"endTime":309.09,"body":"sports-like cases in the"},{"speaker":"Charles Goldfarb","startTime":309.09,"endTime":312.57,"body":"afternoon. And one of my cases"},{"speaker":"Charles Goldfarb","startTime":309.09,"endTime":312.57,"body":"was a proximal scaphoid,"},{"speaker":"Charles Goldfarb","startTime":312.66,"endTime":318.87,"body":"proximal pole scaphoid nonunion"},{"speaker":"Charles Goldfarb","startTime":312.66,"endTime":318.87,"body":"that was quite old. And on X ray"},{"speaker":"Charles Goldfarb","startTime":318.87,"endTime":322.77,"body":"and CT, the viability of the"},{"speaker":"Charles Goldfarb","startTime":318.87,"endTime":322.77,"body":"proximal pole was questionable."},{"speaker":"Charles Goldfarb","startTime":323.28,"endTime":326.97,"body":"But given the patient being a"},{"speaker":"Charles Goldfarb","startTime":323.28,"endTime":326.97,"body":"high level athlete being that,"},{"speaker":"Charles Goldfarb","startTime":327.42,"endTime":329.85,"body":"you know, the options are"},{"speaker":"Charles Goldfarb","startTime":327.42,"endTime":329.85,"body":"limited, I thought"},{"speaker":"Charles Goldfarb","startTime":329.85,"endTime":332.85,"body":"reconstruction made sense. I had"},{"speaker":"Charles Goldfarb","startTime":329.85,"endTime":332.85,"body":"several conversations with the"},{"speaker":"Charles Goldfarb","startTime":332.85,"endTime":336.57,"body":"patient about the options,"},{"speaker":"Charles Goldfarb","startTime":332.85,"endTime":336.57,"body":"including a more localized"},{"speaker":"Charles Goldfarb","startTime":336.57,"endTime":341.58,"body":"vascularized bone flap, versus a"},{"speaker":"Charles Goldfarb","startTime":336.57,"endTime":341.58,"body":"distant bone flap, and we"},{"speaker":"Charles Goldfarb","startTime":341.58,"endTime":345.66,"body":"elected to proceed with a one"},{"speaker":"Charles Goldfarb","startTime":341.58,"endTime":345.66,"body":"two, distal radius, bone flap."},{"speaker":"Charles Goldfarb","startTime":346.17,"endTime":354.03,"body":"And by CT, the proximal pole"},{"speaker":"Charles Goldfarb","startTime":346.17,"endTime":354.03,"body":"appeared to be volarly migrated."},{"speaker":"Charles Goldfarb","startTime":354.66,"endTime":357.15,"body":"And so what I guess what I'm"},{"speaker":"Charles Goldfarb","startTime":354.66,"endTime":357.15,"body":"getting at before it, rather"},{"speaker":"Charles Goldfarb","startTime":357.15,"endTime":360.87,"body":"than describing the CT as a"},{"speaker":"Charles Goldfarb","startTime":357.15,"endTime":360.87,"body":"markedly displaced, non union."},{"speaker":"Chris Dy","startTime":361.5,"endTime":365.85,"body":"So a displaced and"},{"speaker":"Chris Dy","startTime":361.5,"endTime":365.85,"body":"possibly non viable proximal"},{"speaker":"Chris Dy","startTime":365.85,"endTime":368.4,"body":"pole, so a displaced non union"},{"speaker":"Chris Dy","startTime":365.85,"endTime":368.4,"body":"with a, you know, questionable"},{"speaker":"Chris Dy","startTime":368.4,"endTime":369.6,"body":"status of the proximal pole."},{"speaker":"Charles Goldfarb","startTime":369.87,"endTime":372.36,"body":"Right, right."},{"speaker":"Charles Goldfarb","startTime":369.87,"endTime":372.36,"body":"And so, you know, again, the"},{"speaker":"Charles Goldfarb","startTime":372.36,"endTime":376.86,"body":"distant bone flap was an option,"},{"speaker":"Charles Goldfarb","startTime":372.36,"endTime":376.86,"body":"a salvage procedure was an"},{"speaker":"Charles Goldfarb","startTime":376.86,"endTime":379.56,"body":"option. But after a lengthy"},{"speaker":"Charles Goldfarb","startTime":376.86,"endTime":379.56,"body":"discussion with the patient we"},{"speaker":"Charles Goldfarb","startTime":379.56,"endTime":383.94,"body":"elected to proceed with, as I"},{"speaker":"Charles Goldfarb","startTime":379.56,"endTime":383.94,"body":"described, and started the case."},{"speaker":"Charles Goldfarb","startTime":383.97,"endTime":387.6,"body":"And technically, you know, the"},{"speaker":"Charles Goldfarb","startTime":383.97,"endTime":387.6,"body":"approach and all that was just"},{"speaker":"Charles Goldfarb","startTime":387.6,"endTime":390.96,"body":"fine. And then we get down in"},{"speaker":"Charles Goldfarb","startTime":387.6,"endTime":390.96,"body":"the proximal aspect of the"},{"speaker":"Charles Goldfarb","startTime":390.96,"endTime":394.92,"body":"distal fragment was, was"},{"speaker":"Charles Goldfarb","startTime":390.96,"endTime":394.92,"body":"relatively healthy as one might"},{"speaker":"Charles Goldfarb","startTime":394.92,"endTime":398.61,"body":"expect. And we curated that got"},{"speaker":"Charles Goldfarb","startTime":394.92,"endTime":398.61,"body":"back to good healthy cancellous"},{"speaker":"Charles Goldfarb","startTime":398.61,"endTime":402.09,"body":"bone, scaphoid was flexed, which"},{"speaker":"Charles Goldfarb","startTime":398.61,"endTime":402.09,"body":"we don't always see with a"},{"speaker":"Charles Goldfarb","startTime":402.09,"endTime":405.12,"body":"proximal pole, which was"},{"speaker":"Charles Goldfarb","startTime":402.09,"endTime":405.12,"body":"interesting. But it was able to"},{"speaker":"Charles Goldfarb","startTime":405.12,"endTime":408.69,"body":"be reduced, no problem after I"},{"speaker":"Charles Goldfarb","startTime":405.12,"endTime":408.69,"body":"did a little work. And the"},{"speaker":"Charles Goldfarb","startTime":408.69,"endTime":412.68,"body":"proximal pole was very hard to"},{"speaker":"Charles Goldfarb","startTime":408.69,"endTime":412.68,"body":"access, but also had bone"},{"speaker":"Charles Goldfarb","startTime":412.68,"endTime":416.67,"body":"attached to it, which did not"},{"speaker":"Charles Goldfarb","startTime":412.68,"endTime":416.67,"body":"look unhealthy. And so I"},{"speaker":"Charles Goldfarb","startTime":416.67,"endTime":420.03,"body":"proceeded with harvesting the"},{"speaker":"Charles Goldfarb","startTime":416.67,"endTime":420.03,"body":"bone flap, and had a nice"},{"speaker":"Charles Goldfarb","startTime":420.03,"endTime":425.97,"body":"pedicle. And then is where the"},{"speaker":"Charles Goldfarb","startTime":420.03,"endTime":425.97,"body":"struggle began, in that I was"},{"speaker":"Charles Goldfarb","startTime":425.97,"endTime":430.02,"body":"having trouble obtaining a"},{"speaker":"Charles Goldfarb","startTime":425.97,"endTime":430.02,"body":"reduction. And I think there are"},{"speaker":"Charles Goldfarb","startTime":430.02,"endTime":433.5,"body":"various different approaches,"},{"speaker":"Charles Goldfarb","startTime":430.02,"endTime":433.5,"body":"you know, some will work many"},{"speaker":"Charles Goldfarb","startTime":433.53,"endTime":436.98,"body":"hours on a case if they think"},{"speaker":"Charles Goldfarb","startTime":433.53,"endTime":436.98,"body":"there's hope in achieving the"},{"speaker":"Charles Goldfarb","startTime":436.98,"endTime":439.47,"body":"goals. And certainly, if there's"},{"speaker":"Charles Goldfarb","startTime":436.98,"endTime":439.47,"body":"hope we should always continue"},{"speaker":"Charles Goldfarb","startTime":439.47,"endTime":442.86,"body":"working as surgeons to achieve"},{"speaker":"Charles Goldfarb","startTime":439.47,"endTime":442.86,"body":"our goals. And I tend to be one"},{"speaker":"Charles Goldfarb","startTime":442.86,"endTime":445.26,"body":"of those surgeons who will"},{"speaker":"Charles Goldfarb","startTime":442.86,"endTime":445.26,"body":"really do everything in my"},{"speaker":"Charles Goldfarb","startTime":445.26,"endTime":449.1,"body":"power, but I my decision making"},{"speaker":"Charles Goldfarb","startTime":445.26,"endTime":449.1,"body":"tends to be somewhat more rapid."},{"speaker":"Charles Goldfarb","startTime":449.4,"endTime":454.86,"body":"And I was almost at the point"},{"speaker":"Charles Goldfarb","startTime":449.4,"endTime":454.86,"body":"where I said, I cannot obtain an"},{"speaker":"Charles Goldfarb","startTime":454.86,"endTime":459.09,"body":"anatomical reduction. And when I"},{"speaker":"Charles Goldfarb","startTime":454.86,"endTime":459.09,"body":"make that decision firmly,"},{"speaker":"Charles Goldfarb","startTime":459.21,"endTime":462.36,"body":"because I've given up on"},{"speaker":"Charles Goldfarb","startTime":459.21,"endTime":462.36,"body":"everything, I move on. And I was"},{"speaker":"Charles Goldfarb","startTime":462.36,"endTime":466.38,"body":"going to accept a less than"},{"speaker":"Charles Goldfarb","startTime":462.36,"endTime":466.38,"body":"anatomical reduction, and with"},{"speaker":"Charles Goldfarb","startTime":466.38,"endTime":468.99,"body":"the hope that it would heal but"},{"speaker":"Charles Goldfarb","startTime":466.38,"endTime":468.99,"body":"didn't feel really good."},{"speaker":"Chris Dy","startTime":469.41,"endTime":471.12,"body":"So before it before"},{"speaker":"Chris Dy","startTime":469.41,"endTime":471.12,"body":"you tell us the rest of the"},{"speaker":"Chris Dy","startTime":471.12,"endTime":473.94,"body":"story. Can I ask you a couple of"},{"speaker":"Chris Dy","startTime":471.12,"endTime":473.94,"body":"questions, just rapid fire ones."},{"speaker":"Chris Dy","startTime":473.97,"endTime":477.33,"body":"So what was your surgical"},{"speaker":"Chris Dy","startTime":473.97,"endTime":477.33,"body":"approach here for for this? Were"},{"speaker":"Chris Dy","startTime":477.33,"endTime":479.79,"body":"are you coming from dorsal, were"},{"speaker":"Chris Dy","startTime":477.33,"endTime":479.79,"body":"are you coming from radial? You"},{"speaker":"Chris Dy","startTime":479.79,"endTime":481.77,"body":"know, to get that one-two or"},{"speaker":"Chris Dy","startTime":479.79,"endTime":481.77,"body":"were you coming from volar."},{"speaker":"Charles Goldfarb","startTime":482.28,"endTime":484.86,"body":"So dorsal"},{"speaker":"Charles Goldfarb","startTime":482.28,"endTime":484.86,"body":"radial incision, which gave me"},{"speaker":"Charles Goldfarb","startTime":484.86,"endTime":489.57,"body":"access to the proximal pole, the"},{"speaker":"Charles Goldfarb","startTime":484.86,"endTime":489.57,"body":"scaphoid, and the flap. Again,"},{"speaker":"Charles Goldfarb","startTime":489.57,"endTime":492.03,"body":"relatively straightforward for"},{"speaker":"Charles Goldfarb","startTime":489.57,"endTime":492.03,"body":"the flap, it was just between"},{"speaker":"Charles Goldfarb","startTime":492.03,"endTime":494.7,"body":"the first and second dorsal"},{"speaker":"Charles Goldfarb","startTime":492.03,"endTime":494.7,"body":"compartments for the approach to"},{"speaker":"Charles Goldfarb","startTime":494.7,"endTime":498.24,"body":"the scaphoid I transposed the"},{"speaker":"Charles Goldfarb","startTime":494.7,"endTime":498.24,"body":"EPL. Ultimately, I brought the"},{"speaker":"Charles Goldfarb","startTime":498.24,"endTime":501.42,"body":"flap under the second"},{"speaker":"Charles Goldfarb","startTime":498.24,"endTime":501.42,"body":"compartment and under the EPL,"},{"speaker":"Charles Goldfarb","startTime":501.51,"endTime":503.55,"body":"to bring it in proximity where"},{"speaker":"Charles Goldfarb","startTime":501.51,"endTime":503.55,"body":"it needed to be."},{"speaker":"Chris Dy","startTime":503.819,"endTime":507.629,"body":"So then with your,"},{"speaker":"Chris Dy","startTime":503.819,"endTime":507.629,"body":"with your assessment of the"},{"speaker":"Chris Dy","startTime":507.629,"endTime":510.929,"body":"proximal pole, and putting aside"},{"speaker":"Chris Dy","startTime":507.629,"endTime":510.929,"body":"the reduction, how do you assess"},{"speaker":"Chris Dy","startTime":510.929,"endTime":513.149,"body":"viability of the proximal pole"},{"speaker":"Chris Dy","startTime":510.929,"endTime":513.149,"body":"in surgery?"},{"speaker":"Charles Goldfarb","startTime":514.14,"endTime":517.65,"body":"I don't"},{"speaker":"Charles Goldfarb","startTime":514.14,"endTime":517.65,"body":"personally believe that letting"},{"speaker":"Charles Goldfarb","startTime":517.65,"endTime":520.32,"body":"down the tourniquet is super"},{"speaker":"Charles Goldfarb","startTime":517.65,"endTime":520.32,"body":"helpful, because I don't believe"},{"speaker":"Charles Goldfarb","startTime":520.32,"endTime":524.91,"body":"that truly determines viability."},{"speaker":"Charles Goldfarb","startTime":520.32,"endTime":524.91,"body":"So for me is is there sufficient"},{"speaker":"Charles Goldfarb","startTime":524.91,"endTime":528.6,"body":"cancellous bone on that piece."},{"speaker":"Charles Goldfarb","startTime":524.91,"endTime":528.6,"body":"And if there is then I consider"},{"speaker":"Charles Goldfarb","startTime":528.6,"endTime":529.65,"body":"it potentially viable."},{"speaker":"Chris Dy","startTime":530.04,"endTime":532.65,"body":"Do you do anything to"},{"speaker":"Chris Dy","startTime":530.04,"endTime":532.65,"body":"kind of stir things up, you"},{"speaker":"Chris Dy","startTime":532.65,"endTime":534.78,"body":"know, put a K wire and"},{"speaker":"Chris Dy","startTime":532.65,"endTime":534.78,"body":"fenestrate it, you know, quote,"},{"speaker":"Chris Dy","startTime":534.78,"endTime":535.65,"body":"microfracture it?"},{"speaker":"Charles Goldfarb","startTime":535.69,"endTime":537.4,"body":"Whether the k"},{"speaker":"Charles Goldfarb","startTime":535.69,"endTime":537.4,"body":"wire or fenestration was"},{"speaker":"Charles Goldfarb","startTime":537.4,"endTime":542.08,"body":"intentional or not, I definitely"},{"speaker":"Charles Goldfarb","startTime":537.4,"endTime":542.08,"body":"did that. I did curette, I did"},{"speaker":"Charles Goldfarb","startTime":542.08,"endTime":542.71,"body":"curette though-"},{"speaker":"Chris Dy","startTime":542.71,"endTime":543.1,"body":"Got it."},{"speaker":"Charles Goldfarb","startTime":543.1,"endTime":545.47,"body":"just to get"},{"speaker":"Charles Goldfarb","startTime":543.1,"endTime":545.47,"body":"rid of any corticated bone."},{"speaker":"Chris Dy","startTime":545.91,"endTime":548.43,"body":"And then the last"},{"speaker":"Chris Dy","startTime":545.91,"endTime":548.43,"body":"question before you give us the"},{"speaker":"Chris Dy","startTime":548.46,"endTime":552.96,"body":"conclusion. Were you always that"},{"speaker":"Chris Dy","startTime":548.46,"endTime":552.96,"body":"type of surgeon who says you"},{"speaker":"Chris Dy","startTime":552.96,"endTime":556.83,"body":"know what, you know, like as you"},{"speaker":"Chris Dy","startTime":552.96,"endTime":556.83,"body":"described, when you cannot you"},{"speaker":"Chris Dy","startTime":556.83,"endTime":559.47,"body":"feel you cannot get an anatomic"},{"speaker":"Chris Dy","startTime":556.83,"endTime":559.47,"body":"reduction in this particular"},{"speaker":"Chris Dy","startTime":559.47,"endTime":561.96,"body":"case, say, you know what, I did"},{"speaker":"Chris Dy","startTime":559.47,"endTime":561.96,"body":"everything I could I feel like"},{"speaker":"Chris Dy","startTime":561.96,"endTime":565.23,"body":"I'm plenty capable, and it is"},{"speaker":"Chris Dy","startTime":561.96,"endTime":565.23,"body":"what it is, or did you evolve to"},{"speaker":"Chris Dy","startTime":565.23,"endTime":565.71,"body":"get there?"},{"speaker":"Charles Goldfarb","startTime":566.71,"endTime":569.65,"body":"I believe I'm"},{"speaker":"Charles Goldfarb","startTime":566.71,"endTime":569.65,"body":"a meticulous surgeon. But as I"},{"speaker":"Charles Goldfarb","startTime":569.65,"endTime":573.07,"body":"mentioned earlier, I believe"},{"speaker":"Charles Goldfarb","startTime":569.65,"endTime":573.07,"body":"that my decision making may be"},{"speaker":"Charles Goldfarb","startTime":573.07,"endTime":577.12,"body":"more, not decision making, but"},{"speaker":"Charles Goldfarb","startTime":573.07,"endTime":577.12,"body":"my conclusions may be more"},{"speaker":"Charles Goldfarb","startTime":577.12,"endTime":580.15,"body":"rapidly obtained than others. I"},{"speaker":"Charles Goldfarb","startTime":577.12,"endTime":580.15,"body":"think I've always been exactly"},{"speaker":"Charles Goldfarb","startTime":580.15,"endTime":582.67,"body":"that way. And I think that's"},{"speaker":"Charles Goldfarb","startTime":580.15,"endTime":582.67,"body":"something that we are either"},{"speaker":"Charles Goldfarb","startTime":582.67,"endTime":586.09,"body":"born with or not, not not that"},{"speaker":"Charles Goldfarb","startTime":582.67,"endTime":586.09,"body":"is good or bad. And I certainly"},{"speaker":"Charles Goldfarb","startTime":586.09,"endTime":590.23,"body":"wouldn't criticize someone for"},{"speaker":"Charles Goldfarb","startTime":586.09,"endTime":590.23,"body":"using a greater length of time"},{"speaker":"Charles Goldfarb","startTime":590.23,"endTime":594.19,"body":"to come to certain conclusions."},{"speaker":"Charles Goldfarb","startTime":590.23,"endTime":594.19,"body":"I think that's always how I've"},{"speaker":"Charles Goldfarb","startTime":594.19,"endTime":596.17,"body":"been again, for better or worse."},{"speaker":"Chris Dy","startTime":597.51,"endTime":598.83,"body":"So give us the"},{"speaker":"Chris Dy","startTime":597.51,"endTime":598.83,"body":"conclusion."},{"speaker":"Charles Goldfarb","startTime":599.74,"endTime":602.29,"body":"So and I don't"},{"speaker":"Charles Goldfarb","startTime":599.74,"endTime":602.29,"body":"know that there's any lessons in"},{"speaker":"Charles Goldfarb","startTime":602.29,"endTime":609.25,"body":"how this worked. But ultimately,"},{"speaker":"Charles Goldfarb","startTime":602.29,"endTime":609.25,"body":"I was able to antegrade three k"},{"speaker":"Charles Goldfarb","startTime":609.25,"endTime":616.03,"body":"wires into the distal pole of"},{"speaker":"Charles Goldfarb","startTime":609.25,"endTime":616.03,"body":"the scaphoid. And then I was"},{"speaker":"Charles Goldfarb","startTime":616.03,"endTime":620.65,"body":"able to manipulate the carpus,"},{"speaker":"Charles Goldfarb","startTime":616.03,"endTime":620.65,"body":"which you know, include the"},{"speaker":"Charles Goldfarb","startTime":620.65,"endTime":623.5,"body":"lunate, which helped manipulate"},{"speaker":"Charles Goldfarb","startTime":620.65,"endTime":623.5,"body":"the proximal pole of the"},{"speaker":"Charles Goldfarb","startTime":623.5,"endTime":626.98,"body":"scaphoid, given the scapholunate"},{"speaker":"Charles Goldfarb","startTime":623.5,"endTime":626.98,"body":"ligament, back into position."},{"speaker":"Charles Goldfarb","startTime":627.04,"endTime":630.76,"body":"And I think it was a combination"},{"speaker":"Charles Goldfarb","startTime":627.04,"endTime":630.76,"body":"of manual manipulation, use of a"},{"speaker":"Charles Goldfarb","startTime":630.76,"endTime":633.76,"body":"hohmann retractor around the"},{"speaker":"Charles Goldfarb","startTime":630.76,"endTime":633.76,"body":"proximal pole. And I was able to"},{"speaker":"Charles Goldfarb","startTime":633.76,"endTime":638.77,"body":"obtain an anatomical reduction,"},{"speaker":"Charles Goldfarb","startTime":633.76,"endTime":638.77,"body":"I drove all three pins across"},{"speaker":"Charles Goldfarb","startTime":638.95,"endTime":644.14,"body":"the proximal pole. And I use one"},{"speaker":"Charles Goldfarb","startTime":638.95,"endTime":644.14,"body":"of those to place a micro screw,"},{"speaker":"Charles Goldfarb","startTime":644.2,"endTime":648.58,"body":"a headless screw, and then I"},{"speaker":"Charles Goldfarb","startTime":644.2,"endTime":648.58,"body":"created a window to insert our"},{"speaker":"Charles Goldfarb","startTime":648.79,"endTime":652.36,"body":"vascularized bone flap, and I"},{"speaker":"Charles Goldfarb","startTime":648.79,"endTime":652.36,"body":"was really could not have been"},{"speaker":"Charles Goldfarb","startTime":652.36,"endTime":656.44,"body":"happier, I left the OR, thinking"},{"speaker":"Charles Goldfarb","startTime":652.36,"endTime":656.44,"body":"that I don't think I've been"},{"speaker":"Charles Goldfarb","startTime":656.44,"endTime":660.31,"body":"happier with a case in as long"},{"speaker":"Charles Goldfarb","startTime":656.44,"endTime":660.31,"body":"as I can remember. And certainly"},{"speaker":"Charles Goldfarb","startTime":660.31,"endTime":662.56,"body":"part of that is attributed to"},{"speaker":"Charles Goldfarb","startTime":660.31,"endTime":662.56,"body":"the frustration that I"},{"speaker":"Charles Goldfarb","startTime":662.56,"endTime":666.16,"body":"experienced, and the nearly"},{"speaker":"Charles Goldfarb","startTime":662.56,"endTime":666.16,"body":"coming to the decision that I"},{"speaker":"Charles Goldfarb","startTime":666.16,"endTime":670.24,"body":"could not obtain what I hoped to"},{"speaker":"Charles Goldfarb","startTime":666.16,"endTime":670.24,"body":"obtain preoperatively."