Latest / AHF Podcast / Look Back, Leap Forward. A Mid-Career Reflection with Dr. Khalid Yousuf

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Look Back, Leap Forward. A Mid-Career Reflection with Dr. Khalid Yousuf · AHF Podcast

0:24
Joseph M. Schwab: Hello and welcome to this episode of the A HF Podcast.
0:28
Joseph M. Schwab: I'm your host, Joe Schwab.
0:30
Joseph M. Schwab: Today we're honored to sit down with Dr.
0:33
Joseph M. Schwab: Khalid Yusef, an accomplished orthopedic surgeon, educator, and leader, to talk not just about what he does, but who he's become.
0:43
Joseph M. Schwab: Over the course of an evolving, and some might even say brilliant career.
0:48
Joseph M. Schwab: If you're in the middle of your journey in orthopedic surgery or if you're just starting out, this is an episode you'll wanna listen to all the way through.
0:57
Joseph M. Schwab: Dr.
0:57
Joseph M. Schwab: Yusef, welcome to the A HF Podcast.
1:01
Khalid Yousuf: Thanks for having me here, Joe.
1:03
Khalid Yousuf: Uh, nice seeing you.
1:05
Joseph M. Schwab: Great seeing you.
1:06
Joseph M. Schwab: Before we jump right into the heavy stuff, how about you introduce yourself to our listeners, where you're based?
1:12
Joseph M. Schwab: Maybe tell them a little bit about your background.
1:16
Khalid Yousuf: Sure.
1:17
Khalid Yousuf: Um, so my name's Kaha Yusuf.
1:19
Khalid Yousuf: I'm in Dallas, Texas now, uh, in the suburbs of Dallas.
1:22
Khalid Yousuf: I work with a large healthcare system and, uh, my journey, uh, like most was medical school, orthopedic surgery at University of Oklahoma.
1:32
Khalid Yousuf: For residency, Mayo Clinic for fellowship.
1:35
Khalid Yousuf: Joe and I met along this journey and, uh, kindled a friendship from that point.
1:41
Khalid Yousuf: Uh, and then I took a job in Chicago, practiced there for five years, so we stayed.
1:46
Khalid Yousuf: Uh, Joe and I stayed in touch.
1:47
Khalid Yousuf: Uh, and then as Joe transitioned over the pond, I came down to Texas.
1:53
Khalid Yousuf: I had some ties to Texas and it has been a great, um, uh, transition to my practice.
1:59
Khalid Yousuf: So I've been in Dallas now for eight years.
2:01
Khalid Yousuf: And, uh, that's also around the time I was introduced to the Anter Hip Foundation.
2:06
Khalid Yousuf: Uh, and I'm sure we're gonna talk more about that.
2:09
Joseph M. Schwab: So tell me a little bit and tell our listeners a little bit about how you got interested in orthopedics in the first place.
2:17
Khalid Yousuf: Yeah.
2:18
Khalid Yousuf: Um, being Pakistani, you know, you're kind of born with two options.
2:22
Khalid Yousuf: You're gonna be a doc or engineer.
2:24
Khalid Yousuf: Uh, and I really struggled with that.
2:26
Khalid Yousuf: Um, I like the engineering side more.
2:29
Khalid Yousuf: Uh, for sure.
2:31
Khalid Yousuf: At the same token, my dad's a doc, uh, I have other family members that are docs, and I really was drawn to the human element of medicine.
2:38
Khalid Yousuf: Um, and then, so I, you know, almost like by default, I didn't think too hard about medical school.
2:45
Khalid Yousuf: I, uh, fortunate and was blessed to have good grades and kind of went down that path almost by default.
2:53
Khalid Yousuf: But as soon as, uh, you start getting into that.
2:56
Khalid Yousuf: A finish line of just, Hey, now I'm really gonna start medical school.
2:59
Khalid Yousuf: The finish line of like the pre into the med school part, you start to say, I gotta pick what kind of doc I wanna be, and now the human element, uh, of illness and sickness and all the other parts come in.
3:13
Khalid Yousuf: Um, and so very quickly, uh, conversations with my dad, other folks, um, uh, I was very confused.
3:21
Khalid Yousuf: I mean, truly, honestly confused to the point where I was like, I don't think I should be a doctor.
3:26
Khalid Yousuf: And fortunately for me, um, the second week of Gross anatomy lab, the orthopedic surgery residents would come into our cadaver lab, um, and uh, do the joint dissection of the cadaver just to kind of like show, um, the anatomy.
3:44
Khalid Yousuf: And it was good for them'cause they were learning the anatomy themselves.
3:46
Khalid Yousuf: It was good for medical students to learn from, uh, you know, others.
3:50
Khalid Yousuf: And right away I was drawn to their, you know, that, that.
3:54
Khalid Yousuf: That feel and excitement that they had about what they were showing us and teaching us.
3:58
Khalid Yousuf: And, uh, lo and behold, that was my introduction to Ortho.
4:03
Khalid Yousuf: Um, and specific, and it's a long-winded answer, but really I think, you know, that's how your life is shaped, is these little interactions that then make a, a amazing, you know, hopefully experience for you in your life.
4:15
Khalid Yousuf: And it went from that to research in ortho.
4:18
Khalid Yousuf: Um, and putting little EMG sensors and feline multifidus muscles to figure out how their spine works and what makes their spine hurt to grand rounds and other research opportunities.
4:33
Khalid Yousuf: And, um, just, that's how I kind of all got started and I'm so grateful for.
4:40
Joseph M. Schwab: So given where you're at in your career now and what you've accomplished, uh, since that time, if you could sit down with that younger colleague and, and give him some advice or answer some of his questions, what would you tell him?
4:53
Joseph M. Schwab: I guess, what would you wish you would've known?
4:55
Joseph M. Schwab: That the people around you weren't telling you at the time, or it wasn't the information you were getting?
5:03
Khalid Yousuf: Yeah, that's a tough question.
5:04
Khalid Yousuf: So, you know, I was.
5:08
Khalid Yousuf: I don't know if I would've given him any different advice.
