Interview Summary

Dr. Hess has been an orthopedic surgeon for about 12 years. He explains how he always had an interest in medicine from a young age, especially since he grew up on a farm where he worked with a lot of tools.
Orthopedic surgeons work with a broad range of patients from all different age groups. There are many different specialties within orthopedics, but Dr. Hess works in sports medicine.
To become an orthopedic surgeon, one must earn an undergraduate degree, followed by medical school, and then complete a five-year residency program. After residency, some surgeons decide to also go through a one-to-two-year fellowship program where they can get additional training in their specialty.
A big misconception about orthopedic surgeons is that they primarily do surgery. However, Dr. Hess emphasizes that orthopedic surgery involves a combination of clinical and surgical care. In fact, Dr. Hess spends a lot of time in the clinic treating patients with various conditions and injuries, rather than in the operating room.
Dr. Hess describes how he loves seeing patients get better throughout their treatment and return to the sport they love. He sometimes gets pictures or videos from patients of them playing their sport again, which makes him very happy to see.
Dr. Hess encourages those interested in medicine to shadow doctors and gain exposure in the field. Additionally, he says that maintaining high grades is very important, especially when applying to medical school.

CRNA Interview With Nicoli Bettin

What does a day in your life as an orthopedic surgeon look like?

It depends on the day. For example, I had been on-call this past weekend and had to go to the hospital a few times to operate on a few elderly ladies that had fallen and broken their hips. On Monday morning, I worked in the clinic with my PA and saw about 24 patients. That afternoon, I completed two surgeries, one on an eleven-year-old girl and the other on a guy in his twenties who tore his ACL. Today, I am in the clinic all day. Tomorrow, I have surgery in the morning and then I will be in the clinic all afternoon. On Thursday, I will be in the operating room all day as I am scheduled for six surgeries. Finally, on Friday, I will be in the clinic in the morning and then I am going to take the rest of the day off. This week is pretty busy for me, but it really depends on the week.

When I am in the clinic, I help patients who come in and have something that is bothering them. We then complete an exam of these patients and do some imaging to figure out what the best course of action is for them.

The length of my surgeries is also something that can vary. Some surgeries that I do are quite short. For example, I do a good amount of knee arthroscopic surgeries where I use a small camera to go inside the knee joint and trim away damaged parts of the meniscus. This surgery is typically done on patients in their forties and fifties who have torn their meniscus and are in pain when they move. It only takes about eight-to-ten minutes for me to complete this surgery, and it is one of the shorter surgeries that I do. However, I can also do some longer surgeries that are more complex and can take up to about three hours to complete.

What does being an orthopedic surgeon mean to you?

I would say that it is a combination of surgical and non-surgical care. Most people think of us as only doing surgery, but that is not the case. In fact, of the patients that I see in the clinic, I do surgery on far fewer patients than I don't. Being an orthopedic surgeon means that I am taking care of conditions in the bones, muscles, and joints.

There are many specialties within orthopedics, such as spine, hand, foot and ankle, and joint replacement surgery. My specialty in orthopedic surgery is sports medicine.

The age range of patients that orthopedic surgeons work with can also vary depending on the specialty they work in. For me personally, I work with patients from a very broad age range. For example, yesterday I saw an eight-year-old in the clinic and did surgery on an eleven-year-old. Today, however, I have a 94-year-old on my clinic schedule. As a result, the age range that I see is very large, and it all depends on what joints and bones are hurting in patients.

Can you tell us about yourself?

I have been in practice as an orthopedic surgeon for about 12 years now. I grew up in a little town west of Brainerd, Minnesota called Verndale, and my parents owned a dairy farm. For whatever reason, I always wanted to be a doctor, but I do not know why that was. We did not have any doctors in my family or anything like that, but I just always wanted to be a doctor.

I went to Concordia College in Moorhead for my undergraduate degree and then I went to the Medical College of Wisconsin in Milwaukee for my medical school. After deciding that I wanted to be an orthopedic surgeon, I matched into my residency in Nebraska at the University of Nebraska Medical Center. This was a five-year residency program. I then did what is called a fellowship, which is an additional year of training after residency. My fellowship was in sports medicine, which is mainly focused on the care of athletes and the use of arthroscopic surgery. I completed my fellowship program in Gulf Breeze, Florida, which is near Pensacola. I worked with a pretty famous surgeon there, and we operated on lots of professional athletes from all over the world. This was an amazing experience.

My wife and I got married during the year of my fellowship, and since we did not have kids at that time, we decided to live somewhere else for a while. We moved to South Carolina, where we lived for three years. In South Carolina, I practiced at the University of South Carolina and was one of the team physicians for the university, which was really fun. In 2015, we had our first son. Since we had kids now, my wife and I decided to move back to the Twin Cities in 2016 to be closer to family. I have been working with Twin Cities Orthopedics (TCO) for about 10 years now.

