BOSS Business of Surgery Series

Amy Vertrees, MD
BOSS Business of Surgery Series

Welcome to BOSS Business of Surgery Series! This program was specifically designed to help surgeons learn concepts not taught in residency but necessary for a successful surgery career. We were not told that most of our job would be interacting with others. We thought it was about the technical success of surgery or the knowledge that we learn. But it is so much more. Difficult partners and colleagues. Dealing with complications. Negotiating with administration. Running a successful and efficient clinic that doesn’t take bleed into our home life. How to have a life outside of surgery But if we don’t learn these concepts, we will end up in a negative spiral that will lead us into misery. And all of the time we spent training for the job we love, that could be so rewarding, is lost. You know there has to be a solution out there. That you can’t be the only one unhappy or wondering if it is just you. It’s time for a program that addresses your specific problems run by someone who knows what you are going through. You need a fellow surgeon who knows the way. You need a surgeon who has been where you are and found her way out to the other side: -Loving surgery again -Not taking work home -finishing notes immediately after clinic and heading home on time -Not letting complications set you back -Interacting with others with confidence -Finally seeing that you can control the results you get at work and home You can find out more about Dr. Vertrees and her work at www.BOSSsurgery.com.

  1. FEB 3

    Ep 170 Removing the mental health stigma with Dr. Stefanie Simmons

    Find more information here: https://www.cdc.gov/niosh/healthcare/impactwellbeingguide/index.html https://drlornabreen.org/become-an-ambassador/  Summary In this interview, Dr. Stephanie Simmons, an emergency room physician and Chief Medical Officer of the Lorna Breen Foundation, discussed the critical issue of mental health among healthcare workers. Dr. Simmons shared her personal experience with postpartum depression during residency and how it shaped her understanding of mental health stigma in medicine. She described her work leading professional well-being initiatives for 26,000 physicians across 1,000 hospitals in 36 states before the pandemic. Dr. Simmons detailed the foundation's mission to remove barriers to mental health care for healthcare workers, particularly focusing on changing licensing and credentialing practices that discriminate against those with past mental health treatment. She emphasized the importance of culturally competent care for healthcare workers and discussed legislative efforts, including the Dr. Lorna Breen Healthcare Provider Protection Act, which funded 45 projects across the country to promote healthcare workforce well-being. The conversation highlighted the three sources of stigma facing healthcare workers: internal, external, and institutional, and how the foundation is working to address these issues through advocacy, collaboration, and solution acceleration. Chapters Introduction and Personal Journey Dr. Simmons introduced herself as an emergency medicine physician and Chief Medical Officer of the Lorna Breen Foundation. She shared her personal experience with postpartum depression during residency and the initial fears that prevented her from seeking help, which later informed her work in professional well-being. Scaling Well-Being Programs Dr. Simmons explained her approach to implementing well-being programs for 26,000 physicians across 1,000 hospitals in 36 states, focusing on leadership training, coaching programs, and developing Wellness Champion networks at each site. The Impact of the Pandemic Dr. Simmons described how the pandemic changed the landscape of healthcare worker well-being, comparing pre-pandemic efforts to the increased urgency and visibility of mental health issues during the crisis. The Lorna Breen Foundation Dr. Simmons detailed the foundation's origins following Dr. Lorna Breen's death, its mission to change perceptions of mental health care as a sign of strength, and its focus on removing workplace obstacles to joyful medical practice. Addressing Stigma and Barriers Dr. Simmons discussed the three sources of stigma facing healthcare workers: internal, external, and institutional. She outlined the foundation's strategies to address these issues through legislative advocacy and systemic change. Legislative Advocacy and Impact Dr. Simmons explained the foundation's work on the Dr. Lorna Breen Healthcare Provider Protection Act, its funding of 45 projects, and ongoing efforts to reauthorize the legislation and implement its findings. Action Items Dr. Simmons mentioned the need to remove invasive and stigmatizing language from licensing and credentialing applications Dr. Simmons emphasized the importance of increasing access to culturally competent mental healthcare for healthcare workers Dr. Simmons proposed implementing screening programs like the ISP (Interactive Screening Program) backed by culturally competent care Dr. Simmons recommended using the Impact Well-Being Guide as a starter resource for hospital leaders Dr. Simmons highlighted the need to advocate for changes in peer reference forms to eliminate questions about past mental health treatment