5:10
Khalid Yousuf: I don't think he understood the, I don't think he understood the, the life he got placed into, you know, just he was lucky in that.
5:22
Khalid Yousuf: And let me ex, uh, exp uh, expound on that a little bit.
5:26
Khalid Yousuf: So I didn't get into med school one of my years, uh, for a little while.
5:29
Khalid Yousuf: And so I was guided to go into business and I went in and gotten healthcare management, um, masters.
5:36
Khalid Yousuf: And, uh, I, I think these opportunities that like sometimes seem like your life is ending and you're saying, man, I wanna be a doc and I didn't get into med school.
5:48
Khalid Yousuf: My grades are good.
5:49
Khalid Yousuf: Why didn't this work?
5:50
Khalid Yousuf: Sometimes it's just not meant to be worked out, right?
5:53
Khalid Yousuf: It's not the right time.
5:55
Khalid Yousuf: So baking the best of what you have, I think, and to take that with a smile, which, uh, I'm not saying I always did, but at the same token, luckily for me, the people around me, the support sector helped me smile through it, put my head down, work through it, do the best at that opportunity.
6:13
Khalid Yousuf: I think that's been the strength of mine that, uh, I do try to do the best at whatever sit situation I'm in.
6:19
Khalid Yousuf: Um, even if I internally don't like it, uh, I know the outward product is.
6:24
Khalid Yousuf: It gotta be my best effort.
6:26
Khalid Yousuf: And uh, and so then, um, you know, you just dunno.
6:30
Khalid Yousuf: So what did I learn through all those?
6:32
Khalid Yousuf: Is that the business acumen I gained by going to business school?
6:38
Khalid Yousuf: The idea of conversations with my dad saying, I know I thought I wanted to be a doctor, but now I realize the sick patient isn't the patient model.
6:48
Khalid Yousuf: I might thrive in the hurt patient model is maybe the model I would thrive in.
6:53
Khalid Yousuf: And understanding that there's.
6:54
Khalid Yousuf: Doctors that take care of sick patients versus hurt patients.
6:58
Khalid Yousuf: Um, and I think most orthopedic surgeons are better at the hurt patient, um, versus the sick patient.
7:05
Khalid Yousuf: And, uh, understanding that very early on or having someone explain that to you,'cause as a student you don't understand, there's two different types of patients.
7:13
Khalid Yousuf: Um, so those are the things I would tell the young college that, Hey, you, you got a curve ball thrown to you.
7:19
Khalid Yousuf: Life isn't meant to be just a bunch of.
7:21
Khalid Yousuf: Smooth, uh, straight sailing, um, you know, it's gonna have its bumps to just take it and do what you do.
7:28
Khalid Yousuf: And when you, when you're hurt, you don't, you know, just talk to the people around you that support you.
7:33
Khalid Yousuf: And because we all hurt at different times and it's okay to hurt you, just work through that.
7:38
Joseph M. Schwab: I haven't heard that distinction between the, the hurt patient and the sick patient that way.
7:43
Joseph M. Schwab: I think that's a, a fascinating way to think about.
7:47
Joseph M. Schwab: Not just patients, but different types of physicians.
7:49
Joseph M. Schwab: Right.
7:50
Joseph M. Schwab: What kind of physician you want to be?
7:52
Joseph M. Schwab: Um, I, I, I haven't heard it in those terms.
7:55
Joseph M. Schwab: Was there a moment in that early journey where you went from not just knowing what you wanted to do, but knowing that you were gonna be able to do it, um, knowing that, um, this was not just the career path that you were gonna choose, but that it was gonna happen for you?
8:13
Joseph M. Schwab: Or was that always, uh, a bit uncertain for you
8:18
Khalid Yousuf: Yeah, I think that question and, and the way I hear it, uh, for me puts me in residency.
8:23
Khalid Yousuf: Um, and there was a time in residency where, you know, I was fortunate enough to have an autonomous or semi-autonomous residency experience and, um.
8:34
Khalid Yousuf: I was able to, you know, um, nail a sub tr femur.
8:39
Khalid Yousuf: Uh, it was a trauma case.
8:40
Khalid Yousuf: I was, uh, you know, upper level on call faculty was there, but close by type there, there, you know, and to a, you know, and I, and I connected with the patient.
8:52
Khalid Yousuf: So there's this, you know, so many aspects of that.
8:54
Khalid Yousuf: A story in my mind is you, you connect with the patient.
8:58
Khalid Yousuf: It's a tougher fracture.
9:00
Khalid Yousuf: You have to open it.
9:02
Khalid Yousuf: Um, and, and then.
9:04
Khalid Yousuf: Successfully accomplished that.
9:06
Khalid Yousuf: Um, surgery, that's when it culminated.
9:09
Khalid Yousuf: And, and on that drive home, I was, you know, I'm o okay to say, you know, almost like teary-eyed that hey, wow, it's gone from where I couldn't even maybe, you know, do a vertical mattress suture to now I, I took this person who got in a car wreck, you know, and now myself.
9:28
Khalid Yousuf: Reduced it.
9:29
Khalid Yousuf: Fixed it, and you know, hopefully he'll have a union.
9:32
Khalid Yousuf: Um, I didn't get follow up, you know, residency always get follow up.
9:35
Khalid Yousuf: But, but the, but the point is that that was a transformative, uh, realization in my life.
9:41
Khalid Yousuf: Uh, and uh, I think that's when it became, um, a reality that, hey, this is gonna happen.
9:47
Khalid Yousuf: Uh, and, and, and soon enough I'll be a board certified orthopedic surgeon.
9:52
Khalid Yousuf: And, and I, the responsibilities I should be able to.
9:56
Khalid Yousuf: As long as I keep doing what I've done to this point.
9:59
Joseph M. Schwab: you know, we had a former chairman, uh, in, in my program who used to say nothing kills enthusiasm, like, follow up.
10:06
Joseph M. Schwab: So.
10:06
Joseph M. Schwab: A good thing you didn't get follow up on that patient.
10:09
Joseph M. Schwab: Right.
10:10
Joseph M. Schwab: That's just, you just run the risk of killing the enthusiasm.
