Lessons in Orthopaedic Leadership: An AOA Podcast
Lessons in Orthopaedic Leadership: An AOA Podcast
Shaping Orthopaedic's Future: Insights from AOA Past President, Dr. Alexander Ghanayem
What makes a great orthopaedic leader? Dr. Alex Ghanayem, fresh off his term as the 137th President of the American Orthopaedic Association (AOA), shares candid reflections on leadership, legacy, and the future of orthopaedic surgery in this thought-provoking conversation with podcast host, Dr. Doug Lundy.
Dr. Ghanayem brings refreshing humility to his assessment of presidential leadership, emphasizing that the organization's strength lies in its committee members and chairs doing the essential work. His greatest satisfaction came not from personal accomplishment but from identifying emerging leaders who will guide orthopaedics through future challenges.
Hear the advice that resonates far beyond orthopaedics: balance subspecialty expertise with broader engagement, develop interests outside medicine (like Dr. Ghanayem’s own wildlife photography), and recognize that leadership service provides returns far exceeding what you invest.
Listen to discover how orthopaedic leadership principles might transform your own approach to medicine and career development.
Welcome to the AOA Future in Orthopaedic Surgery podcast series. This AOA podcast series will focus on the future in orthopaedic surgery and the impact on leaders in our profession. These podcasts will focus on the vast spectrum of change that will occur. As the future reveals itself, we will consider changes as they occur in the domains of culture, employment, technology, scope of practice, compensation and other areas. My name is Doug Lundy, host for this podcast series. Joining us today is Dr. Alex Ghanayem.
Douglas Lundy, MD, FAOA:Dr. Ghanayem is chair and professor of orthopaedic surgery at Loyola in Chicago. He served on the American Orthopaedic Association Executive Committee as treasurer and then, most recently, as the 137th president of the AOA. He spent his entire professional career at Loyola University, Chicago Stritch School of Medicine. He was named the Dr. William H. Scholl Professor and Chair of Loyola's Department of Orthopaedic Surgery and Rehabilitation in 2016. In 2021, he also assumed the role of Loyola Medicine's Medical Group Chief Medical Officer, leading an 850 multi-specialty physician and advanced practice provider group in providing care at a large tertiary academic medical center and two community hospitals. His clinical interest is in spine surgery, focusing on degenerative and traumatic conditions involving the spine. He went to medical school at Northwestern did his residency at Case Western Reserve and his fellowship at the University of Wisconsin in spine surgery.
Douglas Lundy, MD, FAOA:So, Dr. Ghanayem, welcome to the podcast series, sir. Thanks for having me, Doug. Alex, it's truly a pleasure talking with you today. You just rolled off as the 137th president of the AOA, handing the reins to Dr. Kyle Jeray.
Alexander Ghanayem, MD, FAOA:What are your thoughts after a long year of being president of our esteemed organization. Well, you know, first of all, I'm really happy that Kyle is sitting in that role right now because I mean, like I said at the meeting, I mean I was preceded by people that were really well qualified and dedicated to the organization and friends and the people that are following are in the same boat. So, you know, I'm really happy for you know Kyle personally but the organization is really going to benefit because our leadership pipeline, or our leaders that are currently serving, you know, really are high quality people and dedicated to the organization.
Douglas Lundy, MD, FAOA:That's oh, that couldn't be more true. I mean, you look around at the all the folks, not just necessarily on the executive committee and not just necessarily chairing the committees themselves, but as you go all the way down into staff in the committees and even the attendees at the annual meeting. I've always said it's a who's who in orthopaedic surgery and if you want to get something done, that's the room to get it in your thoughts.
Alexander Ghanayem, MD, FAOA:Yeah, I think that the people that are involved are concerned about larger issues. I mean, obviously, day to day, you get down to the individual patient. That is the fabric of what we do. I mean, we take care of people and we help solve their problems.
Alexander Ghanayem, MD, FAOA:But you know there's a larger arena around that. You know that starts with just making sure that our workforce, that our residents, are properly educated and to make sure that the environment by which we provide care is set up in a way where it's patient-centric and it's reliable in its ability to do what's right and what's best for the patient and for our students. Over and over and over again, despite the fact that you know what I call the barbarians at the gate, you know all the things that are lined up against us you know we still have to head above that and execute for the benefit of the country and our patients and society things kind of pop to mind in terms of notable events or or things that will be, you know, flashes in your memory as you move forward over your year as president of the AOA.