    41 min
  2. JAN 27

    Ep 169 Leaving medicine behind with Dr. Mel Thacker

    Summary In this interview, Dr. Mel Thacker discussed her significant career transition from a successful surgical practice to becoming a coach for surgeons. Dr. Thacker shared that she left her practice in December 2024 after nearly a decade of service, despite being at the peak of her career with a high six-figure income. She cited three main reasons for her departure: moral injury from the healthcare system, witnessing unsafe practices in the for-profit hospital system, and personal growth. Dr. Thacker described a pivotal moment in September 2023 when she encountered systemic issues with insurance approvals that deeply affected her practice. She emphasized her transformation through coaching, which helped her overcome panic attacks and develop new methods for handling surgical complications. Now, she focuses on empowering surgeons through coaching, offering group programs and resources to help them navigate the challenges of modern medical practice. Chapters Career Transition and Current Status Dr. Thacker explained her recent career change, leaving a successful surgical practice after nearly a decade. She described being at the top of her game, with excellent surgical skills and patient connections, before making the decision to leave. Reasons for Leaving Practice Dr. Thacker outlined three primary reasons for her departure: moral injury from the healthcare system, witnessing unsafe practices in the for-profit hospital system, and personal growth through coaching. She emphasized that her husband supported her decision despite being the primary breadwinner. Experiences with Healthcare System Challenges Dr. Thacker detailed her experiences with moral injury, including a specific incident in September 2023 where an insurance company denied necessary surgery for a patient. She described multiple instances of systemic issues affecting patient care and treatment options. Coaching Transformation and Methodology Dr. Thacker discussed her transformation through coaching, developing what she calls the 'on layering method' for handling surgical complications. She explained how she applies coaching concepts to surgery and helps other surgeons through this process. New Direction and Coaching Focus Dr. Thacker introduced her new coaching program, the 'Empowered Surgeons Group,' starting April 30, 2025. She described the program structure, including weekly meetings, self-directed learning modules, and a comprehensive workbook.

    41 min
  3. JAN 20

    Ep 168 What you don't know about insurance contracts with Frank Lobb

    Summary The meeting featured Frank Lobb, a former Navy pilot, discussing healthcare insurance contracts and their impact on medical care. Lobb shared his personal experience of losing his wife after being denied healthcare coverage, despite offering to pay out of pocket. He explained how his investigation through legal proceedings revealed that healthcare insurance contracts are secret, state-approved documents that effectively allow insurance companies to ration healthcare. Lobb discovered that these contracts, standardized around 1990, contain provisions that prevent patients from paying for care when insurance denies coverage. He emphasized how the Consumer Financial Protection Bureau's recent involvement has shifted the burden of proof for billing accuracy to healthcare providers. The discussion highlighted how the current system disadvantages both patients and healthcare providers, with Lobb suggesting that medical organizations like the AMA should push for contract reform. Chapters Introduction to Frank Lobb and His Healthcare Experience Frank Lobb introduced himself as a former Navy pilot who became involved in healthcare contract analysis after personal tragedy. He shared his experience with DuPont's Clean Air Act negotiations, demonstrating his ability to analyze complex legal situations despite not being an attorney. Personal Tragedy and Legal Investigation Lobb described how his wife's illness led to his investigation of healthcare contracts. Despite offering to pay, multiple hospitals denied care after his insurance company's denial. Through legal proceedings, he gained rare access to typically secret insurance contracts. Evolution of Healthcare Insurance System Lobb explained how healthcare insurance evolved from a simple fee-for-service model in 1929-1930 to the current complex system. He highlighted the Supreme Court's 1990 ruling that confirmed insurance companies' right to ration healthcare. Contract Structure and Patient Rights Lobb revealed that unlike other insurance types, health insurance operates on a single contract system. He emphasized that patients don't actually have contracts with their insurance companies, only providers do. Consumer Financial Protection Bureau's Impact Lobb discussed how the Consumer Financial Protection Bureau's involvement has shifted the burden of proof for billing accuracy to healthcare providers, potentially creating leverage for system reform.