10:14
Khalid Yousuf: Yeah, for sure.
10:15
Khalid Yousuf: Tough university patients for sure.
10:17
Joseph M. Schwab: Yeah, for sure.
10:18
Joseph M. Schwab: Um, so then you end up at the Mayo Clinic with, um, a fellowship in adult reconstruction.
10:24
Joseph M. Schwab: Tell me about how you ended up in adult reconstruction when now you've gone from n knowing whether you want, uh, to deal with sick patients or hurt patients.
10:34
Joseph M. Schwab: To certain types of hurt patients.
10:36
Joseph M. Schwab: How, what was that like?
10:39
Khalid Yousuf: Yeah.
10:39
Khalid Yousuf: And so that required for me, um, um, uh, a lot of my peers at in residency were saying, Hey, you're putting the cart before the horse.
10:47
Khalid Yousuf: Course, but I honestly, um, for me, that's just how my mind was working.
10:52
Khalid Yousuf: And it was, I was torn between spine joints, uh, maybe even trauma.
10:57
Khalid Yousuf: I, I kinda liked some of the bigger surgeries that came with trauma.
11:00
Joseph M. Schwab: Mm-hmm.
11:02
Khalid Yousuf: And then, so I, I basically said I wanna live in Dallas, Texas.
11:07
Khalid Yousuf: That was the goal at the time.
11:09
Khalid Yousuf: And, uh, so kind of worked backwards and I said, Hey, what kind of jobs are out there in Dallas?
11:15
Khalid Yousuf: And, and going back to.
11:17
Khalid Yousuf: Circa 2010, right?
11:19
Khalid Yousuf: Like joints was not as popular as it is today.
11:23
Khalid Yousuf: And the, the patients were in hospitals for, um, at the VA for our rotation.
11:28
Khalid Yousuf: They were at the hospital for easily three to five days.
11:31
Khalid Yousuf: Um, and the, we had a great private practice experience as part of our residency.
11:35
Khalid Yousuf: So even in the private sector, they were in the hospital for, uh, you know, one night for sure, maybe even two nights.
11:43
Khalid Yousuf: Uh, the Medicare two night rule was like, you know, full effect, all these types of things.
11:48
Khalid Yousuf: So the job market told me joints is gonna lead to maybe a better, um, uh, you know, salary and, and that type of situation.
11:57
Khalid Yousuf: Um, having a family, uh, or having family of family doctors.
12:03
Khalid Yousuf: 'cause we have a lot of family doc in our pri uh, in our family, in the use of family.
12:07
Khalid Yousuf: Um, and seeing how.
12:09
Khalid Yousuf: They were always connected to patients.
12:11
Khalid Yousuf: I think I always did better with, um, chronic, uh, patients, chronic ailment patients.
12:16
Khalid Yousuf: From that standpoint, I bonded with them better, so I was drawn to, um, joints and spine for that reason.
12:24
Khalid Yousuf: And then the surgery of joints, uh, just fit my, uh, like, um.
12:31
Khalid Yousuf: My engineering mind a lot better.
12:33
Khalid Yousuf: I, I, I really felt like, uh, I understand these concepts better.
12:38
Khalid Yousuf: The materials are exciting to me'cause it was not being taught well at the time.
12:44
Khalid Yousuf: To me, not, not a fault of the residency, but in na in general, we didn't understand metals and plastics and ceramics.
12:51
Khalid Yousuf: So I liked reading about that and just understanding that.
12:55
Khalid Yousuf: Um, and so that was the attraction, um, into joints.
12:59
Khalid Yousuf: And then the business side of my mind really kicked into, and I don't think this is a negative, but the business mind, the mind said okay.
13:07
Khalid Yousuf: If I do this operation well, uh, and one of my mentors did do it well, um, and efficiently.
13:14
Khalid Yousuf: I was like, wow, he's doing, like at that time there was, you know, Charlie, uh, Charlie was probably not even in residency.
13:21
Khalid Yousuf: He was probably in med school too.
13:22
Khalid Yousuf: Yeah.
13:22
Khalid Yousuf: Charlie's only four years ahead of me.
13:25
Khalid Yousuf: So at that point, uh, Charlie maybe was in residency, I guess.
13:28
Khalid Yousuf: Um, there's no 12 by 12, I mean Dr.
13:31
Khalid Yousuf: Ache would do sticks in the day.
13:34
Khalid Yousuf: And was doing very well financially.
13:38
Khalid Yousuf: And, um, I looked up to him and I thought, man, I could do six of these a day also.
13:44
Khalid Yousuf: Um, and that means x and that means, you know, paying off debt in school and all of that kind of stuff.
13:51
Khalid Yousuf: So I said, why not do this?
13:53
Khalid Yousuf: And my attention span, uh, is better for, you know, a good hour and a half'cause that's how long joints took about at that time, versus a three hour, you know, spine case or something like that.
14:04
Joseph M. Schwab: or a five hour trauma
14:05
Khalid Yousuf: again, a lot of reflection I made.
14:07
Khalid Yousuf: I'm very deliberate with my decision that I'm grateful for that.
14:10
Khalid Yousuf: Sometimes I'm slow making my decisions.
14:12
Khalid Yousuf: Um, but those deliberate thoughts and conversations with people led me to joints and that's kind of what led me to
14:21
Joseph M. Schwab: this is, it's interesting you mentioned this,'cause this is what always struck me about you.
14:26
Joseph M. Schwab: Um, in, uh, when we first met each other, uh, on, I, I think even looking at residency programs, right?
14:35
Joseph M. Schwab: We were, we were interviewing for residency programs together was how thoughtful and deliberate and contemplative you were.
14:44
Joseph M. Schwab: Um, and I, you know, the.
14:45
Joseph M. Schwab: Uh, in one sense that could be viewed as making, um, decisions slowly in another sense.
14:51
Joseph M. Schwab: Like that's kind of what you want in a doctor who's you're putting, you know, a portion of your livelihood in their hands.
14:57
Joseph M. Schwab: So that was something that always struck me about the way you approach things and, and one of those areas that we reconnected in.
