Latest / AHF Podcast / Scrubbing In With the Giants (2026 Traveling Fellows - Ep 1)

Transcript

Scrubbing In With the Giants (2026 Traveling Fellows - Ep 1) · AHF Podcast

• 0:21
  Joseph M. Schwab: Hello and welcome to the AHF Podcast.
• 0:24
  Joseph M. Schwab: I'm your host, Joe Schwab.
• 0:26
  Joseph M. Schwab: Every year, the Anterior Hip Foundation sends a small group of early career surgeons on the road for two and a half weeks, going city to city, scrubbing in with some of the most experienced anterior hip surgeons in the US, and some of the most innovative ones.
• 0:43
  Joseph M. Schwab: Today, I'm joined by three of the 2026 AHF traveling fellows: Dr.
• 0:49
  Joseph M. Schwab: Alex Savage from Northwestern Medicine in Chicago, Dr.
• 0:52
  Joseph M. Schwab: Anoop Prasad from Mass General in Boston by way of Imperial College London, and Dr.
• 0:58
  Joseph M. Schwab: Brent Albracht from Banner Health in Phoenix.
• 1:02
  Joseph M. Schwab: We have academic, community, and transatlantic, three very different vantage points on the same trip.
• 1:09
  Joseph M. Schwab: Gentlemen, welcome to the AHF Podcast
• 1:14
  Brent Albracht: Thanks for having us
• 1:16
  Alex Savage: to be here
• 1:17
  Joseph M. Schwab: So let's go around first of all, and I kinda gave a brief introduction, but if you can just tell me a little bit about yourself, a little bit about your practice, um, how you got to where you are, and maybe how you ended up applying for the AHF, fellowship.
• 1:31
  Joseph M. Schwab: And Brent, why don't we start with you?
• 1:35
  Brent Albracht: Yeah.
• 1:35
  Brent Albracht: So, uh, been down here in Phoenix for, uh, coming up on four years.
• 1:40
  Brent Albracht: Um, Midwest guy, uh, born and raised in Nebraska, trained in Texas and Missouri, and thought I was gonna get an anterior hip, um, training while I was in Missouri, but unfortunately, our, uh, anterior guy left, uh, just a couple months after matching into fellowship.
• 1:56
  Brent Albracht: So had a little bit of, uh, work with, uh, their trauma group, but just didn't feel like I had the immersive anterior experience that I needed to really try it on my own.
• 2:08
  Brent Albracht: Um, about two years into practice after passing boards, I was, uh, hearing the demand for it from my patient population.
• 2:17
  Brent Albracht: And so, I thought I would try it, uh, about a year ago and did a, um, a Stryker course over the weekend and had one of our new partners scrub in with me for my first four, but it didn't go well.
• 2:30
  Brent Albracht: It was, uh-- The learning curve was steep, and so really wanted to put that on pause for a little bit.
• 2:37
  Brent Albracht: And so, um, applied last year, uh, didn't work out, uh, and then was, uh, fortunate enough to get picked this year.
• 2:44
  Brent Albracht: Um, and it's been a game changer for my practice.
• 2:48
  Brent Albracht: Um, I've probably done about a dozen now since, uh, um, finishing the fellowship and just been really selective trying to, to hone in at, uh, the correct patients to get started on.
• 3:02
  Brent Albracht: But yeah, uh, the last two or three have gone smooth and, uh, happy to kinda get past that-- not past the learning curve, but at least working my way through it for sure.
• 3:12
  Joseph M. Schwab: Well, and we're gonna talk a little bit about what's different after the fellowship in a little bit, but Anoop, let's have you, um, tell us a little bit about yourself first
• 3:22
  Anoop Prasad: Yeah.
• 3:23
  Anoop Prasad: Thanks.
• 3:23
  Anoop Prasad: Um, so I'm, uh, a hip and knee arthroplasty surgeon at Mass Gen.
• 3:28
  Anoop Prasad: Um, I've been attending for probably over, uh, just over three years now.
• 3:33
  Anoop Prasad: Um, I started doing, uh, DAs when I was back in the UK.
• 3:37
  Anoop Prasad: It wasn't something that was covered, um, a huge amount in my, um, fellowship.
• 3:42
  Anoop Prasad: Um, and so I kind of visited different surgeons in the UK, um, where it was not as popular, and then decided to go to visit different surgeons in Europe, and that's where I kind of started my practice.
• 3:55
  Anoop Prasad: Um, and because of capital budget constraints, I wasn't able to have a table, so I learned an off-table technique, which, uh, which was an interesting way to go.
• 4:04
  Anoop Prasad: Um, and the interest in the AHF really for me was to try and, exactly as you described, see the most experienced anterior hip surgeons, the highest volume guys, but also to gain exposure into revision, um, DA surgery, uh, and complex ones, which I thought we, we got very good exposure to
• 4:26
  Joseph M. Schwab: Hmm.
• 4:27
  Joseph M. Schwab: Alex, tell us a little bit about your story.
• 4:29
  Joseph M. Schwab: I, uh, if I remember correctly, you're probably the earliest in your practice.
• 4:35
  Joseph M. Schwab: Is that correct, uh, amongst the three of you?
• 4:38
  Alex Savage: I am, yeah.
• 4:39
  Alex Savage: So I, uh, just hit the two-year anniversary of, uh, active practice for me, so I just passed my boards, which was nice.
• 4:44
  Alex Savage: I was prepping for that while I was on the fellowship.
• 4:47
  Alex Savage: But, um, yeah, so I am, uh, born and raised in Ohio.
• 4:51
  Alex Savage: I've done my training throughout the Midwest, and I landed here in Chicago at Northwestern's, uh, Palos Hospital in the south suburbs of Chicago.
• 4:59
  Alex Savage: Um, so I've been here with a primary hip and knee arthroplasty practice.
• 5:02
  Alex Savage: Um, I did have, fortunately, a fair amount of exposure to anterior hip arthroplasty throughout both residency and fellowship.
• 5:09
  Alex Savage: Um, but I think like anything, um, you know, I, I was always looking for more tips and tricks, more, uh, you know, ways to get efficient and, and, um, really hone in my skills in the OR.
• 5:20
  Alex Savage: I think whether you, whether you train with DA or not, uh, there is a little bit of a learning curve.
• 5:24
  Alex Savage: It's a little different when, uh, when you get started in practice.
• 5:28
  Alex Savage: Um, so I was looking to really see what the most efficient and sort of the, the best DA surgeons in the country were doing to create those, uh, highly efficient and, um, technically, um, you know, active and difficult practices.
• 5:40
  Alex Savage: So it was, it was great to see some of the things that were being done, especially from the complex revision side, but also just from a practice building side.
• 5:47
  Alex Savage: I think there's a lot to learn outside of the OR, and it was great to be able to see all those different, um, practice models that the various surgeons we spent time with were in and, um, how they, uh, managed that and sort of built up to what they have now.
• 6:02
  Joseph M. Schwab: So I- w- we're gonna get into a lot of stuff, but I wanna start with a little bit of an icebreaker question.
• 6:08
  Joseph M. Schwab: And, and maybe Anoop and Alex, this one might be for you guys specifically.
• 6:12
  Joseph M. Schwab: Shania Twain's You're Still the One, what do you think about that song specifically?
• 6:17
  Joseph M. Schwab: Can you give me your thoughts about it?
• 6:20
  Alex Savage: Honestly, some of her best work.
• 6:22
  Alex Savage: I mean, you know, it just, you can't deny.
• 6:25
  Alex Savage: Yeah
• 6:26
  Joseph M. Schwab: It's, it's something y- you, you could pull out at a, um, at, at, for instance, a, a, um...
• 6:34
  Anoop Prasad: Indications conference?
• 6:35
  Anoop Prasad: We do.
• 6:36
  Alex Savage: Yeah.
• 6:36
  Alex Savage: Indication.
• 6:38
  Alex Savage: Yeah.
• 6:39
  Alex Savage: Eminem, if you need to lighten the mood a little bit, it's always good for Eminem.
• 6:43
  Alex Savage: Uh,
• 6:44
  Anoop Prasad: just to break the, uh, ice, yeah.
• 6:45
  Anoop Prasad: Is that okay?
• 6:47
  Alex Savage: you know, morale in general in the OR, wherever you need it
• 6:50
  Joseph M. Schwab: What,
• 6:51
  Anoop Prasad: know why Brent gets away with it
• 6:52
  Joseph M. Schwab: w- what were you guys thinking when you were singing that song lovingly into each other's eyes at, uh, during the AHF?
• 7:00
  Joseph M. Schwab: That, that's what I wanna know
• 7:02
  Alex Savage: Sure
• 7:04
  Anoop Prasad: I
• 7:04
  Brent Albracht: the climax of, uh, three weeks later, you know, after, uh, just, uh, a great three weeks, so
• 7:13
  Alex Savage: That's right.
• 7:13
  Alex Savage: You know, what better way to
• 7:15
  Joseph M. Schwab: the icing on the cake, the cherry on top.
• 7:18
  Joseph M. Schwab: This was, that's what you get is karaoke Shania Twain
• 7:22
  Alex Savage: That's right.
• 7:23
  Alex Savage: What better way to express our deep appreciation and love for anterior hip arthroplasty than through the majesty of song, particularly Shania Twain?
• 7:34
  Joseph M. Schwab: So all right.
• 7:36
  Joseph M. Schwab: Thank you for indulging me.
• 7:37
  Joseph M. Schwab: Um, Anoop, y- you, you have mentioned in a post, I think it was on LinkedIn, about a cadaver lab experience with Dr.
• 7:47
  Joseph M. Schwab: Matta that you had, uh, during the, during this experience.
• 7:51
  Joseph M. Schwab: Um, and I think you said it, it's something that can't be overstated.
• 7:55
  Joseph M. Schwab: I, I wanna hear from you what it was that you experienced
• 8:03
  Anoop Prasad: Um, with, with Dr.
• 8:04
  Anoop Prasad: Matta in, in particular, you mean?
• 8:06
  Joseph M. Schwab: Mm-hmm.
• 8:07
  Anoop Prasad: Yeah, the, um, so I think the I think the opportunity, it was, it was a combination of the talk he gave as well as, um, the time, uh, in the cadaveric lab.