Douglas Lundy, MD, FAOA:Anything comes specifically that rings a bell, that would be interesting or something that you could reflect on in the future.
Alexander Ghanayem, MD, FAOA:You know, here's a little secret for you, being president's not a big deal, okay, I mean, think about it for a second. You've got a bunch of people that are on committees, that are working hard, and then you've got a bunch of committee chairs that are, you know, herding all of us cats, if you will, because you know how we are. You know we're high performers, we're doing this or doing that, we're multi-engaged, and then these committee chairs, some of which are sitting on executive committee, will report up to other executive committee members are or they're digging the, they're, they're drawing out the, the roads, they're digging the ditches, they're laying the concrete, and all you got to do is president and say it's like, yeah, make sure, and that looks good. Who wants to vote for this road to be named?
Alexander Ghanayem, MD, FAOA:You know, Doug Lundy way and then you do it and so the thing that's the most fun about being president and having having been one of those entry-level committee people and then you know a little subcommittee chair, then a committee chair, then executive it's the fun part of it is watching people and saying that guy, that girl, that resident, they're going places. You could see in them the commitment to the organization, the commitment to mission. That's the fun part. And you make all these little micro observations about people and you know this is someone that's going to be important 10 years from now, 20 years from now, 30 years from now.
Alexander Ghanayem, MD, FAOA:That's that's the fun part of being president is is seeing that, that, that growth in people, that commitment and being able to kind of smile behind the curtain and go. I wish there was a video right now Because you get this big Cheshire Cat type smile and going. This is going to be good and I hope I'm alive to see it. For some of them I hope I'm like Mac Evarts and come to the meeting when I'm in my 90s and having all my marbles, because that's the fun part is seeing people develop and become more ingrained in the fabric that makes us what we are.
Douglas Lundy, MD, FAOA:So I can totally resonate to a little bit different degree that what you're talking about. I'm currently the president of the orthopedic trauma association and it's it was a little anticlimactic, right. I mean you're like, okay, here we are and really all you do is watch everybody do all the cool things that they're doing and kind of coordinate across the matrix. But specifically, people would ask me go, what is your thing going to be? What is your legacy as OTA president? And I thought long and hard about it and I said you know, really, what right do I have as OTA president to put my fingerprint on anything other than move the five-year strategic plan another 20 yards down the field? That's what my legacy should be is not putting my individual mark on it, but moving the organization, making sure we keep heading the right thing and then, as I hand off to Tom Higgins, tom moves at another 20 yards. What are your thoughts relative to that?
Alexander Ghanayem, MD, FAOA:So, you know, in the post-COVID world, the game plan has changed and we can go in such a deep rabbit hole in that. But when I was being interviewed to enter the presidential line, the five-year plan wasn't enough. I mean, it's the 10-year plan and it's almost like what we do today. People may not even realize the benefit of it in the next one to two or three years. And I was treasurer of another organization and we had done something very different with that organization from a fiscal standpoint back in 2017. And then I got a call maybe six months ago from the executive director and said you know, we were talking about you today, eight years later, wow, and everybody was so happy about that idea you had and the way you led us in our fiscal plan and how we changed things. And it's like, okay, you know, I do have an ego All right, you know, it's a slightly healthy one. I immediately, you know, sat up real straight and kind of felt good about it. But in my mind I thought, exactly, you know, and it was okay. People remembered, fine, but what was more important is that they realized that something had happened with a real long game in mind and we were at a decision point that we had to, you know, do something different. And we worked through it and it turned out.
Alexander Ghanayem, MD, FAOA:And I think you know that's. You know it's almost like American presidents. You know, the further away you get from them, the smarter they sound. You know, like you know someone that was president 30 years ago or 40 years ago sure sounds a hell of a lot better today than they did the day they left office. You know it's, it's a little bit like that, but no one's really keeping track of us in the media, which is kind of good, but it's that long-term thinking.
Alexander Ghanayem, MD, FAOA:And so we need to make some changes in how the organization runs, how we engage leaders. Who are the leaders? The standard academic practice doesn't exist anymore in the way that we thought about it 10, you know, 10 years ago, 15 years ago, 20 years ago, and not because we're not dedicated to that, but it's because of situations, you know, and issues beyond our control that are changing the face of healthcare. And so you know who are the people we want on the bus, what do they look like, what are their genetics, what do their DNA look like? How have they been successful? What can they contribute to the organization? Those are things I think we do differently, which still keeps the mission front and center, but it allows us to to really stay true to the mission while securing the mission and the success of the organization. And those are.