15:06
Joseph M. Schwab: Was you were a few years into your practice before you decided to do anterior approach, total hips.
15:14
Joseph M. Schwab: Tell me a little bit about that.
15:16
Joseph M. Schwab: That must have been a deliberative process for you as well.
15:19
Khalid Yousuf: Yeah, for sure.
15:21
Khalid Yousuf: So, um, Rob Trusdale, who many know, um, just amazing surgeon, right?
15:27
Khalid Yousuf: Such a charismatic individual.
15:29
Khalid Yousuf: I really am grateful that he taught me so much and was part of our life.
15:35
Khalid Yousuf: I wrapped up fellowship with his rotation near the end by design.
15:39
Khalid Yousuf: Everyone spoke highly of him and I didn't want to rotate with him early on'cause I wanted my hands to be better.
15:45
Khalid Yousuf: I wanted the program to know me better, so I get to have more autonomy, especially at a place like the clinic where autonomy, something is you really gotta earn your chance at autonomy, rightfully so.
15:58
Khalid Yousuf: So, um, I wrap up.
16:01
Khalid Yousuf: I'm doing, you know, it's, hi, uh, it's him for six weeks and PAGs for six weeks.
16:06
Khalid Yousuf: And I'm saying, man, I'm a posterior approach.
16:09
Khalid Yousuf: This is it.
16:10
Khalid Yousuf: These guys are master surgeons.
16:12
Khalid Yousuf: And Robbie just said, Rob goes, so what do you think of anterior approach?
16:16
Khalid Yousuf: Because I'd done Mike ton's rotation prior.
16:19
Khalid Yousuf: Mike's a amazing individual and great up and coming leader now, and just great guy.
16:26
Khalid Yousuf: And at that time.
16:28
Khalid Yousuf: Even in his first two years, he, you know, got me through anterior approach and helped me, taught me so much.
16:35
Khalid Yousuf: I mean, so much of it all started with m right, and I gotta give him credit.
16:39
Khalid Yousuf: So, uh, a Trusdale said, you, you do the approach you end your rotation with, and.
16:50
Khalid Yousuf: So that's what, you know, um, he said that just'cause you're most comfortable, you're gonna leave and this is gonna be your memory and you're gonna go into practice and that's what you might do.
17:00
Khalid Yousuf: So, um, my other co-fellow, Nate Nelms was at the meeting this past year and Nate's amazing, smart individual, and Nate was all in on the anterior approach.
17:11
Khalid Yousuf: Jamie, the other co-fellow was all in on the anterior approach and I was like, I don't know.
17:16
Khalid Yousuf: I'm not sure.
17:18
Khalid Yousuf: So go.
17:18
Khalid Yousuf: Uh, so that's where I ended.
17:20
Khalid Yousuf: Now, I did go 50 51st year out.
17:21
Khalid Yousuf: So full disclosure, first year out I was 50 50.
17:24
Khalid Yousuf: And um, ironically, I did the hard hips from the front.
17:30
Khalid Yousuf: And so everyone said, why are you doing the hard hips from the front?
17:33
Khalid Yousuf: Again, my crazy mind said, the hard hips are the ones that.
17:38
Khalid Yousuf: I don't have a pa, I get like a hospital assigned, you know, retractor holder and they don't know how to control the thigh and the leg and it's hard for me to bro, but they can hold retractors when they're on the other side of the bed.
17:52
Khalid Yousuf: And so, um, so the approach which is harder for me at that age, the releases, which are harder for me at that point in my career.
18:01
Khalid Yousuf: Are me problems I can fix me problems I can't fix, Hey, hold the leg this way, or be intuitive and know that I'm doing this or do that.
18:10
Khalid Yousuf: You know?
18:11
Khalid Yousuf: 'cause your body's moving this way and you're like, today my PA just looks at how I stand.
18:15
Khalid Yousuf: She knows, okay, move this way'cause he's doing that.
18:18
Khalid Yousuf: I didn't have that luxury, that and so, so hard hips anterior approach.
18:24
Khalid Yousuf: So my hips, my anterior approaches were like two hour, you know, um, just challenges, but good outcomes.
18:33
Khalid Yousuf: Um, that's how I did it.
18:34
Khalid Yousuf: So for me it was 50 50'cause couldn't go through a day of multiple hips that were two hours long for me at that time, but got better and better and better.
18:44
Khalid Yousuf: So that was that.
18:45
Khalid Yousuf: Again, thinking through the process and solve the problems that are in your control.
18:50
Khalid Yousuf: Maybe don't worry about the problems that are not in your control.
18:53
Khalid Yousuf: It's, um, what I would teach to the audience or remind the audience that's listening to this podcast, we get so caught up on, you know, other people's problems and that's not our problem's.
19:02
Khalid Yousuf: Just do, do you?
19:04
Joseph M. Schwab: Right, right.
19:05
Joseph M. Schwab: My, uh, my wife was reading a book called, I think it was called Let Them, and it was about, uh, you know, when other people get worked up and tell you what you should do.
19:14
Joseph M. Schwab: All right.
19:14
Joseph M. Schwab: Let'em, let'em tell you, you know, let, let them get worked up.
19:17
Joseph M. Schwab: That's just fine.
20:25
Joseph M. Schwab: So in that journey of you becoming an anterior approach predominant surgeon, um, you reached out to the anterior hip foundation, and if I'm mis if I'm, unless I'm mistaken, you pioneered the idea of the traveling fellowship for the a HF You were the f essentially the first or one of the first formal traveling fellows for the a HF.
20:50
Joseph M. Schwab: Isn't that right?
20:52
Khalid Yousuf: I, I, um, I think I was the inaugural traveling fellow, and I think the idea came again.
20:58
Khalid Yousuf: Having a connection with you and Charlie.
21:01
Khalid Yousuf: The idea was, so I came to the meeting and really, um, enjoyed the meeting.
21:08
Khalid Yousuf: And then as I went home, so probably at this point in my career, I'm um, um, probably 70 30 inch here posterior.
21:17
Khalid Yousuf: Um, and really it was only 70 30 at that point because of limitations and resources at the hospital.