• 8:23
  Anoop Prasad: So the talk he gave made me appreciate kind of radiographic inclination versus acetabular inclination in a way that I'd never really thought of before, because I would previously, you know, looked at the radiograph and said,"Okay, this is where it is." And in fact, one of the revisions that I've done since is based on the fact that this was sent in by a surgeon who had taken an extreme outlet view, and in that view you don't appreciate that as you continue to medialize, you're actually coming anterior and into the ramus, right?
• 8:58
  Anoop Prasad: And this is what had happened in turn created essentially a 3D defect.
• 9:02
  Anoop Prasad: So that was the main takeaway where I thought,"Wow, I've been looking at radiographs for a long time, um, but I've never really appreciated this difference and also not appreciated the change that occurs when you go from an inlet to an outlet." So that was the kind of what I thought was remarkable in the way that he was talking about it and such, and the understanding he had, um, about how you actually calculate these versus simply drawing two lines, you know, from the, um, teardrops and then along the edge of the cup.
• 9:32
  Anoop Prasad: And then the intraoperatively, like with-- uh, sorry, um, in the actual cadaveric lab, it was his comfort with moving around the pelvis and actually the fact that he was a trauma surgeon, and so he was accessing places, and this was a recurring theme that we saw with, um, Dr.
• 9:50
  Anoop Prasad: Bradbury, um, and with Beau Mason about how you get into the pelvis and ASIS osteotomies and how you would, um, fix those, um, back, you know, pre-drilling, et cetera, et cetera.
• 10:03
  Anoop Prasad: So that was the second bit where I thought,"Well, I've been confined in a primary to these planes and to this dissection," and then to watch somebody who was so comfortable at saying,"No, there isn't a limit here.
• 10:15
  Anoop Prasad: You can just go around here, and these are the things to avoid," was quite eye-opening and I think a really good way to start the fellowship
• 10:22
  Joseph M. Schwab: Hmm.
• 10:24
  Joseph M. Schwab: Brent, you also referred to, I think, Matta as, and this is a, a common reference to him, as the godfather of, uh, anterior approach hips.
• 10:33
  Joseph M. Schwab: What is it like sort of learning a technique, a surgical technique, straight from someone who's so sort of foundational to that approach as opposed to maybe secondhand through, or thirdhand or fourth hand through trainees of trainees?
• 10:51
  Brent Albracht: I mean, just, yeah, hearing it straight from him, you know, from the, from the source, uh, hard to put into words, I guess.
• 10:58
  Brent Albracht: And, and I guess, yeah, the cadaver lab was beneficial, but yeah, I would go back to what Anoop said is, um, his...
• 11:07
  Brent Albracht: the talk that he gave before him was almost more instrumental of just how he came up with it and just a completely different way of thinking about, about the approach, I guess.
• 11:20
  Brent Albracht: Uh, it's hard to put into words
• 11:22
  Joseph M. Schwab: Hmm.
• 11:23
  Joseph M. Schwab: Um, Alex, you, um, had spent some time, I think, i-i- in part of this fellowship, one of the stops that you did was in Houston, and you had mentioned that specifically in a post that you put up on LinkedIn.
• 11:39
  Joseph M. Schwab: Tell me a little bit about what stuck with you from that stop
• 11:44
  Alex Savage: Yeah.
• 11:45
  Alex Savage: So Houston was, uh, great.
• 11:46
  Alex Savage: We were at Texas Orthopedic Hospital.
• 11:48
  Alex Savage: Uh, we were able to spend a lot of time, uh, with, uh, a handful of their surgeons, but it was great to see, um, a couple of interesting complex primaries.
• 11:58
  Alex Savage: Uh, one in particular that sticks out was just an anterior hip nail conversion, which, uh, interestingly enough, full circle, I just saw another one in clinic on Friday that I'm signing up for surgery, and, uh, I thought back to Anay Patel's, uh, case that he had with us and all the, uh, technical tips and tricks that he had to offer us with that particular case.
• 12:16
  Alex Savage: So, uh, you know, I literally was thinking about it in clinic yesterday.
• 12:19
  Alex Savage: You know, four months ago, this would've stressed me out about 10 times more than it is right now.
• 12:24
  Alex Savage: You know, I would've thought,"Oh, should I-- do I need to do this posterior?" And now I'm like,"No, I can, I can give this patient exactly the same, you know, anterior hip that I want to give all my patients.
• 12:33
  Alex Savage: Um, it's not a problem that the nail's in there.
• 12:35
  Alex Savage: I have X, Y, and Z strategies to, to take care of her and give her that, uh, same great outcome that I hope to give to all of my, you know, primary-- regular primary patients." So, um, it was great
• 12:46
  Joseph M. Schwab: So just to follow up on that, uh, because this is something y- like you said, would've stressed you out 10 times more.
• 12:52
  Joseph M. Schwab: Now it's, uh, it's something that you're much more potentially comfortable
• 12:56
  Alex Savage: Mm-hmm.
• 12:56
  Joseph M. Schwab: with dealing.
• 12:58
  Joseph M. Schwab: For your experience before and after the fellowship, if somebody who scrubs in with you regularly watched your first case after you came back from the fellowship, what's one thing that they would've noticed that was different about you?
• 13:13
  Joseph M. Schwab: I- is there, was there a technical trick?
• 13:16
  Joseph M. Schwab: Was there just a sense of confidence?
• 13:18
  Joseph M. Schwab: Tell me a little bit about that.
• 13:21
  Alex Savage: Yeah.
• 13:21
  Alex Savage: So I think, um, definitely a sense of, you know, at least myself, I feel far more confident in general.
• 13:27
  Alex Savage: I think part of that is just being early in practice.
• 13:30
  Alex Savage: I'm, I'm even a little bit earlier in practice than I think everyone else that was on the fellowship.
• 13:34
  Alex Savage: Um, but yeah, just gaining, uh, confidence with experience.
• 13:37
  Alex Savage: But I think, um, particularly the experience with, uh, the anterior hip fellowship really, um, accelerates, uh, your level of, of, of experience and confidence as you kind of move forward with surgery.
• 13:48
  Alex Savage: My efficiency has certainly gone up, uh, dramatically, I would say, since, since the fellowship.
• 13:53
  Alex Savage: Um, I-- it, it's easy to, to forget, um, how there's so many different ways to do a procedure, right?
• 14:02
  Alex Savage: You, you go through training and it's easy to remember'cause you see one attending do it for six weeks, and then you go to the next attending and you say,"Oh, this is totally different.
• 14:09
  Alex Savage: I guess it's fine.
• 14:10
  Alex Savage: You can get there either way." And then, you know, I think you get into practice and you kind of find your way of doing things and you forget that there are alternatives.
• 14:18
  Alex Savage: Um, and you forget that, you know, maybe you're not thinking about this, uh, the best way to do it.
• 14:23
  Alex Savage: Um, so this, this fellowship was a great reminder, um, that, you know, you can always be learning, you can always be, um, expanding your, your toolbox, so to speak.
• 14:32
  Alex Savage: Um, and, and that has certainly, uh, you know, benefited me in the short term, but I think really will continue to benefit me in the long term, right?
• 14:39
  Alex Savage: It's reinforced that, okay, I might think I know the best way to do this, but really, you know, there's always an opportunity to improve and, and to maybe challenge what I think is, is true and, and, and the best way, so...
• 14:50
  Joseph M. Schwab: Well, and speaking of improving things, so Anoop, you've got a, a background in research, um, specifically I think in, in the areas of patient outcomes and gait analysis.
• 15:00
  Joseph M. Schwab: Was there anything on this trip or anything that you experienced during the fellowship that made you wanna go study something that you hadn't thought to look at before?
• 15:10
  Joseph M. Schwab: Or was it mostly technical skills that you feel like you came away with?
• 15:17
  Anoop Prasad: Um I think Probably it's from a biomechanical perspective, one, one thing that I am trying to look at is the-- what we saw amazingly well, um, that was amazingly well executed was, um, these anterior trying to do revisions from the front for different defects, including 3B.
• 15:50
  Anoop Prasad: And I think the, the necessity of having kind of inferior screw fixation when you do have a buttress is something that we will be looking at.
• 15:59
  Anoop Prasad: So I think that the principles for successful placement of a, of a cup for a large defect from the back, I think will be different than it will be from the front, just because you are able to put a buttress, which I think is biomechanically superior to certain screws.
• 16:17
  Anoop Prasad: Uh, so that is something that we will be looking at, uh, for sure.
• 16:20
  Anoop Prasad: Because I think that my general sense, and, you know, you'll know more about this than I do, is, is that there are more and more people doing anterior revisions.
• 16:29
  Anoop Prasad: And I think that of the-- Actually, I think you guys must remember this.
• 16:34
  Anoop Prasad: At Texas, we had a journal club, and they were discussing the difference between anterior and posterior revisions and outcomes.
• 16:41
  Anoop Prasad: And then actually the, the point was is that you're comparing 20-year, like attendings, so some very senior guys and their outcomes with people who are just starting out doing DAs, and there wasn't really a difference shown.
• 16:55
  Anoop Prasad: We said,"Well, that's comparing apples to oranges." Even the techniques are different, their skill level or experience level is different, the equipment is different, you know, porous, whatever you wanna call it.
• 17:04
  Anoop Prasad: So I think that is something which, um, we are looking at now because there are more people who, as we continue to increase our kind of anterior hip revision cohort, we'll be comparing that against posterior.
• 17:16
  Anoop Prasad: So that will probably be the, the main one.
• 17:19
  Joseph M. Schwab: so on the fellowship itself, were-- Just to stay with you for a second, Anoop, the-- Was your exposure to primary and revisions roughly equal?
• 17:29
  Joseph M. Schwab: Was it majority primary and a couple of revisions sprinkled in?
• 17:32
  Joseph M. Schwab: Or, or what, what was it that got you thinking about revisions from an anterior perspective?
• 17:39
  Anoop Prasad: So the, the purpose of me applying for this fel- this, this fellowship was specifically to say, um, can this be done?
• 17:48
  Anoop Prasad: And it's something which I think is very technically difficult, and so it doesn't count if you haven't seen the best people do it.
