Dr. Richard Haynes

Have a five minute conversation with Dr. Richard Haynes, former Director of the American Board of Orthopaedic Surgery (ABOS), and the theme of his life will be evident…what a privilege it is to take care of patients with orthopedic problems. As the former Chief of Staff at Shriners Hospital for Children in Houston, Dr. Haynes did witness much suffering. But he didn’t just stand on the sidelines—he got involved.

Dr. Haynes: “I was particularly drawn to working with children who were missing limbs, most of them who were born this way. Getting involved with them and their families seemed to be a privilege as opposed to a burden…I was genuinely surprised to learn that not all doctors feel this way.”

The winner of the 2006 Tipton Award for Outstanding Orthopaedic Leadership, Dr. Haynes has led parents through the grief process and orthopedic trainees through difficult educational and life lessons. “To be selected for an award with Bill Tipton’s name attached to it is an honor indeed.”

I think one of the leadership mantras I have followed is, ‘Focus on what you can do about a situation as opposed to dwelling on the event itself.’

“Rather than spending one’s efforts on ruminating about a problem (although it is important to review one’s mistakes later), in the moment you should focus on how you can salvage the situation. If, for example, a patient gets a postop infection, instead of attempting to deny your involvement or blame others, focus on having a mature reaction, i.e., being calm and finding a solution.”

This responsible attitude was cultivated with the help of Richard Haynes’ psychiatrist father. “My father was a neurologist and a psychiatrist, and was the most influential person in my life. We moved several times, but ‘landed’ in Toledo, Ohio, where I grew up. He never pressured me to go into medicine, but he did point out that medical school would give me more options than any other field. Between my dad—a southern Democrat—and my mother, a Boston conservative, my brother and I were treated to animated discussions—and quizzes…lots of quizzes about medicine, life, and self knowledge.”

Richard Haynes would develop self knowledge in part by getting to know the suffering and strivings of those who saw too much in Vietnam. “Upon the recommendation of my father, I joined the Army and did an internship in Honolulu. I also trained at Letterman Army Hospital and began to develop a love of orthopedics courtesy of the young men (and it was mainly men) who served in military during Vietnam. Their fortitude and perseverance were awe-inspiring, and their stories are still with me today.”

Indeed, the memory of being in that Honolulu military hospital in 1975 put an eternal stamp on Dr. Haynes’ life. “In July 1975 we had 750 inpatients; by October there were 1, 700 people in our care. When I continued on as an orthopedic resident at Letterman, our practice was dominated by casualties from Vietnam. Although I did not serve in Vietnam, more than anything else in my career, I was impacted by taking care of these men who were suffering from horrific injuries. To be responsible for the future of hundreds of 18-year-old men who were severely wounded was quite daunting. Communicating bad news is one of the hardest things that doctors have to learn. During these years I was doing it quite often.”

Having an enthusiasm for the field of orthopedics, says Dr. Haynes, is the major reason for his success. And observers would likely say that it is Dr. Haynes’ unselfish, mature attitude as well. As there so often is, there was an early mentor to thank. “During my fourth year of medical school I worked with a superb general surgeon who created an enthusiasm in me for learning the principles of patient care. He was also the perfect example of how to be a responsible physician. I recall a situation where a patient didn’t survive and I commented to him, ‘What a sad thing.’ He looked at me and said, ‘The patient came to the operating room alive, and we are responsible for the patient leaving the operating room alive.’ That was a stunning statement for me, and helped transition my thinking from medical student to mature physician.”

Richard Haynes took this—and other life lessons—and went on to be involved with teaching future orthopedists at eight residency programs. “I was one year out of training when I was assigned as the junior faculty member of the residency program at Brooke Army Hospital. It was pretty stressful because I was about the same age as my students. But I did my best, and tried to convey some wisdom I received from my father, namely, that more mistakes are made by not looking than by not knowing. In your heart you must know that you have done your best for your patients; they will likely know it as well…and will be very grateful.”

“I also counsel young surgeons to keep their options open via participation in the wider field of orthopedics. There are fascinating volunteer opportunities available if you just keep your eyes open and are willing to learn something new.”