21:24
Khalid Yousuf: So if I had two, if I had two rooms, I had one table.
21:27
Khalid Yousuf: It was hard to like move the table and that kind of stuff.
21:30
Khalid Yousuf: So, so I would still do posterior, but for sure I didn't do revisions posteriorly and I wanted to.
21:38
Khalid Yousuf: And I was transitioning my practice from a, uh, purely employed hospital practice in Chicago to a private emic practice in Dallas, uh, at Baylor.
21:50
Khalid Yousuf: So the Baylor in Dallas is different than the Baylor in Houston.
21:53
Khalid Yousuf: The Baylor in Houston's a big academic center at the Texas Medical Center versus the Baylor in Dallas is a more of a, uh.
22:01
Khalid Yousuf: PRI private demo is what we would call it.
22:03
Khalid Yousuf: We've got residency, we've got, uh, a foot and ankle fellowship.
22:06
Khalid Yousuf: Um, but you can also just be a employee of Baylor as an orthopedic surgeon.
22:11
Khalid Yousuf: Just do that life if you want, or you can have what I have, which is, uh, exposure to, to residents, uh, uh, which I enjoy.
22:20
Khalid Yousuf: So this transition's about to happen and I'm coming to a new market and, uh, everything is.
22:26
Khalid Yousuf: Bigger, faster wilder in Texas.
22:29
Khalid Yousuf: So I knew I didn't want to come into this market, um, and not be, uh, the best, uh, surgeon I can be.
22:37
Khalid Yousuf: And, and I wanted to take some time at that point to, to get better.
22:41
Khalid Yousuf: And that doesn't happen from textbooks, I don't believe.
22:43
Khalid Yousuf: I think it's very important to take the time and go travel and, and reflect and learn and, and have those inter meaningful interactions with.
22:53
Khalid Yousuf: Other leaders in this space.
22:55
Khalid Yousuf: Um, so, uh, fortunately I talked to Joe, uh, I talked to you and, and, uh, and basically said, I've got this idea that I wanna travel, but, um, I can go do a visitation with a industry sponsor trip.
23:09
Khalid Yousuf: I can go do that on my own.
23:11
Khalid Yousuf: Um, but I don't wanna just do it that way.
23:14
Khalid Yousuf: I wanna make it more formal.
23:17
Khalid Yousuf: Um, that's what I want.
23:19
Khalid Yousuf: I want it, I want it to be a line item on my CV that I really put the time into it, which deserves the, the memorialization of it on, on a resume.
23:29
Khalid Yousuf: So we worked through all of that, that goes into that.
23:31
Khalid Yousuf: We, uh, you guys helped me identify people like Nick Maths, that, you know, the name was very, uh, known to me through literature, but I didn't know him personally at all, and his name was given to me.
23:43
Khalid Yousuf: Of course Dr.
23:44
Khalid Yousuf: De Cook, Jonathan, you asked me is Charlie, who, who now all three are so close to me.
23:49
Khalid Yousuf: Um, you know, their names were given to me.
23:52
Khalid Yousuf: Tom Bradbury, what a great guy and stud surgeon.
23:56
Khalid Yousuf: Um, but, you know, a deficiency of mine.
24:00
Khalid Yousuf: But I didn't know him at the time.
24:01
Khalid Yousuf: I didn't know his name, his literature, but you guys introduced me to him.
24:06
Khalid Yousuf: Um, George Gale, I mean he, George was a year behind me at LSU.
24:11
Khalid Yousuf: Um, but we didn't know each other well.
24:13
Khalid Yousuf: 'cause George was out there partying of course, as you would know, and, and driving fast cars.
24:18
Khalid Yousuf: And I don't, I don't wanna say he's married now, but maybe chasing women.
24:21
Khalid Yousuf: Who knows, right?
24:22
Khalid Yousuf: I don't know.
24:23
Khalid Yousuf: But I didn't know him at that time, even though he was a year behind me at LSU and Katrina.
24:28
Khalid Yousuf: The years you get to know your, the junior class in the senior class, like the, the two years that get to know each other is the clinical years.
24:34
Khalid Yousuf: And in my clinical year, I got shipped out'cause Hurricane Katrina hit.
24:38
Khalid Yousuf: So I really didn't get to bond with them.
24:40
Khalid Yousuf: And I meet him at that trip and we connect and say, Hey, wow, we're both at LLU.
24:44
Khalid Yousuf: We're both from New Orleans.
24:45
Khalid Yousuf: Like what a small world.
24:47
Khalid Yousuf: And learning how to do hip resurfacing from the front, which is what he taught me.
24:52
Khalid Yousuf: I mean, these were the interactions I gained in that traveling fellowship.
24:56
Khalid Yousuf: So formative for my career.
24:58
Khalid Yousuf: Honestly, I think put me on the map.
25:01
Khalid Yousuf: 'cause at that point, um, I'm being asked to talk about anterior approach, how I do revisions from the front of coming back and doing things that are uncomfortable again, but better for patient care and working through that.
25:13
Khalid Yousuf: So, so that is really when you're all in now, right?
25:17
Khalid Yousuf: You can't go be the anterior hip fellow, the first one and then come back and say, Yeah, I'm gonna book a poster approach.
25:23
Khalid Yousuf: But no, it doesn't work that way.
25:25
Khalid Yousuf: You're all in, everyone knows you took time off work.
25:27
Khalid Yousuf: Um.
25:28
Khalid Yousuf: My partners knew I went and did this.
25:30
Khalid Yousuf: They're excited and they're saying, wow, you, you're, let me send you this VMI 50.
25:35
Khalid Yousuf: You're gonna do it from the front.
25:36
Khalid Yousuf: And I'm like, Yep.
25:37
Khalid Yousuf: I am bikini incision from the front.
25:39
Khalid Yousuf: You know, let me send you this revision.
25:41
Khalid Yousuf: And I'm like, yep.
25:43
Khalid Yousuf: Uh, your pelvis looks good on the backside.
25:46
Khalid Yousuf: I don't think I need to get back there.
25:47
Khalid Yousuf: Everything's in the front.