• 17:55
  Anoop Prasad: You know, that, that I think is a really important point, is that you can watch any operation made to look very difficult by somebody who may not be able to do it well and then be put off by it.
• 18:04
  Anoop Prasad: So my take on this was, okay, let's actually go and see the best people in the country, and possibly the world, doing these operations, and then make a decision about whether this is an area that I would like to pursue and look at, right?
• 18:18
  Anoop Prasad: And that was-- it wasn't an answered question for me.
• 18:20
  Anoop Prasad: And I think having seen people across the different sites doing it, I then realized, okay, if you can, if you can master this art, it can be done exceptionally well with great outcomes for your patients.
• 18:33
  Anoop Prasad: And so that was the question.
• 18:36
  Anoop Prasad: Um, and I think, um, that seeing that done...
• 18:39
  Anoop Prasad: So in answer to your question about primaries versus, uh, revisions, they were majority primaries.
• 18:45
  Anoop Prasad: So there were revisions at, I would say, two or three centers, but it was also the fact that we had so many cadaveric labs where they said, you know, Dr.
• 18:54
  Anoop Prasad: Bradbury took me through a technique or took, sorry, all of us through, that we recorded, and I used that in, when I was rehearsing and prepping for a case, because it was a different...
• 19:04
  Anoop Prasad: So, um, Beau Mason showed us, um, an ACIS osteotomy.
• 19:08
  Anoop Prasad: So he did a triflange from the front, well, technically it was a biflange, but from the front, amazing, very slick, showed us how he, um, took down the ACIS, et cetera.
• 19:17
  Anoop Prasad: And then Bradbury has a slightly different take on it, where he just peels, uh, the tissue.
• 19:22
  Anoop Prasad: Um, so those things, even though they weren't anywhere close in terms of the number versus the primaries we saw, the time we got with them, um, especially in the cadaveric labs and the questions, meant that it was almost a more significant part of my experience.
• 19:37
  Joseph M. Schwab: So in the cadaveric labs, you got to explore a little bit more ideas and thoughts and maybe spend a little bit more time with techniques than when you were just observing mostly primaries during the actual clinical day.
• 19:50
  Joseph M. Schwab: Is that correct?
• 19:52
  Anoop Prasad: Yeah.
• 19:53
  Anoop Prasad: There were, uh, different centers, so a couple of the centers did have some revisions on.
• 19:58
  Anoop Prasad: Um, but, you know, it's difficult sometimes to line up revisions just for the couple, because, you know, in a lot of the places we were there for a day, maybe two days, and so you almost have to get lucky.
• 20:09
  Anoop Prasad: You know, some of the centers said,"Oh, we've got a lot of revisions tomorrow," but, you know, we were flying out.
• 20:13
  Anoop Prasad: So that I think is an essential part and one of the great things that the fellowship did, it was to organize these kind of wet labs, which meant that you almost guarantee that learning.
• 20:21
  Anoop Prasad: So I remember, um, Savage was creating a massive defect with the reamer with all his enormous might and kind of just pushed it through, and then we ended up-- Then after he created that de- and I failed to actually even create the defect, which is embarrassing.
• 20:36
  Anoop Prasad: Um, it needed a bit more force.
• 20:38
  Alex Savage: you're a good surgeon.
• 20:39
  Alex Savage: You can't, you can't mess it up, you know?
• 20:41
  Anoop Prasad: I just, I just couldn't go intra-pelvic.
• 20:43
  Anoop Prasad: Yeah, so then, um, and then Bradbury took us through, okay, how he would do it.
• 20:47
  Anoop Prasad: Here's the dissection plane.
• 20:48
  Anoop Prasad: This is where you see the defect.
• 20:49
  Anoop Prasad: This is where you'd lay a bu- a buttress down, et cetera.
• 20:52
  Anoop Prasad: And that ended up doing ex- uh, being exactly what we did, um, what I did, uh, later for a case
• 20:58
  Joseph M. Schwab: So, uh, Brent, I want to go to you'cause you had mentioned doing some anteriors before going on this fellowship, and then now wanting to learn kind of, um, a more solid technique.
• 21:08
  Joseph M. Schwab: Was there a moment on the trip where you realized that maybe a habit you had formed doing anterior approach, or maybe you hadn't had enough time to build a habit, but where something that you had, uh, a technique that you had created for yourself, uh, during your time doing anterior approach was actually working against you?
• 21:31
  Brent Albracht: I think my biggest, uh, issue I had in my prior experience was just getting the angle of the femur.
• 21:38
  Brent Albracht: I don't know, when you're on the table and you're bringing it to the floor and adducting, you think it's this shooting towards the floor at 45 degrees with your broach.
• 21:47
  Brent Albracht: But really it seems so counterintuitive.
• 21:50
  Brent Albracht: It still kind of blows my mind that you're heading more just kind of down towards yourself as if the foot was just not adducted at all, and that angle just was huge.
• 22:02
  Brent Albracht: I mean, so yeah, w- you know, a year ago was, uh, two perforations of the femur, and so when, uh...
• 22:09
  Brent Albracht: And I don't know who...
• 22:10
  Brent Albracht: I think everyone just kind of emphasized that, you know, you, you find the calcar and just almost hug that on the way down as you're dropping your hand and not too much, uh, diversion, I guess, once the leg is externally rotated anterior or posterior.
• 22:25
  Brent Albracht: Um, that's been a, a, just a, a big game changer for me.
• 22:28
  Brent Albracht: And then, you know, you had talked about the cada- uh, cadaver labs.
• 22:31
  Brent Albracht: It was a nice spacing of them, so we had one at our second stop in California, so early on.
• 22:38
  Brent Albracht: Uh, but it was also after our first stop with Dr.
• 22:40
  Brent Albracht: Sah, so we got to see s- you know, things in San Francisco, then do a cadaver lab in LA, and then get a couple more stops in Houston and North Carolina, and then we did another cadaver lab in, um, in Atlanta, and then wrapped things up with- in Atlanta and then, um, I think all of us stuck around for the cadaver lab, uh, at AHF then as well.
• 23:01
  Brent Albracht: So a total of three cadaver labs evenly spaced, and to try new things as we were seeing things in OR and then could go and experiment with those, uh, or challenge our minds in the cadaver lab as we picked things up along as we went.
• 23:17
  Joseph M. Schwab: So we're gonna get to some more questions in just a second, but before we do that, I, I'd like you guys to just walk me through briefly what the schedule was.
• 23:27
  Joseph M. Schwab: What were the different sites that you went to in order, roughly how much time did you spend at them, and, um, what were the things that you experienced there, both surgery and cadaver lab?
• 23:37
  Joseph M. Schwab: And maybe if there's, um, if there was a, an event or something that you went to there, just to kinda give our listeners an idea of what that agenda was like.
• 23:47
  Joseph M. Schwab: And I'll-- Y- you guys can talk amongst yourselves.
• 23:49
  Joseph M. Schwab: I wanna hear it from all of you
• 23:53
  Alex Savage: Yeah.
• 23:54
  Alex Savage: So we, uh, we started in California, uh, with Dr.
• 23:57
  Alex Savage: Sah.
• 23:58
  Alex Savage: Um, we I think had a total of two to three days with him.
• 24:02
  Alex Savage: We saw two operative days with him.
• 24:05
  Alex Savage: Um, we went to a Giants game, which was a blast, and Anoop saw his first grand slam.
• 24:09
  Alex Savage: I told him baseball is normally not this exciting, so don't get,
• 24:12
  Anoop Prasad: Yeah.
• 24:13
  Alex Savage: it twisted.
• 24:14
  Alex Savage: But, uh, he got a great, he got a great, uh, first experience with that, so that was an absolute blast.
• 24:19
  Alex Savage: But, um, yeah, Dr.
• 24:20
  Alex Savage: Sah was a, a fantastic host for us.
• 24:23
  Alex Savage: Um, we got to watch him operate in the, uh, in the OR for two days and, uh, pick up on a lot of efficiency tips and tricks.
• 24:30
  Alex Savage: He has a very successful high-volume, uh, private practice business and, um, you know, I think, um, uh, we had been told this ahead of time, but y- we really found this to be true.
• 24:40
  Alex Savage: As much as we learned in the OR, it was the dinners we'd have with him at night or in the car rides from one place to another where he's telling us about,"Well, when I was early in practice, I started doing this," and, you know, he calls all his patients on X, Y, and Z days, and he said,"These are the things I found to really make a difference in the patient experience and their, you know, comfort level and make sure that they are feeling well cared for and that, you know, this is why people come back to me and why they send their friends and relatives to me." Um, so it was a, it was a really fantastic start to, to the experience.
• 25:10
  Alex Savage: He was, uh, extremely...
• 25:11
  Alex Savage: You know, I know he's been instrumental in building the fellowship, and you could really just, uh, feel his passion for it, and he loves, I think, hosting people and, and sharing that knowledge and experience.
• 25:19
  Alex Savage: So, um, really, really great, great start to the trip.
• 25:24
  Joseph M. Schwab: Anoop, where did you go for the second site?
• 25:25
  Joseph M. Schwab: Tell me about that
• 25:28
  Anoop Prasad: Um, so we went to-- We, we, we went via, um, LA next, right?
• 25:34
  Anoop Prasad: So then we had the, um, the lab with, um, Matta.
• 25:38
  Anoop Prasad: Um, so that was a, a short trip for us.
• 25:41
  Anoop Prasad: Uh, and then from there we went to Texas.
• 25:44
  Anoop Prasad: So we spent, I think, uh, three days.
• 25:47
  Anoop Prasad: Was it three days, guys, in Texas?
• 25:49
  Alex Savage: I think so, yeah.
• 25:50
  Alex Savage: Mm-hmm
• 25:51
  Anoop Prasad: with, uh, Hugo, um, and Anne.
• 25:54
  Anoop Prasad: So that was a good time, and we got a good amount of kind of, uh, primaries and as, as you were saying, um, a nail conversion.
• 26:01
  Anoop Prasad: So those are interesting cases.
• 26:03
  Anoop Prasad: Um, and then from there we went to Ortho Carolina.
• 26:08
  Anoop Prasad: Um, and that was, uh, again, I think two days.