Douglas Lundy, MD, FAOA:Those are hard things to put your finger on, but if you think long you can, you can lay the foundation for it tertiary and quaternary medical centers, but there's been a more recent focus, recognizing that there's a lot of strong, dynamic leadership within the private practice sector, specifically within OrthoForum and the other huge mega groups in America, and the large medium-sized groups as well, in terms of trying to learn from those leaders and also have those leaders join us and share information with them. So what are your thoughts on this new diversification of the membership base and what we're trying to do?
Alexander Ghanayem, MD, FAOA:So what I would say to that is you've almost got it right. Okay, those large non-academic groups, and there's a lot of different ways to look at them. There are leaders in those groups that need to be part of the American Rampage Association. But I would take it down even to the. Just take the two-person group, the three-person group, and if there's somebody in that group that says you know what? The education I had was really important, that person needs to be engaged in the AOA. And if that person says the education I had was lacking, that person needs to be engaged in the American Orthopaedic Association.
Alexander Ghanayem, MD, FAOA:Any of those people consume our products, whether it's regional meetings, whether it's the annual meeting leadership institute. If they have an interest in what we're talking about, that person should be a member of the organization. If they're concerned about the specialty, they may be a leader of one and their voices need to be heard. And their voices need to be heard. They may have great. You may be in a small 15,000 person town, in a county of 80,000 people, but yet you're still a leader in the operating room, you're a leader in your office, you're a leader in your community and you may have ideas, contributions to make to the organization. That'll benefit the organization, you know, just because you know I have a DAO chair and I'm a full professor and yada yada yada doesn't mean I have all the right ideas. So, yes, the big mega groups, absolutely. The medium-sized groups, sure, but to the individual that believes in what we're doing and cares about our specialty, that person needs a pathway, needs to be welcomed in the organization. The contributions could be immense. You never know.
Douglas Lundy, MD, FAOA:Yeah, I'm glad to hear you say that I just sponsored or nominated Jim Barber, who is in private solo practice down in South Georgia, but he also happens to be the vice chair of the board of counselors for the academy. So once again a guy in solo practice been to Jim's practice. That's pretty close to the middle of nowhere. Yet he's shown extensively and we fortunately now have him within our ranks. That's a good point. So we've been around a long time. We formed the American Board of Orthopaedic Surgery. We formed the American Academy of Orthopaedic Surgery. We'd be in the AOA Of course not you or me. So, and Kyle is currently a 138th president.
Alexander Ghanayem, MD, FAOA:Where do you see the AOA going from here in the future? You know, if you think about our mission, it's only forward. I mean, this is not a selfish mission, this is a mission that benefits society. And so we're going to have hurdles, we're going to have challenges. I mean, just look at what's happening with healthcare economics right now. There's going to be so many challenges, but our mission is going to keep us sound, it's going to keep us safe and fortunately there's enough people in this specialty that believe in it that if they have to carry the mission on their backs and walk uphill in snow, both directions to and from our headquarters they'll do it. Both directions, you know, to and from our headquarters they'll do it. And so I think we're going to be successful in the short term, the near term, the midterm and the long term.
Alexander Ghanayem, MD, FAOA:I have total confidence and faith in our organization. We're an institution I mean we founded in 1887. Look what we've been through A couple of world wars, you know a couple of other, you know mid-sized wars, all kinds of politics, you know the depression, market crashes, you know COVID. We've been through everything, and yet here we are, we're still going.
Douglas Lundy, MD, FAOA:So what challenges do you see facing the AAOA?
Alexander Ghanayem, MD, FAOA:Well, I mean, the challenges we have are shared by everybody. You know some of those. You know the economic challenges. You know the dollars are value added Benefits that we provide to membership and to trainees are always going to be under threat. I mean, that's just. You know. Take AOA and replace it with OTA or AAOS or OREF or anybody, and our residency. You know training programs, our own hospitals. That's going to be a substantial challenge going forward because you know there are not a lot of people that care about what we do, that control all the dollars, and and so you know there's, there's the list of people ahead of us is long. So I think that you know the economic challenges are going to be substantial, but I think we have a game plan. You know, through philanthropy, member engagement and the dedication of our, of our membership, to make sure that we can overcome that.