},{"speaker":"Chris Dy","startTime":670.72,"endTime":672.7,"body":"That's what makes"},{"speaker":"Chris Dy","startTime":670.72,"endTime":672.7,"body":"surgery so exciting. And you"},{"speaker":"Chris Dy","startTime":672.7,"endTime":675.01,"body":"know, I think, you know, the"},{"speaker":"Chris Dy","startTime":672.7,"endTime":675.01,"body":"fact that you still get excited"},{"speaker":"Chris Dy","startTime":675.01,"endTime":677.83,"body":"about cases is great, you know,"},{"speaker":"Chris Dy","startTime":675.01,"endTime":677.83,"body":"I hope that you know, when I'm,"},{"speaker":"Chris Dy","startTime":677.86,"endTime":681.31,"body":"you know, 87 years old, like"},{"speaker":"Chris Dy","startTime":677.86,"endTime":681.31,"body":"you, I'm still able to get into"},{"speaker":"Chris Dy","startTime":681.31,"endTime":687.94,"body":"cases and you know, telling,"},{"speaker":"Chris Dy","startTime":681.31,"endTime":687.94,"body":"regaling these these cases, and"},{"speaker":"Chris Dy","startTime":687.94,"endTime":690.58,"body":"sharing the stories. But that's"},{"speaker":"Chris Dy","startTime":687.94,"endTime":690.58,"body":"fantastic. So it sounds like you"},{"speaker":"Chris Dy","startTime":690.58,"endTime":693.94,"body":"reduced the proximal, you reduce"},{"speaker":"Chris Dy","startTime":690.58,"endTime":693.94,"body":"the carpus to the distal"},{"speaker":"Chris Dy","startTime":693.94,"endTime":698.47,"body":"fragments, and then fired your"},{"speaker":"Chris Dy","startTime":693.94,"endTime":698.47,"body":"wires, as opposed to bringing"},{"speaker":"Chris Dy","startTime":698.47,"endTime":700.96,"body":"the distal fragment to the"},{"speaker":"Chris Dy","startTime":698.47,"endTime":700.96,"body":"proximal pole."},{"speaker":"Charles Goldfarb","startTime":701.83,"endTime":703.51,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":701.83,"endTime":703.51,"body":"right. It was a combination of"},{"speaker":"Charles Goldfarb","startTime":703.51,"endTime":706.03,"body":"all that. Yeah, it was a really"},{"speaker":"Charles Goldfarb","startTime":703.51,"endTime":706.03,"body":"unusual reduction maneuver."},{"speaker":"Charles Goldfarb","startTime":706.03,"endTime":708.7,"body":"Again, you don't usually have to"},{"speaker":"Charles Goldfarb","startTime":706.03,"endTime":708.7,"body":"do much reduction with the"},{"speaker":"Charles Goldfarb","startTime":708.7,"endTime":710.77,"body":"proximal pole. But you know-"},{"speaker":"Chris Dy","startTime":710.77,"endTime":712.63,"body":"What size, what size k"},{"speaker":"Chris Dy","startTime":710.77,"endTime":712.63,"body":"wires were they?"},{"speaker":"Charles Goldfarb","startTime":713.17,"endTime":715.93,"body":"I had two,"},{"speaker":"Charles Goldfarb","startTime":713.17,"endTime":715.93,"body":"four-fives, let me Yeah, that"},{"speaker":"Charles Goldfarb","startTime":715.93,"endTime":718.78,"body":"should probably finish that. To"},{"speaker":"Charles Goldfarb","startTime":715.93,"endTime":718.78,"body":"obtain the reduction, I use two,"},{"speaker":"Charles Goldfarb","startTime":718.78,"endTime":721.45,"body":"four-fives and one three-five."},{"speaker":"Charles Goldfarb","startTime":718.78,"endTime":721.45,"body":"And the three five was really"},{"speaker":"Charles Goldfarb","startTime":721.45,"endTime":726.79,"body":"used to drive the screw, I left"},{"speaker":"Charles Goldfarb","startTime":721.45,"endTime":726.79,"body":"both of the four-five k wires in"},{"speaker":"Charles Goldfarb","startTime":726.79,"endTime":731.5,"body":"place in addition to the screw,"},{"speaker":"Charles Goldfarb","startTime":726.79,"endTime":731.5,"body":"and I added a third k wire, as"},{"speaker":"Charles Goldfarb","startTime":731.5,"endTime":736.42,"body":"taught by Joe Slade at the"},{"speaker":"Charles Goldfarb","startTime":731.5,"endTime":736.42,"body":"distal scaphoid into the"},{"speaker":"Charles Goldfarb","startTime":736.42,"endTime":737.29,"body":"capitate."},{"speaker":"Chris Dy","startTime":737.63,"endTime":738.65,"body":"To block the SC joint."},{"speaker":"Charles Goldfarb","startTime":739.13,"endTime":742.94,"body":"Yes, exactly."},{"speaker":"Charles Goldfarb","startTime":739.13,"endTime":742.94,"body":"To decrease those forces on the"},{"speaker":"Charles Goldfarb","startTime":742.94,"endTime":744.83,"body":"proximal scaphoid and the non"},{"speaker":"Charles Goldfarb","startTime":742.94,"endTime":744.83,"body":"union site."},{"speaker":"Chris Dy","startTime":745.13,"endTime":747.5,"body":"Yeah. So I mean for"},{"speaker":"Chris Dy","startTime":745.13,"endTime":747.5,"body":"you know you, for those of you"},{"speaker":"Chris Dy","startTime":747.5,"endTime":749.93,"body":"that are earlier on or perhaps"},{"speaker":"Chris Dy","startTime":747.5,"endTime":749.93,"body":"aren't surgeons, you want to"},{"speaker":"Chris Dy","startTime":749.93,"endTime":753.8,"body":"stop the scaphoid from trying to"},{"speaker":"Chris Dy","startTime":749.93,"endTime":753.8,"body":"flex and try to deform across"},{"speaker":"Chris Dy","startTime":753.8,"endTime":756.05,"body":"your fracture site. And for"},{"speaker":"Chris Dy","startTime":753.8,"endTime":756.05,"body":"those of you that are trainees,"},{"speaker":"Chris Dy","startTime":756.05,"endTime":758.69,"body":"I mean, I think this is a great"},{"speaker":"Chris Dy","startTime":756.05,"endTime":758.69,"body":"example of when you're doing a"},{"speaker":"Chris Dy","startTime":758.69,"endTime":761.57,"body":"case, you're doing a fracture"},{"speaker":"Chris Dy","startTime":758.69,"endTime":761.57,"body":"case being judicious and"},{"speaker":"Chris Dy","startTime":761.57,"endTime":764.6,"body":"strategic about where and what"},{"speaker":"Chris Dy","startTime":761.57,"endTime":764.6,"body":"type of k wires you place and"},{"speaker":"Chris Dy","startTime":764.6,"endTime":768.53,"body":"where you place them. Because if"},{"speaker":"Chris Dy","startTime":764.6,"endTime":768.53,"body":"he had not put in that"},{"speaker":"Chris Dy","startTime":768.53,"endTime":771.74,"body":"three-five wire, he would have"},{"speaker":"Chris Dy","startTime":768.53,"endTime":771.74,"body":"had to put, you know, a whole"},{"speaker":"Chris Dy","startTime":771.74,"endTime":775.16,"body":"new path for a micro screw or it"},{"speaker":"Chris Dy","startTime":771.74,"endTime":775.16,"body":"just would not have been as"},{"speaker":"Chris Dy","startTime":775.16,"endTime":776.9,"body":"smooth. So that's something that"},{"speaker":"Chris Dy","startTime":775.16,"endTime":776.9,"body":"you should always keep in the"},{"speaker":"Chris Dy","startTime":776.9,"endTime":778.97,"body":"back of your mind, you know,"},{"speaker":"Chris Dy","startTime":776.9,"endTime":778.97,"body":"when you're using those k wires,"},{"speaker":"Chris Dy","startTime":778.97,"endTime":780.59,"body":"just just don't just put them"},{"speaker":"Chris Dy","startTime":778.97,"endTime":780.59,"body":"anywhere, you know."},{"speaker":"Charles Goldfarb","startTime":780.0,"endTime":783.06,"body":"Yeah, the"},{"speaker":"Charles Goldfarb","startTime":780.0,"endTime":783.06,"body":"other teaching point I think I"},{"speaker":"Charles Goldfarb","startTime":783.06,"endTime":788.46,"body":"processed after, I tend to make"},{"speaker":"Charles Goldfarb","startTime":783.06,"endTime":788.46,"body":"an assumption that trainees will"},{"speaker":"Charles Goldfarb","startTime":789.51,"endTime":793.14,"body":"prepare for surgery, they'll ask"},{"speaker":"Charles Goldfarb","startTime":789.51,"endTime":793.14,"body":"for help if they need to and"},{"speaker":"Charles Goldfarb","startTime":793.14,"endTime":795.09,"body":"finding the right articles. And"},{"speaker":"Charles Goldfarb","startTime":793.14,"endTime":795.09,"body":"I think you and I've talked"},{"speaker":"Charles Goldfarb","startTime":795.09,"endTime":799.44,"body":"about this, but but what I don't"},{"speaker":"Charles Goldfarb","startTime":795.09,"endTime":799.44,"body":"insist on is a written"},{"speaker":"Charles Goldfarb","startTime":799.44,"endTime":802.8,"body":"preoperative plan. In this case,"},{"speaker":"Charles Goldfarb","startTime":799.44,"endTime":802.8,"body":"it probably would have been"},{"speaker":"Charles Goldfarb","startTime":802.8,"endTime":807.33,"body":"helpful to go through reduction"},{"speaker":"Charles Goldfarb","startTime":802.8,"endTime":807.33,"body":"steps, just the complexity of"},{"speaker":"Charles Goldfarb","startTime":807.33,"endTime":810.21,"body":"this case was different, I"},{"speaker":"Charles Goldfarb","startTime":807.33,"endTime":810.21,"body":"think, than many that I do. And"},{"speaker":"Charles Goldfarb","startTime":810.21,"endTime":813.81,"body":"so a written preoperative plan"},{"speaker":"Charles Goldfarb","startTime":810.21,"endTime":813.81,"body":"about how to attempt reduction,"},{"speaker":"Charles Goldfarb","startTime":813.93,"endTime":817.89,"body":"how to place wires versus screws"},{"speaker":"Charles Goldfarb","startTime":813.93,"endTime":817.89,"body":"versus etc, etc. might have been"},{"speaker":"Charles Goldfarb","startTime":817.89,"endTime":821.28,"body":"useful. And I did not do that. I"},{"speaker":"Charles Goldfarb","startTime":817.89,"endTime":821.28,"body":"have great trainees, it's not"},{"speaker":"Charles Goldfarb","startTime":821.28,"endTime":824.28,"body":"about their quality or their"},{"speaker":"Charles Goldfarb","startTime":821.28,"endTime":824.28,"body":"interest or their preparation."},{"speaker":"Charles Goldfarb","startTime":824.52,"endTime":827.82,"body":"It's just about another way to"},{"speaker":"Charles Goldfarb","startTime":824.52,"endTime":827.82,"body":"think about training."},{"speaker":"Chris Dy","startTime":828.18,"endTime":829.92,"body":"Yeah, I mean, I'll be"},{"speaker":"Chris Dy","startTime":828.18,"endTime":829.92,"body":"very blunt, you know, I don't"},{"speaker":"Chris Dy","startTime":829.92,"endTime":832.2,"body":"make our fellows template"},{"speaker":"Chris Dy","startTime":829.92,"endTime":832.2,"body":"fracture cases, I make our"},{"speaker":"Chris Dy","startTime":832.2,"endTime":834.3,"body":"residents template fracture"},{"speaker":"Chris Dy","startTime":832.2,"endTime":834.3,"body":"cases when they're with me,"},{"speaker":"Chris Dy","startTime":834.3,"endTime":837.15,"body":"because it's not like it's a ton"},{"speaker":"Chris Dy","startTime":834.3,"endTime":837.15,"body":"of cases and I want to see how"},{"speaker":"Chris Dy","startTime":837.15,"endTime":841.59,"body":"they're thinking about strategy,"},{"speaker":"Chris Dy","startTime":837.15,"endTime":841.59,"body":"planning, all the things that"},{"speaker":"Chris Dy","startTime":841.59,"endTime":844.77,"body":"they need to own as they, you"},{"speaker":"Chris Dy","startTime":841.59,"endTime":844.77,"body":"know, become independent"},{"speaker":"Chris Dy","startTime":844.77,"endTime":849.03,"body":"surgeons. So, I templated every"},{"speaker":"Chris Dy","startTime":844.77,"endTime":849.03,"body":"fracture case, as a resident on"},{"speaker":"Chris Dy","startTime":849.03,"endTime":851.31,"body":"the trauma service, I know that"},{"speaker":"Chris Dy","startTime":849.03,"endTime":851.31,"body":"they don't do that, you know,"},{"speaker":"Chris Dy","startTime":851.31,"endTime":854.79,"body":"for every case here on the"},{"speaker":"Chris Dy","startTime":851.31,"endTime":854.79,"body":"trauma service. But I think that"},{"speaker":"Chris Dy","startTime":854.79,"endTime":856.8,"body":"it's something where, you know,"},{"speaker":"Chris Dy","startTime":854.79,"endTime":856.8,"body":"I ask them to draw up a"},{"speaker":"Chris Dy","startTime":856.8,"endTime":858.87,"body":"template, we look at the"},{"speaker":"Chris Dy","startTime":856.8,"endTime":858.87,"body":"template together, we look at"},{"speaker":"Chris Dy","startTime":858.87,"endTime":861.81,"body":"the template afterwards, I ask"},{"speaker":"Chris Dy","startTime":858.87,"endTime":861.81,"body":"them what they thought went well"},{"speaker":"Chris Dy","startTime":861.81,"endTime":864.12,"body":"and how it deviated from the"},{"speaker":"Chris Dy","startTime":861.81,"endTime":864.12,"body":"template and I try to tell them"},{"speaker":"Chris Dy","startTime":864.12,"endTime":867.48,"body":"how my decision making may have"},{"speaker":"Chris Dy","startTime":864.12,"endTime":867.48,"body":"differed from theirs and why and"},{"speaker":"Chris Dy","startTime":867.48,"endTime":869.64,"body":"not necessarily that I'm right"},{"speaker":"Chris Dy","startTime":867.48,"endTime":869.64,"body":"and they're wrong. It's just"},{"speaker":"Chris Dy","startTime":869.64,"endTime":870.6,"body":"there are different ways to do"},{"speaker":"Chris Dy","startTime":869.64,"endTime":870.6,"body":"it."},{"speaker":"Charles Goldfarb","startTime":871.23,"endTime":873.12,"body":"Yeah it's the"},{"speaker":"Charles Goldfarb","startTime":871.23,"endTime":873.12,"body":"preparation, which is the key."},{"speaker":"Charles Goldfarb","startTime":873.12,"endTime":875.34,"body":"It's not even the actual"},{"speaker":"Charles Goldfarb","startTime":873.12,"endTime":875.34,"body":"template, you know, it is just"},{"speaker":"Charles Goldfarb","startTime":875.34,"endTime":877.02,"body":"the preparation, which is so"},{"speaker":"Charles Goldfarb","startTime":875.34,"endTime":877.02,"body":"important."},{"speaker":"Chris Dy","startTime":877.95,"endTime":878.67,"body":"Absolutely."},{"speaker":"Charles Goldfarb","startTime":878.88,"endTime":880.65,"body":"Any good"},{"speaker":"Charles Goldfarb","startTime":878.88,"endTime":880.65,"body":"reviews to share."},{"speaker":"Chris Dy","startTime":881.11,"endTime":885.1,"body":"Yeah, so we've had a"},{"speaker":"Chris Dy","startTime":881.11,"endTime":885.1,"body":"fantastic email that was sent in"},{"speaker":"Chris Dy","startTime":885.1,"endTime":888.82,"body":"by Dr. Frank Walter. Frank,"},{"speaker":"Chris Dy","startTime":885.1,"endTime":888.82,"body":"thank you for listening. He's"},{"speaker":"Chris Dy","startTime":888.82,"endTime":891.82,"body":"tells us that he's an upper"},{"speaker":"Chris Dy","startTime":888.82,"endTime":891.82,"body":"extremity surgeon in Wisconsin."},{"speaker":"Chris Dy","startTime":892.78,"endTime":897.13,"body":"Sorry about my Bucks beating"},{"speaker":"Chris Dy","startTime":892.78,"endTime":897.13,"body":"your Packers buddy. I became a"},{"speaker":"Chris Dy","startTime":897.13,"endTime":899.23,"body":"listener this year after seeing"},{"speaker":"Chris Dy","startTime":897.13,"endTime":899.23,"body":"a recommendation on the"},{"speaker":"Chris Dy","startTime":899.23,"endTime":902.38,"body":"listserv, shout out to the"},{"speaker":"Chris Dy","startTime":899.23,"endTime":902.38,"body":"listserv folks, it's been time"},{"speaker":"Chris Dy","startTime":902.38,"endTime":905.59,"body":"well spent. I especially love"},{"speaker":"Chris Dy","startTime":902.38,"endTime":905.59,"body":"the non dogmatic approach that"},{"speaker":"Chris Dy","startTime":905.59,"endTime":909.1,"body":"you both use to talk about these"},{"speaker":"Chris Dy","startTime":905.59,"endTime":909.1,"body":"common problems. That is to say"},{"speaker":"Chris Dy","startTime":909.1,"endTime":911.86,"body":"that you were teaching me new"},{"speaker":"Chris Dy","startTime":909.1,"endTime":911.86,"body":"and often better, more efficient"},{"speaker":"Chris Dy","startTime":911.86,"endTime":914.59,"body":"ways to treat patients without"},{"speaker":"Chris Dy","startTime":911.86,"endTime":914.59,"body":"making me feel, quote, dumb,"},{"speaker":"Chris Dy","startTime":914.74,"endTime":917.2,"body":"smiley emoji because we know"},{"speaker":"Chris Dy","startTime":914.74,"endTime":917.2,"body":"you're not dumb, Frank, come on,"},{"speaker":"Chris Dy","startTime":917.65,"endTime":919.72,"body":"I appreciate that you have"},{"speaker":"Chris Dy","startTime":917.65,"endTime":919.72,"body":"created a great thing. And I"},{"speaker":"Chris Dy","startTime":919.72,"endTime":922.39,"body":"certainly hope that you can keep"},{"speaker":"Chris Dy","startTime":919.72,"endTime":922.39,"body":"it going. I have my therapist"},{"speaker":"Chris Dy","startTime":922.39,"endTime":924.79,"body":"and assistants listening as"},{"speaker":"Chris Dy","startTime":922.39,"endTime":924.79,"body":"well. And they have picked up"},{"speaker":"Chris Dy","startTime":924.79,"endTime":929.17,"body":"lots of pearls. So Frank, we"},{"speaker":"Chris Dy","startTime":924.79,"endTime":929.17,"body":"appreciate the email. We love"},{"speaker":"Chris Dy","startTime":929.17,"endTime":931.54,"body":"the fact that you're getting"},{"speaker":"Chris Dy","startTime":929.17,"endTime":931.54,"body":"people listening. And if you"},{"speaker":"Chris Dy","startTime":931.54,"endTime":933.94,"body":"ever have anything you want to"},{"speaker":"Chris Dy","startTime":931.54,"endTime":933.94,"body":"share with us about how we can"},{"speaker":"Chris Dy","startTime":933.94,"endTime":935.89,"body":"do better please, please let us"},{"speaker":"Chris Dy","startTime":933.94,"endTime":935.89,"body":"know."},{"speaker":"Charles Goldfarb","startTime":936.61,"endTime":938.59,"body":"Absolutely."},{"speaker":"Charles Goldfarb","startTime":936.61,"endTime":938.59,"body":"Thank you. Thank you, Frank."},{"speaker":"Charles Goldfarb","startTime":939.22,"endTime":943.72,"body":"Very, again, very nice words."},{"speaker":"Charles Goldfarb","startTime":939.22,"endTime":943.72,"body":"And this is our fuel comments"},{"speaker":"Charles Goldfarb","startTime":943.72,"endTime":947.71,"body":"and questions and interactions"},{"speaker":"Charles Goldfarb","startTime":943.72,"endTime":947.71,"body":"are what make this fun for Chris"},{"speaker":"Charles Goldfarb","startTime":947.71,"endTime":948.01,"body":"and I."},{"speaker":"Chris Dy","startTime":948.19,"endTime":951.43,"body":"I will say if anybody"},{"speaker":"Chris Dy","startTime":948.19,"endTime":951.43,"body":"leaves us a five star review on"},{"speaker":"Chris Dy","startTime":951.43,"endTime":955.12,"body":"iTunes and puts any sort of"},{"speaker":"Chris Dy","startTime":951.43,"endTime":955.12,"body":"question in there, we will"},{"speaker":"Chris Dy","startTime":955.12,"endTime":958.87,"body":"literally answer it on the air."},{"speaker":"Chris Dy","startTime":955.12,"endTime":958.87,"body":"So that is your automatic way to"},{"speaker":"Chris Dy","startTime":958.87,"endTime":962.56,"body":"get your question asked on the"},{"speaker":"Chris Dy","startTime":958.87,"endTime":962.56,"body":"air. If you leave us a five star"},{"speaker":"Chris Dy","startTime":962.56,"endTime":966.37,"body":"review on iTunes. So please feel"},{"speaker":"Chris Dy","startTime":962.56,"endTime":966.37,"body":"free to do that, or email us at"},{"speaker":"Chris Dy","startTime":966.37,"endTime":967.54,"body":"handpodcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":968.71,"endTime":972.46,"body":"Perfect. We"},{"speaker":"Charles Goldfarb","startTime":968.71,"endTime":972.46,"body":"were discussing a couple of not"},{"speaker":"Charles Goldfarb","startTime":972.46,"endTime":976.99,"body":"specifically clinical topics."