25:49
Khalid Yousuf: I'm gonna go through the front.
25:50
Khalid Yousuf: I can use fluoro to my advantage.
25:52
Khalid Yousuf: I can take that new cup out, keep my hip center where I want.
25:54
Khalid Yousuf: It's not blind for me.
25:56
Khalid Yousuf: Absolutely.
25:57
Khalid Yousuf: You know, then you're presenting it in residents or.
26:00
Khalid Yousuf: They're looking at you always keeping you honest.
26:03
Khalid Yousuf: And um, so that was such a, that 12 months meant a lot happened for me in 20 17, 20 18, um, sorry, 27, uh, 20 18, 20 19.
26:15
Khalid Yousuf: A lot happened for me in those 12 months.
26:17
Khalid Yousuf: Um, um, so very grateful for that opportunity and highly, highly, highly recommend all surgeons.
26:24
Khalid Yousuf: Probably every six years, five years, maybe even.
26:27
Khalid Yousuf: You should stop.
26:29
Khalid Yousuf: It takes some time to go watch other people learn from other people.
26:33
Khalid Yousuf: Um, and specifically like the Anter Foundation, we have such a great opportunity now.
26:38
Khalid Yousuf: We take four fellows a year.
26:40
Khalid Yousuf: Um, it's international flavored.
26:42
Khalid Yousuf: I mean, it's, it's just a great opportunity for, for anyone who's trying to get better at their craft.
26:49
Khalid Yousuf: Um, you know, another thing that comes to mind, I think you're gonna appreciate this joke.
26:55
Khalid Yousuf: We're surgeons, right?
26:56
Khalid Yousuf: We call each, we we, we are surgeons.
26:58
Khalid Yousuf: Absolutely we're surgeons, but in a way we're artisans, right?
27:03
Khalid Yousuf: We, we are crafting something.
27:04
Khalid Yousuf: So if you go back to like the Renaissance and you wanted to learn how to make the best like arm law, you'd find the guy who makes it the best and learn some skill sets from him.
27:17
Khalid Yousuf: And then what if you figured out that, hey, there's someone else who makes really good metal hinges.
27:23
Khalid Yousuf: And because your arm wall's gotta have doors, then you go to like this metal guy and learn how to like craft metal.
27:28
Khalid Yousuf: 'cause you want your door handles to be more intricate and um, and the hinges to be just seamless and soft clothes or whatever.
27:36
Khalid Yousuf: I don't know, I'm just, well I picked Armo wall.
27:38
Khalid Yousuf: I don't even know I picked our arm wall, but my, that's the example that comes to mind right now that we are artisans would wanna learn our craft from the best.
27:45
Khalid Yousuf: So I think the point of my career I'm at now is I talk to certain people when I see them.
27:52
Khalid Yousuf: About, you know, cup and I really think they understand the cup so well and I wanna know about the cup from them.
27:59
Khalid Yousuf: And then there's others I run into and I say, Hey, talk to me about femur.
28:03
Khalid Yousuf: Others I talked to about approach, uh, others.
28:06
Khalid Yousuf: I talked about bearings and implants and get to that.
28:09
Khalid Yousuf: I'm excited about that phase in my career where I'm at, where I'm trying to say, Hey, you are the artisan of acetabular, you know, understanding.
28:17
Khalid Yousuf: I wanna learn that from you.
28:19
Khalid Yousuf: 'cause the best version of me is a, is a combination.
28:23
Khalid Yousuf: I'm very proud of my Pakistani heritage, so I'm not gonna call it Jamal.
28:27
Khalid Yousuf: I'm gonna call it Biani.
28:28
Khalid Yousuf: So the biani, which is rice and spice and meat and everything in one pop and tastes amazing.
28:34
Khalid Yousuf: If you haven't tried it, you should go try some biani tonight.
28:37
Khalid Yousuf: But, uh, uh, you can't just get from one person.
28:41
Khalid Yousuf: You just can't.
28:42
Khalid Yousuf: You gotta get your best.
28:43
Khalid Yousuf: Bani is gonna happen when you go pick up everything from everyone different, sorry for the long answer, but
28:50
Joseph M. Schwab: no, I uh, I love it.
28:52
Joseph M. Schwab: It's fantastic.
28:54
Joseph M. Schwab: Um, as you've gained that experience, did your definition of success change?
29:02
Khalid Yousuf: Uh, Yeah.
29:03
Khalid Yousuf: I think, uh, yes.
29:04
Khalid Yousuf: I think the answer is yes.
29:06
Khalid Yousuf: Uh, have I reflected upon that at that time?
29:10
Khalid Yousuf: I, I'm sure I did.
29:11
Khalid Yousuf: Right?
29:11
Khalid Yousuf: Success at that time was measured in terms of, um, big picture things.
29:15
Khalid Yousuf: I was measuring my success of.
29:18
Khalid Yousuf: Hey, did I accomplish this revision from the front and dysplasia, which was scary for me, and I was seeing a lot of dysplasia, and so it was very, um, uh, uh, success.
29:27
Khalid Yousuf: Uh, I measured success when Charlie and Jonathan would respond back to my post-op x-rays because I would shoot on my pre-op x-rays and say, this is my challenge.
29:38
Khalid Yousuf: Can I do this from the front?
29:39
Khalid Yousuf: Question number one, the answer sounds so obvious right now.
29:42
Khalid Yousuf: Yes, you can do it from the front, but at that time it wasn't obvious.
29:45
Khalid Yousuf: You know, that was the reality.
29:47
Khalid Yousuf: And that was a, again, a me thing.
29:49
Khalid Yousuf: Like, Hey, can I,'cause they'd met me, they'd worked with me.
29:52
Khalid Yousuf: So the question was very.
29:54
Khalid Yousuf: And I think that's so important when people say, can I do this?
29:58
Khalid Yousuf: I don't know you yet.
29:59
Khalid Yousuf: I don't know if you can do it yet, you know, but those guys knew me and they were saying, I know you, I know you can do this from the front.
30:06
Khalid Yousuf: And that is so powerful.