Full Q&A With Dr. Hess

What are the biggest challenges of being an orthopedic surgeon?

I would say that it is balance, especially because I have two young kids. For example, I am one of the assistant coaches on my son’s baseball team. This weekend, his team was in the championship game of their tournament, but I could not make it to the game because I got called into the hospital to do a surgery. This was kind of a bummer for me because they won the game and I could not be there. Although this is part of the responsibilities for my job, it can be hard when you want to be there for your kids but you need to prioritize your work.

Although it can be hard to balance my family with my professional obligations, I would say that my work-life balance is pretty good. One nice thing about working in a practice like mine is that we are an independent group, meaning that we are not owned by a hospital group. This allows me to set my hours and take vacation time. That is a very nice benefit of my job because it gives me some autonomy over my schedule. There are some doctors that work for hospitals and are told how much vacation time they have, when they can take vacation, etc. I think that would be difficult, so I benefit from being in private practice because I get a better say over how much work I do and when I will take vacation time.

What is your favorite part of being an orthopedic surgeon?

I would say that my favorite part is when I get to see my patients get back to the sport that they love to do. Sometimes, patients send me a video or picture of them playing their sport again after they have undergone surgery and treatment with me. I love seeing this and it is an amazing part of my job.

A lot of times when I first see patients, they are hurt, swollen, in pain, and scared. I get to see these patients progress from post-surgical recovery all the way to being fully mobile again. It is fun to see this transformation from an injured patient who might be scared to someone who is fearlessly playing their sport again.

How much education is required to be an orthopedic surgeon?

You must earn your undergraduate degree, complete medical school, and then complete a five-year residency program. After residency, you can also do an optional fellowship program to gain additional training. Most fellowship programs are one-year long, but there are also some two-year fellowships. In the past, many graduating orthopedic residents did not do a fellowship. However, this has shifted over the years, and now I would say that about 95% of graduating residents do a fellowship in something. This also differs by specialty. For example, most people in anesthesia do not do a fellowship.

During residency, you rotate through all kinds of specialties. For my residency program, I would do about three months of pediatric orthopedics, three months of spine surgery, three months of hand surgery, three months of shoulder surgery, and three months of joint replacement surgery. While my residency rotated every few months between various specialties, my fellowship program was focused on one specialty for the whole year. For me, I learned about sports medicine. During this time, I did a lot of arthroscopic surgery, ACL surgery, and rotator cuff surgery.

What advice would you give to someone who is interested in the healthcare field and is trying to figure out what profession is best for them?

I would say that it is nice to have exposure. If you have shadowing or volunteer opportunities to be in a medical setting, I think that is a really good idea. Going into medicine is a lot of work, so you want to make sure that you love the field and that you want to pursue it before making any decisions.

I also think that it is important to get good grades. Doing well in college is a really important prerequisite for getting into medical school. In a lot of ways, I think that the hardest part of the whole process to becoming a doctor is getting into medical school in the first place. There are so many talented people applying to these programs, so it can be hard to make an impression on paper. If you do not do well in school, your application might get tossed out before anyone even looks at it.

When did you realize that you wanted to be an orthopedic surgeon?

I figured out that I wanted to do surgery because it was kind of part of the way that I grew up. On my parent’s farm, I grew up using saws, hammers, drills, and other tools. I always had an aptitude for using tools and working with my hands, which was why surgery seemed to make more sense to me.

Although I kind of always knew that I wanted to be a surgeon, I was not sure exactly what speciality in surgery I wanted to pursue. When I first started medical school, I initially thought that I would want to do either plastic surgery, orthopedic surgery, or even cardiovascular surgery. After a few clinical rotations, however, I felt like orthopedic surgery was the right thing for me.

What is the career outlook for an orthopedic surgeon?

I would think it would be pretty good. Generally speaking, the population is getting older. Elderly people tend to have more wear and tear on their bodies and need more intervention from an orthopedic surgeon, whether that is joint replacement, rotator cuff repair, or if they fall and hurt themselves. There is also an increase in the amount of kids participating in sports at an intense level. This can result in injuries, which I see a lot of.

Obviously, there are some unknowns because of the future of robots and AI. I think there could be a time when AI has a big impact on the cognitive medical specialties, which means that there are no procedures involved. There might be a day when a robot can do surgery, but I think that is further away than the possibility of an AI program reading EKGs, X-rays, MRIs, etc. I have even seen some studies that AI programs are just as good as radiologists at reading certain studies. Although I think that surgical specialties are a little more protected from AI, I still think it will affect our practice in some way.