Alexander Ghanayem, MD, FAOA:And then you know the membership issues. You know the being pulled in 14 different directions to do 18 different things. I mean we're good at that. I mean, as orthopaedic surgeons, we're pretty good at multitasking, but we have to make sure that we don't we don't burn our members out. And then we provide a platform for what I call free members and members to remain engaged and to really and then we provide a platform for what I call free members and members to remain engaged and to really get that value added benefit from being part of something special like the American Orthopaedic Association. Why do we do it? I mean, you know, the time is a fiscal draw out of us and we give up family time, we give up work time, but what, what makes us tick? And and fortunately it's that mission, and and that mission is so important that people are willing to make those sacrifices such a great thing?
Douglas Lundy, MD, FAOA:absolutely, I think. And I've I got to interact some degree, moderating the symposium last year on resident unions where Lisa Lufthansa asked us to involve some of the carousel presidents in our symposium, and it was very, very interesting talking with those folks. So certainly you've got to meet quite your share of the English-speaking orthopedic presidents across the globe during your year while you were on Carousel. Any notable experiences or vignettes that you glean from these spectacular men and women as they lead our sister organizations across the globe?
Alexander Ghanayem, MD, FAOA:You know we'll leave the fun stuff out for the podcast, if that's okay. Okay, just this time.
Douglas Lundy, MD, FAOA:What happens in South Africa stays in South Africa. We'll leave the fun stuff out for the podcast, if that's okay.
Alexander Ghanayem, MD, FAOA:Okay, just this time. Yeah, what happens in South Africa stays in South Africa. You know, they're all in different healthcare delivery systems. Their training programs are somewhat different. I mean, I was at the New Zealand organization and they were having their big banquet at the end of the meeting and they were graduating their residents. I can't remember. I think there was 10 or 11. There could have been 15. I'm not sure For the whole country.
Douglas Lundy, MD, FAOA:Oh my gosh.
Alexander Ghanayem, MD, FAOA:And so I mean that's. You know. I think there's a number of programs that have, you know, between 12 or 10 and 12, 10 and 13, just in their program, you know, but the challenges are the same. I mean, you know they still put in one screw at a time. You know the bones still break the same way and the biology of patients is all the same and leadership's the same. I mean you know, whether you're fighting the challenges set up by a provincial government or by a bureaucratic system that governs your resident education, or dealing with issues of access to care, I mean, for whatever reason, they're all the same.
Alexander Ghanayem, MD, FAOA:It's like the NBA versus the NFL versus the NHL. I mean it's still a contest between two teams. You have the puck, the ball. It's different, the number of players per side are different. You know you're still trying to score, but the game is different. And there are things that are the same Patience, people, teamwork, patience, again, the way they heal and the problems they have. But the circus around it is just just over, so slightly different. But the pathway to success is is common. You know you have to stay focused on the mission which a goal is in. You know leverage what we know. You know education, science and getting to where we need to be, and then you have to deal with the weeds of each country, each organization that has to deal with each set of weeds which are slightly different, but we have the same challenges. You know, it's something between us and executing on our mission to provide musculoskeletal care and to advocate for it for the benefit of society.
Douglas Lundy, MD, FAOA:Were you at the Australian meeting in Brisbane? Yes, yeah, I was there too. I was the Australia Orthopaedic Association as a guest nation at the Trauma Association this year. I was there representing them and I did a talk comparing the US, the Canadian because our OTA president at the time was Canadian and the Australian system. And, to your point, access in Australia, access in Canada, blows away any access problems we have in the US. It was just amazing at the problems that we have. Other countries actually have much worse, but they also do some pretty savvy, innovative stuff that we should maybe consider. Is there anything that you picked up along the way that you thought you know the US healthcare system should try that in a microcosm experiment to maybe see if it'll work here.
Alexander Ghanayem, MD, FAOA:Yeah, I think those little end-to-rounds that they use are possible because the systems are different. You know, the players are a little different and the goals of the players are different. I mean you don't have, you know, major health care insurance carriers in Canada, per se, that has perhaps a different goal than the NHS in England, and you know two tier systems you may see in other places like Australia, new or South Africa for that matter. The cost of providing that care is so much different. I mean, just, you know what we pay in malpractice in this country, what we pay to execute our billing in this country compared to, I mean, what happens in Canada, is just so different, is just so different. But those end-of-rounds are possible because the systems are a little bit different and they've learned how to leverage the holes in the system.