    49 min
  4. JAN 6

    Ep 166 Surgery mission work with Dr. Erin Stevens

    Summary The meeting featured Dr. Erin Stevens, a gynecologist oncologist at Prevea Health, discussing her experiences with medical mission trips to Bolivia through Solidarity Bridge since 2019. Dr. Stevens shared how she began these missions through a former surgery partner's invitation, initially working in Santa Cruz and later in Sucre. She detailed the significant differences between US and Bolivian healthcare systems, particularly in equipment usage and resource conservation. Dr. Stevens emphasized how Bolivian medical staff meticulously maintain and reuse equipment that would be discarded in the US. She highlighted the critical issue of cervical cancer in Bolivia, where screening rates are below 20% and treatment options are limited. The discussion also covered the evolution of her teaching approach, focusing on building sustainable surgical skills among Bolivian doctors and the importance of cultural understanding in medical missions. Chapters Introduction to Medical Mission Work in Bolivia Dr. Stevens described her background as a gynecologist with 11-12 years of experience in rural medicine, practicing in Montana and Wisconsin. She began mission trips to Bolivia with Solidarity Bridge in 2019, initially working in Santa Cruz and later in Sucre. Impact of COVID-19 on Mission Work Dr. Stevens discussed how the 2020 mission was cancelled due to the pandemic. She explained the lasting effects on Bolivia's healthcare system, including continued universal masking and delayed vaccine distribution. The pandemic significantly impacted cancer screening rates, which dropped to zero during 2020-2022. Equipment and Resource Management in Bolivian Healthcare Dr. Stevens detailed how Bolivian healthcare providers maximize resource utilization, including meticulous cleaning and reuse of surgical equipment. She highlighted the stark contrast with US practices regarding medical waste and equipment disposal. Teaching and Cultural Exchange Dr. Stevens emphasized the importance of working in solidarity with Bolivian medical professionals, focusing on teaching surgical skills while learning from their practices and culture. She described the progress made in teaching laparoscopic procedures and the relationship built with local medical staff. Action Items Stevens mentioned the need to continue providing essential surgical equipment to Bolivian hospitals Stevens highlighted the importance of establishing sustainable training programs for laparoscopic surgery Stevens emphasized the need to address cervical cancer prevention through increased screening and vaccination programs Stevens suggested exploring ways to improve medical supply conservation and reuse practicesFind her TEDx talk HERE

    40 min
4.9
out of 5
50 Ratings

About

Welcome to BOSS Business of Surgery Series! This program was specifically designed to help surgeons learn concepts not taught in residency but necessary for a successful surgery career. We were not told that most of our job would be interacting with others. We thought it was about the technical success of surgery or the knowledge that we learn. But it is so much more. Difficult partners and colleagues. Dealing with complications. Negotiating with administration. Running a successful and efficient clinic that doesn’t take bleed into our home life. How to have a life outside of surgery But if we don’t learn these concepts, we will end up in a negative spiral that will lead us into misery. And all of the time we spent training for the job we love, that could be so rewarding, is lost. You know there has to be a solution out there. That you can’t be the only one unhappy or wondering if it is just you. It’s time for a program that addresses your specific problems run by someone who knows what you are going through. You need a fellow surgeon who knows the way. You need a surgeon who has been where you are and found her way out to the other side: -Loving surgery again -Not taking work home -finishing notes immediately after clinic and heading home on time -Not letting complications set you back -Interacting with others with confidence -Finally seeing that you can control the results you get at work and home You can find out more about Dr. Vertrees and her work at www.BOSSsurgery.com.

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