30:08
Khalid Yousuf: And, and again, I, I would, I wish everyone have people like that in your life.
30:13
Khalid Yousuf: Um, um, even your spouses, I hope are doing that for you in your life.
30:16
Khalid Yousuf: You know, be that for your kids, right?
30:18
Khalid Yousuf: Hey, I know you can do that.
30:20
Khalid Yousuf: You know,'cause I know you really well.
30:22
Khalid Yousuf: Now I would go do it and, and then they would be honest with me and say, why did your cup end up where it ended up?
30:28
Khalid Yousuf: Could have been lower.
30:29
Khalid Yousuf: No, it couldn't have been.
30:30
Khalid Yousuf: Well, tell me why you think it couldn't have been And that reflection was such a, a helpful thing.
30:35
Khalid Yousuf: So I magic success like that for sure.
30:38
Khalid Yousuf: At that point.
30:39
Khalid Yousuf: And then I measured success with referrals because when non Baylor doctors in Dallas were calling me saying, I have a problem.
30:47
Khalid Yousuf: I've heard about you and I wanna send this to you.
30:50
Khalid Yousuf: Can you help this person?
30:51
Khalid Yousuf: I felt like that was success.
30:53
Khalid Yousuf: Like these two things.
30:54
Khalid Yousuf: I, I think I was measuring success with these two readily, real time, um, uh, weekly, monthly, you know, at that time for sure.
31:02
Joseph M. Schwab: You mentioned that you're always working to get better, um, always working to make yourself a better surgeon to learn more.
31:10
Joseph M. Schwab: What's, what's the motivation, um, to pushing yourself toward becoming the best version of of you
31:19
Khalid Yousuf: Uh, yeah, I think probably again, family, right?
31:24
Khalid Yousuf: Two parts of the family.
31:25
Khalid Yousuf: One, I think, uh, my dad.
31:28
Khalid Yousuf: The sacrifices that he made, the sacrifices that my mom made to get to this country and being an immigrant family, um, I think, um, means so much was put into me.
31:40
Khalid Yousuf: And so what's gonna, you know, what's the product of that?
31:44
Khalid Yousuf: And that product better be really good.
31:46
Khalid Yousuf: So that pressure, uh, I put on myself, I think is, um, um, part of it.
31:51
Khalid Yousuf: And now I got, um, now on the other hand, there's, uh.
31:56
Khalid Yousuf: There's a potential echo chamber, right?
31:58
Khalid Yousuf: Those are your kids.
31:59
Khalid Yousuf: So are they gonna echo?
32:01
Khalid Yousuf: I I and I definitely, um, I don't have any pressure on them.
32:07
Khalid Yousuf: Hey, you need to be an orthopedic surgeon, or even a physician for that matter.
32:10
Khalid Yousuf: But for sure the echo that I would love to see.
32:14
Khalid Yousuf: Is they are the best, best version of themselves.
32:16
Khalid Yousuf: We all want that for our family and kids and, and people around us that we love.
32:20
Khalid Yousuf: And so actions are what make that happen and verbalizing that commitment, I think it's so important to verbalize that intent.
32:27
Khalid Yousuf: For me to come out here and say that to you, Um, in a vulnerable space and do that puts me on the spot, right?
32:33
Khalid Yousuf: Same thing like going on the anterior foundation.
32:35
Khalid Yousuf: You verbalize that commitment.
32:36
Khalid Yousuf: Not everyone knows your intent.
32:38
Khalid Yousuf: You gotta, you know, shut up or put up, right?
32:41
Khalid Yousuf: And so at that point, like, you know, I, I love these things, right?
32:45
Khalid Yousuf: Um, uh, and so these are the types of things I think that motivate me to be the best version of me.
32:51
Khalid Yousuf: And for sure, we can never forget the patients that entrust in us that, you know, we, that they, they need care.
32:57
Khalid Yousuf: And they, they truly, honestly say, you know, I trusted you.
33:02
Khalid Yousuf: Please help me.
33:04
Khalid Yousuf: There's a lot to that one simple sentence when they say, I trusted you.
33:08
Khalid Yousuf: Trusted you for what?
33:09
Khalid Yousuf: Just that 30 minutes to do the hip or trusted you that the journey you've taken to this is the best version of you today.
33:16
Khalid Yousuf: Hence the next 30 minute operation will be the best output.
33:20
Khalid Yousuf: Right?
33:20
Khalid Yousuf: And that's how I hear that question.
33:24
Joseph M. Schwab: Um, if you could, so first of all, I want to thank you for your time.
33:29
Joseph M. Schwab: You've been more than generous with us, and as always, your ability to be contemplative, to be thoughtful and um, to be measured and well-spoken and, and defend what you say.
33:42
Joseph M. Schwab: I, I, I always, it's one of the things I appreciate the most about you and have appreciated about.
33:48
Joseph M. Schwab: Our friendship, the, the, if I could ask one last question.
33:54
Joseph M. Schwab: If you could write a note, um, to the next generation of orthopedic surgeons and, um, leave it in every or locker room all around the world, what would it say?
34:10
Khalid Yousuf: Hmm.
34:11
Khalid Yousuf: So the surgeons in the or I would say?
34:15
Khalid Yousuf: turn a tough problem into a simple problem.
34:19
Khalid Yousuf: Um, it's what I told myself repeatedly.
34:21
Khalid Yousuf: Every time I saw revisions and they were hard and I turned a revision, I, I wanted to turn that revision into a primary.
34:29
Khalid Yousuf: Um, so turn simple problems into, uh, turn tough problems.
34:33
Khalid Yousuf: Into simple problems.
34:35
Joseph M. Schwab: Not the other way around.
34:36
Khalid Yousuf: yeah, Not the other way around.
34:38
Khalid Yousuf: Absolutely.
34:39
Khalid Yousuf: I hope, I hope what they take from that is, you know, when you're seeing, if you're a trauma guy and you see a bunch of pieces, make'em into combination of pieces and, and, and, you know, six turns into four, it turns into two type of thing.
34:53
Khalid Yousuf: If you're doing a, a primary hip, break it down into, let me get my approach right.