Dr. Haynes, winner of the 2005 Distinguished Service Award from the American Academy of Pediatrics Section on Orthopedics, explains how working with children brought a lifetime of gifts…not only to the children, but to him. “The majority of orthopedics is what you call ‘incident medicine, ’ i.e., you break your arm, you are treated by a doctor, and you move on. The total time that you and the patient spend together is brief, and is usually incidental to your overall life.”

At Shriners the work is about children with lifelong problems, meaning that you have the privilege of meeting a child early in his or her life, and then having them, in essence, grow up alongside you. I’ve often said that for me, the ‘surgery’ part of orthopedic surgery was almost incidental.

Dr. Haynes’ eyes were unexpectedly opened even wider when he transitioned from a career in the military to one in private practice. He notes, “After ten years of military service I thought it was time to try something different. I joined two orthopedists in Phoenix, and had the interesting experience of getting used to a wider range of individuals. Whereas I used to treat American GIs, who are the very finest of Americans, in private practice I encountered a broader spectrum of people, some of whom didn’t follow the same set of principles. In addition to treating those involved with violent crime, I recall one patient who, after he robbed our office and ‘borrowed’ our cast saw, cut the locks on neighboring offices and helped himself to various supplies.”

Dr. Haynes let the justice system handle that gentleman. His investigational capabilities would be put to use later, however. “I have recently completed ten years as Director of the American Board of Orthopaedic Surgery. During that time I got to meet and review up and coming orthopedists either on paper or in person, all the while overseeing the certification process. The Board’s responsibility is to ensure to the American public the Board Certified Orthopaedic Surgeons are competent to care for their musculoskeletal problems. While prior to my tenure the Board had never revoked a physician’s certification, during my time we found the need to revoke approximately fifty certifications. Fundamentally, it’s about assuring the public that they are safe under our care.”

A leader at—and with—heart, for three years Dr. Haynes had the helm of the AAOS (American Academy of Orthopaedic Surgeons) Diversity Advisory Board (DAB). “I just finished three years as Chair of the DAB where my colleagues and I sought to further incorporate the concept of diversity into orthopedics. We also focused on promoting the practice of culturally competent care.”

“The success story is that in ten years the number of women in orthopedics has doubled, and now stands at 14%. Increasing the diversity of our specialty remains a work in progress. The recruitment of underrepresented minorities to consider a career in orthopedic surgery through mentoring programs has been a real privilege.”

Dr. Haynes’ latest role puts him in a position to learn more about this and other issues facing the field. “I retired from Shriners in 2007 and now work half time for the Accreditation Council for Graduate Medical Education (ACGME). The 14 years I spent volunteering for the organization in various capacities set the stage for this job. Now, I review orthopedic and other programs all over the country, typically visiting about 70 residencies a year. I’m not speaking for the ACGME here, but from my personal observation only…I have found that the vast majority of residents are excited about their specialty and their programs. The biggest thing programs struggle with is support for graduate medical education. In my opinion there should be less reliance on the federal government and more support from the home institutions.”

And the highlight of Dr. Haynes’ career? Working with children who have special orthopedic needs. “I know that this is not an area that all people can or are willing to tackle. Several years ago the Pediatric Orthopaedic Society of North America surveyed graduating residents, and asked why they selected their subspecialty. This was done to help define recruitment of orthopedic residents to pediatric orthopedics. One of the results that struck me was that many of the young doctors really struggled with the prospect of treating children with special orthopedic needs. I had always thought that everyone would be enthused about that.”

When Dr. Haynes shifts gears, he reflects on the life he has built with his wife of 45 years, Sherrill. “Growing up, my wife had the best preparation possible for being the wife of an orthopedic surgeon…she is the daughter of an orthopedic surgeon. We have two spectacular children, one of whom is a radiologist and has given us two perfect grandchildren. We also have an accomplished, thoughtful son in San Francisco. Aging has changed our hobbies; whereas we used to be avid skiers, our biggest hobby now is taking our new puppy hiking in the mountains around Phoenix.”

Dr. Richard Haynes…finding privilege in the art and science of being of service.