If you ever pass by a playground and see Stuart Hirsch playing on the monkey bars…he’s earned it. Dr. Hirsch, the recipient of the 2007 American Academy of Orthopaedic Surgeons (AAOS) Tipton Award for Outstanding Leadership, knows what it means for children to have access to safe, fun places to explore…indeed, he was instrumental in creating the annual AAOS playground build event.
Dr. Hirsch, who had also served on the AAOS Board of Councilors and the Board of Directors, says he grew up in a much simpler time when things just “were.” “I was raised in New York City by warm parents who made it clear that my siblings and I must get good grades and should always be polite and honest. The expectations were high and the love was deep.”
This solid ethical foundation would serve Dr. Hirsch well when he later became the treasurer of AAOS and then chair of the AAOS Communications Council. Of his early days, the accomplished Dr. Hirsch states, “Not only was I influenced by my brother, who entered medical school when I was in college, but I was profoundly changed by the relationships I had with numerous teachers. I always felt close to my instructors, and in medical school at the end of each rotation we were invited to a professor’s home for dinner. I believe in things such as this because it helps break down barriers such that teaching is more Socratic/mentoring in nature.”
But you don’t need Socrates to mop a floor. Dr. Hirsch smiles and says, “Although my residency at Downstate Medical Center-Kings County Hospital was challenging because we didn’t have a lot of ancillary personnel, it taught my fellow trainees and I to work as a team and to be independent. As a resident I mopped the OR floor and wheeled stretchers; when the X-ray technician left for the day he left the machine on so we could use it…all of this meant a real appreciation for the value of teamwork.”
Much of what I have done in the communication and leadership realms has focused on teamwork and on the value of having a reliable support system. Fundamentally, it’s not about a lone person toiling away…it’s about a team of individuals with shared goals working together and empowering one another.
This philosophy ties in nicely with something Dr. Hirsch sees as one of his most important life accomplishments, namely, his work in communications. “When I became the AAOS Communications Chair I moved forward with the thought that the Academy needed to communicate its vision to members, patients, the public, and thought leaders. The surveys we were doing at the time found that the public didn’t know what an orthopedic surgeon does. I’m proud to have worked on communications initiatives, which garnered Emmy, Clio, and Mercury awards and brought the Academy into association with other industries that have been supportive of our efforts.”
To some, the word “communication” conveys an air of fluff…something that cannot be measured and thus perhaps is somehow less valuable. Nonsense, says Dr. Hirsch. “Far from being a peripheral part of our work as physicians, communicating a clear message is important, for example, when you have an older patient who relies heavily on his or her family. Or, if you are treating a teen, but you haven’t communicated the importance of the rehabilitation program to the parent, then the child may not follow through in full. For each patient I provide the diagnosis in writing, what tests we are going to perform, and what we are going to do to help them recover and why. That way we are all on the same page.”
Which, says Dr. Hirsch, is a bit more than can be said for some orthopedists and their perceptions. “As part of my work with AAOS we did a survey and asked orthopedists if they were good communicators. A full 80% replied, ‘Yes, ’ whereas when asked the same question about their partners, only 22% said, ‘Yes.’ Patients felt differently, responding that we were ‘high tech’ but not ‘high touch.’ All of us—even the star communicators—can be better under certain circumstances and will occasionally miss something because of culture, educational differences, or language issues.”
Taking the time to properly communicate with patients can make the difference between a success and a poor outcome, states Dr. Hirsch. “If I say, ‘You need physical therapy three times a week, ’ but the person doesn’t drive then there could be a hitch in the program. It is also helpful to ask patients to repeat what you have told them, and ask them if there is anything that would interfere with them fully participating in their post operative care.”
Dr. Hirsch especially enjoys—and is proud of—his work as a mentor to young orthopedists. “In medicine, unlike in industry, we have traditionally not put the time and effort into developing leaders. But the future of orthopedics is looking very bright these days because more and more specially trained people will be at the helm of important organizations and academic departments.”
The advice he gives to future leaders? “When you hold a position of leadership you will ideally feel that the role comes with responsibilities, but is not filled with perks or rights. It is not about what you have accrued, but is about what you can do to enhance care, promote lifelong learning, and display best practices. My advice is to be trustworthy, show integrity, and create a meritocracy—then you can translate lofty goals into something of substance.”
A master at making great-sounding things come alive, Dr. Hirsch is energized by the work he has done on the AAOS playground build.
Sandy Gordon and I initiated this project at a time when the concept of handicap accessible playgrounds had not yet taken hold. We could see that building safe playgrounds for all children resonated with our message that as orthopedists we don’t just fix bones…we prevent them from breaking.
“Along with many AAOS members and staff, we took the plunge in 2000 and built the first playground during the conference in Orlando. As has become the norm, the community helped design the space, the children selected the equipment, and we met with community representatives to select the site.”
Reflecting on the earlier days of playgrounds and their hazards, Dr. Hirsch says, “There used to be no science to the development of playground equipment. For example, there were lots of metal edges that caught jackets; now there are rounded edges. It’s an amazing event: in the early morning we start with a flat piece of empty land. At the end of the day 600 volunteers will have come in, given their time and energy, and left with a smile on their faces as they look around upon the fruits of their labor.”
Known for becoming involved with unusual, meaningful efforts, Dr. Hirsch also devotes time to helping those who survived the initial attack of a society-wide scourge—polio—only to be left years later with muscle fatigue and other issues. “In 1970 I treated a patient who was having increasing problems because of childhood polio. At the time we did not know that there was a whole range of symptoms that would come to be known as ‘Post Polio Syndrome’—things such as increasing fatigue and neurologic deficits. My patient was devastated as she had to rely on crutches, use wheelchairs, and was becoming breathless at times. I worked closely with her and built a Post Polio Syndrome support group that grew to include 300 patients. It wasn’t too difficult to ‘connect’ with this work as I grew up in a time when parents still had a horrific fear of polio. The treatment was often barbaric, and involved isolating children such that their parents could only see them through a window.”
Clearly a success in many realms, Dr. Hirsch credits his careful attention to patients for creating a wonderful career. “It is imperative that we put ourselves into the patients’ position, and that we work hard to educate patients so that they can be our partners in their care. Ask them what their goals are…if you think someone has had a successful operation but the person can’t do what he wanted to do postoperatively, then that is not a success. And of course, a happier patient is overall a more satisfied patient. In the days of Facebook and Twitter, negative evaluations go ‘viral’ in the blink of an eye and your good reputation can be seriously affected.”
When Dr. Hirsch and his family head for quiet time, there are no tweets or phones allowed. “We escape to a quiet harbor on the New Jersey shore…a place that is blessedly free of phones and full of sunshine. Our friends join us as we engage in water sports such as fishing and kayaking. I like to sit and look at the water because it reminds me that we are just a little piece of life and that the power of nature is much stronger.”
Dr. Stuart Hirsch…leading by example and loving his field.