},{"speaker":"Charles Goldfarb","startTime":972.46,"endTime":976.99,"body":"And today, Chris, and I believe"},{"speaker":"Charles Goldfarb","startTime":976.99,"endTime":979.42,"body":"it'll be an interesting"},{"speaker":"Charles Goldfarb","startTime":976.99,"endTime":979.42,"body":"conversation to talk a little"},{"speaker":"Charles Goldfarb","startTime":979.42,"endTime":983.62,"body":"about practice development, and"},{"speaker":"Charles Goldfarb","startTime":979.42,"endTime":983.62,"body":"how our practices have developed"},{"speaker":"Charles Goldfarb","startTime":983.86,"endTime":988.18,"body":"and a little about marketing."},{"speaker":"Charles Goldfarb","startTime":983.86,"endTime":988.18,"body":"And the hope is that we can get"},{"speaker":"Charles Goldfarb","startTime":988.18,"endTime":991.6,"body":"a marketing expert and the plan"},{"speaker":"Charles Goldfarb","startTime":988.18,"endTime":991.6,"body":"is to get a marketing expert to"},{"speaker":"Charles Goldfarb","startTime":991.6,"endTime":995.41,"body":"join us, either directly after"},{"speaker":"Charles Goldfarb","startTime":991.6,"endTime":995.41,"body":"this podcast or in the near"},{"speaker":"Charles Goldfarb","startTime":995.41,"endTime":995.8,"body":"term."},{"speaker":"Chris Dy","startTime":995.83,"endTime":998.95,"body":"I think that'll be a"},{"speaker":"Chris Dy","startTime":995.83,"endTime":998.95,"body":"good topic. I mean, so back in"},{"speaker":"Chris Dy","startTime":998.95,"endTime":1002.76,"body":"the stone ages. At the turn of"},{"speaker":"Chris Dy","startTime":998.95,"endTime":1002.76,"body":"the century, when a young"},{"speaker":"Chris Dy","startTime":1002.79,"endTime":1006.48,"body":"strapping Chuck Goldfarb was"},{"speaker":"Chris Dy","startTime":1002.79,"endTime":1006.48,"body":"coming out of his fellowship."},{"speaker":"Chris Dy","startTime":1007.17,"endTime":1009.36,"body":"How did, how were you set up for"},{"speaker":"Chris Dy","startTime":1007.17,"endTime":1009.36,"body":"your practice? What did your"},{"speaker":"Chris Dy","startTime":1009.36,"endTime":1011.37,"body":"practice look like? And what"},{"speaker":"Chris Dy","startTime":1009.36,"endTime":1011.37,"body":"were you told about what your"},{"speaker":"Chris Dy","startTime":1011.37,"endTime":1012.09,"body":"practice would be?"},{"speaker":"Charles Goldfarb","startTime":1013.41,"endTime":1015.87,"body":"So it's pretty"},{"speaker":"Charles Goldfarb","startTime":1013.41,"endTime":1015.87,"body":"obvious that I have an academic"},{"speaker":"Charles Goldfarb","startTime":1015.87,"endTime":1020.31,"body":"practice. And that was always my"},{"speaker":"Charles Goldfarb","startTime":1015.87,"endTime":1020.31,"body":"plan. And I had a significant"},{"speaker":"Charles Goldfarb","startTime":1020.31,"endTime":1025.92,"body":"interest in pediatric and"},{"speaker":"Charles Goldfarb","startTime":1020.31,"endTime":1025.92,"body":"congenital care. And other than"},{"speaker":"Charles Goldfarb","startTime":1025.92,"endTime":1030.45,"body":"that, I like several of my"},{"speaker":"Charles Goldfarb","startTime":1025.92,"endTime":1030.45,"body":"mentors thought a more general"},{"speaker":"Charles Goldfarb","startTime":1030.45,"endTime":1035.46,"body":"adult practice would make sense."},{"speaker":"Charles Goldfarb","startTime":1030.45,"endTime":1035.46,"body":"And I guess my my personal"},{"speaker":"Charles Goldfarb","startTime":1035.46,"endTime":1041.43,"body":"principles, which I believe"},{"speaker":"Charles Goldfarb","startTime":1035.46,"endTime":1041.43,"body":"others would echo, include the"},{"speaker":"Charles Goldfarb","startTime":1041.43,"endTime":1045.78,"body":"need to stay broad in one's"},{"speaker":"Charles Goldfarb","startTime":1041.43,"endTime":1045.78,"body":"practice as long as possible, I"},{"speaker":"Charles Goldfarb","startTime":1045.78,"endTime":1048.87,"body":"just think it makes sense, the"},{"speaker":"Charles Goldfarb","startTime":1045.78,"endTime":1048.87,"body":"sooner we narrow our practice"},{"speaker":"Charles Goldfarb","startTime":1048.87,"endTime":1052.62,"body":"parameters, if our practice"},{"speaker":"Charles Goldfarb","startTime":1048.87,"endTime":1052.62,"body":"location changes, or something"},{"speaker":"Charles Goldfarb","startTime":1052.62,"endTime":1055.5,"body":"about practice dynamic changes,"},{"speaker":"Charles Goldfarb","startTime":1052.62,"endTime":1055.5,"body":"I think it's hard to then"},{"speaker":"Charles Goldfarb","startTime":1055.5,"endTime":1060.66,"body":"broaden your patient population"},{"speaker":"Charles Goldfarb","startTime":1055.5,"endTime":1060.66,"body":"later. And so staying broad was"},{"speaker":"Charles Goldfarb","startTime":1060.66,"endTime":1064.92,"body":"a goal. I'll keep going for a"},{"speaker":"Charles Goldfarb","startTime":1060.66,"endTime":1064.92,"body":"minute and say that, as we've"},{"speaker":"Charles Goldfarb","startTime":1064.92,"endTime":1069.36,"body":"also said, on this podcast, that"},{"speaker":"Charles Goldfarb","startTime":1064.92,"endTime":1069.36,"body":"opportunities arise. And those"},{"speaker":"Charles Goldfarb","startTime":1069.36,"endTime":1073.26,"body":"opportunities can be unexpected"},{"speaker":"Charles Goldfarb","startTime":1069.36,"endTime":1073.26,"body":"and can be dramatic. And so the"},{"speaker":"Charles Goldfarb","startTime":1073.26,"endTime":1076.83,"body":"opportunity that arise that"},{"speaker":"Charles Goldfarb","startTime":1073.26,"endTime":1076.83,"body":"arose, for me, was the"},{"speaker":"Charles Goldfarb","startTime":1076.83,"endTime":1079.71,"body":"opportunity to care, participate"},{"speaker":"Charles Goldfarb","startTime":1076.83,"endTime":1079.71,"body":"in the care of the St. Louis"},{"speaker":"Charles Goldfarb","startTime":1079.71,"endTime":1083.85,"body":"Rams football team. And I became"},{"speaker":"Charles Goldfarb","startTime":1079.71,"endTime":1083.85,"body":"an assistant team physician, I"},{"speaker":"Charles Goldfarb","startTime":1083.85,"endTime":1089.1,"body":"traveled with the team. And I"},{"speaker":"Charles Goldfarb","startTime":1083.85,"endTime":1089.1,"body":"realized that A) I like that, I"},{"speaker":"Charles Goldfarb","startTime":1089.1,"endTime":1093.93,"body":"no longer travel, haven't for"},{"speaker":"Charles Goldfarb","startTime":1089.1,"endTime":1093.93,"body":"many years, and B) the"},{"speaker":"Charles Goldfarb","startTime":1093.93,"endTime":1099.06,"body":"opportunity to take care of"},{"speaker":"Charles Goldfarb","startTime":1093.93,"endTime":1099.06,"body":"sports, at every level, really"},{"speaker":"Charles Goldfarb","startTime":1099.06,"endTime":1101.34,"body":"appealed to me. And that became"},{"speaker":"Charles Goldfarb","startTime":1099.06,"endTime":1101.34,"body":"a huge part of my practice. Now"},{"speaker":"Charles Goldfarb","startTime":1101.34,"endTime":1103.41,"body":"part of that was because my"},{"speaker":"Charles Goldfarb","startTime":1101.34,"endTime":1103.41,"body":"partners weren't necessarily"},{"speaker":"Charles Goldfarb","startTime":1103.41,"endTime":1106.62,"body":"interested in that. And again,"},{"speaker":"Charles Goldfarb","startTime":1103.41,"endTime":1106.62,"body":"that's an opportunity. But I"},{"speaker":"Charles Goldfarb","startTime":1106.62,"endTime":1111.06,"body":"built on that so that my date,"},{"speaker":"Charles Goldfarb","startTime":1106.62,"endTime":1111.06,"body":"my practice today is pediatric"},{"speaker":"Charles Goldfarb","startTime":1111.06,"endTime":1114.48,"body":"and congenital, sports, I've"},{"speaker":"Charles Goldfarb","startTime":1111.06,"endTime":1114.48,"body":"limited and I've recently"},{"speaker":"Charles Goldfarb","startTime":1114.48,"endTime":1117.45,"body":"limited the age of my patients."},{"speaker":"Charles Goldfarb","startTime":1114.48,"endTime":1117.45,"body":"And so for a patient who just"},{"speaker":"Charles Goldfarb","startTime":1117.45,"endTime":1122.25,"body":"randomly calls in it's 45 years"},{"speaker":"Charles Goldfarb","startTime":1117.45,"endTime":1122.25,"body":"and younger. But it's been a"},{"speaker":"Charles Goldfarb","startTime":1122.25,"endTime":1126.06,"body":"it's been a very slow process"},{"speaker":"Charles Goldfarb","startTime":1122.25,"endTime":1126.06,"body":"that has, you know, taken 20"},{"speaker":"Charles Goldfarb","startTime":1126.06,"endTime":1126.78,"body":"years to get there."},{"speaker":"Chris Dy","startTime":1127.92,"endTime":1131.31,"body":"So you mentioned"},{"speaker":"Chris Dy","startTime":1127.92,"endTime":1131.31,"body":"earlier about the benefits of"},{"speaker":"Chris Dy","startTime":1131.31,"endTime":1134.7,"body":"staying broad as long as you"},{"speaker":"Chris Dy","startTime":1131.31,"endTime":1134.7,"body":"can. And you've listed a few"},{"speaker":"Chris Dy","startTime":1134.7,"endTime":1137.4,"body":"reasons, dive deeper into that,"},{"speaker":"Chris Dy","startTime":1134.7,"endTime":1137.4,"body":"you know, so because I think we"},{"speaker":"Chris Dy","startTime":1137.4,"endTime":1141.06,"body":"have a lot of current fellows,"},{"speaker":"Chris Dy","startTime":1137.4,"endTime":1141.06,"body":"and perhaps residents that are"},{"speaker":"Chris Dy","startTime":1141.06,"endTime":1143.28,"body":"listening and that are"},{"speaker":"Chris Dy","startTime":1141.06,"endTime":1143.28,"body":"interested in, you know,"},{"speaker":"Chris Dy","startTime":1143.28,"endTime":1147.09,"body":"different practice environments."},{"speaker":"Chris Dy","startTime":1143.28,"endTime":1147.09,"body":"You know, did you know what was"},{"speaker":"Chris Dy","startTime":1147.42,"endTime":1150.69,"body":"your thought process in doing so"},{"speaker":"Chris Dy","startTime":1147.42,"endTime":1150.69,"body":"or was that were you told you"},{"speaker":"Chris Dy","startTime":1150.69,"endTime":1151.32,"body":"had to do that?"},{"speaker":"Charles Goldfarb","startTime":1153.25,"endTime":1158.74,"body":"I believe that"},{"speaker":"Charles Goldfarb","startTime":1153.25,"endTime":1158.74,"body":"one can choose to step into a"},{"speaker":"Charles Goldfarb","startTime":1158.74,"endTime":1163.15,"body":"practice that's very focused in"},{"speaker":"Charles Goldfarb","startTime":1158.74,"endTime":1163.15,"body":"only a limited number of"},{"speaker":"Charles Goldfarb","startTime":1163.15,"endTime":1165.61,"body":"practice settings in the United"},{"speaker":"Charles Goldfarb","startTime":1163.15,"endTime":1165.61,"body":"States, and it may be different"},{"speaker":"Charles Goldfarb","startTime":1165.61,"endTime":1169.57,"body":"elsewhere. But for anyone to"},{"speaker":"Charles Goldfarb","startTime":1165.61,"endTime":1169.57,"body":"come in and say I'm just going"},{"speaker":"Charles Goldfarb","startTime":1169.57,"endTime":1173.26,"body":"to do brachial plexus, unless"},{"speaker":"Charles Goldfarb","startTime":1169.57,"endTime":1173.26,"body":"you're at a very, again, a very"},{"speaker":"Charles Goldfarb","startTime":1173.26,"endTime":1177.04,"body":"limited number of centers,"},{"speaker":"Charles Goldfarb","startTime":1173.26,"endTime":1177.04,"body":"that's not possible. And so I"},{"speaker":"Charles Goldfarb","startTime":1177.04,"endTime":1181.33,"body":"think it has to be a process of"},{"speaker":"Charles Goldfarb","startTime":1177.04,"endTime":1181.33,"body":"developing your name, developing"},{"speaker":"Charles Goldfarb","startTime":1181.33,"endTime":1184.93,"body":"connections. And so while you"},{"speaker":"Charles Goldfarb","startTime":1181.33,"endTime":1184.93,"body":"are perhaps building your"},{"speaker":"Charles Goldfarb","startTime":1184.93,"endTime":1188.35,"body":"preferred practice, staying"},{"speaker":"Charles Goldfarb","startTime":1184.93,"endTime":1188.35,"body":"broad brings many benefits it"},{"speaker":"Charles Goldfarb","startTime":1188.35,"endTime":1190.99,"body":"establish, it in of itself"},{"speaker":"Charles Goldfarb","startTime":1188.35,"endTime":1190.99,"body":"establishes your relationships,"},{"speaker":"Charles Goldfarb","startTime":1190.99,"endTime":1194.38,"body":"gets your name out in the"},{"speaker":"Charles Goldfarb","startTime":1190.99,"endTime":1194.38,"body":"community, gives you chances to"},{"speaker":"Charles Goldfarb","startTime":1194.38,"endTime":1200.62,"body":"if you're in academics to write"},{"speaker":"Charles Goldfarb","startTime":1194.38,"endTime":1200.62,"body":"and just keeps your skill set A)"},{"speaker":"Charles Goldfarb","startTime":1200.62,"endTime":1203.14,"body":"as broad as possible, and two"},{"speaker":"Charles Goldfarb","startTime":1200.62,"endTime":1203.14,"body":"allows you to fully develop that"},{"speaker":"Charles Goldfarb","startTime":1203.14,"endTime":1205.45,"body":"skill set, because no one is"},{"speaker":"Charles Goldfarb","startTime":1203.14,"endTime":1205.45,"body":"fully developed as a surgeon"},{"speaker":"Charles Goldfarb","startTime":1205.45,"endTime":1208.87,"body":"after fellowship. And so that"},{"speaker":"Charles Goldfarb","startTime":1205.45,"endTime":1208.87,"body":"repetition in different areas is"},{"speaker":"Charles Goldfarb","startTime":1208.87,"endTime":1212.5,"body":"absolutely beneficial. And if"},{"speaker":"Charles Goldfarb","startTime":1208.87,"endTime":1212.5,"body":"one chooses to narrow his or her"},{"speaker":"Charles Goldfarb","startTime":1212.5,"endTime":1216.13,"body":"practice later, well, that's"},{"speaker":"Charles Goldfarb","startTime":1212.5,"endTime":1216.13,"body":"fine. But I just think that it"},{"speaker":"Charles Goldfarb","startTime":1216.13,"endTime":1217.99,"body":"needs to be broad for as long as"},{"speaker":"Charles Goldfarb","startTime":1216.13,"endTime":1217.99,"body":"possible."},{"speaker":"Chris Dy","startTime":1218.59,"endTime":1220.45,"body":"What do you think the"},{"speaker":"Chris Dy","startTime":1218.59,"endTime":1220.45,"body":"slope on that learning curve"},{"speaker":"Chris Dy","startTime":1220.45,"endTime":1223.48,"body":"starts to flatten out? You know,"},{"speaker":"Chris Dy","startTime":1220.45,"endTime":1223.48,"body":"you've been in the game for 20"},{"speaker":"Chris Dy","startTime":1223.48,"endTime":1227.14,"body":"years now? Do you feel like you"},{"speaker":"Chris Dy","startTime":1223.48,"endTime":1227.14,"body":"are still kind of in that"},{"speaker":"Chris Dy","startTime":1227.23,"endTime":1229.9,"body":"climbing phase? Or do you feel"},{"speaker":"Chris Dy","startTime":1227.23,"endTime":1229.9,"body":"like you're not plateaued, but"},{"speaker":"Chris Dy","startTime":1229.9,"endTime":1232.33,"body":"you know, a space, a flatter"},{"speaker":"Chris Dy","startTime":1229.9,"endTime":1232.33,"body":"slope."},{"speaker":"Charles Goldfarb","startTime":1233.02,"endTime":1235.6,"body":"I think the"},{"speaker":"Charles Goldfarb","startTime":1233.02,"endTime":1235.6,"body":"first 10 years are key, I think"},{"speaker":"Charles Goldfarb","startTime":1235.6,"endTime":1238.75,"body":"by five years, you know, the"},{"speaker":"Charles Goldfarb","startTime":1235.6,"endTime":1238.75,"body":"learning curve has definitely"},{"speaker":"Charles Goldfarb","startTime":1238.75,"endTime":1242.2,"body":"flattened by the time you get"},{"speaker":"Charles Goldfarb","startTime":1238.75,"endTime":1242.2,"body":"into your 40s. And this is 100%."},{"speaker":"Charles Goldfarb","startTime":1242.59,"endTime":1245.77,"body":"just my opinion, there's no"},{"speaker":"Charles Goldfarb","startTime":1242.59,"endTime":1245.77,"body":"science behind this, I think"},{"speaker":"Charles Goldfarb","startTime":1245.77,"endTime":1248.5,"body":"into your 40s, you still"},{"speaker":"Charles Goldfarb","startTime":1245.77,"endTime":1248.5,"body":"absolutely learn and I still"},{"speaker":"Charles Goldfarb","startTime":1248.5,"endTime":1251.41,"body":"learn today, but that the curve"},{"speaker":"Charles Goldfarb","startTime":1248.5,"endTime":1251.41,"body":"becomes much flatter. I think"},{"speaker":"Charles Goldfarb","startTime":1251.41,"endTime":1253.99,"body":"what I've learned a little bit"},{"speaker":"Charles Goldfarb","startTime":1251.41,"endTime":1253.99,"body":"during the pandemic, and having"},{"speaker":"Charles Goldfarb","startTime":1253.99,"endTime":1257.14,"body":"to operate in places that I may"},{"speaker":"Charles Goldfarb","startTime":1253.99,"endTime":1257.14,"body":"not operate, is that part of the"},{"speaker":"Charles Goldfarb","startTime":1257.14,"endTime":1261.52,"body":"reason I believe I stay sharp"},{"speaker":"Charles Goldfarb","startTime":1257.14,"endTime":1261.52,"body":"and I am stimulated is the fact"},{"speaker":"Charles Goldfarb","startTime":1261.52,"endTime":1264.67,"body":"that I have residents and"},{"speaker":"Charles Goldfarb","startTime":1261.52,"endTime":1264.67,"body":"fellows. They don't there's no,"},{"speaker":"Charles Goldfarb","startTime":1264.79,"endTime":1268.15,"body":"there's no escaping"},{"speaker":"Charles Goldfarb","startTime":1264.79,"endTime":1268.15,"body":"accountability in our current"},{"speaker":"Charles Goldfarb","startTime":1268.15,"endTime":1272.38,"body":"practice situation. But the"},{"speaker":"Charles Goldfarb","startTime":1268.15,"endTime":1272.38,"body":"learning curve is very different"},{"speaker":"Charles Goldfarb","startTime":1272.38,"endTime":1273.67,"body":"now, for me."},{"speaker":"Chris Dy","startTime":1274.18,"endTime":1276.1,"body":"Do you think it's your"},{"speaker":"Chris Dy","startTime":1274.18,"endTime":1276.1,"body":"surgical skill? Or do you think"},{"speaker":"Chris Dy","startTime":1276.1,"endTime":1279.19,"body":"it's maturing as a doctor or as"},{"speaker":"Chris Dy","startTime":1276.1,"endTime":1279.19,"body":"a person or all of them?"},{"speaker":"Charles Goldfarb","startTime":1280.11,"endTime":1282.09,"body":"It's"},{"speaker":"Charles Goldfarb","startTime":1280.11,"endTime":1282.09,"body":"everything, it's family,"},{"speaker":"Charles Goldfarb","startTime":1282.78,"endTime":1287.31,"body":"requirements outside of work."},{"speaker":"Charles Goldfarb","startTime":1282.78,"endTime":1287.31,"body":"It's the fact that most cases"},{"speaker":"Charles Goldfarb","startTime":1287.31,"endTime":1290.19,"body":"now my surgical skills are"},{"speaker":"Charles Goldfarb","startTime":1287.31,"endTime":1290.19,"body":"probably as good as there ever"},{"speaker":"Charles Goldfarb","startTime":1290.19,"endTime":1292.53,"body":"will be. Right? There's been"},{"speaker":"Charles Goldfarb","startTime":1290.19,"endTime":1292.53,"body":"there has been science around"},{"speaker":"Charles Goldfarb","startTime":1292.53,"endTime":1295.65,"body":"when do you peak as a surgeon,"},{"speaker":"Charles Goldfarb","startTime":1292.53,"endTime":1295.65,"body":"and, you know, at my age it is"},{"speaker":"Charles Goldfarb","startTime":1295.65,"endTime":1299.49,"body":"probably is 50. In between, I"},{"speaker":"Charles Goldfarb","startTime":1295.65,"endTime":1299.49,"body":"don't know was at 40 and 60. Or,"},{"speaker":"Charles Goldfarb","startTime":1299.52,"endTime":1302.31,"body":"you know, today may be different"},{"speaker":"Charles Goldfarb","startTime":1299.52,"endTime":1302.31,"body":"than it was 20 years ago, but,"},{"speaker":"Charles Goldfarb","startTime":1302.43,"endTime":1305.4,"body":"but I think surgical skills are"},{"speaker":"Charles Goldfarb","startTime":1302.43,"endTime":1305.4,"body":"pretty good. At my age, decision"},{"speaker":"Charles Goldfarb","startTime":1305.4,"endTime":1308.43,"body":"making is pretty good at my age."