• 26:13
  Anoop Prasad: And that was, that was nice'cause it was again, like going to an academic center, and they had luckily got a few revisions on, uh, at that time.
• 26:20
  Anoop Prasad: So we managed to get stuck in on that stuff.
• 26:23
  Anoop Prasad: Um, so that was with, uh, Beau Mason and Masonist.
• 26:26
  Anoop Prasad: So that was a wonderful time, and we were hosted at their-- at, um, Beau Mason's house for dinner.
• 26:32
  Anoop Prasad: Um, I remember we went down to Beau's basement, and there was lots of guns and 3D printers and fine wine, and it was very interesting which is apparently what everyone has in their basement in North Carolina.
• 26:46
  Anoop Prasad: Um, and then, and then we went to, uh, um, Atlanta, Georgia.
• 26:51
  Anoop Prasad: So that was a wonderful experience, um, in terms of the timing.
• 26:55
  Anoop Prasad: Uh, again, cadaveric lab, um, with Dr.
• 26:58
  Anoop Prasad: Bradbury.
• 26:58
  Anoop Prasad: Uh, and then we were-- we saw, uh, DeCook doing a, a swift number of operations.
• 27:04
  Anoop Prasad: That was really interesting to see how he manages his OR team, the staff, et cetera, the efficiency.
• 27:09
  Anoop Prasad: That was, uh, amazing to see.
• 27:11
  Anoop Prasad: Uh, and then it was, you know, Porsche experience after, um, a number of joints that will remain not clarified.
• 27:20
  Anoop Prasad: So we, we did, you know, from 6:00 to 12:00, many, many joints, and then went for, went for lunch, and then went for a two-hour driving experience.
• 27:29
  Anoop Prasad: And then we managed to get, um, uh...
• 27:32
  Anoop Prasad: Well, D-Dr.
• 27:33
  Anoop Prasad: DeCook was very kind to lend us his car, and we drove for five hours to the AHF, and that was kind of the, the whole thing.
• 27:41
  Joseph M. Schwab: So
• 27:42
  Brent Albracht: that's where we were pr- I think that's where we were practicing"Shania," I think, was in the car on the way to Nashville,
• 27:47
  Alex Savage: Yeah.
• 27:47
  Alex Savage: Yeah.
• 27:47
  Alex Savage: That's where we,
• 27:48
  Joseph M. Schwab: that makes sense that that would, that would be on Dr.
• 27:52
  Joseph M. Schwab: DeCook's, um, playlists, yeah, in his car.
• 27:55
  Joseph M. Schwab: I understand it now.
• 27:56
  Joseph M. Schwab: All right.
• 27:56
  Joseph M. Schwab: I get it.
• 27:57
  Joseph M. Schwab: Um, he usually has it on repeat, I think.
• 28:00
  Alex Savage: He had the whole album in there.
• 28:01
  Alex Savage: It
• 28:02
  Joseph M. Schwab: Oh, he did.
• 28:03
  Joseph M. Schwab: I'll have to talk to him about that.
• 28:04
  Joseph M. Schwab: So, so I mean, uh, that experience sounds, um, incredible and, and Brent, I think you referred to it as, um, scrubbing with giants, right, of the ortho world.
• 28:17
  Joseph M. Schwab: W- was there a moment, um, where one of them did something, maybe even just in passing, not really a formal teaching point, um, that still strikes you or that you still think about?
• 28:37
  Brent Albracht: There's just so many.
• 28:38
  Brent Albracht: Um not great with words.
• 28:44
  Brent Albracht: Uh, I'm, uh, it was just really just totally the experience.
• 28:49
  Brent Albracht: I don't know.
• 28:49
  Brent Albracht: There wasn't necessarily one in particular moment, but, um Just their overall care at OrthoCarolina just, I mean, it, it is truly a team across the whole, the whole residency fellowship, uh, everything there was just, um, beginning to end was, was great.
• 29:14
  Brent Albracht: That was, uh, just seeing the whole package there was probably one of the most, uh, instrumental, I think, in, uh, me taking that forward, uh, home
• 29:25
  Joseph M. Schwab: Hmm.
• 29:25
  Joseph M. Schwab: Uh, Anoop, was there a, a mentor on this trip or somebody who ended up being a mentor on this trip that you weren't necessarily expecting them to be the most mentor-like going in?
• 29:42
  Anoop Prasad: Um, I don't think I had any specific expectations of mentorship.
• 29:48
  Anoop Prasad: Um, but, you know, as Alex said, every- everyone who hosted us, clearly they enjoy teaching, training, and they're naturally brilliant teachers, trainers, and mentors.
• 30:00
  Anoop Prasad: So I have, um, been in touch with a few different surgeons since then, and it's surprising because it's not all surgical stuff, you know?
• 30:11
  Anoop Prasad: So, um, you know, Dr.
• 30:13
  Anoop Prasad: Bradbury, as I said, for a few of the cases, Dr.
• 30:15
  Anoop Prasad: Bradbury, uh, Dr.
• 30:17
  Anoop Prasad: Mason, I've reached out to about, okay, you know, how would you tackle this problem, et cetera, um, as well as Dr.
• 30:23
  Anoop Prasad: Sah.
• 30:24
  Anoop Prasad: And then other things, as Alex was saying, about practice management, um, how you kind of follow patients up.
• 30:31
  Anoop Prasad: Um, I've spoken to Dr.
• 30:32
  Anoop Prasad: Sah, in fact, yesterday about this kind of stuff.
• 30:35
  Anoop Prasad: So it's ended up being extremely useful because these are...
• 30:39
  Anoop Prasad: You know, they're very successful surgeons who also happen to really care about teaching and training.
• 30:45
  Anoop Prasad: So the mentorship aspect, I think I didn't expect it going in, but I found that actually everyone was open to it.
• 30:51
  Anoop Prasad: And then I think it's just a personality fit with, okay, who do you think that would be able to, to help you best?
• 30:57
  Anoop Prasad: Um, so I'd say probably, um, three people that I'm in touch with from the fellowship, which has been something that I didn't expect, but would be a definite reason and huge, huge positive aspect of the fellowship and the way that it's been organized
• 31:10
  Joseph M. Schwab: Hmm.
• 31:11
  Joseph M. Schwab: Alex, did any of the fellowship mentors, um, change your mind about maybe how you thought you would be practicing in 5 or 10 years?
• 31:25
  Alex Savage: It's a good question.
• 31:26
  Alex Savage: Yeah, I think I, uh, you know, in the throes of the first couple of years of practice, I think I, I've, I've struggled to have that long-term vision.
• 31:33
  Alex Savage: But I think it's helped me to maybe shape my idea of what that next five to 10 years, uh, should look like or what I'd like it to look like.
• 31:41
  Alex Savage: So, um, while I can't tell you I had a great idea of where I thought I would be in five to 10 years, I now certainly have a target in mind, um, because I've been able to see what these, uh, surgeons have been able to do and, uh, have been able to just get, uh, super close and honest, uh, insight into the reality of what it takes to, to build a practice, which are just the things you don't learn when you're in training or at least that I wasn't, you know, as focused on learning.
• 32:06
  Alex Savage: Um, I'm sure had I thought to ask all those questions at the time, it, it would have been helpful.
• 32:10
  Alex Savage: But, um, you know, it's, uh, now that I'm, I'm in a stage where I'm getting a little bit more comfortable, a little bit more efficient, and then my bandwidth is expanding a little bit.
• 32:19
  Alex Savage: Uh, um, you know, Anoop and I were talking earlier about trying to, uh, think more holistically about the entire care episode that you're providing to patients and what really matters to them, which can be easy to lose sight of.
• 32:31
  Alex Savage: You know, you think of yourself as just a technician and, you know, I have to do a good hip surgery, which of course you do.
• 32:37
  Alex Savage: Um, but patients', uh, s- I think satisfaction and their comfort in, uh, with the care you're providing them is based on perhaps a lot, uh, of other factors that are maybe even more important than the actual, you know, the actual technical kind of care that you're giving them in the OR.
• 32:53
  Alex Savage: So, um, yeah, it's been, it's been great.
• 32:56
  Alex Savage: I think I've, I've learned a lot about how to communicate with patients, how to, um, you know, build that trust even further, um, and how to just, uh, grow into what I hope will be a practice somewhat, somewhat comparable to, to some of the ones that we were able to get experience with, uh, on this-- over the fellowship.
• 33:13
  Joseph M. Schwab: Now,
• 33:13
  Anoop Prasad: Yeah.
• 33:14
  Anoop Prasad: I, if I could just, um,
• 33:15
  Joseph M. Schwab: Please
• 33:16
  Anoop Prasad: just j- so, so we were, we were talking about this and it's like they are all outliers in what they do, and they have all built, um, very, very successful practices.
• 33:24
  Anoop Prasad: And so it's, um, you, in any kind of fellowship like this, you are not just going there for the, for the surgery aspect.
• 33:32
  Anoop Prasad: It's kind of how they lead teams, their interaction with all members of their team, you know, PAs, et cetera.
• 33:39
  Anoop Prasad: And this is one of the things that, um, Alex and I were talking about before, and, uh, we talked to, uh, Brent, we discussed this whilst we were on it, is that it would be nice probably to have seen them in a clinical, in a clinic setting, is actually how is it that they--'cause they are extremely successful surgeons, which means that they are doing all aspects of it well.
• 33:59
  Anoop Prasad: As we said, you know, they are owning the entire care episode.
• 34:03
  Anoop Prasad: And so it would be useful to have seen, um, even if it was for a short amount of time, how they run their clinics, you know.
• 34:09
  Anoop Prasad: Um, but it was, yeah, definitely for anyone considering this fellowship, it is not just the operative side of it that you gain from.
• 34:16
  Anoop Prasad: Um, it's even things like their relationship with industry, right?
• 34:19
  Anoop Prasad: How do they cultivate that?
• 34:20
  Anoop Prasad: A lot of the questions we had were like: How did you develop that, uh, relationship?
• 34:25
  Anoop Prasad: How did you cultivate it?
• 34:26
  Anoop Prasad: What is the value that you think a surgeon provides for these companies?