Alexander Ghanayem, MD, FAOA:And so think about the end-of-rounds you use in your place or the ones we use in our place. They're harder to do because there's so many other constraints and there's so many other people with thumbs in the healthcare pie, if you will. Pie is big but there's. You know what's it called when you have like 20 fingers on a hand. Besides polydactyly, you know, there's like 40 thumbs meets pie. So I think everyone's challenges are different and everyone's ways of dealing with them are different, but I think we have some advantages here. We do spend a lot of money on healthcare and access is a little bit better, depending on your sponsorship whether you have non-government sponsorship or a certain type of government sponsorship and what happens with Medicaid down the road is going to be a real problem, but I think we're still in a better place than others we're still in a better place than than others.
Douglas Lundy, MD, FAOA:So being president of the AOA, I mean you and the Academy president are pretty much atop the biggest, most prestigious organizations in orthopaedic surgery in the country and have a unique view of the healthcare delivery system, especially during that year. Any thoughts, reflections, vignettes that you picked up over that year that you kind of can reflect on, and how orthopaedic surgery is practiced and delivered across the United States and North America?
Alexander Ghanayem, MD, FAOA:I think from the at the individual level it's practiced with enthusiasm. You know, you genuinely still see at the early, mid and late stages of people's career that they enjoy what they're doing. I mean, I don't take colony anymore, I've aged out, but I just really dread having to get up at midnight and go in for a 2 am spine case. It just sucked, it just it sucked. But but you know, once, once we made the incision and the resident operating together, it was just fun again. You know the, the, the disruption in your sleep, you know, and now two days to recover after missing a night of sleep versus just one, and the disruption to your practice. It all went away and in the moment we were having fun and I almost, you almost still feel like a kid again.
Alexander Ghanayem, MD, FAOA:And I see that regardless of where people practice, you know you talk to the Canadians, you know the Americans, even to the other English speaking organizations yeah, there's always exception. There's always a curmudgeon in the corner somewhere that they I should never have done this, I should have done something else with my career, I should have been a kosher butcher like my brother or something like that. But they still, when they talk about operating, they still get the little twinkle and they enjoy that patient care part. That's something we kind of have really special in orthopaedics. I'm not sure it exists in every specialty and I don't know whether it's because we're we're simple orthopaedic surgeons or we're gifted orthopaedic surgeons or something in between or a combination of both. But that's something I've seen everywhere and geographically and stage and career.
Douglas Lundy, MD, FAOA:What advice would you give your residents or your recent graduates in terms of let's suppose that they are being nominated for AOA membership in the future? What advice would you give them regarding our organization, how they should invest their time in it?
Alexander Ghanayem, MD, FAOA:This is, and a way to think about this is left brain, right brain. You've got art and science on one side I mean art and literature on one side and science and math on the other. So you're a trauma guy and so you need to go to your trauma meeting. You need to roll up your sleeves, get engaged. But you're an orthopedic surgeon and you need to invest yourself in things that cross over all disciplines, whether it's the education of our residents and you may never be an educator in the future but guess what? You got a farm team that you're going to hire partners from.
Alexander Ghanayem, MD, FAOA:You think you might be interested in that farm team and how good the players are coming out of that farm team. So better believe you'll be it's. You know, the smart people that are in non-academic practices want to make sure that the farm team is working really well, because that's your future partner coming out of those farm teams. You need to cross-talk with a different subspecialist. If you talk to trauma guys all day, you'd probably be pretty bored. I know I'm pretty bored talking to spine guys all day. Trauma guys are kind of colorful.
Douglas Lundy, MD, FAOA:So if you talk, to trauma guys all day. You'd probably be pretty bored. I know I'm pretty bored talking to spine guys all day, and so Trauma guys are kind of colorful so they keep you entertained.
Alexander Ghanayem, MD, FAOA:It's, it's, but you know you hear the same joke over and over again. It gets kind of tiring. So this is a place where you get to cross disciplines, you know. You get to shed your, your, your specialty and remember why you became a right-take surgeon and then work toward your goals of education, guiding the future of musculoskeletal care for everybody. And that's the other side of your brain, and if all you do is focus on one side of your brain and forget the other, you're really missing out. So I think what I would tell my residents is find the value added in something outside of your own subspecialty and don't forget about that and keep consuming that, Because what you'll learn from other people that are similar but a little different than you, and what you'll learn in looking at the bigger picture from a 10,000 or 20,000 or 30,000 foot view is going to be so different than what size drill bit to use for what size screw, and that's going to make you a better person and a better physician down the road.
Douglas Lundy, MD, FAOA:Speaking of which, I was looking at your bio, and you published a paper in JBJS on wild horses.