},{"speaker":"Charles Goldfarb","startTime":1305.4,"endTime":1308.43,"body":"And so those things become"},{"speaker":"Charles Goldfarb","startTime":1308.46,"endTime":1312.3,"body":"easier. But everything's"},{"speaker":"Charles Goldfarb","startTime":1308.46,"endTime":1312.3,"body":"swirling around, it's just more"},{"speaker":"Charles Goldfarb","startTime":1312.3,"endTime":1312.75,"body":"difficult."},{"speaker":"Chris Dy","startTime":1313.38,"endTime":1315.63,"body":"Well, now, now you're,"},{"speaker":"Chris Dy","startTime":1313.38,"endTime":1315.63,"body":"you know, a leader in our"},{"speaker":"Chris Dy","startTime":1315.63,"endTime":1319.74,"body":"department. And you were chief"},{"speaker":"Chris Dy","startTime":1315.63,"endTime":1319.74,"body":"co chief of the hand service for"},{"speaker":"Chris Dy","startTime":1319.74,"endTime":1323.82,"body":"quite some time. So you've seen"},{"speaker":"Chris Dy","startTime":1319.74,"endTime":1323.82,"body":"Junior surgeons come in the hand"},{"speaker":"Chris Dy","startTime":1323.82,"endTime":1327.0,"body":"service, peds service, and just"},{"speaker":"Chris Dy","startTime":1323.82,"endTime":1327.0,"body":"our department in general, have"},{"speaker":"Chris Dy","startTime":1327.0,"endTime":1330.33,"body":"you noticed any shifts over"},{"speaker":"Chris Dy","startTime":1327.0,"endTime":1330.33,"body":"time, as you know, in terms of"},{"speaker":"Chris Dy","startTime":1330.33,"endTime":1333.36,"body":"how starting surgeons approach"},{"speaker":"Chris Dy","startTime":1330.33,"endTime":1333.36,"body":"their practice?"},{"speaker":"Charles Goldfarb","startTime":1334.83,"endTime":1336.75,"body":"I don't know"},{"speaker":"Charles Goldfarb","startTime":1334.83,"endTime":1336.75,"body":"that I've noticed shifts over"},{"speaker":"Charles Goldfarb","startTime":1336.75,"endTime":1340.44,"body":"time. But it's clear, like your"},{"speaker":"Charles Goldfarb","startTime":1336.75,"endTime":1340.44,"body":"practice is a great example. And"},{"speaker":"Charles Goldfarb","startTime":1340.44,"endTime":1346.83,"body":"you have a very focused"},{"speaker":"Charles Goldfarb","startTime":1340.44,"endTime":1346.83,"body":"interest. And that is nerve any"},{"speaker":"Charles Goldfarb","startTime":1346.83,"endTime":1351.09,"body":"shape, any size, any location."},{"speaker":"Charles Goldfarb","startTime":1346.83,"endTime":1351.09,"body":"And you you're wise enough to"},{"speaker":"Charles Goldfarb","startTime":1351.09,"endTime":1353.46,"body":"realize that's going to take"},{"speaker":"Charles Goldfarb","startTime":1351.09,"endTime":1353.46,"body":"time to build, there's a lot of"},{"speaker":"Charles Goldfarb","startTime":1353.46,"endTime":1360.57,"body":"dynamics around that. But yet"},{"speaker":"Charles Goldfarb","startTime":1353.46,"endTime":1360.57,"body":"you built a thriving practice in"},{"speaker":"Charles Goldfarb","startTime":1360.57,"endTime":1363.27,"body":"hand surgery. And I don't know"},{"speaker":"Charles Goldfarb","startTime":1360.57,"endTime":1363.27,"body":"what your goals are, I'd be"},{"speaker":"Charles Goldfarb","startTime":1363.27,"endTime":1366.87,"body":"interested to hear is one day"},{"speaker":"Charles Goldfarb","startTime":1363.27,"endTime":1366.87,"body":"your practice 90% or 100% nerve,"},{"speaker":"Charles Goldfarb","startTime":1366.87,"endTime":1369.45,"body":"or is that never a goal. But you"},{"speaker":"Charles Goldfarb","startTime":1366.87,"endTime":1369.45,"body":"know, there are different things"},{"speaker":"Charles Goldfarb","startTime":1369.45,"endTime":1372.3,"body":"that I think have have grabbed"},{"speaker":"Charles Goldfarb","startTime":1369.45,"endTime":1372.3,"body":"you as well. And certainly the"},{"speaker":"Charles Goldfarb","startTime":1372.3,"endTime":1374.73,"body":"WALANT type surgery seems to be"},{"speaker":"Charles Goldfarb","startTime":1372.3,"endTime":1374.73,"body":"an area now whether that's"},{"speaker":"Charles Goldfarb","startTime":1374.73,"endTime":1377.34,"body":"purely the local market forces"},{"speaker":"Charles Goldfarb","startTime":1374.73,"endTime":1377.34,"body":"that is driving your interest in"},{"speaker":"Charles Goldfarb","startTime":1377.37,"endTime":1379.89,"body":"WALANT, or whether you really"},{"speaker":"Charles Goldfarb","startTime":1377.37,"endTime":1379.89,"body":"like that and will continue to"},{"speaker":"Charles Goldfarb","startTime":1379.89,"endTime":1381.99,"body":"make that a part of your"},{"speaker":"Charles Goldfarb","startTime":1379.89,"endTime":1381.99,"body":"practice. I think you're a good"},{"speaker":"Charles Goldfarb","startTime":1381.99,"endTime":1387.24,"body":"example of someone who has an"},{"speaker":"Charles Goldfarb","startTime":1381.99,"endTime":1387.24,"body":"interest and is either taking"},{"speaker":"Charles Goldfarb","startTime":1387.24,"endTime":1391.17,"body":"the time to get to a, you know,"},{"speaker":"Charles Goldfarb","startTime":1387.24,"endTime":1391.17,"body":"a dominant nerve practice, or"},{"speaker":"Charles Goldfarb","startTime":1391.17,"endTime":1394.98,"body":"maybe decides that not only will"},{"speaker":"Charles Goldfarb","startTime":1391.17,"endTime":1394.98,"body":"you practice nerve, how do you"},{"speaker":"Charles Goldfarb","startTime":1394.98,"endTime":1397.14,"body":"think about it for yourself? And"},{"speaker":"Charles Goldfarb","startTime":1394.98,"endTime":1397.14,"body":"then we can talk about others?"},{"speaker":"Chris Dy","startTime":1397.54,"endTime":1400.81,"body":"Yeah, I mean, I think"},{"speaker":"Chris Dy","startTime":1397.54,"endTime":1400.81,"body":"that I actually was having this"},{"speaker":"Chris Dy","startTime":1400.81,"endTime":1404.77,"body":"discussion with one of our"},{"speaker":"Chris Dy","startTime":1400.81,"endTime":1404.77,"body":"fellows Shobhit this week, and I"},{"speaker":"Chris Dy","startTime":1404.77,"endTime":1407.32,"body":"don't know if I want to have an"},{"speaker":"Chris Dy","startTime":1404.77,"endTime":1407.32,"body":"only nerve  practice, because I"},{"speaker":"Chris Dy","startTime":1407.32,"endTime":1410.47,"body":"do like hand surgery a lot. You"},{"speaker":"Chris Dy","startTime":1407.32,"endTime":1410.47,"body":"know, there are some things that"},{"speaker":"Chris Dy","startTime":1410.47,"endTime":1413.62,"body":"I like more than others. You"},{"speaker":"Chris Dy","startTime":1410.47,"endTime":1413.62,"body":"know, I don't know if I want to"},{"speaker":"Chris Dy","startTime":1413.62,"endTime":1416.95,"body":"limit sort of myself based on"},{"speaker":"Chris Dy","startTime":1413.62,"endTime":1416.95,"body":"conditions. But you know, it's"},{"speaker":"Chris Dy","startTime":1416.95,"endTime":1419.71,"body":"more fun when you have trainees"},{"speaker":"Chris Dy","startTime":1416.95,"endTime":1419.71,"body":"and they bring new ideas. And"},{"speaker":"Chris Dy","startTime":1419.71,"endTime":1422.95,"body":"you know, I love fixing"},{"speaker":"Chris Dy","startTime":1419.71,"endTime":1422.95,"body":"fractures, I love, you know,"},{"speaker":"Chris Dy","startTime":1423.73,"endTime":1427.21,"body":"running the gamut of the hand"},{"speaker":"Chris Dy","startTime":1423.73,"endTime":1427.21,"body":"surgery stuff. And I think I'm"},{"speaker":"Chris Dy","startTime":1427.21,"endTime":1430.54,"body":"still in the skill accumulation"},{"speaker":"Chris Dy","startTime":1427.21,"endTime":1430.54,"body":"phase of my career, as you"},{"speaker":"Chris Dy","startTime":1430.54,"endTime":1434.53,"body":"mentioned earlier, so the more"},{"speaker":"Chris Dy","startTime":1430.54,"endTime":1434.53,"body":"skills I pick up the better. Who"},{"speaker":"Chris Dy","startTime":1434.53,"endTime":1437.14,"body":"knows when a dissection"},{"speaker":"Chris Dy","startTime":1434.53,"endTime":1437.14,"body":"technique that I use in a thumb,"},{"speaker":"Chris Dy","startTime":1437.14,"endTime":1440.05,"body":"CMC, arthroplasty may be useful"},{"speaker":"Chris Dy","startTime":1437.14,"endTime":1440.05,"body":"when I'm, you know, exploring a"},{"speaker":"Chris Dy","startTime":1440.05,"endTime":1447.04,"body":"nerve, it's, it's, I think, for"},{"speaker":"Chris Dy","startTime":1440.05,"endTime":1447.04,"body":"me, I recognize that I'm still"},{"speaker":"Chris Dy","startTime":1447.04,"endTime":1450.31,"body":"getting better at what I do, and"},{"speaker":"Chris Dy","startTime":1447.04,"endTime":1450.31,"body":"why not expose myself to as much"},{"speaker":"Chris Dy","startTime":1450.31,"endTime":1452.92,"body":"as I can, and maybe down the"},{"speaker":"Chris Dy","startTime":1450.31,"endTime":1452.92,"body":"line, you know, I'll try to"},{"speaker":"Chris Dy","startTime":1452.92,"endTime":1455.17,"body":"narrow myself to only nerve I"},{"speaker":"Chris Dy","startTime":1452.92,"endTime":1455.17,"body":"was thinking about that after we"},{"speaker":"Chris Dy","startTime":1455.17,"endTime":1458.02,"body":"interviewed Amy. And you know, I"},{"speaker":"Chris Dy","startTime":1455.17,"endTime":1458.02,"body":"think when she started her"},{"speaker":"Chris Dy","startTime":1458.02,"endTime":1462.58,"body":"practice in Columbus after"},{"speaker":"Chris Dy","startTime":1458.02,"endTime":1462.58,"body":"moving from from washu, she only"},{"speaker":"Chris Dy","startTime":1462.58,"endTime":1466.24,"body":"wanted nerve. So I think that"},{"speaker":"Chris Dy","startTime":1462.58,"endTime":1466.24,"body":"there are definitely ups and"},{"speaker":"Chris Dy","startTime":1466.24,"endTime":1469.45,"body":"downs to it. And I'm honestly"},{"speaker":"Chris Dy","startTime":1466.24,"endTime":1469.45,"body":"not sure yet. But I do like what"},{"speaker":"Chris Dy","startTime":1469.45,"endTime":1472.9,"body":"I do right now, obviously I love"},{"speaker":"Chris Dy","startTime":1469.45,"endTime":1472.9,"body":"the practice I have because it's"},{"speaker":"Chris Dy","startTime":1472.9,"endTime":1475.48,"body":"busy in the hand surgery"},{"speaker":"Chris Dy","startTime":1472.9,"endTime":1475.48,"body":"perspective, and it's busy and"},{"speaker":"Chris Dy","startTime":1475.48,"endTime":1477.55,"body":"growing in from a nerve"},{"speaker":"Chris Dy","startTime":1475.48,"endTime":1477.55,"body":"perspective."},{"speaker":"Charles Goldfarb","startTime":1478.39,"endTime":1480.49,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":1478.39,"endTime":1480.49,"body":"that's well said. And this is in"},{"speaker":"Charles Goldfarb","startTime":1480.67,"endTime":1484.87,"body":"contradistinction to one of our"},{"speaker":"Charles Goldfarb","startTime":1480.67,"endTime":1484.87,"body":"partners, Ryan Calfee, who has"},{"speaker":"Charles Goldfarb","startTime":1484.9,"endTime":1487.99,"body":"kept a broad practice and"},{"speaker":"Charles Goldfarb","startTime":1484.9,"endTime":1487.99,"body":"really, you know, he has always"},{"speaker":"Charles Goldfarb","startTime":1487.99,"endTime":1491.92,"body":"enjoyed trauma from the elbow"},{"speaker":"Charles Goldfarb","startTime":1487.99,"endTime":1491.92,"body":"distally but he has a very broad"},{"speaker":"Charles Goldfarb","startTime":1491.98,"endTime":1494.53,"body":"practice, one could say it's a"},{"speaker":"Charles Goldfarb","startTime":1491.98,"endTime":1494.53,"body":"bread and butter hand practice."},{"speaker":"Charles Goldfarb","startTime":1494.53,"endTime":1496.99,"body":"He's extraordinarily busy"},{"speaker":"Charles Goldfarb","startTime":1494.53,"endTime":1496.99,"body":"because he's good and he's"},{"speaker":"Charles Goldfarb","startTime":1497.26,"endTime":1500.89,"body":"affable. But it's just a"},{"speaker":"Charles Goldfarb","startTime":1497.26,"endTime":1500.89,"body":"different approach and I don't"},{"speaker":"Charles Goldfarb","startTime":1500.89,"endTime":1504.13,"body":"think Ryan has any interest in"},{"speaker":"Charles Goldfarb","startTime":1500.89,"endTime":1504.13,"body":"ever tapering his practice."},{"speaker":"Chris Dy","startTime":1504.75,"endTime":1506.49,"body":"Yeah, and I mean, I"},{"speaker":"Chris Dy","startTime":1504.75,"endTime":1506.49,"body":"actually was reading a, I'm"},{"speaker":"Chris Dy","startTime":1506.49,"endTime":1509.25,"body":"still reading a book, my wife is"},{"speaker":"Chris Dy","startTime":1506.49,"endTime":1509.25,"body":"reminding me that it's taking me"},{"speaker":"Chris Dy","startTime":1509.25,"endTime":1512.82,"body":"months to get through this book."},{"speaker":"Chris Dy","startTime":1509.25,"endTime":1512.82,"body":"It's a book called range. And"},{"speaker":"Chris Dy","startTime":1512.82,"endTime":1515.79,"body":"it's you know, why generalists"},{"speaker":"Chris Dy","startTime":1512.82,"endTime":1515.79,"body":"thrive in a specialist world."},{"speaker":"Chris Dy","startTime":1516.39,"endTime":1519.24,"body":"And, you know, I honestly think"},{"speaker":"Chris Dy","startTime":1516.39,"endTime":1519.24,"body":"there's a lot of value in, you"},{"speaker":"Chris Dy","startTime":1519.24,"endTime":1523.56,"body":"know, in what you can learn by"},{"speaker":"Chris Dy","startTime":1519.24,"endTime":1523.56,"body":"doing cases of different sorts."},{"speaker":"Chris Dy","startTime":1524.04,"endTime":1527.31,"body":"And honestly, I, you know, doing"},{"speaker":"Chris Dy","startTime":1524.04,"endTime":1527.31,"body":"trauma call has been very good"},{"speaker":"Chris Dy","startTime":1527.31,"endTime":1531.27,"body":"for me, because it's allowed me"},{"speaker":"Chris Dy","startTime":1527.31,"endTime":1531.27,"body":"to, you know, keep some skills"},{"speaker":"Chris Dy","startTime":1531.27,"endTime":1534.84,"body":"up that I learned in residency."},{"speaker":"Chris Dy","startTime":1531.27,"endTime":1534.84,"body":"And there are many times where I"},{"speaker":"Chris Dy","startTime":1534.84,"endTime":1537.45,"body":"wish I had paid more attention"},{"speaker":"Chris Dy","startTime":1534.84,"endTime":1537.45,"body":"to some rotations in my"},{"speaker":"Chris Dy","startTime":1537.45,"endTime":1539.64,"body":"residency, so that I could have"},{"speaker":"Chris Dy","startTime":1537.45,"endTime":1539.64,"body":"picked up skills that would have"},{"speaker":"Chris Dy","startTime":1539.64,"endTime":1542.85,"body":"been useful now, like, for"},{"speaker":"Chris Dy","startTime":1539.64,"endTime":1542.85,"body":"example, like, I explore the"},{"speaker":"Chris Dy","startTime":1542.85,"endTime":1546.57,"body":"brachial plexus with some"},{"speaker":"Chris Dy","startTime":1542.85,"endTime":1546.57,"body":"frequency, and, you know, a year"},{"speaker":"Chris Dy","startTime":1546.57,"endTime":1550.23,"body":"for an acdf, you're literally"},{"speaker":"Chris Dy","startTime":1546.57,"endTime":1550.23,"body":"inches away. And I wish I had"},{"speaker":"Chris Dy","startTime":1550.23,"endTime":1553.02,"body":"paid more attention during those"},{"speaker":"Chris Dy","startTime":1550.23,"endTime":1553.02,"body":"acdf approaches, because maybe I"},{"speaker":"Chris Dy","startTime":1553.02,"endTime":1555.9,"body":"would have picked up a few more"},{"speaker":"Chris Dy","startTime":1553.02,"endTime":1555.9,"body":"tricks in terms of exposing"},{"speaker":"Chris Dy","startTime":1555.9,"endTime":1558.99,"body":"nerve roots, I feel good about"},{"speaker":"Chris Dy","startTime":1555.9,"endTime":1558.99,"body":"what I do now. But you know,"},{"speaker":"Chris Dy","startTime":1558.99,"endTime":1561.42,"body":"there, there are things where I"},{"speaker":"Chris Dy","startTime":1558.99,"endTime":1561.42,"body":"wish I had paid a little more"},{"speaker":"Chris Dy","startTime":1561.42,"endTime":1564.33,"body":"attention as a resident to"},{"speaker":"Chris Dy","startTime":1561.42,"endTime":1564.33,"body":"because I think it's, it's"},{"speaker":"Chris Dy","startTime":1564.33,"endTime":1566.19,"body":"really important to have a broad"},{"speaker":"Chris Dy","startTime":1564.33,"endTime":1566.19,"body":"range of skills."},{"speaker":"Charles Goldfarb","startTime":1567.08,"endTime":1568.76,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":1567.08,"endTime":1568.76,"body":"well said. And I think one of"},{"speaker":"Charles Goldfarb","startTime":1568.76,"endTime":1572.96,"body":"the one of the, you know, given"},{"speaker":"Charles Goldfarb","startTime":1568.76,"endTime":1572.96,"body":"my advanced age, as you so"},{"speaker":"Charles Goldfarb","startTime":1572.99,"endTime":1577.88,"body":"commonly and delightfully note"},{"speaker":"Charles Goldfarb","startTime":1572.99,"endTime":1577.88,"body":"is, you know, staying on"},{"speaker":"Chris Dy","startTime":1577.96,"endTime":1580.48,"body":"Donald Trump is not"},{"speaker":"Chris Dy","startTime":1577.96,"endTime":1580.48,"body":"president anymore, you, you're"},{"speaker":"Chris Dy","startTime":1580.48,"endTime":1581.98,"body":"still you're oriented times"},{"speaker":"Chris Dy","startTime":1580.48,"endTime":1581.98,"body":"four."},{"speaker":"Charles Goldfarb","startTime":1583.12,"endTime":1585.37,"body":"The you know,"},{"speaker":"Charles Goldfarb","startTime":1583.12,"endTime":1585.37,"body":"it is about, you know, staying"},{"speaker":"Charles Goldfarb","startTime":1585.37,"endTime":1588.94,"body":"young is about doing different"},{"speaker":"Charles Goldfarb","startTime":1585.37,"endTime":1588.94,"body":"things. And I think that's part"},{"speaker":"Charles Goldfarb","startTime":1588.94,"endTime":1591.94,"body":"of my life. And we talked about"},{"speaker":"Charles Goldfarb","startTime":1588.94,"endTime":1591.94,"body":"learning Spanish and the like."},{"speaker":"Charles Goldfarb","startTime":1592.75,"endTime":1597.64,"body":"But moving over and doing more"},{"speaker":"Charles Goldfarb","startTime":1592.75,"endTime":1597.64,"body":"true pediatric orthopedic"},{"speaker":"Charles Goldfarb","startTime":1597.64,"endTime":1600.64,"body":"surgery five years ago has been"},{"speaker":"Charles Goldfarb","startTime":1597.64,"endTime":1600.64,"body":"great, you know, it's"},{"speaker":"Charles Goldfarb","startTime":1600.64,"endTime":1604.09,"body":"reinvigorated my interest in"},{"speaker":"Charles Goldfarb","startTime":1600.64,"endTime":1604.09,"body":"that field. And I think doing"},{"speaker":"Charles Goldfarb","startTime":1604.09,"endTime":1606.37,"body":"new things is good. And so"},{"speaker":"Charles Goldfarb","startTime":1604.09,"endTime":1606.37,"body":"that's another danger, you taper"},{"speaker":"Charles Goldfarb","startTime":1606.37,"endTime":1609.1,"body":"your practice too much. And it"},{"speaker":"Charles Goldfarb","startTime":1606.37,"endTime":1609.1,"body":"becomes routine, it becomes"},{"speaker":"Charles Goldfarb","startTime":1609.1,"endTime":1612.82,"body":"mundane, no matter how"},{"speaker":"Charles Goldfarb","startTime":1609.1,"endTime":1612.82,"body":"specialized. And, you know, that"},{"speaker":"Charles Goldfarb","startTime":1612.82,"endTime":1615.1,"body":"kind of stuff, just over time, I"},{"speaker":"Charles Goldfarb","startTime":1612.82,"endTime":1615.1,"body":"think it's old."