• 34:30
  Anoop Prasad: How is it that you can improve your, um, your ability to sell to them, et cetera?
• 34:35
  Joseph M. Schwab: Hmm.
• 34:36
  Joseph M. Schwab: Well, and let's talk a little bit about what you guys learned from each other,'cause y- obviously you're all hip surgeons, but you all come from different backgrounds.
• 34:43
  Joseph M. Schwab: You all have slightly different or more different practices, um, and different levels of experience going into this.
• 34:50
  Joseph M. Schwab: Um, Brent, let me ask you, what's something you picked up from watching how these other two guys think?
• 34:58
  Joseph M. Schwab: Not necessarily operate, but just think
• 35:01
  Brent Albracht: Um, I think the biggest thing that the, uh, the other three of us, uh, bounced off Anoop was just his, uh, experience with off-table, ex- excuse me.
• 35:11
  Brent Albracht: So yeah, we would, you know, pretty much almost everyone was exclusively on-table during the fellowship, but we were constantly asking Anoop, you know,"Yes, we're learning this on-table, but how do you translate this to off-table if, if we would ever be in the situation in our practice in the future where, where off-table would be more advantageous or, um, constrained by not having a table available, you know, later on?"
• 35:37
  Joseph M. Schwab: Hmm.
• 35:37
  Joseph M. Schwab: And Alex, how about you?
• 35:39
  Joseph M. Schwab: Was there something Brent or Anoop said maybe about where they're at in their practice or coming from a totally different setup, being on-table, off-table, that changed how you're thinking about your next few years?
• 35:55
  Alex Savage: Yeah.
• 35:55
  Alex Savage: I would, uh, I would share, uh, Brent's sentiment on the off-table, um, experience.
• 36:00
  Alex Savage: We had a lot of, uh, really good, uh, discussions with Anoop throughout, uh, where we'd both kind of go back and forth.
• 36:06
  Alex Savage: "Well, you know, I struggle on-table with this particular part.
• 36:08
  Alex Savage: How do you compensate for this if you're off-table?" Um, I had-- I've had no, uh, off-table experience at all, um, and throughout my training.
• 36:16
  Alex Savage: I have, uh, one partner who does, um, off-table hips, who I actually scrubbed with, uh, for just a case or two just to see it, um, about a year ago.
• 36:25
  Alex Savage: But apart from that, that was, uh, a really valuable experience.
• 36:28
  Alex Savage: But I think the other part that I, I really enjoyed was, um, you know, you, you really miss-- Uh, again, I, I, I found, you know, when you're in training, you're with all these people who are doing the same subspecialty area you are, and you're able to talk about complex questions and how you think about these things.
• 36:43
  Alex Savage: And you really-- At least for me, I'm the only-- You know, I, I do work for Northwestern, but I'm at one of their satellite hospitals.
• 36:48
  Alex Savage: I'm the only, uh, hip and knee surgeon there.
• 36:51
  Alex Savage: So, you know, we're not having regular conferences where you talk about these things.
• 36:54
  Alex Savage: So I think just after we had the, you know, the lecture by Dr.
• 36:58
  Alex Savage: Matta or any of the other lectures or the journal club in Texas, um, you know, being surrounded by, you know, these other guys and the attendings we're visiting, but also, you know, the other, the other traveling fellows and being able to talk about, um, how you think about cup position and how you think about assessing cup position and what if the spine is stiff, and what about medializing all the way or not medializing all the way, or what about getting this exposure or struggling with this particular thing, I think it's just, um, a great exercise in, in challenging, you know, your own thinking about these things in ways that you just don't frequently get the opportunity to do really as, uh, as an attending.
• 37:33
  Joseph M. Schwab: Hmm.
• 37:34
  Joseph M. Schwab: So Anoop, they both talked about kind of bouncing things off of you a little bit.
• 37:39
  Joseph M. Schwab: What was it that you heard from them, whether it was maybe something about how they handled a patient or difficult conversation, how they handle a bad day?
• 37:50
  Joseph M. Schwab: Was there something that you heard from your fellow co-fellows that stuck with you?
• 37:59
  Anoop Prasad: I think, um, we had-- It's almost like if you look at the effect size of us being-- if we had done this as individuals versus us being together, think I would've...
• 38:11
  Anoop Prasad: It's just I can't imagine how much more I got out of it because we were together.
• 38:15
  Anoop Prasad: Um, and it was, you know, if you say, what did we learn more from each other just from watching the same surgery, is that we would then dissect the operations and say,"Oh, did you see this?""Oh, I didn't notice.""Okay, I've tried that," et cetera.
• 38:29
  Anoop Prasad: I remember, um, with one of the surgeons, you know, it's the first time anyone so clearly showed the layers of dissection in a simple primary and, and only two of us were in the room, and then we went back to the other guys and said,"Oh, guys, did you know that actually, look, these are the different layers.
• 38:43
  Anoop Prasad: We've never really seen it in practice or any video like that, or we've never seen it written down." So there was, there was just that level where we were just kind of cross-pollinating across everything we were seeing and then discussing everything at the end of the day and at dinners.
• 38:58
  Anoop Prasad: Uh, and then also from, from these guys, I learned a lot about--'cause I'm, I'm newer to the US healthcare system, so I learned so much from them about kind of efficiency, about governance, um, about things like coding.
• 39:12
  Anoop Prasad: So there was a huge amount that I learned, um, probably too much to, to mention, um, uh, any-anyone in particular.
• 39:19
  Anoop Prasad: But it was basically about how I should be running my practice,'cause, you know, Brent's been doing this for a good number of years, so it's really useful to hear how, you know, how you work with your PA, how you incentivize them, what level of responsibility, um, uh, you apportion to them, et cetera, how you're following up your patients, stuff like that.
• 39:37
  Anoop Prasad: So I learned a huge about- amount, um, about kind of practice management as well.
• 39:42
  Joseph M. Schwab: So let's talk a little bit about the time and effort that it takes to do a fellowship like this'cause it's, it's a nontrivial amount of time away from your practice and in some cases away from family and, and friends and support.
• 39:56
  Joseph M. Schwab: And Brent, you actually I think wrote about how much your wife's support sort of meant to you during this stretch.
• 40:02
  Joseph M. Schwab: Um, what does it actually take, um, practice coverage, family, all of it, to say yes to an opportunity like this?
• 40:11
  Brent Albracht: It was a big undertaking.
• 40:13
  Brent Albracht: So yeah, we've got three kids, uh, under eight, and so, uh, it-- we, we started, uh, Memorial Day weekend, so all the kids, uh, actually, uh, stayed an extra twelve hours and showed up a little bit late to the fellowship, so I could see my son's, uh, kindergarten graduation.
• 40:29
  Brent Albracht: Uh, but then yeah, she went into full mom mode with, uh, with the three kids.
• 40:34
  Brent Albracht: Um, luckily, we were able to overlap, and she drove from Phoenix to LA with the kids, uh, so met up, uh, on that second stop, so I could see them for a little bit before we, we continued on.
• 40:45
  Brent Albracht: Um, so that was mainly from the family aspect.
• 40:48
  Brent Albracht: Uh, but then yeah, my, my PA, you know, stepped up.
• 40:51
  Brent Albracht: She was only, uh, six months new grad, uh, into starting with me to kind of handle things, uh, while I was gone.
• 41:00
  Brent Albracht: So, uh, I-- kudos to, to Christina because that, that was big for her and, and then it's also carried forward with her since, since being back that, you know, uh, gave her the confidence, uh, and to really carry that forward.
• 41:13
  Brent Albracht: So, um, it was a big thing.
• 41:15
  Brent Albracht: Um, it's-- it has trickled into not seeing patients for three weeks and not getting people signed up, uh, took a small hit, but just knowing in the long run, having this in my toolbox and being able to provide this for patients in the future was just such a, a huge opportunity.
• 41:30
  Brent Albracht: So still well worth it.
• 41:32
  Joseph M. Schwab: Anoop, how about you?
• 41:33
  Joseph M. Schwab: What did you have to put down or delay to make two and a half weeks on the road work?
• 41:41
  Anoop Prasad: I think for me, um, it was mainly my kids, and so I made the decision fairly early that I would fly back, because I think, uh, funnily enough, I've not spent, um, more than a few days away from my kids.
• 41:56
  Anoop Prasad: Uh, my kids are six and two.
• 41:58
  Anoop Prasad: Um, so for me it was like, okay, let me try and organize how I can get back for the weekends.
• 42:05
  Anoop Prasad: Um, but one thing I would say is that when you're doing this fellowship, it is-- I can't even believe it's two and a half weeks.
• 42:11
  Anoop Prasad: It felt like six weeks, if not potentially two months, because the, um, I think your experience of time is to do with the number of new experiences, and every day we're just seeing so many things.
• 42:22
  Anoop Prasad: I mean, we said about that day with, with DeCook where you, you know, we woke-- we checked out of our hotel at 4:30 in the morning.
• 42:30
  Anoop Prasad: We're at the surgical center at 5:45, right?
• 42:34
  Anoop Prasad: With our suitcases, right?
• 42:37
  Anoop Prasad: Being dropped off on the other side of the hospital, 15-minute hike.
• 42:40
  Anoop Prasad: Okay, no problem.
• 42:41
  Anoop Prasad: We get in, start surgery at 6:00, several cases later, 12.
• 42:47
  Anoop Prasad: You know, an hour to lunch, have lunch, an hour and a half to the Porsche place, two hours of driving Porsches, five hours to Tennessee.
• 42:56
  Anoop Prasad: You know, having drinks on a rooftop.
• 42:58
  Anoop Prasad: Like that's one day, right?
• 43:00
  Anoop Prasad: And I've-- that's like more than I would do in most weekends.
• 43:03
  Alex Savage: was seven days in one.
• 43:05
  Alex Savage: Yeah
• 43:07
  Anoop Prasad: It was crazy.
• 43:07
  Anoop Prasad: So I think it is, um, for people who think like you gain so much from it in the sense that it's so condensed and you're talking about everything again and again.
• 43:17
  Anoop Prasad: Um, so I think the sacrifice, um, is I think it's a good amount of time because actually it's kind of similar to taking a holiday.
