As Dr. Blair Filler rappelled down the craggy cliffs of a canyon on a search and rescue mission he was living his motto…love orthopedics, but love something else as well. Dr. Filler, an attending surgeon with Los Angeles UCLA Orthopaedic Hospital, is also a sheriff, a pilot, and a veteran of 53 marathons. He strongly believes that his fellow orthopedists should have interests outside of the OR…if not, says Dr. Filler, you are setting yourself up for burnout.
For his concrete results and willingness to address difficult situations, Dr. Filler, a hand and upper extremities specialist, was honored with the AAOS William Tipton Leadership Award in 2009. His sense of what a situation calls for may have been honed in his youth as he repeatedly entered new environments and had to adapt. Dr. Filler: “I was born in small town Ohio where my dad managed a local 5 and 10 store. He was transferred every nine months so I ended up attending 14 different schools before I graduated from high school. The downside was that I never had close long-term friends; the upside was that I learned to adjust to things quickly and developed a great deal of self sufficiency.”
He would need this maturity in the coming years. “It was a difficult time personally, as my parents divorced when I was 13; also, the country was in the midst of World War II. The day after I finished high school I signed up for the military, knowing in the back of my mind that I eventually wanted to become a physician. Having had both a sledding accident and an ongoing skin disease meant that I had a fair amount of exposure to doctors. I was quite impressed by their kindness and talents…and I hoped to emulate them.”
But first Dr. Filler would have a less captivating role. “I failed the eye exam, so the Air Force was out. During my boot camp days the atomic bomb was dropped; my training was halted and I was sent to a Corpus Christi Navy airbase where I peeled three tubs of onions a day for four months. I was then given the job of educational advisor where I helped discharged vets decide on a college. When I was ready to attend college myself, I knew there was an opening at Bowling Green State University…and I already knew the registrar. I called him and said, ‘I have someone for you.’ When he said, ‘Is he any good?’ I replied, ‘It’s me.’”
Perhaps it was that experience of watching his hands work for four months that led Blair Filler to become a hand surgeon. Whatever forces brought him in that direction, the fact is that he has helped innumerable children and adults get a handle on…get a sense of control over…their lives. “It is very powerful to enable a child with a completely disabled hand to have some function. It has also been rewarding to work with cerebral palsy patients, something that led to my learning upper and lower extremity procedures. There is not a lot that an orthopedist can do for these patients that’s going to make a huge difference—but we can make little differences. I recall one patient who could not open his hand, but after our team operated on him, he improved significantly, turned into a great artist, and designed beautiful Christmas cards.”
The appeal of hand surgery, jokes Dr. Filler, is that you can sit to do the procedures. “We are handling tissue much more gently, and fortunately don’t have to do a lot of tugging and pulling that is often required to get visualization in other parts of the body. Hand surgery takes a detail-oriented person because you are working in a smaller area with a substantial concentration of nerves and other important structures. While the long hoped-for future is here—hand transplantation—the serious drawback is that patients must remain on anti-immunologic medication the rest of their lives. The minute you sew someone else’s hand onto a patient the body tries to reject it. There is research being done on this aspect of transplantation; we will likely see some positive developments in the next five to ten years.”
Dr. Filler, who was chief of the hand service at Los Angeles County Hospital for 22 years, recalls, “When I first came to Los Angles, Dr. Herbert Stark was a premier hand specialist in the area. Dr. Stark took me under his wing and said, ‘I’m establishing a hand service here at L.A. County. If you can guarantee me five years we’ll make you a subspecialist.’ Five years later I became chief of the hand service.”
From his long-term vantage point, Dr. Filler sees a growing tendency that concerns him.
Now, surgeons are being forced to be musculoskeletal physicians with no in depth knowledge of patient care. In residency, trainees are not rotating through internal medicine or general surgery, meaning that doctors are becoming technicians—albeit good ones. The bottom line is that if a patient has a problem that is unrelated to musculoskeletal medicine a young orthopedist is more apt to miss it.
But for those who found themselves in trouble while wandering the hills and valleys of Los Angeles County, for 26 years Dr. Filler—and his extensive medical knowledge—was on hand to assist. “Many people don’t realize how mountainous the L.A. area is; they set out hiking and encounter some steep, crumbly terrain. We—the county search and rescue team—would find people hanging on little ledges or isolated in deep caverns. The helicopter would hover, we would rappel down a rope and then would either treat any injured parties there and then bring them up, or wait until they were on board and treat them if the situation required. I had to become a sheriff, as did the paramedics; we all carried guns and badges. But when the calendar turned and I hit 77 years of age the county made me retire.”
For his insight and courage in a variety of challenging situations, Dr. Filler was recognized by AAOS with the William Tipton Leadership Award. “I think people see in me someone who is determined to get to the bottom of things in as fair a manner as possible.”
Reflecting on his years of service to others, Dr. Filler highlights his volunteer work and says that it is likely going the way of the T-Rex.
I run a charity clinic at the Los Angeles UCLA Orthopaedic Hospital where we see 55, 000 children a year (either for a minimal fee or at no charge.) When I started in practice years ago there was no Medicare or Medicaid and we were strongly encouraged by the senior orthopedists in the community to devote one day a week to charity…everyone did it. Then came Medicare and for the average doctor, charity work is history. There are doctor payment issues and hospital payment issues…in the end the community suffers.
Dr. Filler talks of these and other important lessons of the field with those plotting their courses for the future. He says, “I suppose my philosophy is simple: if you are doing something you truly like and believe in, then things seem to work out. And if you are enjoying your work your enthusiasm will be contagious to the people you’re educating. Some individuals don’t have enough passion or talent for orthopedics; in fact, I have counseled some students that they should look elsewhere for a career.”
Although proud of his work with AAOS, the Western Orthopaedic Association, the American Medical Association and other groups, Dr. Filler says his most important life’s work was right at home. “My wife and I have four kids who are leading productive, happy lives. I couldn’t ask for anything more.”
Far from empty nesters, Dr. Filler and his wife are both pilots and often take their Piper Cherokee Six to go skiing, head down to Cozumel, or up to Alaska. “A small plane is especially great for getting to the out of the way valleys of Idaho; and the bonus is that you don’t have to deal with airline security.”
A surgeon who has hit numerous milestones, Dr. Filler has also hit a multitude of mile markers. “Running is both calming and energizing, and I have enjoyed being in a running group for many years. We meet every Sunday morning and cover 6 to 8 miles; truth be told, however, it is becoming a walking group.”
His advice to those whose energy is solely focused on, say, “The Match, ” or getting the best contract with that new hospital? “Orthopedics IS fun and rewarding, but we need other interests. My search and rescue work was stimulating in part because I got to learn other people’s jobs. Find something to recharge yourself…something re-create yourself…if not you will burn out.”
Dr. Blair Filler…focused, but willing to handle the big (difficult) picture.