},{"speaker":"Chris Dy","startTime":1615.6,"endTime":1617.79,"body":"Well, and I think, a"},{"speaker":"Chris Dy","startTime":1615.6,"endTime":1617.79,"body":"good example of, you know,"},{"speaker":"Chris Dy","startTime":1617.79,"endTime":1620.19,"body":"seeing how mixing things up in"},{"speaker":"Chris Dy","startTime":1617.79,"endTime":1620.19,"body":"your practice can be helpful. It"},{"speaker":"Chris Dy","startTime":1620.19,"endTime":1622.92,"body":"was one of our partners, Marty"},{"speaker":"Chris Dy","startTime":1620.19,"endTime":1622.92,"body":"Boyer, starting to do flaps, you"},{"speaker":"Chris Dy","startTime":1622.92,"endTime":1626.31,"body":"know, I think as recently as"},{"speaker":"Chris Dy","startTime":1622.92,"endTime":1626.31,"body":"five years ago, and seeing not"},{"speaker":"Chris Dy","startTime":1626.31,"endTime":1629.55,"body":"only a clinical need, but then"},{"speaker":"Chris Dy","startTime":1626.31,"endTime":1629.55,"body":"also, you know, recognizing that"},{"speaker":"Chris Dy","startTime":1629.55,"endTime":1632.64,"body":"this was a way for him to stay"},{"speaker":"Chris Dy","startTime":1629.55,"endTime":1632.64,"body":"fresh, and to learn new skills"},{"speaker":"Chris Dy","startTime":1632.64,"endTime":1637.14,"body":"and to apply recent skills. So I"},{"speaker":"Chris Dy","startTime":1632.64,"endTime":1637.14,"body":"think that's a good example. I"},{"speaker":"Chris Dy","startTime":1637.14,"endTime":1639.9,"body":"had one question I wanted to ask"},{"speaker":"Chris Dy","startTime":1637.14,"endTime":1639.9,"body":"you. Because I think there are"},{"speaker":"Chris Dy","startTime":1639.9,"endTime":1642.48,"body":"probably a lot of people in the"},{"speaker":"Chris Dy","startTime":1639.9,"endTime":1642.48,"body":"who are listening who are"},{"speaker":"Chris Dy","startTime":1642.48,"endTime":1645.42,"body":"thinking about private practice"},{"speaker":"Chris Dy","startTime":1642.48,"endTime":1645.42,"body":"jobs, did you ever look at"},{"speaker":"Chris Dy","startTime":1645.42,"endTime":1649.35,"body":"private practice as an option"},{"speaker":"Chris Dy","startTime":1645.42,"endTime":1649.35,"body":"for yourself? Or even, perhaps"},{"speaker":"Chris Dy","startTime":1649.35,"endTime":1652.05,"body":"they weren't around as much, you"},{"speaker":"Chris Dy","startTime":1649.35,"endTime":1652.05,"body":"know, way back in the day, but"},{"speaker":"Chris Dy","startTime":1652.08,"endTime":1654.36,"body":"you know, hospital employed jobs"},{"speaker":"Chris Dy","startTime":1652.08,"endTime":1654.36,"body":"other than the university"},{"speaker":"Chris Dy","startTime":1654.36,"endTime":1654.63,"body":"setting?"},{"speaker":"Charles Goldfarb","startTime":1655.56,"endTime":1657.69,"body":"Yeah, I think,"},{"speaker":"Charles Goldfarb","startTime":1655.56,"endTime":1657.69,"body":"you know, private private"},{"speaker":"Charles Goldfarb","startTime":1657.69,"endTime":1662.04,"body":"practices today run the gamut as"},{"speaker":"Charles Goldfarb","startTime":1657.69,"endTime":1662.04,"body":"far as the size of the practice."},{"speaker":"Charles Goldfarb","startTime":1662.04,"endTime":1666.9,"body":"But the supergroup practices"},{"speaker":"Charles Goldfarb","startTime":1662.04,"endTime":1666.9,"body":"have certainly become much more"},{"speaker":"Charles Goldfarb","startTime":1666.93,"endTime":1670.23,"body":"commonplace than they were 20"},{"speaker":"Charles Goldfarb","startTime":1666.93,"endTime":1670.23,"body":"years ago. And that's for a"},{"speaker":"Charles Goldfarb","startTime":1670.23,"endTime":1672.63,"body":"number of reasons. And we can"},{"speaker":"Charles Goldfarb","startTime":1670.23,"endTime":1672.63,"body":"talk about that. That's a super"},{"speaker":"Charles Goldfarb","startTime":1672.63,"endTime":1675.84,"body":"interesting topic to me as well,"},{"speaker":"Charles Goldfarb","startTime":1672.63,"endTime":1675.84,"body":"based on payers and, and"},{"speaker":"Charles Goldfarb","startTime":1676.05,"endTime":1679.56,"body":"negotiations and the like, I"},{"speaker":"Charles Goldfarb","startTime":1676.05,"endTime":1679.56,"body":"never did think about private"},{"speaker":"Charles Goldfarb","startTime":1679.56,"endTime":1682.89,"body":"practice. I certainly in in"},{"speaker":"Charles Goldfarb","startTime":1679.56,"endTime":1682.89,"body":"private practice, unless you are"},{"speaker":"Charles Goldfarb","startTime":1682.89,"endTime":1686.13,"body":"in a very large group. I think"},{"speaker":"Charles Goldfarb","startTime":1682.89,"endTime":1686.13,"body":"by definition, you have to be"},{"speaker":"Charles Goldfarb","startTime":1686.13,"endTime":1689.58,"body":"broader based in how you"},{"speaker":"Charles Goldfarb","startTime":1686.13,"endTime":1689.58,"body":"approach things. There are"},{"speaker":"Charles Goldfarb","startTime":1689.58,"endTime":1692.67,"body":"certainly exceptions to that."},{"speaker":"Charles Goldfarb","startTime":1689.58,"endTime":1692.67,"body":"But I think in general, that is"},{"speaker":"Charles Goldfarb","startTime":1692.67,"endTime":1696.36,"body":"the rule. And again, no problem"},{"speaker":"Charles Goldfarb","startTime":1692.67,"endTime":1696.36,"body":"with that. It's just a different"},{"speaker":"Charles Goldfarb","startTime":1696.36,"endTime":1697.26,"body":"way of thinking about it."},{"speaker":"Chris Dy","startTime":1697.87,"endTime":1701.08,"body":"Yeah, I think that I"},{"speaker":"Chris Dy","startTime":1697.87,"endTime":1701.08,"body":"think this is one area where"},{"speaker":"Chris Dy","startTime":1701.11,"endTime":1703.03,"body":"we'll probably need to bring"},{"speaker":"Chris Dy","startTime":1701.11,"endTime":1703.03,"body":"somebody on to talk about"},{"speaker":"Chris Dy","startTime":1703.03,"endTime":1707.53,"body":"private practice. Because, you"},{"speaker":"Chris Dy","startTime":1703.03,"endTime":1707.53,"body":"know, I came in knowing that I"},{"speaker":"Chris Dy","startTime":1707.53,"endTime":1710.29,"body":"wanted to do academics, I think"},{"speaker":"Chris Dy","startTime":1707.53,"endTime":1710.29,"body":"largely because my dad was in"},{"speaker":"Chris Dy","startTime":1710.29,"endTime":1712.96,"body":"private practice, as a general"},{"speaker":"Chris Dy","startTime":1710.29,"endTime":1712.96,"body":"surgeon, and I saw the toll that"},{"speaker":"Chris Dy","startTime":1712.96,"endTime":1715.84,"body":"took I saw how hard that was."},{"speaker":"Chris Dy","startTime":1712.96,"endTime":1715.84,"body":"And he, you know, admittedly, he"},{"speaker":"Chris Dy","startTime":1715.84,"endTime":1719.26,"body":"was in solo practice, which made"},{"speaker":"Chris Dy","startTime":1715.84,"endTime":1719.26,"body":"it very challenging, you know,"},{"speaker":"Chris Dy","startTime":1719.26,"endTime":1722.17,"body":"taking all of your own calls,"},{"speaker":"Chris Dy","startTime":1719.26,"endTime":1722.17,"body":"you know, sometimes having to"},{"speaker":"Chris Dy","startTime":1722.17,"endTime":1726.16,"body":"find somebody to, you know, to"},{"speaker":"Chris Dy","startTime":1722.17,"endTime":1726.16,"body":"cover yourself, because to cover"},{"speaker":"Chris Dy","startTime":1726.16,"endTime":1728.92,"body":"your patients, if you wanted to"},{"speaker":"Chris Dy","startTime":1726.16,"endTime":1728.92,"body":"go out of town, vacation, etc,"},{"speaker":"Chris Dy","startTime":1729.16,"endTime":1731.89,"body":"all the financial burden, you"},{"speaker":"Chris Dy","startTime":1729.16,"endTime":1731.89,"body":"know, seeing when referring"},{"speaker":"Chris Dy","startTime":1731.89,"endTime":1735.91,"body":"physicians would retire and not,"},{"speaker":"Chris Dy","startTime":1731.89,"endTime":1735.91,"body":"you know, renewing that crop of"},{"speaker":"Chris Dy","startTime":1735.91,"endTime":1740.83,"body":"referrals, that that looked"},{"speaker":"Chris Dy","startTime":1735.91,"endTime":1740.83,"body":"hard. It was more than I wanted"},{"speaker":"Chris Dy","startTime":1740.83,"endTime":1743.56,"body":"to deal with. And then also, you"},{"speaker":"Chris Dy","startTime":1740.83,"endTime":1743.56,"body":"know, I had academic"},{"speaker":"Chris Dy","startTime":1743.56,"endTime":1746.17,"body":"inclinations in terms of"},{"speaker":"Chris Dy","startTime":1743.56,"endTime":1746.17,"body":"research, so I kind of went in"},{"speaker":"Chris Dy","startTime":1746.17,"endTime":1746.83,"body":"this direction."},{"speaker":"Charles Goldfarb","startTime":1748.22,"endTime":1750.02,"body":"Yeah, you"},{"speaker":"Charles Goldfarb","startTime":1748.22,"endTime":1750.02,"body":"know, it's been, it's been fun"},{"speaker":"Charles Goldfarb","startTime":1750.02,"endTime":1754.43,"body":"to watch. One of the many zoom"},{"speaker":"Charles Goldfarb","startTime":1750.02,"endTime":1754.43,"body":"benefits for conference during"},{"speaker":"Charles Goldfarb","startTime":1754.43,"endTime":1758.27,"body":"the pandemic has been that we"},{"speaker":"Charles Goldfarb","startTime":1754.43,"endTime":1758.27,"body":"have included some private"},{"speaker":"Charles Goldfarb","startTime":1758.27,"endTime":1760.7,"body":"practice hand surgeons, and"},{"speaker":"Charles Goldfarb","startTime":1758.27,"endTime":1760.7,"body":"honestly, we'd welcome that to"},{"speaker":"Charles Goldfarb","startTime":1760.7,"endTime":1763.64,"body":"anyone in our conferences on"},{"speaker":"Charles Goldfarb","startTime":1760.7,"endTime":1763.64,"body":"Monday mornings early and"},{"speaker":"Charles Goldfarb","startTime":1763.64,"endTime":1765.92,"body":"several of our previous"},{"speaker":"Charles Goldfarb","startTime":1763.64,"endTime":1765.92,"body":"residents and fellows join us."},{"speaker":"Charles Goldfarb","startTime":1766.13,"endTime":1769.25,"body":"And that's a win, I think they"},{"speaker":"Charles Goldfarb","startTime":1766.13,"endTime":1769.25,"body":"enjoy it, we enjoy having a"},{"speaker":"Charles Goldfarb","startTime":1769.25,"endTime":1772.97,"body":"different perspective. So just"},{"speaker":"Charles Goldfarb","startTime":1769.25,"endTime":1772.97,"body":"because one is in private"},{"speaker":"Charles Goldfarb","startTime":1772.97,"endTime":1777.83,"body":"practice doesn't need make it a"},{"speaker":"Charles Goldfarb","startTime":1772.97,"endTime":1777.83,"body":"necessity that that person feel"},{"speaker":"Charles Goldfarb","startTime":1777.83,"endTime":1783.47,"body":"isolated and, and not in the"},{"speaker":"Charles Goldfarb","startTime":1777.83,"endTime":1783.47,"body":"spirit of what we do. Obviously,"},{"speaker":"Charles Goldfarb","startTime":1783.47,"endTime":1787.58,"body":"we're not saying that. So, when"},{"speaker":"Charles Goldfarb","startTime":1783.47,"endTime":1787.58,"body":"we think about practice,"},{"speaker":"Charles Goldfarb","startTime":1787.58,"endTime":1792.56,"body":"development, marketing becomes,"},{"speaker":"Charles Goldfarb","startTime":1787.58,"endTime":1792.56,"body":"you know, is is by necessity, a"},{"speaker":"Charles Goldfarb","startTime":1792.56,"endTime":1798.59,"body":"part of that discussion, when"},{"speaker":"Charles Goldfarb","startTime":1792.56,"endTime":1798.59,"body":"you join a big practice, like"},{"speaker":"Charles Goldfarb","startTime":1798.59,"endTime":1803.51,"body":"Washington University"},{"speaker":"Charles Goldfarb","startTime":1798.59,"endTime":1803.51,"body":"orthopedics. Or a major private"},{"speaker":"Charles Goldfarb","startTime":1803.51,"endTime":1807.8,"body":"practice, a large private"},{"speaker":"Charles Goldfarb","startTime":1803.51,"endTime":1807.8,"body":"practice, you have some some"},{"speaker":"Charles Goldfarb","startTime":1808.16,"endTime":1813.08,"body":"benefits built in. That is the"},{"speaker":"Charles Goldfarb","startTime":1808.16,"endTime":1813.08,"body":"practice is a referral source."},{"speaker":"Charles Goldfarb","startTime":1813.23,"endTime":1815.24,"body":"And people get sent to"},{"speaker":"Charles Goldfarb","startTime":1813.23,"endTime":1815.24,"body":"Washington University"},{"speaker":"Charles Goldfarb","startTime":1815.24,"endTime":1818.21,"body":"orthopedics or Washington"},{"speaker":"Charles Goldfarb","startTime":1815.24,"endTime":1818.21,"body":"University hand surgery, and"},{"speaker":"Charles Goldfarb","startTime":1818.21,"endTime":1822.41,"body":"then they may come to you or I,"},{"speaker":"Charles Goldfarb","startTime":1818.21,"endTime":1822.41,"body":"and that that is unbelievably"},{"speaker":"Charles Goldfarb","startTime":1822.41,"endTime":1822.8,"body":"important."},{"speaker":"Chris Dy","startTime":1824.9,"endTime":1827.06,"body":"Yeah, I think that is"},{"speaker":"Chris Dy","startTime":1824.9,"endTime":1827.06,"body":"super important. But you know, I"},{"speaker":"Chris Dy","startTime":1827.06,"endTime":1830.57,"body":"think that, you know, when you"},{"speaker":"Chris Dy","startTime":1827.06,"endTime":1830.57,"body":"come in as a new attending, you"},{"speaker":"Chris Dy","startTime":1830.57,"endTime":1833.06,"body":"know, in our practice, and I can"},{"speaker":"Chris Dy","startTime":1830.57,"endTime":1833.06,"body":"only say, based on our practice,"},{"speaker":"Chris Dy","startTime":1833.06,"endTime":1835.88,"body":"you, you want to be busy, and"},{"speaker":"Chris Dy","startTime":1833.06,"endTime":1835.88,"body":"you want to feel like you're"},{"speaker":"Chris Dy","startTime":1836.12,"endTime":1839.21,"body":"doing something other than"},{"speaker":"Chris Dy","startTime":1836.12,"endTime":1839.21,"body":"relying on the machine. And I"},{"speaker":"Chris Dy","startTime":1839.21,"endTime":1843.2,"body":"remember, you know, when I"},{"speaker":"Chris Dy","startTime":1839.21,"endTime":1843.2,"body":"started having to, you know, not"},{"speaker":"Chris Dy","startTime":1843.2,"endTime":1845.6,"body":"having to but, you know, being"},{"speaker":"Chris Dy","startTime":1843.2,"endTime":1845.6,"body":"asked, and then saying yes, to"},{"speaker":"Chris Dy","startTime":1845.6,"endTime":1848.63,"body":"go out to, you know, to"},{"speaker":"Chris Dy","startTime":1845.6,"endTime":1848.63,"body":"different primary primary care"},{"speaker":"Chris Dy","startTime":1848.63,"endTime":1851.09,"body":"offices and, you know,"},{"speaker":"Chris Dy","startTime":1848.63,"endTime":1851.09,"body":"essentially shake hands and say,"},{"speaker":"Chris Dy","startTime":1851.09,"endTime":1853.58,"body":"Hello, and maybe give a talk at"},{"speaker":"Chris Dy","startTime":1851.09,"endTime":1853.58,"body":"lunch, you know, do you see"},{"speaker":"Chris Dy","startTime":1853.58,"endTime":1856.85,"body":"value in that now, now that"},{"speaker":"Chris Dy","startTime":1853.58,"endTime":1856.85,"body":"you're the other, you're the"},{"speaker":"Chris Dy","startTime":1856.85,"endTime":1857.9,"body":"number two in our department."},{"speaker":"Charles Goldfarb","startTime":1858.8,"endTime":1861.17,"body":"I absolutely"},{"speaker":"Charles Goldfarb","startTime":1858.8,"endTime":1861.17,"body":"think there's value there it is"},{"speaker":"Charles Goldfarb","startTime":1861.17,"endTime":1867.32,"body":"non quantifiable value. But one"},{"speaker":"Charles Goldfarb","startTime":1861.17,"endTime":1867.32,"body":"has to figure out a way to make"},{"speaker":"Charles Goldfarb","startTime":1867.32,"endTime":1871.19,"body":"connections in the community,"},{"speaker":"Charles Goldfarb","startTime":1867.32,"endTime":1871.19,"body":"especially with some different"},{"speaker":"Charles Goldfarb","startTime":1871.19,"endTime":1874.7,"body":"trends that we've all noted. So"},{"speaker":"Charles Goldfarb","startTime":1871.19,"endTime":1874.7,"body":"what there are two things that"},{"speaker":"Charles Goldfarb","startTime":1874.7,"endTime":1877.94,"body":"always strike me as interesting"},{"speaker":"Charles Goldfarb","startTime":1874.7,"endTime":1877.94,"body":"comparing our practice of"},{"speaker":"Charles Goldfarb","startTime":1877.94,"endTime":1881.09,"body":"medicine today versus 20-30"},{"speaker":"Charles Goldfarb","startTime":1877.94,"endTime":1881.09,"body":"years ago. The first is the"},{"speaker":"Charles Goldfarb","startTime":1881.09,"endTime":1883.13,"body":"doctor's lounge. I don't"},{"speaker":"Charles Goldfarb","startTime":1881.09,"endTime":1883.13,"body":"remember if we've talked about"},{"speaker":"Charles Goldfarb","startTime":1883.13,"endTime":1887.06,"body":"that on this podcast before, but"},{"speaker":"Charles Goldfarb","startTime":1883.13,"endTime":1887.06,"body":"the doctors lounge used to be"},{"speaker":"Charles Goldfarb","startTime":1887.06,"endTime":1890.33,"body":"vital. That's where you saw"},{"speaker":"Charles Goldfarb","startTime":1887.06,"endTime":1890.33,"body":"other doctors in every"},{"speaker":"Charles Goldfarb","startTime":1890.33,"endTime":1893.18,"body":"specialty. Maybe you ate lunch"},{"speaker":"Charles Goldfarb","startTime":1890.33,"endTime":1893.18,"body":"with them, maybe ate breakfast"},{"speaker":"Charles Goldfarb","startTime":1893.18,"endTime":1896.96,"body":"with them. And you became"},{"speaker":"Charles Goldfarb","startTime":1893.18,"endTime":1896.96,"body":"friends with them. And that"},{"speaker":"Charles Goldfarb","startTime":1896.96,"endTime":1899.9,"body":"drove referrals. Well, the"},{"speaker":"Charles Goldfarb","startTime":1896.96,"endTime":1899.9,"body":"doctor's lounge looks very"},{"speaker":"Charles Goldfarb","startTime":1899.9,"endTime":1904.13,"body":"different today. And I don't"},{"speaker":"Charles Goldfarb","startTime":1899.9,"endTime":1904.13,"body":"think that built in network is"},{"speaker":"Charles Goldfarb","startTime":1904.13,"endTime":1909.29,"body":"there. And then the second issue"},{"speaker":"Charles Goldfarb","startTime":1904.13,"endTime":1909.29,"body":"is, ER. So ER, coverage is still"},{"speaker":"Charles Goldfarb","startTime":1909.29,"endTime":1912.05,"body":"important to many in the"},{"speaker":"Charles Goldfarb","startTime":1909.29,"endTime":1912.05,"body":"community. But in previous"},{"speaker":"Charles Goldfarb","startTime":1912.05,"endTime":1915.8,"body":"generations, it was the way to"},{"speaker":"Charles Goldfarb","startTime":1912.05,"endTime":1915.8,"body":"build a practice, because that's"},{"speaker":"Charles Goldfarb","startTime":1915.8,"endTime":1919.19,"body":"where you got patients. That's"},{"speaker":"Charles Goldfarb","startTime":1915.8,"endTime":1919.19,"body":"where you showed patients, you"},{"speaker":"Charles Goldfarb","startTime":1919.19,"endTime":1924.41,"body":"were very good and, and a great"},{"speaker":"Charles Goldfarb","startTime":1919.19,"endTime":1924.41,"body":"person to be seen. And that's"},{"speaker":"Charles Goldfarb","startTime":1924.41,"endTime":1928.07,"body":"where you could depend on word"},{"speaker":"Charles Goldfarb","startTime":1924.41,"endTime":1928.07,"body":"of mouth to spread that the new"},{"speaker":"Charles Goldfarb","startTime":1928.07,"endTime":1932.12,"body":"doctor was good. And, and that's"},{"speaker":"Charles Goldfarb","startTime":1928.07,"endTime":1932.12,"body":"less prominent these days. Any"},{"speaker":"Charles Goldfarb","startTime":1932.12,"endTime":1933.83,"body":"comment on those two issues?"},{"speaker":"Chris Dy","startTime":1934.68,"endTime":1936.6,"body":"Yeah, well, you know,"},{"speaker":"Chris Dy","startTime":1934.68,"endTime":1936.6,"body":"as as we record this, I'm"},{"speaker":"Chris Dy","startTime":1936.6,"endTime":1940.62,"body":"sitting in doctors lounge with"},{"speaker":"Chris Dy","startTime":1936.6,"endTime":1940.62,"body":"Dr. Alexander Aleem your, your"},{"speaker":"Chris Dy","startTime":1940.62,"endTime":1944.25,"body":"other podcast co host. I won't"},{"speaker":"Chris Dy","startTime":1940.62,"endTime":1944.25,"body":"say you're cheating on me with"},{"speaker":"Chris Dy","startTime":1944.31,"endTime":1948.57,"body":"Alexander. But he says he has a"},{"speaker":"Chris Dy","startTime":1944.31,"endTime":1948.57,"body":"better podcast, but he probably"},{"speaker":"Chris Dy","startTime":1948.57,"endTime":1950.79,"body":"he probably puts more effort"},{"speaker":"Chris Dy","startTime":1948.57,"endTime":1950.79,"body":"into the editing process than I"},{"speaker":"Chris Dy","startTime":1950.79,"endTime":1955.5,"body":"do. No, he says you are, but"},{"speaker":"Chris Dy","startTime":1950.79,"endTime":1955.5,"body":"yeah, no, I think you're right."