34:58
Khalid Yousuf: Let me get my cut right, let me get my exposure, you know, releases.
35:02
Khalid Yousuf: Right.
35:02
Khalid Yousuf: Simplify it in your life and, and, and do that.
35:05
Khalid Yousuf: Um.
35:07
Khalid Yousuf: Then I would tell, uh, if I could leave a message to, to anyone or something I share with everyone is you just really can't be the best at everything.
35:15
Khalid Yousuf: And so just remember for every, everything that's a yes, something's a no, and it's okay to pick your top, you know, three, four, or five things.
35:25
Khalid Yousuf: Be the best at those, right?
35:26
Khalid Yousuf: And so, uh, prioritize those, verbalize those intent.
35:30
Khalid Yousuf: Be intentional in the things that you do.
35:32
Khalid Yousuf: And I think, um, uh, at the end of the day, at the, I hope that you're, uh, happy with, uh, what you're doing at that point
35:41
Joseph M. Schwab: What
35:42
Khalid Yousuf: and love the people in your life.
35:43
Khalid Yousuf: I think friendship is such, I mean, that's, this is where this all comes from, friendship and, and sincerity.
35:48
Khalid Yousuf: So I appreciate you for just having me on here and, and love the people in your life for that.
35:53
Joseph M. Schwab: I, I, uh, I said it was one last question, but I, I lied and I actually, you, you made me think of another one.
35:59
Joseph M. Schwab: So for all the things, tell me the number one thing that you wanted to say yes to, and the number one most difficult thing you had to say no to
36:13
Khalid Yousuf: Eh, ally, it's a easy question.
36:16
Khalid Yousuf: My mind goes to non-orthopedic there, but, but orthopedically, it's easy.
36:19
Khalid Yousuf: I really wanted to say yes to shoulder replacements.
36:23
Khalid Yousuf: um, really wanted to do shoulder replacement.
36:26
Khalid Yousuf: The, the, the 12 by 12 to in my world was, uh, Dr.
36:32
Khalid Yousuf: Sperling at the Mayo Clinic shoulder guy, and he would do 18 shoulders, uh, on an operative day.
36:39
Khalid Yousuf: And so 18 shoulders, um, that's not me.
36:43
Khalid Yousuf: Uh, sorry.
36:45
Khalid Yousuf: So I'll pause and go back.
36:46
Khalid Yousuf: So the, the, the Charlie in my life before Charlie's 12 by 12 was Dr.
36:51
Khalid Yousuf: Sperling at the Mayo Clinic.
36:52
Khalid Yousuf: He was a shoulder arthroplasty surgeon and he would do 12, uh, 18 shoulders on an operative day.
36:57
Khalid Yousuf: And, uh, and I just saw how well oiled his machine was.
37:02
Khalid Yousuf: The average shoulder replacement was about 20 minutes for sure.
37:05
Khalid Yousuf: He had resources like fellows and three rooms and all that kind of stuff, but.
37:10
Khalid Yousuf: I saw efficiency and I really love shoulders and unfortunately I had to say no to shoulders, uh, in our practice because of how it's, that's the first thing that's to know that was hard to do, um, in life.
37:23
Khalid Yousuf: Um, I think I had to say no to Chicago.
37:27
Khalid Yousuf: That was really tough.
37:28
Khalid Yousuf: I'm a big Chicago guy.
37:29
Khalid Yousuf: I love Chicago, and I had to say yes to my career.
37:33
Khalid Yousuf: Um, and so Chicago, I've got family.
37:36
Khalid Yousuf: I love the Chi Chicago, I love the Midwest.
37:38
Khalid Yousuf: I love Chicago itself.
37:40
Khalid Yousuf: Um, uh, and uh, I was there just two weeks ago and, um, to say no to Chicago because I'm saying yes to my career, my practice, my passion, my love for that, um, was really tough.
37:55
Khalid Yousuf: But.
37:56
Khalid Yousuf: Said, um, I said yes to the thing I love the most, which is, uh, hip and knee surgery in my, in my practice.
38:03
Khalid Yousuf: Um, which meant I said no to Chicago.
38:05
Khalid Yousuf: So those are my kind of answers I guess.
38:09
Khalid Yousuf: You got me thinking I day about this one now.
38:12
Khalid Yousuf: Yeah.
38:13
Joseph M. Schwab: well you'll, you'll find the video.
38:14
Joseph M. Schwab: You can always leave it in the comments below afterwards, right.
38:18
Khalid Yousuf: Yeah.
38:19
Khalid Yousuf: Don't be surprised.
38:20
Khalid Yousuf: I might.
38:21
Joseph M. Schwab: And any updates are always appreciated.
38:24
Joseph M. Schwab: Well, uh, Dr.
38:26
Joseph M. Schwab: Yusef, um, it's been too long since we've seen each other in person, but I really appreciate having the opportunity to talk with you today and again, to get to experience your thoughtfulness, your, your, your measured attitude, um, and, um, just be able to enjoy our friendship for a, a, a couple of minutes here.
38:48
Khalid Yousuf: Joe, thanks for having me.
38:49
Khalid Yousuf: It's an honor to be, uh, involved with the Your Hip Foundation.
38:53
Khalid Yousuf: Uh, I highly, highly support the traveling fellowship and the work that you guys do.
38:58
Khalid Yousuf: Um, thank you so much and I hope everyone has a great weekend the rest of the weekend.
39:03
Joseph M. Schwab: Alright, thanks.
39:06
Joseph M. Schwab: Thank you for joining me for this episode of the A HF Podcast.
39:11
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39:17
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39:20
Joseph M. Schwab: Please also drop any topic ideas or feedback in the comments below.
39:25
Joseph M. Schwab: You can find the ahf podcast on Apple Podcasts, Spotify, or in any of your favorite podcast apps, as well as in video form on YouTube slash at anterior hip foundation.
39:39
Joseph M. Schwab: All one word.
39:41
Joseph M. Schwab: episode of the A HF Podcast come out on Fridays.
39:46
Joseph M. Schwab: I'm your host, Joe Schwab, asking you to keep those hips happy and healthy and contemplative.