• 43:24
  Anoop Prasad: So it's not-- I think I would struggle to take a month off or six weeks off, um, because I think that's personally is, is almost too much time away from firstly your practice, um, but also more importantly, your family.
• 43:37
  Anoop Prasad: So I think this is a real sweet spot, which you get as much, uh, of the exposure as you need.
• 43:43
  Anoop Prasad: 'Cause I think if it was any-- if it was shorter, I'm not sure we would've gained as much.
• 43:46
  Anoop Prasad: So it was perfect length.
• 43:48
  Anoop Prasad: Um, and I think the fact that the weekends were free meant that you could balance a family.
• 43:53
  Anoop Prasad: And I think that everyone here would agree that, you know, from a clinical perspective, taking a couple of weeks off to do something that's gonna build your practice for the next 20, 30 years, that's a no-brainer.
• 44:04
  Anoop Prasad: Um, but you still have to negotiate, you know, with your wife and your kids.
• 44:07
  Anoop Prasad: So I think you guys, it, it was very well planned to allow for that.
• 44:12
  Joseph M. Schwab: Alex, was it hard to justify the time away?
• 44:15
  Alex Savage: So yeah, luckily for me, um, you know, I'm, I'm early in practice, um, so I'm still ramping up a little bit.
• 44:21
  Alex Savage: It was probably a little less challenging for me than maybe some of the other guys who are further along in practice and maybe have busier clinics at this point.
• 44:28
  Alex Savage: Um, I have been lucky to inherit the practice of a couple of my partners, so it's been a good start.
• 44:32
  Alex Savage: But, um, I, I was lucky to have great institutional supports, uh, from Northwestern to, uh, to take the time and go on this and have really great support while I'm away.
• 44:41
  Alex Savage: Um, from a family perspective, certainly easier for me than, than these guys.
• 44:45
  Alex Savage: I have no kids yet.
• 44:46
  Alex Savage: I'm getting married here in about two months, so, um, you know, and she's in, she's in fellowship herself now, so, uh, she's got, she's got plenty to...
• 44:52
  Alex Savage: had plenty to do while I was gone.
• 44:54
  Alex Savage: But, um,
• 44:54
  Anoop Prasad: We're still waiting for the
• 44:55
  Alex Savage: yeah.
• 44:57
  Alex Savage: right.
• 44:57
  Alex Savage: Hey, uh, we just, we just mailed them out, so
• 44:59
  Brent Albracht: He, he downplays it.
• 45:00
  Brent Albracht: He didn't have kids, but the fact that he was going through board prep during this two and a half weeks was, uh, a huge undertaking.
• 45:07
  Brent Albracht: I mean, and the summer before getting married.
• 45:09
  Brent Albracht: So, uh, we all kind of complained, but, uh, Alex was a trooper.
• 45:13
  Brent Albracht: And I think just having the support of the other three guys, I mean, each of us in our own situation, but, um, you know, supporting Anoop going back home, uh, flying back and, uh, just all of us just kinda helped each other through it.
• 45:25
  Brent Albracht: Uh, certainly not something I would've done on an individual basis without some co-fellows going through it, for sure
• 45:34
  Anoop Prasad: Yeah.
• 45:34
  Anoop Prasad: It wouldn't have been as enjoyable.
• 45:36
  Anoop Prasad: And definitely, yeah, Alex is underplaying the fact that he was very good in terms of balancing socializing with us when we're like,"Oh, just another few beers, it'll be okay," uh, with the fact that he's,"Okay, fine.
• 45:47
  Anoop Prasad: I'll just get up earlier and do my board stuff," you know?
• 45:50
  Alex Savage: Yeah
• 45:51
  Joseph M. Schwab: Uh, but Anoop, you would say you were definitely the better father,'cause it sounds like you went back every weekend, and Brent, just
• 45:58
  Anoop Prasad: Better father, better husband.
• 46:01
  Anoop Prasad: Yeah.
• 46:03
  Joseph M. Schwab: Better surgeon?
• 46:03
  Joseph M. Schwab: I didn't hear better surgeon.
• 46:06
  Anoop Prasad: No, I wouldn't say that.
• 46:07
  Anoop Prasad: Let's not get ahead of ourselves
• 46:09
  Joseph M. Schwab: z- so, so let's l- uh, just, um, this was mentioned briefly earlier about how most of the sites that you visited, if not all the sites, were predominantly on-table, right?
• 46:19
  Joseph M. Schwab: Can you guys just talk a little bit about what you're doing in your practice right now on-table versus off-table, and was there anything in the fellowship that sort of changed your mind about that?
• 46:29
  Joseph M. Schwab: I mean, I'm curious of your perspective, and Brent, why don't you go first?
• 46:32
  Joseph M. Schwab: 'Cause you mentioned doing some early ones, I believe, off-table.
• 46:35
  Joseph M. Schwab: Is that correct?
• 46:37
  Brent Albracht: Uh, no, sorry.
• 46:38
  Brent Albracht: No, I've, uh, never really done off-table.
• 46:41
  Brent Albracht: Um, but, um, everything was on, but I do have some clinical constraints in that, uh, I operate at two hospitals, and one does not have a table.
• 46:51
  Brent Albracht: So I've just chosen to not do anteriors at that hospital for right now just to get my, my feet wet, and they're, they're in the process of getting one.
• 47:00
  Brent Albracht: But, um, but yeah, uh,
• 47:05
  Joseph M. Schwab: So you're do- you're doing on table at the moment, is that correct?
• 47:09
  Brent Albracht: Cor- correct, yeah
• 47:10
  Joseph M. Schwab: And was that a result of your previous training?
• 47:13
  Joseph M. Schwab: Was that a result of the fellowship?
• 47:15
  Joseph M. Schwab: Were there multiple factors going into that?
• 47:18
  Joseph M. Schwab: What, what was your thought process in doing that?
• 47:21
  Brent Albracht: I mean, I think the standard, not the-- I don't wanna say the standard, but I think the most common practice, and I think this was stated at the AHF conferences, I, I think it was somewhere in the, the realm of 80 to 90% of people are on-table.
• 47:32
  Brent Albracht: So I was just trying to not get too exotic with, with starting things and just trying to...
• 47:38
  Brent Albracht: And, and then, you know, every single one of the attendings we, uh, we saw was on-table.
• 47:42
  Brent Albracht: So, um, I guess one thing that maybe would've been nice was to see, um, someone who was off-table during the fellowship.
• 47:51
  Brent Albracht: Um, that would be-- I mean, I have very few critiques of the, of the fellowship itself.
• 47:57
  Brent Albracht: Maybe that would be, be the one.
• 47:58
  Brent Albracht: It was just having that experience, but then also getting to, to, to talk to Anoop about his experience of, of off-table was good too.
• 48:07
  Joseph M. Schwab: Yeah.
• 48:07
  Joseph M. Schwab: So Anoop, let's, let's talk to you'cause you, y- your experience was predominantly off-table, and has it remained that way since?
• 48:16
  Anoop Prasad: Yeah.
• 48:16
  Anoop Prasad: So I would say that I, um, I definitely came onto this fellowship being open to the idea of is there-- Um, you know, I was, I was almost forced into learning the technique, which, um, initially I think is more difficult to do, but I've got used to and I have no, no issues with it.
• 48:34
  Anoop Prasad: And I learnt from...
• 48:34
  Anoop Prasad: You know, I visited, uh, Prof.
• 48:36
  Anoop Prasad: Corten, um, and learnt kind of DA from him and another chap called Barros in, um, in Spain, uh, and also Prof.
• 48:44
  Anoop Prasad: Fields who uses the Medactor, the Medactor table.
• 48:47
  Anoop Prasad: Um, and I-- So I was open to the idea, but I actually, I found that, um, most of the surgeons, um, and some of them weren't necessarily using the table as I would have expected them to.
• 49:02
  Anoop Prasad: Um, so I think DeCook uses a table but doesn't use a hook, you know, like...
• 49:07
  Anoop Prasad: So then I realized, actually, I'm not entirely sure what the-- So I-I-I left thinking,"Okay, I don't necessarily need to change that." Um, and I wasn't, um-- I didn't think that it was, um, there's any specific reason for me in my setup to, to change.
• 49:25
  Anoop Prasad: And that, that's obviously an individual thing where we have residents and fellows, um, et cetera.
• 49:31
  Anoop Prasad: So maybe it's something if you don't have as many hands, it might be, uh, beneficial to use.
• 49:36
  Anoop Prasad: So I was certainly open to the idea, but I didn't find anything that was being done that was significantly different that would make me think of it, you know.
• 49:43
  Anoop Prasad: So one of the things that people talk about is, um, when you're, you know, when you wanna knock a cup-- uh, when you wanna knock the head off, it's easier if you have traction.
• 49:52
  Anoop Prasad: Um, and I found that actually knocking a head off is actually, it's fine.
• 49:56
  Anoop Prasad: You just ask somebody to pull on the leg and you knock it out, and then, you know, use a bone hook to move the, the femur out of the way, and you can, you can take the head out like that.
• 50:03
  Anoop Prasad: So those are the things that were very interesting to have seen, um, and then have done in practice and realized actually there isn't too much of a difference.
• 50:10
  Anoop Prasad: So I'm still open to, um, if I find a clear indication, then there's no doubt that I will use a table.
• 50:17
  Anoop Prasad: Um, but for now, no, I haven't, I haven't seen a reason to.
• 50:21
  Joseph M. Schwab: Alex, tell me a bit about your practice from that perspective
• 50:25
  Alex Savage: Yeah.
• 50:25
  Alex Savage: So, um, as these other two guys already mentioned, all of the, uh, experiences that we had on the fellowship were on table.
• 50:31
  Alex Savage: Um, you know, I think that's certainly the most common way, at least in this country, that it's done.
• 50:36
  Alex Savage: Um, my-- all of my experiences in training, uh, were on table as well.
• 50:40
  Alex Savage: That's been what I've, uh, done out in practice, uh, ever since I started.
• 50:44
  Alex Savage: Um, it was interesting as, uh, as some of the other guys mentioned.
• 50:47
  Alex Savage: So the table has been used in different ways even throughout our ex- our, uh, our different sites that we saw on the fellowship.