Alexander Ghanayem, MD, FAOA:Yeah.
Douglas Lundy, MD, FAOA:What was that all about? I didn't look at it yet.
Alexander Ghanayem, MD, FAOA:You know, it's that special section in JBJS of arts and humanities and I think what they're trying to accomplish is to make sure that we're using the other half of our brain, and so if you follow that series, there's all kinds of cool things that are not nuts and bolts and no p-values and you know no stats and most of the time not even anything to do with a specific you know fracture or injury. It's just something different and that person that uses both sides of their brain can relate to patients better. And I think when Mark started that Mark Slonkowski, I think that was his goal. And so you know I'd given a talk at the 1887 dinner on something unrelated to medicine, on America's wild horses, and then he wanted me and wildlife photography is my hobby and he said listen, I want you to write a short article for the arts and humanities section.
Alexander Ghanayem, MD, FAOA:So I did, and it's just another part of me, but it's just something different. You would not expect that from somebody that's wearing loops and doing a spine case.
Douglas Lundy, MD, FAOA:Or would you Living in Chicago?
Alexander Ghanayem, MD, FAOA:Yeah, or would you?
Douglas Lundy, MD, FAOA:Yeah, that's a good point. Yeah, or would you? And speaking of which I mean Rex Hayden. I guess he'll be the 140th president, Is that right? Because he follows Steve Cates?
Alexander Ghanayem, MD, FAOA:I need to get my calculator out to count that guy.
Douglas Lundy, MD, FAOA:Yes, you guys are racking up those years, but Rex, at the 1887 dinner this year, rex talked about the headhunters. I believe it was Peru.
Alexander Ghanayem, MD, FAOA:I mean, archaeology is his gig, I mean archaeology is his gig.
Douglas Lundy, MD, FAOA:I mean, archaeology is crazy.
Alexander Ghanayem, MD, FAOA:Yeah, but I mean it's a flashy title, but you know, here's the other half of his brain. You know, rex Hayden is not just a nutty professor when it comes to oncology, he's a nutty professor like Indiana Jones, you know, right, Looking at relics in South America, that's cool, that's cool.
Alexander Ghanayem, MD, FAOA:That's cool. That's really different about him, but it shows another facet of the individual and you know the things you do when you're on digs and relating to you know local laborers and people that have similar interests. It's team building, again you know. It's understanding your environment, again, where do you hear that Sound? Like the operating room a little bit.
Douglas Lundy, MD, FAOA:Yeah, absolutely All right, boss, parting shot here as the past president of our esteemed organization, any parting shot thoughts in terms of future in orthopaedic surgery, future in AOA, future in AOA, future in leadership in our profession.
Alexander Ghanayem, MD, FAOA:You know, when I became a member of the organization, I had no aspirations of being its president.
Alexander Ghanayem, MD, FAOA:I mean, if someone said to me, whatever it was, 2004, you know you're going to be AOA president someday, I would have laughed at them so hard, okay, hard, okay.
Alexander Ghanayem, MD, FAOA:And so what I would tell young members and members is no matter how busy things get, then you know the rvu and the next clinic visit, and then you know another surgery I don't forget about, about why you're an orthopaedic surgeon, what the the goal of our profession is, and don't forget to exercise the other part of that brain, because the value I've gotten I mean the time served, you know, and everything else I've put in the organization I've gotten 100 times back in terms of you know what it's done for me quietly, as an individual, and what I've been able to gather from the AOA and then give back to my colleagues that I lead my department.
Alexander Ghanayem, MD, FAOA:Just little things, little trinkets of, little pearls of wisdom, little ways of doing things, ways of working with people and dealing with struggles and developing their own personal leadership, and so this gives us back so much more than we put into it. But it takes you a little time to realize that it's like a little investing in yourself and the specialty and then in the people that work around you and that you hope that will be taking care of you someday when you need their help.
Douglas Lundy, MD, FAOA:Very well said. That's excellent. Closing there. So it's been my absolute pleasure to have this time discussing future in orthopaedic surgery and leadership with Dr. Alex Ghanayem, who is a spine surgeon. He's chair at Loyola and, most recently, the 137th president of the American Orthopaedic Association. Dr. Ghanayem, thank you, sir, for spending this time with us.
Alexander Ghanayem, MD, FAOA:My pleasure. I'll do it again if you want.
Douglas Lundy, MD, FAOA:All right, let's do that and we look forward to seeing y'all again on other futures in orthopaedic surgery and this AOA podcast channel. Thank you.