},{"speaker":"Chris Dy","startTime":1955.53,"endTime":1958.38,"body":"You know, the the absence of the"},{"speaker":"Chris Dy","startTime":1955.53,"endTime":1958.38,"body":"doctor's lounge, I think, you"},{"speaker":"Chris Dy","startTime":1958.38,"endTime":1960.63,"body":"know, I saw that with my dad,"},{"speaker":"Chris Dy","startTime":1958.38,"endTime":1960.63,"body":"you know, I would actually go"},{"speaker":"Chris Dy","startTime":1960.63,"endTime":1963.51,"body":"make rounds with my dad on the"},{"speaker":"Chris Dy","startTime":1960.63,"endTime":1963.51,"body":"weekend. And he would just be"},{"speaker":"Chris Dy","startTime":1963.51,"endTime":1966.24,"body":"chatting people up. And, you"},{"speaker":"Chris Dy","startTime":1963.51,"endTime":1966.24,"body":"know, he would say that guy"},{"speaker":"Chris Dy","startTime":1966.24,"endTime":1971.7,"body":"sends me patients. I get that. I"},{"speaker":"Chris Dy","startTime":1966.24,"endTime":1971.7,"body":"probably I think, you know, it's"},{"speaker":"Chris Dy","startTime":1971.7,"endTime":1974.07,"body":"it's a function of a number of"},{"speaker":"Chris Dy","startTime":1971.7,"endTime":1974.07,"body":"things. Some of it, I think, is"},{"speaker":"Chris Dy","startTime":1974.07,"endTime":1978.24,"body":"generational changes in terms of"},{"speaker":"Chris Dy","startTime":1974.07,"endTime":1978.24,"body":"how a younger generation"},{"speaker":"Chris Dy","startTime":1978.24,"endTime":1981.75,"body":"approaches social interactions."},{"speaker":"Chris Dy","startTime":1978.24,"endTime":1981.75,"body":"And perhaps, you know, some"},{"speaker":"Chris Dy","startTime":1981.75,"endTime":1984.21,"body":"could argue that the doctors"},{"speaker":"Chris Dy","startTime":1981.75,"endTime":1984.21,"body":"lounge has shifted to online"},{"speaker":"Chris Dy","startTime":1984.21,"endTime":1987.72,"body":"forums, and different different"},{"speaker":"Chris Dy","startTime":1984.21,"endTime":1987.72,"body":"ways of doing it. And then in"},{"speaker":"Chris Dy","startTime":1987.72,"endTime":1990.84,"body":"terms of ER coverage, I totally"},{"speaker":"Chris Dy","startTime":1987.72,"endTime":1990.84,"body":"get that I'm sure that a lot of"},{"speaker":"Chris Dy","startTime":1990.84,"endTime":1994.26,"body":"our listeners who are in private"},{"speaker":"Chris Dy","startTime":1990.84,"endTime":1994.26,"body":"practice, still rely on the ER,"},{"speaker":"Chris Dy","startTime":1994.29,"endTime":1998.49,"body":"and the relationships with the"},{"speaker":"Chris Dy","startTime":1994.29,"endTime":1998.49,"body":"ER doctors. You know not only"},{"speaker":"Chris Dy","startTime":1998.49,"endTime":2001.64,"body":"to, you know, for existing"},{"speaker":"Chris Dy","startTime":1998.49,"endTime":2001.64,"body":"patients, but for future"},{"speaker":"Chris Dy","startTime":2001.64,"endTime":2006.53,"body":"patients. So yeah, I mean, I, I"},{"speaker":"Chris Dy","startTime":2001.64,"endTime":2006.53,"body":"personally did not find the"},{"speaker":"Chris Dy","startTime":2006.56,"endTime":2010.31,"body":"going to different primary care"},{"speaker":"Chris Dy","startTime":2006.56,"endTime":2010.31,"body":"practices to be of tremendous"},{"speaker":"Chris Dy","startTime":2010.31,"endTime":2013.46,"body":"immediate, quantifiable benefit,"},{"speaker":"Chris Dy","startTime":2010.31,"endTime":2013.46,"body":"but maybe they it had a"},{"speaker":"Chris Dy","startTime":2013.46,"endTime":2016.7,"body":"difference that I did not"},{"speaker":"Chris Dy","startTime":2013.46,"endTime":2016.7,"body":"appreciate. But one thing I did"},{"speaker":"Chris Dy","startTime":2016.7,"endTime":2018.98,"body":"find really helpful and still"},{"speaker":"Chris Dy","startTime":2016.7,"endTime":2018.98,"body":"find really helpful and really"},{"speaker":"Chris Dy","startTime":2018.98,"endTime":2022.19,"body":"enjoy doing is actually going"},{"speaker":"Chris Dy","startTime":2018.98,"endTime":2022.19,"body":"and talking to physical therapy,"},{"speaker":"Chris Dy","startTime":2022.19,"endTime":2026.03,"body":"OT and hand therapy groups. I"},{"speaker":"Chris Dy","startTime":2022.19,"endTime":2026.03,"body":"enjoy that, especially as I've"},{"speaker":"Chris Dy","startTime":2026.03,"endTime":2028.37,"body":"developed, you know, as you"},{"speaker":"Chris Dy","startTime":2026.03,"endTime":2028.37,"body":"mentioned, the subspecialty"},{"speaker":"Chris Dy","startTime":2028.37,"endTime":2031.13,"body":"practice. Did you do that a lot?"},{"speaker":"Chris Dy","startTime":2028.37,"endTime":2031.13,"body":"Or do you still do that?"},{"speaker":"Charles Goldfarb","startTime":2032.0,"endTime":2034.31,"body":"I have done"},{"speaker":"Charles Goldfarb","startTime":2032.0,"endTime":2034.31,"body":"that many times over the years."},{"speaker":"Charles Goldfarb","startTime":2034.31,"endTime":2037.7,"body":"And I agree, if you wanted to"},{"speaker":"Charles Goldfarb","startTime":2034.31,"endTime":2037.7,"body":"quantify time invested versus"},{"speaker":"Charles Goldfarb","startTime":2037.7,"endTime":2042.29,"body":"return on that time, talking to"},{"speaker":"Charles Goldfarb","startTime":2037.7,"endTime":2042.29,"body":"therapists and trainers and"},{"speaker":"Charles Goldfarb","startTime":2043.49,"endTime":2047.93,"body":"different groups like that,"},{"speaker":"Charles Goldfarb","startTime":2043.49,"endTime":2047.93,"body":"seemingly would pay much greater"},{"speaker":"Charles Goldfarb","startTime":2047.93,"endTime":2051.11,"body":"dividends versus talking to"},{"speaker":"Charles Goldfarb","startTime":2047.93,"endTime":2051.11,"body":"physicians, and those"},{"speaker":"Charles Goldfarb","startTime":2051.11,"endTime":2056.12,"body":"relationships I would state as"},{"speaker":"Charles Goldfarb","startTime":2051.11,"endTime":2056.12,"body":"being vital. So for me, dealing"},{"speaker":"Charles Goldfarb","startTime":2056.12,"endTime":2059.78,"body":"with local universities and"},{"speaker":"Charles Goldfarb","startTime":2056.12,"endTime":2059.78,"body":"dealing with local high schools,"},{"speaker":"Charles Goldfarb","startTime":2060.41,"endTime":2064.19,"body":"having the athletic trainer"},{"speaker":"Charles Goldfarb","startTime":2060.41,"endTime":2064.19,"body":"relationship has been huge. And"},{"speaker":"Charles Goldfarb","startTime":2064.22,"endTime":2068.93,"body":"I call people after every clinic"},{"speaker":"Charles Goldfarb","startTime":2064.22,"endTime":2068.93,"body":"visit. So if if a trainer sends"},{"speaker":"Charles Goldfarb","startTime":2068.93,"endTime":2072.08,"body":"me a patient, again, no matter"},{"speaker":"Charles Goldfarb","startTime":2068.93,"endTime":2072.08,"body":"what the level is, I try to make"},{"speaker":"Charles Goldfarb","startTime":2072.08,"endTime":2076.25,"body":"verbal communication with that"},{"speaker":"Charles Goldfarb","startTime":2072.08,"endTime":2076.25,"body":"trainer and let him or her know"},{"speaker":"Charles Goldfarb","startTime":2076.25,"endTime":2079.82,"body":"what I thought and what the plan"},{"speaker":"Charles Goldfarb","startTime":2076.25,"endTime":2079.82,"body":"is not only sending them the"},{"speaker":"Charles Goldfarb","startTime":2079.85,"endTime":2083.96,"body":"note, but also talking to them."},{"speaker":"Charles Goldfarb","startTime":2079.85,"endTime":2083.96,"body":"Those relationships for someone"},{"speaker":"Charles Goldfarb","startTime":2083.96,"endTime":2087.47,"body":"interested in sports are"},{"speaker":"Charles Goldfarb","startTime":2083.96,"endTime":2087.47,"body":"incredibly important."},{"speaker":"Chris Dy","startTime":2088.01,"endTime":2090.53,"body":"Yeah, and I think that"},{"speaker":"Chris Dy","startTime":2088.01,"endTime":2090.53,"body":"you know, putting a face and or"},{"speaker":"Chris Dy","startTime":2090.53,"endTime":2093.26,"body":"a voice to a name of somebody"},{"speaker":"Chris Dy","startTime":2090.53,"endTime":2093.26,"body":"who's seen your patients"},{"speaker":"Chris Dy","startTime":2093.26,"endTime":2095.66,"body":"afterwards and potentially"},{"speaker":"Chris Dy","startTime":2093.26,"endTime":2095.66,"body":"sending you back that patient or"},{"speaker":"Chris Dy","startTime":2095.66,"endTime":2098.69,"body":"sending you new patients. That"},{"speaker":"Chris Dy","startTime":2095.66,"endTime":2098.69,"body":"is incredibly helpful. So I"},{"speaker":"Chris Dy","startTime":2098.69,"endTime":2101.81,"body":"found that to be very good."},{"speaker":"Chris Dy","startTime":2098.69,"endTime":2101.81,"body":"useful in terms of, you know,"},{"speaker":"Chris Dy","startTime":2101.9,"endTime":2105.08,"body":"building my general hand surgery"},{"speaker":"Chris Dy","startTime":2101.9,"endTime":2105.08,"body":"practice as well as the the"},{"speaker":"Chris Dy","startTime":2105.08,"endTime":2107.27,"body":"nerve niche, because I have had"},{"speaker":"Chris Dy","startTime":2105.08,"endTime":2107.27,"body":"patients who have been sent"},{"speaker":"Chris Dy","startTime":2107.27,"endTime":2110.93,"body":"over, you know, at the"},{"speaker":"Chris Dy","startTime":2107.27,"endTime":2110.93,"body":"recommendation of the therapist"},{"speaker":"Chris Dy","startTime":2110.93,"endTime":2113.48,"body":"that they're seeing, because,"},{"speaker":"Chris Dy","startTime":2110.93,"endTime":2113.48,"body":"you know, some of the nerve"},{"speaker":"Chris Dy","startTime":2113.48,"endTime":2115.58,"body":"issues they were having,"},{"speaker":"Chris Dy","startTime":2113.48,"endTime":2115.58,"body":"perhaps, were not being"},{"speaker":"Chris Dy","startTime":2115.58,"endTime":2118.13,"body":"addressed in the way that the"},{"speaker":"Chris Dy","startTime":2115.58,"endTime":2118.13,"body":"therapist thought, most useful."},{"speaker":"Charles Goldfarb","startTime":2119.03,"endTime":2120.71,"body":"Yeah, and"},{"speaker":"Charles Goldfarb","startTime":2119.03,"endTime":2120.71,"body":"therapists, especially in hand"},{"speaker":"Charles Goldfarb","startTime":2120.71,"endTime":2124.91,"body":"surgery are a wealth of"},{"speaker":"Charles Goldfarb","startTime":2120.71,"endTime":2124.91,"body":"knowledge, they are a good judge"},{"speaker":"Charles Goldfarb","startTime":2124.94,"endTime":2130.19,"body":"of quality. And, you know, I'm"},{"speaker":"Charles Goldfarb","startTime":2124.94,"endTime":2130.19,"body":"always flattered when an"},{"speaker":"Charles Goldfarb","startTime":2130.19,"endTime":2132.83,"body":"occupational therapist, a hand"},{"speaker":"Charles Goldfarb","startTime":2130.19,"endTime":2132.83,"body":"therapist sends patients our"},{"speaker":"Charles Goldfarb","startTime":2132.83,"endTime":2135.44,"body":"way, because I believe that is"},{"speaker":"Charles Goldfarb","startTime":2132.83,"endTime":2135.44,"body":"the ultimate compliment."},{"speaker":"Chris Dy","startTime":2136.07,"endTime":2137.72,"body":"Yah I mean if you're"},{"speaker":"Chris Dy","startTime":2136.07,"endTime":2137.72,"body":"looking for a hand surgeon in"},{"speaker":"Chris Dy","startTime":2137.72,"endTime":2140.75,"body":"your community ask the hand"},{"speaker":"Chris Dy","startTime":2137.72,"endTime":2140.75,"body":"therapist who to send people to,"},{"speaker":"Chris Dy","startTime":2141.02,"endTime":2143.87,"body":"because I think they have a good"},{"speaker":"Chris Dy","startTime":2141.02,"endTime":2143.87,"body":"sense of what's going on and"},{"speaker":"Chris Dy","startTime":2143.93,"endTime":2146.84,"body":"whose patients do well. And you"},{"speaker":"Chris Dy","startTime":2143.93,"endTime":2146.84,"body":"know, they can see basically the"},{"speaker":"Chris Dy","startTime":2146.84,"endTime":2147.41,"body":"whole gamut of it."},{"speaker":"Charles Goldfarb","startTime":2148.1,"endTime":2151.73,"body":"So the face to"},{"speaker":"Charles Goldfarb","startTime":2148.1,"endTime":2151.73,"body":"face discussions and giving"},{"speaker":"Charles Goldfarb","startTime":2151.73,"endTime":2155.24,"body":"talks in the community and"},{"speaker":"Charles Goldfarb","startTime":2151.73,"endTime":2155.24,"body":"region may be helpful, may be"},{"speaker":"Charles Goldfarb","startTime":2155.24,"endTime":2158.09,"body":"not the best use of our time,"},{"speaker":"Charles Goldfarb","startTime":2155.24,"endTime":2158.09,"body":"but certainly are helpful. And"},{"speaker":"Charles Goldfarb","startTime":2158.27,"endTime":2160.4,"body":"when you're younger, you have"},{"speaker":"Charles Goldfarb","startTime":2158.27,"endTime":2160.4,"body":"more time because your clinical"},{"speaker":"Charles Goldfarb","startTime":2160.4,"endTime":2164.72,"body":"practice is not hugely busy."},{"speaker":"Charles Goldfarb","startTime":2160.4,"endTime":2164.72,"body":"Then we get to online marketing,"},{"speaker":"Charles Goldfarb","startTime":2164.72,"endTime":2167.33,"body":"which, you know, we've always"},{"speaker":"Charles Goldfarb","startTime":2164.72,"endTime":2167.33,"body":"struggled with return on"},{"speaker":"Charles Goldfarb","startTime":2167.33,"endTime":2171.62,"body":"investment. So how do you judge"},{"speaker":"Charles Goldfarb","startTime":2167.33,"endTime":2171.62,"body":"ROI for online marketing? And"},{"speaker":"Charles Goldfarb","startTime":2171.62,"endTime":2176.72,"body":"what does that even mean? I do"},{"speaker":"Charles Goldfarb","startTime":2171.62,"endTime":2176.72,"body":"think there are a variety of"},{"speaker":"Charles Goldfarb","startTime":2176.72,"endTime":2180.95,"body":"different things a practice can"},{"speaker":"Charles Goldfarb","startTime":2176.72,"endTime":2180.95,"body":"do, and an individual can do. So"},{"speaker":"Charles Goldfarb","startTime":2180.95,"endTime":2184.28,"body":"what are the some of the things"},{"speaker":"Charles Goldfarb","startTime":2180.95,"endTime":2184.28,"body":"that you think about, for either"},{"speaker":"Charles Goldfarb","startTime":2184.28,"endTime":2187.22,"body":"social media or just online"},{"speaker":"Charles Goldfarb","startTime":2184.28,"endTime":2187.22,"body":"presence?"},{"speaker":"Chris Dy","startTime":2187.84,"endTime":2190.09,"body":"Well, I'm pretty sure"},{"speaker":"Chris Dy","startTime":2187.84,"endTime":2190.09,"body":"that, you know, social media"},{"speaker":"Chris Dy","startTime":2190.09,"endTime":2193.09,"body":"wise, you know, the stuff we do"},{"speaker":"Chris Dy","startTime":2190.09,"endTime":2193.09,"body":"for the podcast, and, you know,"},{"speaker":"Chris Dy","startTime":2193.15,"endTime":2195.49,"body":"my personal Twitter and"},{"speaker":"Chris Dy","startTime":2193.15,"endTime":2195.49,"body":"Instagram stuff, that's not"},{"speaker":"Chris Dy","startTime":2195.49,"endTime":2197.77,"body":"bringing me patients, you know,"},{"speaker":"Chris Dy","startTime":2195.49,"endTime":2197.77,"body":"and then that's not the purpose"},{"speaker":"Chris Dy","startTime":2197.77,"endTime":2200.71,"body":"of it, right? Like, the podcast,"},{"speaker":"Chris Dy","startTime":2197.77,"endTime":2200.71,"body":"honestly, we, we did it because"},{"speaker":"Chris Dy","startTime":2200.71,"endTime":2205.6,"body":"it's fun. It gets our voices out"},{"speaker":"Chris Dy","startTime":2200.71,"endTime":2205.6,"body":"there, it gets our teaching"},{"speaker":"Chris Dy","startTime":2205.6,"endTime":2208.54,"body":"styles out there. And then the"},{"speaker":"Chris Dy","startTime":2205.6,"endTime":2208.54,"body":"Twitter and Instagram stuff that"},{"speaker":"Chris Dy","startTime":2208.54,"endTime":2212.56,"body":"for me is academic networking,"},{"speaker":"Chris Dy","startTime":2208.54,"endTime":2212.56,"body":"essentially, it's the new"},{"speaker":"Chris Dy","startTime":2212.56,"endTime":2215.38,"body":"version of going to a meeting"},{"speaker":"Chris Dy","startTime":2212.56,"endTime":2215.38,"body":"almost, and networking with"},{"speaker":"Chris Dy","startTime":2215.38,"endTime":2218.8,"body":"people at a meeting. So I don't"},{"speaker":"Chris Dy","startTime":2215.38,"endTime":2218.8,"body":"do that to generate patients."},{"speaker":"Chris Dy","startTime":2218.8,"endTime":2221.68,"body":"And honestly, because I'm in"},{"speaker":"Chris Dy","startTime":2218.8,"endTime":2221.68,"body":"academics, you know, I come to"},{"speaker":"Chris Dy","startTime":2221.68,"endTime":2224.62,"body":"work, and I work hard, and I do"},{"speaker":"Chris Dy","startTime":2221.68,"endTime":2224.62,"body":"my best to get my name out"},{"speaker":"Chris Dy","startTime":2224.62,"endTime":2229.3,"body":"there. But I'm not relying on"},{"speaker":"Chris Dy","startTime":2224.62,"endTime":2229.3,"body":"online marketing, to drive"},{"speaker":"Chris Dy","startTime":2229.3,"endTime":2232.69,"body":"patients to my practice, I do"},{"speaker":"Chris Dy","startTime":2229.3,"endTime":2232.69,"body":"encourage patients to leave"},{"speaker":"Chris Dy","startTime":2232.69,"endTime":2235.45,"body":"reviews online, because we all"},{"speaker":"Chris Dy","startTime":2232.69,"endTime":2235.45,"body":"know that that's useful. Because"},{"speaker":"Chris Dy","startTime":2235.45,"endTime":2237.49,"body":"when patients find out who"},{"speaker":"Chris Dy","startTime":2235.45,"endTime":2237.49,"body":"they're going to see, the first"},{"speaker":"Chris Dy","startTime":2237.49,"endTime":2240.76,"body":"thing they do is Google you. And"},{"speaker":"Chris Dy","startTime":2237.49,"endTime":2240.76,"body":"we talked before a little bit,"},{"speaker":"Chris Dy","startTime":2240.79,"endTime":2244.27,"body":"at least in our grand rounds we"},{"speaker":"Chris Dy","startTime":2240.79,"endTime":2244.27,"body":"did about the importance of"},{"speaker":"Chris Dy","startTime":2244.27,"endTime":2248.32,"body":"those reviews, and perhaps how"},{"speaker":"Chris Dy","startTime":2244.27,"endTime":2248.32,"body":"you can shape them, as well as"},{"speaker":"Chris Dy","startTime":2248.32,"endTime":2251.74,"body":"the pitfalls of them. How do you"},{"speaker":"Chris Dy","startTime":2248.32,"endTime":2251.74,"body":"approach it? You've obviously"},{"speaker":"Chris Dy","startTime":2251.74,"endTime":2255.16,"body":"seen the rise of the Internet"},{"speaker":"Chris Dy","startTime":2251.74,"endTime":2255.16,"body":"during your career."},{"speaker":"Charles Goldfarb","startTime":2255.93,"endTime":2257.91,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":2255.93,"endTime":2257.91,"body":"you're right on the money. So"},{"speaker":"Charles Goldfarb","startTime":2257.91,"endTime":2263.76,"body":"the things I do online are not"},{"speaker":"Charles Goldfarb","startTime":2257.91,"endTime":2263.76,"body":"meant to drive business. But"},{"speaker":"Charles Goldfarb","startTime":2263.76,"endTime":2267.6,"body":"it's always nice when it does."},{"speaker":"Charles Goldfarb","startTime":2263.76,"endTime":2267.6,"body":"So the podcasts, as you said"},{"speaker":"Charles Goldfarb","startTime":2267.63,"endTime":2272.01,"body":"that that's not its goal, and it"},{"speaker":"Charles Goldfarb","startTime":2267.63,"endTime":2272.01,"body":"rarely produces patients, you"},{"speaker":"Charles Goldfarb","startTime":2272.01,"endTime":2275.1,"body":"know, coming to our office,"},{"speaker":"Charles Goldfarb","startTime":2272.01,"endTime":2275.1,"body":"Twitter and Instagram the same."},{"speaker":"Charles Goldfarb","startTime":2275.43,"endTime":2279.57,"body":"The interesting one for me is my"},{"speaker":"Charles Goldfarb","startTime":2275.43,"endTime":2279.57,"body":"blog, which I've been doing for,"},{"speaker":"Charles Goldfarb","startTime":2279.66,"endTime":2282.78,"body":"I want to say six or seven"},{"speaker":"Charles Goldfarb","startTime":2279.66,"endTime":2282.78,"body":"years. And there is a huge"},{"speaker":"Charles Goldfarb","startTime":2282.78,"endTime":2285.84,"body":"amount of information there. And"},{"speaker":"Charles Goldfarb","startTime":2282.78,"endTime":2285.84,"body":"I started for the purpose of"},{"speaker":"Charles Goldfarb","startTime":2285.84,"endTime":2289.59,"body":"educating families. And that"},{"speaker":"Charles Goldfarb","startTime":2285.84,"endTime":2289.59,"body":"remains its purpose it's not"},{"speaker":"Charles Goldfarb","startTime":2289.59,"endTime":2292.83,"body":"about attracting business."