• 50:54
  Alex Savage: So, um, you know, for instance, in, uh, in Atlanta, I think Dr.
• 50:57
  Alex Savage: DeCook is always questioning, you know, is this step necessary?
• 51:00
  Alex Savage: And I think at some point he questioned the step of, uh, putting the hook in there and using it to elevate the femur.
• 51:05
  Alex Savage: And clearly for him it was, you know, it was not a necessary step.
• 51:07
  Alex Savage: So, um, that, that sticks out in my mind as one of those sort of anecdotal experiences.
• 51:12
  Alex Savage: And I think the value that this fellowship provides is challenging, you know, basic assumptions that you never even really think about, right?
• 51:18
  Alex Savage: Do I need to put the hook in here to elevate the femur and access it?
• 51:21
  Alex Savage: Is it worth this extra, you know, minute it takes me to put it in and take it out when I dislocate the hip or, or not?
• 51:27
  Alex Savage: Or who do I need to do it in?
• 51:29
  Alex Savage: Or do I need to do it in everybody?
• 51:30
  Alex Savage: So, um, yeah.
• 51:32
  Alex Savage: So those are the kind of things that, that really I think, uh, collectively you, you sort of-- you get these little tidbits throughout and you-- those are all the things that you sprinkle into your practice one at a time.
• 51:41
  Alex Savage: And, you know, it's a, it's a thousand little efficiency items like that that, uh, can take you from, you know, my, my surgery time was X and now it's cut in half, you know.
• 51:51
  Alex Savage: And, and now, you know, and it's more efficient and it's better for patients and, um, yeah.
• 51:55
  Alex Savage: So it's, it was great.
• 51:57
  Joseph M. Schwab: So I've got a sense from you guys of a generally, um, positive experience.
• 52:04
  Joseph M. Schwab: Um, that, that's what it sounds like.
• 52:06
  Joseph M. Schwab: And Brent, I think you even said there's, there's very little that you could criticize about the fellowship, maybe more exposure to off-table.
• 52:13
  Joseph M. Schwab: Um, but I would, would be interested, and I'm just gonna throw this open to anybody who has a thought on this.
• 52:19
  Joseph M. Schwab: Is there a kind of surgeon, assuming a, a hip surgeon, somebody who wants to do hip replacement surgery, is there a kind of surgeon that this fellowship just isn't built for?
• 52:30
  Joseph M. Schwab: Somebody who might apply for it and regret that they did it?
• 52:34
  Joseph M. Schwab: Or what do you think about that?
• 52:42
  Brent Albracht: I think there's self-restrictions on the-- that this is a, you know, supposed to be for early career, and I think that that's, that's probably, uh, an accurate thing, both being able to take the time off.
• 52:54
  Brent Albracht: I think someone who's got a more established practice long term would have a more difficult time taking this this time.
• 53:00
  Brent Albracht: And then, um, I feel like those, uh, surgeons are usually more cemented in their ways.
• 53:06
  Brent Albracht: I, I think someone who's not, uh, adaptable and, you know, says,"This is, this is my way," like, you know, I, know, I don't know that those are the, the surgeons reaching out to do this fellowship to begin with.
• 53:20
  Brent Albracht: Uh, but yeah, certainly have to be open to, to learning and, um, and changing and seeing things, so
• 53:30
  Joseph M. Schwab: Anoop, it sounded like you were gonna say something
• 53:34
  Anoop Prasad: I would, I would say that this is probably not something for somebody who has never attempted anterior hips.
• 53:43
  Anoop Prasad: I don't think this is a way for you to learn anterior hips, because I think you are, um, like I think you should have been to some cadaveric labs and maybe done some visitations,'cause I think it's so fast-paced.
• 53:57
  Anoop Prasad: You are watching people who are really, like at their prime, at their peak, who are doing extremely slick surgeries where you won't be able to replicate that if you've never done one.
• 54:09
  Anoop Prasad: So I think you need to have done exactly as Brent has done.
• 54:12
  Anoop Prasad: You need to have done some to have then said,"Okay, here's the bits you've identified yourself, what your learning points are or the, the bits that you struggle with," and then you focus on those all the way through.
• 54:22
  Anoop Prasad: So each of us was looking at, overall we're, we were experiencing the same thing, but perhaps from each operation we're taking away slightly different things based on our level of experience.
• 54:32
  Anoop Prasad: And I think that if I'd never done it, it would've been just too much information.
• 54:36
  Anoop Prasad: They're too slick, and they've almost skipped past a few steps, which you wouldn't you know, certain bits of the learning curve that you go,"All right, we're starting the release and now the release is done." And go,"Okay, cool.
• 54:48
  Anoop Prasad: So it should take about 12 seconds to do a femoral release.
• 54:51
  Anoop Prasad: Excellent." You know, so, so I think there are bits where you wanna see-- y- you wanna have gone through that so that you get the appropriate learning.
• 54:59
  Anoop Prasad: Um, and I'd say to the AHF, uh, perhaps to have, um, maybe we actually found it beneficial and it, it's counterintuitive, but to have people of different levels of experience in the same group is actually extremely beneficial'cause it makes you reflect on lots of different things as opposed to grouping people just like, oh, these, these people are just starting out and these people are more experienced.
• 55:21
  Anoop Prasad: Where I think I, I certainly enjoyed having, um, being in a group where there were people who are more senior and less senior in terms of experience levels,'cause we actually managed to learn a lot more, I thought,'cause, um, you pick up different things from different surgeons.
• 55:34
  Joseph M. Schwab: Hmm.
• 55:35
  Joseph M. Schwab: Alex, any thoughts from you?
• 55:37
  Alex Savage: Yeah, I would just echo what, uh, what both of these guys, uh, have said.
• 55:41
  Alex Savage: So I think as far as people who, you know, probably aren't best suited for this experience, um, I think having some level of experience is, is definitely, um...
• 55:51
  Alex Savage: You know, if you want to extract the most you can possibly extract from this, uh, this fellowship, I think having some level of familiarity, familiarity with at least the basics, um, is, is helpful.
• 56:02
  Alex Savage: Not that you won't learn how to refine those, you know, 10 times.
• 56:05
  Alex Savage: Um, but, um, I think, I think like Anoop said, it is just so fast-paced that it would be tough.
• 56:11
  Alex Savage: Uh, you know, it was tough even for, for me having been doing them for, you know, a year and a half at that point, I guess almost two years to, to really catch everything that's been done.
• 56:20
  Alex Savage: Um, and then I think, you know, y- you have to have a willingness to, um, challenge what you think you know, you know, and, and, and adapt and, and be willing to, um...
• 56:32
  Alex Savage: You know, if you're someone who just says,"Ah, I know this.
• 56:35
  Alex Savage: This is the best way," I don't think you're gonna have a great time on the fellowship, you know,'cause everyone's gonna do things differently.
• 56:40
  Alex Savage: And, you know, if you're not willing to engage in those discussions and, and really think about things and, and sort of expand your thinking or maybe challenge some, some of the assumptions that you may not even know you have about, um, about hip replacement, um, you're just gonna not get, um, as much out of it as I think you should
• 56:59
  Joseph M. Schwab: I, I've got a, a kind of a closing question for each of you, and then a, a general closing question, um, that I, I want each of you to address.
• 57:06
  Joseph M. Schwab: But Alex, I'm gonna start with you.
• 57:09
  Joseph M. Schwab: What would you tell yourself, um, on the first day of this trip, apart from, uh, just be calm and everything will everything will work itself out?
• 57:19
  Joseph M. Schwab: If you could go back and do it right now, what would you tell yourself on the first day of this trip?
• 57:25
  Alex Savage: Um, luckily I think I, I a little bit had this thought as I went, but you can always do a better job.
• 57:31
  Alex Savage: I was, I was juggling boards prep while I was, uh, while we had these, you know, seven-day and one days that Anoop was alluding to earlier.
• 57:37
  Alex Savage: But, um, I think taking time to however, you know, you process information or however you retain things, it's-- in the moment it's, you know, you have such clarity when you're in the OR with these incredible surgeons and you watch them do these procedures.
• 57:52
  Alex Savage: You say,"Oh my God, yes, there's that layer.
• 57:54
  Alex Savage: It's so easy.
• 57:55
  Alex Savage: It's right there.
• 57:56
  Alex Savage: He's doing it just like this." Um, you know, I would literally-- we, we had a case with, with, uh, Beau Mason where we just watched a primary hip, and I, I think I learned 15 new things just from a, you know, a 30-minute hip with, with, uh, with Beau Mason that I didn't even-- had never even been on my radar.
• 58:15
  Alex Savage: So I immediately just went out into the hall and I found a little nook where a bunch of X-ray machines were, and I just dictated everything I could possibly remember into my phone.
• 58:24
  Alex Savage: Um, and you know, I think just being very conscientious of i-if you're really trying to-- it's impossible not to extract an incredible amount of information just from going on this, even if you didn't try to take notes.
• 58:35
  Alex Savage: But to try to retain that and really decide and refine and integrate that into your practice, I think figuring out whatever vehicle is best for you to do that, um, is great, but make yourself a little bit of a survival guide, you know, based on what you learn and sort of, um, what you want to bring back to your practice.
• 58:51
  Alex Savage: And, um, as Anoop mentioned, you know, everyone expressed a, a great willingness to, uh, you know, reach out any time, call me any time you ever have any questions.
• 59:00
  Alex Savage: So, you know, these people are accessible, but, you know, you can't obviously go back and do another,"Oh, let me just fly to Flor- uh, fly to California for the day and, and see how you did this release again." So, um, I think just trying to be very conscientious of, uh...
• 59:14
  Alex Savage: We took 1,000 pictures.
• 59:16
  Alex Savage: Literally, I think 1,000 pictures, or at least I did.
• 59:19
  Alex Savage: So, um, yeah.
• 59:21
  Joseph M. Schwab: Anoop, what's the one piece of advice that you would give maybe next year's fellow that has nothing to do with a specific site, with a specific mentor?
• 59:32
  Anoop Prasad: Yeah.
• 59:32
  Anoop Prasad: I, I think, uh, kind of echoing what Alex said, I actually think, and I've kind of started doing that, I would probably look to travel with some kind of recording gear, so like a GoPro or something like that.
• 59:47
  Anoop Prasad: Because I think that we, we shared a lot of information, um, between ourselves in, in various chat groups and pictures and stuff, and some of the p- most useful things have been like the cadaveric labs and people recording it and showing.
• 1:00:03
  Anoop Prasad: Um, so I actually think, you know, as, as Alex was saying, um, you know, his experience with, um, Dr.
• 1:00:11
  Anoop Prasad: Mason, if you had recorded that, we could all be kind of watching it now.
• 1:00:15
  Anoop Prasad: Um, so I think that probably for me is the single thing where I'd say,"Go on this, you'll see so many different things, and then you can, you can debrief on it if you've got the videos." Um, and that I think is-- we've, we've missed a little trick there, I think.
• 1:00:29
  Anoop Prasad: But we've got a huge amount out of it'cause we-- because we didn't have that going on, we've probably debriefed much more than we would've otherwise, and we've all got kind of reams of notes that I'm still, you know, there's still things that I look at and I go,"What did I mean here?
• 1:00:42
  Anoop Prasad: Oh, probably this." So it's, it's one of those things that it's such a compress- compressed learning that it continues for a few months afterwards, I think
• 1:00:51
  Joseph M. Schwab: B- Brent, somewhere down the line, you're gonna have a patient who is probably gonna benefit from something that you picked up during this fellowship and will never know that that's where you got it from.
• 1:01:03
  Joseph M. Schwab: What do you think that'll be?
• 1:01:06
  Joseph M. Schwab: Is it gonna be a particular technique in a surgery?
• 1:01:10
  Joseph M. Schwab: Is it gonna be you calling them on a particular afternoon like Dr.
• 1:01:13
  Joseph M. Schwab: Sah?
• 1:01:13
  Joseph M. Schwab: W- what do you think it'll be?
• 1:01:19
  Brent Albracht: That's a great question.
• 1:01:21
  Brent Albracht: Uh, I think you put it best in we'll n- we'll never know.
• 1:01:24
  Brent Albracht: It's really just the, the overall-- I, I don't know how to put it into words.
• 1:01:30
  Brent Albracht: It's just the overall experience.
• 1:01:32
  Brent Albracht: Uh, uh, um, I think just giving me the tools to actually be able to offer this to my patients.
• 1:01:38
  Brent Albracht: I had been set in my ways of I'm gonna do a good posterior hip, and I'm gonna...
• 1:01:44
  Brent Albracht: You know, that was, that was what I went into practice with, and I was just set that, you know, oh, the research says that, that patients do just as well with posterior hips.
• 1:01:53
  Brent Albracht: But I'll tell you, you know, I, I've walked out of some of these cases where I said,"Wow, I really struggled with that case," and they're coming back to clinic and they're happier than in my...
• 1:02:05
  Brent Albracht: You know, I, I, you know, I walk out of my posterior hips in, you know, 30 minutes and, you know, high-fiving people.
• 1:02:12
  Brent Albracht: But then, you know, get out of a super long struggling anterior hip case and patients are doing twice as, as good.
• 1:02:18
  Brent Albracht: So, um, just, uh, just the overall confidence that I gained in being able to, to carry this forward and, and really put it in part of my practice.
• 1:02:29
  Joseph M. Schwab: So last question, and this is really just kind of a complete the sentence sort of thing, and, and it doesn't have to be anything long.
• 1:02:37
  Joseph M. Schwab: Cou- a short word or two, little phrase would be great.
• 1:02:40
  Joseph M. Schwab: But I want you to complete this sentence for me: The biggest thing I took away from the AHF Traveling Fellowship wasn't a technique, it was blank.
• 1:02:50
  Joseph M. Schwab: Brent, why don't you go first?
• 1:02:53
  Brent Albracht: Confidence.
• 1:02:55
  Joseph M. Schwab: Hmm
• 1:02:55
  Brent Albracht: I think there was a lot of doubt in my head.
• 1:02:57
  Brent Albracht: Uh, this, this gave me some confidence
• 1:03:01
  Joseph M. Schwab: Anoop, the biggest thing I took away from the AHF Traveling Fellowship wasn't a technique, it was
• 1:03:09
  Anoop Prasad: I think approach to practice.
• 1:03:12
  Anoop Prasad: Um, so not, not an individual.
• 1:03:14
  Anoop Prasad: It's kind of all of the outside of the OR things as well.
• 1:03:18
  Anoop Prasad: That's what I'd say.
• 1:03:19
  Anoop Prasad: So how you speak to your patients before, how you follow them up, how you've set up your OR, your, um, the kit, and how you've refined the instruments that you use to reduce the number of trays, surgical efficiency, tho- those things.
• 1:03:34
  Anoop Prasad: So I think it's just seeing people who are very much at the top of their game and how they've, they have iteratively improved the process of everything outside of just the operation.
• 1:03:47
  Joseph M. Schwab: Alex, the biggest thing you took away from the AHF Traveling Fellowship wasn't a technique, it was
• 1:03:54
  Alex Savage: I would say perspective, uh, for me.
• 1:03:56
  Alex Savage: So, you know, in the same way that somebody who lives their entire life in the same town and never leaves and, uh, doesn't, uh, grow to appreciate what different cultures and different places in the world are like and sort of the, uh, how big the world is, I think it's impossible to appreciate the possibilities, uh, of anterior hip replacement and practice outside of anterior hip replacement and delivery of care, uh, without getting these kind of valuable experiences from the people who are doing it better than arguably, you know, anybody else.
• 1:04:26
  Alex Savage: So I think, uh, getting perspective on what's possible, um, how to, how to get there and, and what parts of those are gonna mesh with your personality, your practice, your goals.
• 1:04:37
  Alex Savage: Um, it's, it's difficult to have a vision for the future if you kinda haven't had that exposure to what's possible and what's being done and, and how it's been done.
• 1:04:46
  Joseph M. Schwab: Well, and I'll confess, gentlemen, I lied.
• 1:04:48
  Joseph M. Schwab: I have one more question that just came up because what I remember when I first met you guys at the AHF, I got to meet both traveling fellowship groups, and the word that comes to mind, and I mean this in a loving way, is braggadocious.
• 1:05:04
  Joseph M. Schwab: I remember you guys making it very clear that between the two groups of fellows, you were certainly number one, right?
• 1:05:14
  Anoop Prasad: We're off recording
• 1:05:16
  Joseph M. Schwab: And
• 1:05:17
  Alex Savage: That's right.
• 1:05:18
  Joseph M. Schwab: s- and, and so my last question to you is who's gonna have the better podcast episode, you guys or group number two?
• 1:05:29
  Brent Albracht: Not a question.
• 1:05:30
  Alex Savage: I won't, I won't even dignify that
• 1:05:31
  Brent Albracht: yeah, uh-huh.
• 1:05:32
  Brent Albracht: Yep.
• 1:05:32
  Brent Albracht: Uh-huh.
• 1:05:33
  Brent Albracht: Yeah
• 1:05:34
  Joseph M. Schwab: Would you s- would you say You're Still the One?
• 1:05:37
  Joseph M. Schwab: Yeah.
• 1:05:37
  Joseph M. Schwab: Okay.
• 1:05:38
  Joseph M. Schwab: All right.
• 1:05:38
  Anoop Prasad: Ah, nice.
• 1:05:40
  Anoop Prasad: Well played.
• 1:05:41
  Anoop Prasad: Oh,
• 1:05:42
  Alex Savage: said it best.
• 1:05:43
  Alex Savage: Yeah,
• 1:05:44
  Anoop Prasad: You are the master.
• 1:05:45
  Anoop Prasad: You are the master
• 1:05:47
  Joseph M. Schwab: Gentlemen, I really appreciate you taking the time to be with me on the podcast and talk about your experience and, um, any words of encouragement you wanna give to our listeners to apply for the 2027 fellowship.
• 1:06:00
  Joseph M. Schwab: Um, I, I'm sure they would, would benefit from hearing your experience today
• 1:06:07
  Alex Savage: Yeah, I think if there's, if there's any doubt in your mind, um, that you're gonna learn a lot, um, not only are you gonna learn a lot, it's gonna be about 10 times more than you, than you think.
• 1:06:15
  Alex Savage: Um, and you'll probably walk away, uh, appreciating something about the fellowship that you didn't even, uh, think would be possible.
• 1:06:23
  Alex Savage: Um, so if, you know, if, if there's any doubt in your mind that you might be interested, you are, um, I assure you.
• 1:06:30
  Alex Savage: So I, I, I would encourage you to apply.
• 1:06:32
  Alex Savage: It's been a, it's been a fantastic and, and career-changing experience for me.
• 1:06:37
  Anoop Prasad: Yeah, I
• 1:06:37
  Brent Albracht: I'd echo that too.
• 1:06:38
  Brent Albracht: Yeah, if you're considering it, the answer is yes.
• 1:06:40
  Brent Albracht: I mean, if, if you- if it's even crossed your mind, you're wanting to learn more and gain more, and it will do that for you.
• 1:06:48
  Brent Albracht: So make the time and do it
• 1:06:50
  Joseph M. Schwab: gentlemen, thank you for joining me today on the AHF Podcast
• 1:06:55
  Alex Savage: Thanks a lot
• 1:06:55
  Anoop Prasad: you
• 1:06:56
  Joseph M. Schwab: That's all for today's episode of the AHF Podcast.
• 1:07:00
  Joseph M. Schwab: If you found value in this conversation, share it with a friend or a colleague, or just drop us a comment to let us know.
• 1:07:06
  Joseph M. Schwab: And keep an eye on the Anterior Hip Foundation's website for details about the 2027 Traveling Fellowship.
• 1:07:15
  Joseph M. Schwab: Also make sure to connect with us on LinkedIn and to join the discussion between episodes.
• 1:07:20
  Joseph M. Schwab: There's a link to our brand-new LinkedIn page in the description.
• 1:07:25
  Joseph M. Schwab: Find us every Friday with new episodes on Apple Podcasts, Spotify, YouTube, and all major podcast platforms.
• 1:07:34
  Joseph M. Schwab: I'm your host, Joe Schwab, reminding you to keep those hips happy and healthy