},{"speaker":"Charles Goldfarb","startTime":2289.59,"endTime":2292.83,"body":"However, certainly people have"},{"speaker":"Charles Goldfarb","startTime":2292.83,"endTime":2296.34,"body":"chosen to travel to St. Louis,"},{"speaker":"Charles Goldfarb","startTime":2292.83,"endTime":2296.34,"body":"because of that information and"},{"speaker":"Charles Goldfarb","startTime":2296.34,"endTime":2300.9,"body":"context that I've made. So"},{"speaker":"Charles Goldfarb","startTime":2296.34,"endTime":2300.9,"body":"again, the time invested, versus"},{"speaker":"Charles Goldfarb","startTime":2300.9,"endTime":2303.63,"body":"the patient yield, makes it"},{"speaker":"Charles Goldfarb","startTime":2300.9,"endTime":2303.63,"body":"absolutely not the right"},{"speaker":"Charles Goldfarb","startTime":2303.63,"endTime":2307.71,"body":"strategy to build a practice."},{"speaker":"Charles Goldfarb","startTime":2303.63,"endTime":2307.71,"body":"But that was never my goal. And"},{"speaker":"Charles Goldfarb","startTime":2307.71,"endTime":2310.89,"body":"any patients that I am lucky"},{"speaker":"Charles Goldfarb","startTime":2307.71,"endTime":2310.89,"body":"enough to treat through that"},{"speaker":"Charles Goldfarb","startTime":2310.89,"endTime":2314.7,"body":"process. Well, that's great."},{"speaker":"Charles Goldfarb","startTime":2310.89,"endTime":2314.7,"body":"It's interesting watching what"},{"speaker":"Charles Goldfarb","startTime":2314.7,"endTime":2318.66,"body":"our practice does online, there"},{"speaker":"Charles Goldfarb","startTime":2314.7,"endTime":2318.66,"body":"are targeted ads that are done."},{"speaker":"Charles Goldfarb","startTime":2318.66,"endTime":2321.36,"body":"There's search engine"},{"speaker":"Charles Goldfarb","startTime":2318.66,"endTime":2321.36,"body":"optimization, which can be done."},{"speaker":"Charles Goldfarb","startTime":2321.6,"endTime":2326.46,"body":"Our practice does some things."},{"speaker":"Charles Goldfarb","startTime":2321.6,"endTime":2326.46,"body":"But I don't know."},{"speaker":"Chris Dy","startTime":2327.309,"endTime":2329.169,"body":"Yeah, man, I think"},{"speaker":"Chris Dy","startTime":2327.309,"endTime":2329.169,"body":"that, you know, this is a"},{"speaker":"Chris Dy","startTime":2329.169,"endTime":2332.559,"body":"constant push and pull for think"},{"speaker":"Chris Dy","startTime":2329.169,"endTime":2332.559,"body":"Surgeons of different"},{"speaker":"Chris Dy","startTime":2332.559,"endTime":2337.419,"body":"generations. And you want to be"},{"speaker":"Chris Dy","startTime":2332.559,"endTime":2337.419,"body":"savvy, you want to be you know,"},{"speaker":"Chris Dy","startTime":2337.419,"endTime":2340.059,"body":"at the forefront of things you"},{"speaker":"Chris Dy","startTime":2337.419,"endTime":2340.059,"body":"don't want to be left behind."},{"speaker":"Chris Dy","startTime":2340.719,"endTime":2343.659,"body":"But especially with social"},{"speaker":"Chris Dy","startTime":2340.719,"endTime":2343.659,"body":"media, I think you don't want to"},{"speaker":"Chris Dy","startTime":2343.659,"endTime":2347.079,"body":"be viewed as a self promoter."},{"speaker":"Chris Dy","startTime":2343.659,"endTime":2347.079,"body":"And I think that is a struggle"},{"speaker":"Chris Dy","startTime":2347.589,"endTime":2349.929,"body":"that many people have and why"},{"speaker":"Chris Dy","startTime":2347.589,"endTime":2349.929,"body":"some people don't do social"},{"speaker":"Chris Dy","startTime":2349.929,"endTime":2352.659,"body":"media is because they don't want"},{"speaker":"Chris Dy","startTime":2349.929,"endTime":2352.659,"body":"to to look like they're trying"},{"speaker":"Chris Dy","startTime":2352.659,"endTime":2356.619,"body":"to put themselves to the"},{"speaker":"Chris Dy","startTime":2352.659,"endTime":2356.619,"body":"forefront too much. And I"},{"speaker":"Chris Dy","startTime":2356.619,"endTime":2359.289,"body":"definitely, you know, can I"},{"speaker":"Chris Dy","startTime":2356.619,"endTime":2359.289,"body":"understand the merits of that"},{"speaker":"Chris Dy","startTime":2359.289,"endTime":2361.929,"body":"argument. And I think there's a"},{"speaker":"Chris Dy","startTime":2359.289,"endTime":2361.929,"body":"right way and a wrong way to do"},{"speaker":"Chris Dy","startTime":2361.929,"endTime":2364.869,"body":"things. I mean, if you make it"},{"speaker":"Chris Dy","startTime":2361.929,"endTime":2364.869,"body":"about your content and about the"},{"speaker":"Chris Dy","startTime":2364.869,"endTime":2368.529,"body":"message and not about you, and"},{"speaker":"Chris Dy","startTime":2364.869,"endTime":2368.529,"body":"you back it up with great"},{"speaker":"Chris Dy","startTime":2368.529,"endTime":2371.589,"body":"clinical care and great academic"},{"speaker":"Chris Dy","startTime":2368.529,"endTime":2371.589,"body":"work in our setting. I mean, I"},{"speaker":"Chris Dy","startTime":2371.589,"endTime":2374.319,"body":"think that you have every reason"},{"speaker":"Chris Dy","startTime":2371.589,"endTime":2374.319,"body":"to be out there and you know,"},{"speaker":"Chris Dy","startTime":2374.409,"endTime":2378.819,"body":"showcase the whole thing. You"},{"speaker":"Chris Dy","startTime":2374.409,"endTime":2378.819,"body":"know, I don't know how, how do"},{"speaker":"Chris Dy","startTime":2378.819,"endTime":2383.319,"body":"you view it because you seem to"},{"speaker":"Chris Dy","startTime":2378.819,"endTime":2383.319,"body":"be of your generation of"},{"speaker":"Chris Dy","startTime":2383.319,"endTime":2385.479,"body":"surgeons. And I don't mean that"},{"speaker":"Chris Dy","startTime":2383.319,"endTime":2385.479,"body":"in any way for any of your"},{"speaker":"Chris Dy","startTime":2385.479,"endTime":2387.669,"body":"generation of surgeons, you're"},{"speaker":"Chris Dy","startTime":2385.479,"endTime":2387.669,"body":"out there more than others."},{"speaker":"Charles Goldfarb","startTime":2388.68,"endTime":2392.58,"body":"I I don't want"},{"speaker":"Charles Goldfarb","startTime":2388.68,"endTime":2392.58,"body":"this to come off wrong. But I"},{"speaker":"Charles Goldfarb","startTime":2392.58,"endTime":2399.57,"body":"think in academics especially."},{"speaker":"Charles Goldfarb","startTime":2392.58,"endTime":2399.57,"body":"Our brand is under our control."},{"speaker":"Charles Goldfarb","startTime":2399.6,"endTime":2403.92,"body":"So how I am seen by the academic"},{"speaker":"Charles Goldfarb","startTime":2399.6,"endTime":2403.92,"body":"orthopedic enhanced surgeon"},{"speaker":"Charles Goldfarb","startTime":2403.92,"endTime":2407.76,"body":"community is based on what I"},{"speaker":"Charles Goldfarb","startTime":2403.92,"endTime":2407.76,"body":"share with that community. And I"},{"speaker":"Charles Goldfarb","startTime":2407.76,"endTime":2411.18,"body":"can choose to only share the"},{"speaker":"Charles Goldfarb","startTime":2407.76,"endTime":2411.18,"body":"manuscripts that I write. And"},{"speaker":"Charles Goldfarb","startTime":2411.18,"endTime":2415.02,"body":"that would tell a story. I can"},{"speaker":"Charles Goldfarb","startTime":2411.18,"endTime":2415.02,"body":"choose to share how I speak at"},{"speaker":"Charles Goldfarb","startTime":2415.02,"endTime":2417.96,"body":"annual meetings and various"},{"speaker":"Charles Goldfarb","startTime":2415.02,"endTime":2417.96,"body":"meetings. And that will tell a"},{"speaker":"Charles Goldfarb","startTime":2417.96,"endTime":2421.98,"body":"story. But I can also add to"},{"speaker":"Charles Goldfarb","startTime":2417.96,"endTime":2421.98,"body":"that story with social media."},{"speaker":"Charles Goldfarb","startTime":2421.98,"endTime":2425.64,"body":"And that's how I think about it"},{"speaker":"Charles Goldfarb","startTime":2421.98,"endTime":2425.64,"body":"because it is my brand. And it"},{"speaker":"Charles Goldfarb","startTime":2425.64,"endTime":2428.58,"body":"is my brand is certainly caught"},{"speaker":"Charles Goldfarb","startTime":2425.64,"endTime":2428.58,"body":"up in the Washington University,"},{"speaker":"Charles Goldfarb","startTime":2428.58,"endTime":2434.46,"body":"orthopedics brand. But I like to"},{"speaker":"Charles Goldfarb","startTime":2428.58,"endTime":2434.46,"body":"think that I can control and"},{"speaker":"Charles Goldfarb","startTime":2434.46,"endTime":2438.6,"body":"share with people who I am, how"},{"speaker":"Charles Goldfarb","startTime":2434.46,"endTime":2438.6,"body":"I think about problems, how I"},{"speaker":"Charles Goldfarb","startTime":2438.6,"endTime":2442.68,"body":"think about patient care,"},{"speaker":"Charles Goldfarb","startTime":2438.6,"endTime":2442.68,"body":"through these online social"},{"speaker":"Charles Goldfarb","startTime":2442.68,"endTime":2444.12,"body":"media opportunities."},{"speaker":"Chris Dy","startTime":2444.0,"endTime":2446.04,"body":"You know, I think that"},{"speaker":"Chris Dy","startTime":2444.0,"endTime":2446.04,"body":"that's one thing where, you"},{"speaker":"Chris Dy","startTime":2446.04,"endTime":2449.61,"body":"know, we'll we'll see where it"},{"speaker":"Chris Dy","startTime":2446.04,"endTime":2449.61,"body":"goes, I I like doing this in"},{"speaker":"Chris Dy","startTime":2449.61,"endTime":2451.86,"body":"terms of social media stuff. I"},{"speaker":"Chris Dy","startTime":2449.61,"endTime":2451.86,"body":"don't put in as much effort, I"},{"speaker":"Chris Dy","startTime":2451.86,"endTime":2455.1,"body":"think, as others do. Some people"},{"speaker":"Chris Dy","startTime":2451.86,"endTime":2455.1,"body":"bank a lot on social media"},{"speaker":"Chris Dy","startTime":2455.1,"endTime":2457.56,"body":"presence, and put a lot of"},{"speaker":"Chris Dy","startTime":2455.1,"endTime":2457.56,"body":"effort into it, because it does"},{"speaker":"Chris Dy","startTime":2457.56,"endTime":2462.45,"body":"take time to do it well. And"},{"speaker":"Chris Dy","startTime":2457.56,"endTime":2462.45,"body":"it's you know, it's just as"},{"speaker":"Chris Dy","startTime":2462.45,"endTime":2465.87,"body":"we've said before, it's just"},{"speaker":"Chris Dy","startTime":2462.45,"endTime":2465.87,"body":"another thing. I actually wanted"},{"speaker":"Chris Dy","startTime":2465.87,"endTime":2470.13,"body":"to pivot a little bit and"},{"speaker":"Chris Dy","startTime":2465.87,"endTime":2470.13,"body":"mention that, you know, when I"},{"speaker":"Chris Dy","startTime":2468.21,"endTime":2613.26,"body":"And nothing to add with your"},{"speaker":"Chris Dy","startTime":2468.21,"endTime":2613.26,"body":"story. I think that's hilarious."},{"speaker":"Chris Dy","startTime":2470.13,"endTime":2474.87,"body":"was when Shobhit, our fellow and"},{"speaker":"Chris Dy","startTime":2470.13,"endTime":2474.87,"body":"I were closing a case recently,"},{"speaker":"Chris Dy","startTime":2475.38,"endTime":2478.11,"body":"he kind of asked me how I ended"},{"speaker":"Chris Dy","startTime":2475.38,"endTime":2478.11,"body":"up doing what I do in terms of"},{"speaker":"Chris Dy","startTime":2478.11,"endTime":2480.87,"body":"nerve, you know, and I think"},{"speaker":"Chris Dy","startTime":2478.11,"endTime":2480.87,"body":"that's probably there's probably"},{"speaker":"Chris Dy","startTime":2480.87,"endTime":2484.02,"body":"a little bit you know, you can"},{"speaker":"Chris Dy","startTime":2480.87,"endTime":2484.02,"body":"people can learn something from"},{"speaker":"Chris Dy","startTime":2484.02,"endTime":2486.87,"body":"that. You know, and you may"},{"speaker":"Chris Dy","startTime":2484.02,"endTime":2486.87,"body":"remember this story differently."},{"speaker":"Chris Dy","startTime":2486.87,"endTime":2489.18,"body":"I'm sure I'm certain Marty"},{"speaker":"Chris Dy","startTime":2486.87,"endTime":2489.18,"body":"remembers this story"},{"speaker":"Chris Dy","startTime":2489.18,"endTime":2492.15,"body":"differently. But Shobhit asked"},{"speaker":"Chris Dy","startTime":2489.18,"endTime":2492.15,"body":"me how I became the nerve guy in"},{"speaker":"Chris Dy","startTime":2492.15,"endTime":2496.17,"body":"our practice. And I remember I"},{"speaker":"Chris Dy","startTime":2492.15,"endTime":2496.17,"body":"was a fellow and it was the end"},{"speaker":"Chris Dy","startTime":2496.17,"endTime":2499.05,"body":"of August and I was just coming"},{"speaker":"Chris Dy","startTime":2496.17,"endTime":2499.05,"body":"back from the microsurgery trip"},{"speaker":"Chris Dy","startTime":2499.05,"endTime":2503.04,"body":"to India. And we, I had just"},{"speaker":"Chris Dy","startTime":2499.05,"endTime":2503.04,"body":"touched down in Newark, turned"},{"speaker":"Chris Dy","startTime":2503.04,"endTime":2505.92,"body":"on my phone, was checking my"},{"speaker":"Chris Dy","startTime":2503.04,"endTime":2505.92,"body":"email, and I see an email from"},{"speaker":"Chris Dy","startTime":2505.92,"endTime":2510.15,"body":"Marty to David Chuang"},{"speaker":"Chris Dy","startTime":2505.92,"endTime":2510.15,"body":"worldfamous microsurgeon at"},{"speaker":"Chris Dy","startTime":2510.15,"endTime":2513.39,"body":"Chang Gung Memorial Hospital."},{"speaker":"Chris Dy","startTime":2510.15,"endTime":2513.39,"body":"were two of our former fellows a"},{"speaker":"Chris Dy","startTime":2513.39,"endTime":2516.21,"body":"couple years before me, Danos"},{"speaker":"Chris Dy","startTime":2513.39,"endTime":2516.21,"body":"and Duretti Fufa had done some"},{"speaker":"Chris Dy","startTime":2516.21,"endTime":2519.6,"body":"additional training and emails"},{"speaker":"Chris Dy","startTime":2516.21,"endTime":2519.6,"body":"says, you know, it's from Marty"},{"speaker":"Chris Dy","startTime":2519.6,"endTime":2522.96,"body":"to David. I'm copied on it. It"},{"speaker":"Chris Dy","startTime":2519.6,"endTime":2522.96,"body":"says, David, I hope you're doing"},{"speaker":"Chris Dy","startTime":2522.96,"endTime":2526.11,"body":"well. You know, I wanted to"},{"speaker":"Chris Dy","startTime":2522.96,"endTime":2526.11,"body":"introduce you to my current"},{"speaker":"Chris Dy","startTime":2526.11,"endTime":2529.77,"body":"fellow and soon to be junior"},{"speaker":"Chris Dy","startTime":2526.11,"endTime":2529.77,"body":"partner, he is going to be our"},{"speaker":"Chris Dy","startTime":2529.77,"endTime":2532.77,"body":"peripheral nerve expert. And I'd"},{"speaker":"Chris Dy","startTime":2529.77,"endTime":2532.77,"body":"like him to come spend six"},{"speaker":"Chris Dy","startTime":2532.77,"endTime":2538.68,"body":"months with you in Chang Gung."},{"speaker":"Chris Dy","startTime":2532.77,"endTime":2538.68,"body":"And I was first off, I was like,"},{"speaker":"Chris Dy","startTime":2538.71,"endTime":2541.23,"body":"kind of like, a little pissed. I"},{"speaker":"Chris Dy","startTime":2538.71,"endTime":2541.23,"body":"was like, you know, I didn't"},{"speaker":"Chris Dy","startTime":2541.23,"endTime":2543.36,"body":"nobody told me I was gonna be"},{"speaker":"Chris Dy","startTime":2541.23,"endTime":2543.36,"body":"the peripheral nerve person."},{"speaker":"Chris Dy","startTime":2544.56,"endTime":2547.32,"body":"Nobody told me that I was gonna"},{"speaker":"Chris Dy","startTime":2544.56,"endTime":2547.32,"body":"have to spend six months in"},{"speaker":"Chris Dy","startTime":2547.32,"endTime":2550.47,"body":"Taiwan. What if I don't like"},{"speaker":"Chris Dy","startTime":2547.32,"endTime":2550.47,"body":"nerve? What if, my wife's gonna"},{"speaker":"Chris Dy","startTime":2550.47,"endTime":2555.0,"body":"kill me if I go to Taiwan for"},{"speaker":"Chris Dy","startTime":2550.47,"endTime":2555.0,"body":"six months. That being said, I"},{"speaker":"Chris Dy","startTime":2555.0,"endTime":2559.02,"body":"ended up loving nerve it fits my"},{"speaker":"Chris Dy","startTime":2555.0,"endTime":2559.02,"body":"personality perfectly. It"},{"speaker":"Chris Dy","startTime":2559.02,"endTime":2562.41,"body":"brings, I think, a lot to the"},{"speaker":"Chris Dy","startTime":2559.02,"endTime":2562.41,"body":"fellowship to have that. And"},{"speaker":"Chris Dy","startTime":2562.41,"endTime":2565.17,"body":"then I ended up whittling down"},{"speaker":"Chris Dy","startTime":2562.41,"endTime":2565.17,"body":"the time in Taiwan to"},{"speaker":"Chris Dy","startTime":2565.17,"endTime":2569.28,"body":"approximately three weeks, which"},{"speaker":"Chris Dy","startTime":2565.17,"endTime":2569.28,"body":"I got a lot out of, and was able"},{"speaker":"Chris Dy","startTime":2569.28,"endTime":2572.43,"body":"to, you know, say that I trained"},{"speaker":"Chris Dy","startTime":2569.28,"endTime":2572.43,"body":"in Taiwan and Chang Gung and"},{"speaker":"Chris Dy","startTime":2572.43,"endTime":2576.84,"body":"have the connections there, but"},{"speaker":"Chris Dy","startTime":2572.43,"endTime":2576.84,"body":"not get divorced. So that worked"},{"speaker":"Chris Dy","startTime":2576.84,"endTime":2582.45,"body":"out pretty well, the long story,"},{"speaker":"Chris Dy","startTime":2576.84,"endTime":2582.45,"body":"but that's the I will say that"},{"speaker":"Chris Dy","startTime":2582.45,"endTime":2585.3,"body":"as much as I think that keeping"},{"speaker":"Chris Dy","startTime":2582.45,"endTime":2585.3,"body":"your practice broad at the"},{"speaker":"Chris Dy","startTime":2585.3,"endTime":2589.53,"body":"beginning, having a niche, and"},{"speaker":"Chris Dy","startTime":2585.3,"endTime":2589.53,"body":"not something you only do but"},{"speaker":"Chris Dy","startTime":2589.53,"endTime":2593.79,"body":"having a focus is incredibly"},{"speaker":"Chris Dy","startTime":2589.53,"endTime":2593.79,"body":"helpful as a career accelerant."},{"speaker":"Chris Dy","startTime":2594.12,"endTime":2596.64,"body":"Particularly if you're in"},{"speaker":"Chris Dy","startTime":2594.12,"endTime":2596.64,"body":"academics, I can't say that"},{"speaker":"Chris Dy","startTime":2596.64,"endTime":2598.56,"body":"would apply in private practice,"},{"speaker":"Chris Dy","startTime":2596.64,"endTime":2598.56,"body":"because there are so many"},{"speaker":"Chris Dy","startTime":2598.56,"endTime":2601.14,"body":"considerations if you try to"},{"speaker":"Chris Dy","startTime":2598.56,"endTime":2601.14,"body":"close yourself off. But if"},{"speaker":"Chris Dy","startTime":2601.14,"endTime":2604.23,"body":"you're in academics, having"},{"speaker":"Chris Dy","startTime":2601.14,"endTime":2604.23,"body":"something that you're interested"},{"speaker":"Chris Dy","startTime":2604.23,"endTime":2607.83,"body":"in, or you're told that you're"},{"speaker":"Chris Dy","startTime":2604.23,"endTime":2607.83,"body":"interested in, is incredibly"},{"speaker":"Chris Dy","startTime":2607.83,"endTime":2609.84,"body":"helpful in terms of building"},{"speaker":"Chris Dy","startTime":2607.83,"endTime":2609.84,"body":"your career."},{"speaker":"Chris Dy","startTime":2613.86,"endTime":2614.94,"body":"Is that how you remember it?"},{"speaker":"Charles Goldfarb","startTime":2615.48,"endTime":2619.8,"body":"May- not"},{"speaker":"Charles Goldfarb","startTime":2615.48,"endTime":2619.8,"body":"exactly I don't know. I don't,"},{"speaker":"Charles Goldfarb","startTime":2619.89,"endTime":2621.96,"body":"yah I mean it'd be interesting,"},{"speaker":"Charles Goldfarb","startTime":2619.89,"endTime":2621.96,"body":"good to hear Marty's side of"},{"speaker":"Charles Goldfarb","startTime":2621.96,"endTime":2627.51,"body":"that story. But I agree with the"},{"speaker":"Charles Goldfarb","startTime":2621.96,"endTime":2627.51,"body":"career accelerant phrase for"},{"speaker":"Charles Goldfarb","startTime":2627.51,"endTime":2631.11,"body":"picking a niche. You have to be"},{"speaker":"Charles Goldfarb","startTime":2627.51,"endTime":2631.11,"body":"careful though. Once you are"},{"speaker":"Charles Goldfarb","startTime":2631.11,"endTime":2634.35,"body":"defined as X surgeon, nerve"},{"speaker":"Charles Goldfarb","startTime":2631.11,"endTime":2634.35,"body":"surgeon, congenital surgeon,"},{"speaker":"Charles Goldfarb","startTime":2634.56,"endTime":2638.22,"body":"it's hard to break that mold."},{"speaker":"Charles Goldfarb","startTime":2634.56,"endTime":2638.22,"body":"And what you'll find is when you"},{"speaker":"Charles Goldfarb","startTime":2638.22,"endTime":2641.85,"body":"are invited to speak often it is"},{"speaker":"Charles Goldfarb","startTime":2638.22,"endTime":2641.85,"body":"only on those topics. And that"},{"speaker":"Charles Goldfarb","startTime":2641.85,"endTime":2645.42,"body":"can be really career limiting."},{"speaker":"Charles Goldfarb","startTime":2641.85,"endTime":2645.42,"body":"So you have to be careful and"},{"speaker":"Charles Goldfarb","startTime":2645.42,"endTime":2648.87,"body":"make sure your passion is real."},{"speaker":"Charles Goldfarb","startTime":2645.42,"endTime":2648.87,"body":"I would expect that many are"},{"speaker":"Charles Goldfarb","startTime":2648.87,"endTime":2654.03,"body":"influenced by mentors. Even"},{"speaker":"Charles Goldfarb","startTime":2648.87,"endTime":2654.03,"body":"selected cases or rotations can"},{"speaker":"Charles Goldfarb","startTime":2654.03,"endTime":2657.48,"body":"really have an outsized impact"},{"speaker":"Charles Goldfarb","startTime":2654.03,"endTime":2657.48,"body":"on what we think we like."},{"speaker":"Charles Goldfarb","startTime":2658.29,"endTime":2661.89,"body":"exposure is everything. And"},{"speaker":"Charles Goldfarb","startTime":2658.29,"endTime":2661.89,"body":"that's why prospective fellows"},{"speaker":"Charles Goldfarb","startTime":2661.98,"endTime":2666.36,"body":"should keep their worldview as"},{"speaker":"Charles Goldfarb","startTime":2661.98,"endTime":2666.36,"body":"wide as possible, because you"},{"speaker":"Charles Goldfarb","startTime":2666.36,"endTime":2668.91,"body":"don't know what you're going to"},{"speaker":"Charles Goldfarb","startTime":2666.36,"endTime":2668.91,"body":"fall in love with. And so having"},{"speaker":"Charles Goldfarb","startTime":2669.12,"endTime":2673.92,"body":"different types of faculty"},{"speaker":"Charles Goldfarb","startTime":2669.12,"endTime":2673.92,"body":"mentors, and different exposures"},{"speaker":"Charles Goldfarb","startTime":2673.92,"endTime":2676.68,"body":"to different areas of hand"},{"speaker":"Charles Goldfarb","startTime":2673.92,"endTime":2676.68,"body":"surgery are really important."},{"speaker":"Chris Dy","startTime":2677.2,"endTime":2680.2,"body":"Yeah, you You may"},{"speaker":"Chris Dy","startTime":2677.2,"endTime":2680.2,"body":"remember this story. You may"},{"speaker":"Chris Dy","startTime":2680.2,"endTime":2684.37,"body":"not, I hope you don't. When I"},{"speaker":"Chris Dy","startTime":2680.2,"endTime":2684.37,"body":"was interviewing for the faculty"},{"speaker":"Chris Dy","startTime":2684.37,"endTime":2687.82,"body":"position, I you know, one of my"},{"speaker":"Chris Dy","startTime":2684.37,"endTime":2687.82,"body":"mentors in New York was Aaron"},{"speaker":"Chris Dy","startTime":2687.82,"endTime":2691.42,"body":"Daluiski, who now does a decent"},{"speaker":"Chris Dy","startTime":2687.82,"endTime":2691.42,"body":"amount of congenital hand"},{"speaker":"Chris Dy","startTime":2691.42,"endTime":2694.72,"body":"surgery and has pivoted his"},{"speaker":"Chris Dy","startTime":2691.42,"endTime":2694.72,"body":"career he and Samir are"},{"speaker":"Chris Dy","startTime":2694.75,"endTime":2697.48,"body":"jumpstarting that at HSS. But he"},{"speaker":"Chris Dy","startTime":2694.75,"endTime":2697.48,"body":"was really interested in"},{"speaker":"Chris Dy","startTime":2697.48,"endTime":2699.58,"body":"congenital and we had written a"},{"speaker":"Chris Dy","startTime":2697.48,"endTime":2699.58,"body":"couple of review articles"},{"speaker":"Chris Dy","startTime":2699.58,"endTime":2702.16,"body":"together and I remember sitting"},{"speaker":"Chris Dy","startTime":2699.58,"endTime":2702.16,"body":"across from you in the old"},{"speaker":"Chris Dy","startTime":2702.16,"endTime":2707.47,"body":"offices. And you were like so I"},{"speaker":"Chris Dy","startTime":2702.16,"endTime":2707.47,"body":"see that you've written a couple"},{"speaker":"Chris Dy","startTime":2707.47,"endTime":2710.14,"body":"articles on congenital, do you,"},{"speaker":"Chris Dy","startTime":2707.47,"endTime":2710.14,"body":"do you want to be a congenital"},{"speaker":"Chris Dy","startTime":2710.14,"endTime":2713.74,"body":"hand surgeon? And I was just"},{"speaker":"Chris Dy","startTime":2710.14,"endTime":2713.74,"body":"like a deer in headlights I mean"},{"speaker":"Chris Dy","startTime":2713.74,"endTime":2717.55,"body":"like? I just want a job."},{"speaker":"Charles Goldfarb","startTime":2718.78,"endTime":2720.88,"body":"I wonder if I"},{"speaker":"Charles Goldfarb","startTime":2718.78,"endTime":2720.88,"body":"was threatened by that or"},{"speaker":"Charles Goldfarb","startTime":2720.88,"endTime":2723.52,"body":"encouraging of that. At that"},{"speaker":"Charles Goldfarb","startTime":2720.88,"endTime":2723.52,"body":"point. When did you join our"},{"speaker":"Charles Goldfarb","startTime":2723.52,"endTime":2724.36,"body":"practice? What year?"},{"speaker":"Chris Dy","startTime":2724.45,"endTime":2727.51,"body":"That interview was"},{"speaker":"Chris Dy","startTime":2724.45,"endTime":2727.51,"body":"literally Lindley's first or"},{"speaker":"Chris Dy","startTime":2727.51,"endTime":2730.3,"body":"second month on the practice, in"},{"speaker":"Chris Dy","startTime":2727.51,"endTime":2730.3,"body":"the practice."},{"speaker":"Charles Goldfarb","startTime":2730.9,"endTime":2732.67,"body":"So I was"},{"speaker":"Charles Goldfarb","startTime":2730.9,"endTime":2732.67,"body":"probably being protective of"},{"speaker":"Charles Goldfarb","startTime":2732.67,"endTime":2733.09,"body":"Lindley."},{"speaker":"Chris Dy","startTime":2733.24,"endTime":2735.58,"body":"Yeah, I don't know. It"},{"speaker":"Chris Dy","startTime":2733.24,"endTime":2735.58,"body":"was, it was an awkward"},{"speaker":"Chris Dy","startTime":2735.58,"endTime":2738.61,"body":"interaction. And I'm hoping"},{"speaker":"Chris Dy","startTime":2735.58,"endTime":2738.61,"body":"you'd forgotten about it."},{"speaker":"Charles Goldfarb","startTime":2739.36,"endTime":2741.28,"body":"I had for"},{"speaker":"Charles Goldfarb","startTime":2739.36,"endTime":2741.28,"body":"sure, for sure."},{"speaker":"Chris Dy","startTime":2741.0,"endTime":2745.05,"body":"Good, and I'm glad I"},{"speaker":"Chris Dy","startTime":2741.0,"endTime":2745.05,"body":"reminded you. But yeah, no, I"},{"speaker":"Chris Dy","startTime":2745.05,"endTime":2746.4,"body":"agree with what you're saying."},{"speaker":"Chris Dy","startTime":2745.05,"endTime":2746.4,"body":"You don't want to get"},{"speaker":"Chris Dy","startTime":2746.4,"endTime":2749.22,"body":"pigeonholed too much, especially"},{"speaker":"Chris Dy","startTime":2746.4,"endTime":2749.22,"body":"if you do enjoy the broader, you"},{"speaker":"Chris Dy","startTime":2749.22,"endTime":2751.71,"body":"know, practice parts of it. And"},{"speaker":"Chris Dy","startTime":2749.22,"endTime":2751.71,"body":"you want to be known for the"},{"speaker":"Chris Dy","startTime":2751.71,"endTime":2754.59,"body":"other things, I think, you know,"},{"speaker":"Chris Dy","startTime":2751.71,"endTime":2754.59,"body":"one strategy I've tried to take"},{"speaker":"Chris Dy","startTime":2754.59,"endTime":2757.44,"body":"is that if I'm asked to give a"},{"speaker":"Chris Dy","startTime":2754.59,"endTime":2757.44,"body":"talk, and you, for example, I"},{"speaker":"Chris Dy","startTime":2757.44,"endTime":2759.48,"body":"want to talk about nerves, they"},{"speaker":"Chris Dy","startTime":2757.44,"endTime":2759.48,"body":"ask me to talk about something"},{"speaker":"Chris Dy","startTime":2759.48,"endTime":2761.76,"body":"else, I'll say, Sure, happy to"},{"speaker":"Chris Dy","startTime":2759.48,"endTime":2761.76,"body":"do it. Can I also talk about"},{"speaker":"Chris Dy","startTime":2761.76,"endTime":2765.12,"body":"nerve? And then conversely, if I"},{"speaker":"Chris Dy","startTime":2761.76,"endTime":2765.12,"body":"want to stay known for you know,"},{"speaker":"Chris Dy","startTime":2765.15,"endTime":2767.46,"body":"not necessarily this, like, for"},{"speaker":"Chris Dy","startTime":2765.15,"endTime":2767.46,"body":"example, distal radius"},{"speaker":"Chris Dy","startTime":2767.46,"endTime":2770.61,"body":"fractures. If somebody asked me"},{"speaker":"Chris Dy","startTime":2767.46,"endTime":2770.61,"body":"to give a talk on nerve, I'll"},{"speaker":"Chris Dy","startTime":2770.61,"endTime":2772.71,"body":"say, Well, can I also give this"},{"speaker":"Chris Dy","startTime":2770.61,"endTime":2772.71,"body":"talk I have on distal radius"},{"speaker":"Chris Dy","startTime":2772.71,"endTime":2777.39,"body":"fractures or social media, or,"},{"speaker":"Chris Dy","startTime":2772.71,"endTime":2777.39,"body":"you know, work life balance, you"},{"speaker":"Chris Dy","startTime":2777.39,"endTime":2779.16,"body":"know, I've done that before."},{"speaker":"Chris Dy","startTime":2777.39,"endTime":2779.16,"body":"Because I think that that's an"},{"speaker":"Chris Dy","startTime":2779.16,"endTime":2782.94,"body":"important talk to give that not"},{"speaker":"Chris Dy","startTime":2779.16,"endTime":2782.94,"body":"everybody sees during their"},{"speaker":"Chris Dy","startTime":2782.94,"endTime":2787.47,"body":"training. So there are ways to"},{"speaker":"Chris Dy","startTime":2782.94,"endTime":2787.47,"body":"try to keep yourself broad, even"},{"speaker":"Chris Dy","startTime":2787.47,"endTime":2790.5,"body":"if you if external forces are"},{"speaker":"Chris Dy","startTime":2787.47,"endTime":2790.5,"body":"trying to pigeonhole you."},{"speaker":"Charles Goldfarb","startTime":2791.53,"endTime":2794.95,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":2791.53,"endTime":2794.95,"body":"really good advice. And we"},{"speaker":"Charles Goldfarb","startTime":2794.95,"endTime":2799.39,"body":"probably need to wind down, I"},{"speaker":"Charles Goldfarb","startTime":2794.95,"endTime":2799.39,"body":"would say that one thing, one"},{"speaker":"Charles Goldfarb","startTime":2799.39,"endTime":2805.12,"body":"factor I think about is being"},{"speaker":"Charles Goldfarb","startTime":2799.39,"endTime":2805.12,"body":"true to yourself, when it's not"},{"speaker":"Charles Goldfarb","startTime":2805.12,"endTime":2810.28,"body":"easy, and so practice selection,"},{"speaker":"Charles Goldfarb","startTime":2805.12,"endTime":2810.28,"body":"you know, you need to be honest,"},{"speaker":"Charles Goldfarb","startTime":2810.31,"endTime":2814.3,"body":"we all need to be honest with"},{"speaker":"Charles Goldfarb","startTime":2810.31,"endTime":2814.3,"body":"ourselves about what we want, in"},{"speaker":"Charles Goldfarb","startTime":2814.3,"endTime":2819.07,"body":"our practice, in our lives,"},{"speaker":"Charles Goldfarb","startTime":2814.3,"endTime":2819.07,"body":"balance, time. And likewise,"},{"speaker":"Charles Goldfarb","startTime":2819.07,"endTime":2823.24,"body":"with with time, we how we hone"},{"speaker":"Charles Goldfarb","startTime":2819.07,"endTime":2823.24,"body":"down our practice, and it's very"},{"speaker":"Charles Goldfarb","startTime":2823.24,"endTime":2826.66,"body":"easy to not not do that. And you"},{"speaker":"Charles Goldfarb","startTime":2823.24,"endTime":2826.66,"body":"and I have talked about that"},{"speaker":"Charles Goldfarb","startTime":2826.66,"endTime":2829.87,"body":"making goals and, and and being"},{"speaker":"Charles Goldfarb","startTime":2826.66,"endTime":2829.87,"body":"true. And I think that's"},{"speaker":"Charles Goldfarb","startTime":2829.87,"endTime":2832.03,"body":"incredibly important for all of"},{"speaker":"Charles Goldfarb","startTime":2829.87,"endTime":2832.03,"body":"this. And the same thing goes"},{"speaker":"Charles Goldfarb","startTime":2832.03,"endTime":2835.63,"body":"for marketing, you know, I you"},{"speaker":"Charles Goldfarb","startTime":2832.03,"endTime":2835.63,"body":"know, there was not marketing 30"},{"speaker":"Charles Goldfarb","startTime":2835.63,"endTime":2838.99,"body":"years ago, in medicine, it just"},{"speaker":"Charles Goldfarb","startTime":2835.63,"endTime":2838.99,"body":"didn't exist, it was considered"},{"speaker":"Charles Goldfarb","startTime":2838.99,"endTime":2841.69,"body":"bad form. And so you can call it"},{"speaker":"Charles Goldfarb","startTime":2838.99,"endTime":2841.69,"body":"marketing, you can call it"},{"speaker":"Charles Goldfarb","startTime":2841.72,"endTime":2845.23,"body":"advertising that didn't exist."},{"speaker":"Charles Goldfarb","startTime":2841.72,"endTime":2845.23,"body":"And now it's all over,"},{"speaker":"Charles Goldfarb","startTime":2845.26,"endTime":2850.21,"body":"billboards, radio, newspaper,"},{"speaker":"Charles Goldfarb","startTime":2845.26,"endTime":2850.21,"body":"magazines it's everywhere. And"},{"speaker":"Charles Goldfarb","startTime":2850.21,"endTime":2853.96,"body":"so we our approach is just to"},{"speaker":"Charles Goldfarb","startTime":2850.21,"endTime":2853.96,"body":"try to take the high road, it's"},{"speaker":"Charles Goldfarb","startTime":2853.96,"endTime":2857.14,"body":"never about denigrating anyone"},{"speaker":"Charles Goldfarb","startTime":2853.96,"endTime":2857.14,"body":"else. It's about promoting what"},{"speaker":"Charles Goldfarb","startTime":2857.14,"endTime":2861.67,"body":"we offer. But being true to"},{"speaker":"Charles Goldfarb","startTime":2857.14,"endTime":2861.67,"body":"yourself in all aspects of life,"},{"speaker":"Charles Goldfarb","startTime":2861.67,"endTime":2862.84,"body":"I think are incredibly"},{"speaker":"Charles Goldfarb","startTime":2861.67,"endTime":2862.84,"body":"important."},{"speaker":"Chris Dy","startTime":2863.2,"endTime":2864.91,"body":"Well, I think to bring"},{"speaker":"Chris Dy","startTime":2863.2,"endTime":2864.91,"body":"it to a close, I mean, you know,"},{"speaker":"Chris Dy","startTime":2864.91,"endTime":2868.6,"body":"you and I have had a mutual"},{"speaker":"Chris Dy","startTime":2864.91,"endTime":2868.6,"body":"mentor in Richard Gelberman. And"},{"speaker":"Chris Dy","startTime":2868.6,"endTime":2871.15,"body":"you know, what I loved about,"},{"speaker":"Chris Dy","startTime":2868.6,"endTime":2871.15,"body":"you know, at least from what I"},{"speaker":"Chris Dy","startTime":2871.15,"endTime":2873.79,"body":"knew about his hiring philosophy"},{"speaker":"Chris Dy","startTime":2871.15,"endTime":2873.79,"body":"is that he would bring people"},{"speaker":"Chris Dy","startTime":2873.79,"endTime":2877.54,"body":"here because he wanted the best"},{"speaker":"Chris Dy","startTime":2873.79,"endTime":2877.54,"body":"people here. And he would have"},{"speaker":"Chris Dy","startTime":2877.54,"endTime":2879.73,"body":"an idea of what he wanted them"},{"speaker":"Chris Dy","startTime":2877.54,"endTime":2879.73,"body":"to do clinically. But if it"},{"speaker":"Chris Dy","startTime":2879.73,"endTime":2882.76,"body":"didn't work out with what they"},{"speaker":"Chris Dy","startTime":2879.73,"endTime":2882.76,"body":"envisioned for themselves or, it"},{"speaker":"Chris Dy","startTime":2882.76,"endTime":2886.3,"body":"didn't make them happy. I think"},{"speaker":"Chris Dy","startTime":2882.76,"endTime":2886.3,"body":"he was totally fine with people"},{"speaker":"Chris Dy","startTime":2886.3,"endTime":2888.22,"body":"pivoting and doing something"},{"speaker":"Chris Dy","startTime":2886.3,"endTime":2888.22,"body":"else. And I don't think I was"},{"speaker":"Chris Dy","startTime":2888.22,"endTime":2891.07,"body":"the first person hired by the"},{"speaker":"Chris Dy","startTime":2888.22,"endTime":2891.07,"body":"hand service to do nerve. I"},{"speaker":"Chris Dy","startTime":2891.07,"endTime":2892.45,"body":"ended up being the one that"},{"speaker":"Chris Dy","startTime":2891.07,"endTime":2892.45,"body":"said, Yes."},{"speaker":"Charles Goldfarb","startTime":2893.349,"endTime":2894.849,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":2893.349,"endTime":2894.849,"body":"exactly right. And that's"},{"speaker":"Charles Goldfarb","startTime":2894.849,"endTime":2897.249,"body":"probably a really good way to"},{"speaker":"Charles Goldfarb","startTime":2894.849,"endTime":2897.249,"body":"close. So again, our goal is to"},{"speaker":"Charles Goldfarb","startTime":2897.249,"endTime":2901.929,"body":"bring in someone with marketing"},{"speaker":"Charles Goldfarb","startTime":2897.249,"endTime":2901.929,"body":"chops, and educate us both and"},{"speaker":"Charles Goldfarb","startTime":2901.929,"endTime":2905.259,"body":"those who listen about"},{"speaker":"Charles Goldfarb","startTime":2901.929,"endTime":2905.259,"body":"opportunities and what the state"},{"speaker":"Charles Goldfarb","startTime":2905.259,"endTime":2907.569,"body":"of the art is in the marketing"},{"speaker":"Charles Goldfarb","startTime":2905.259,"endTime":2907.569,"body":"world. Hopefully, we'll do that"},{"speaker":"Charles Goldfarb","startTime":2907.569,"endTime":2908.049,"body":"real soon."},{"speaker":"Chris Dy","startTime":2908.44,"endTime":2910.33,"body":"Absolutely. Well Enjoy"},{"speaker":"Chris Dy","startTime":2908.44,"endTime":2910.33,"body":"the rest of your day."},{"speaker":"Charles Goldfarb","startTime":2910.989,"endTime":2911.499,"body":"Thank you."},{"speaker":"Chris Dy","startTime":2911.8,"endTime":2912.52,"body":"Alright, take care."},{"speaker":"Charles Goldfarb","startTime":2913.09,"endTime":2915.1,"body":"Hey, Chris."},{"speaker":"Charles Goldfarb","startTime":2913.09,"endTime":2915.1,"body":"That was fun. Let's do it again,"},{"speaker":"Charles Goldfarb","startTime":2915.1,"endTime":2915.61,"body":"real soon."},{"speaker":"Chris Dy","startTime":2915.87,"endTime":2918.39,"body":"Sounds good. We'll be"},{"speaker":"Chris Dy","startTime":2915.87,"endTime":2918.39,"body":"sure to check us out on Twitter"},{"speaker":"Chris Dy","startTime":2918.6,"endTime":2920.79,"body":"@handpodcast. Hey, Chuck, what's"},{"speaker":"Chris Dy","startTime":2918.6,"endTime":2920.79,"body":"your Twitter handle?"},{"speaker":"Charles Goldfarb","startTime":2921.15,"endTime":2924.0,"body":"Mine is"},{"speaker":"Charles Goldfarb","startTime":2921.15,"endTime":2924.0,"body":"@congenitalhand. What about you?"},{"speaker":"Chris Dy","startTime":2924.15,"endTime":2927.51,"body":"Mine is @ChrisDyMD"},{"speaker":"Chris Dy","startTime":2924.15,"endTime":2927.51,"body":"spelled d y. And if you'd like"},{"speaker":"Chris Dy","startTime":2927.51,"endTime":2930.81,"body":"to email us, you can reach us at"},{"speaker":"Chris Dy","startTime":2927.51,"endTime":2930.81,"body":"handpodcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":2931.95,"endTime":2934.08,"body":"And remember,"},{"speaker":"Charles Goldfarb","startTime":2931.95,"endTime":2934.08,"body":"please subscribe. Wherever you"},{"speaker":"Charles Goldfarb","startTime":2934.08,"endTime":2935.19,"body":"get your podcasts"},{"speaker":"Chris Dy","startTime":2935.25,"endTime":2937.44,"body":"And be sure to leave a"},{"speaker":"Chris Dy","startTime":2935.25,"endTime":2937.44,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":2937.44,"endTime":2937.83,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":2938.23,"endTime":2940.51,"body":"Special thanks"},{"speaker":"Charles Goldfarb","startTime":2938.23,"endTime":2940.51,"body":"to Peter Martin for the amazing"},{"speaker":"Charles Goldfarb","startTime":2940.51,"endTime":2944.41,"body":"music. And remember, keep the"},{"speaker":"Charles Goldfarb","startTime":2940.51,"endTime":2944.41,"body":"upper hand come back next"}]}