Grit and the Triple Mission: A Blueprint for the Modern Leader

Why I don't have "traditional" hobbies, I have a lifestyle

“I don’t have any hobbies.”

When I said that to a reporter recently, I watched him pause, pen hovering over his notebook. In the era of the “four-hour workweek” and the relentless pursuit of leisure, the idea of a surgeon-entrepreneur with zero interest in a golf handicap sounds like a recipe for burnout. Or perhaps, to some, it sounds like a life out of balance.

But they are looking at the wrong scale.

My work is not a “job.” It is a mission. My family is not a “distraction” from that mission; they are the reason for it. Everything else is just static.

If you want to lead in the modern healthcare environment - if you want to move the needle in an $80 billion industry while fiercely protecting the doctor-patient relationship - you don’t need a better hobby.

You need Grit.

The Triple Mission: Reclaiming the Surgeon’s Authority

In the ivory towers of medical school, we are taught the “Three Pillars”: Patient Care, Research, and Education. Somewhere along the way, the modern corporate hospital system tried to turn those pillars into checkboxes. They wanted surgeons who were “producers” first and thinkers second.

The “Modern Surgeon-Leader” must reject that hierarchy. To truly disrupt a failing system, you must dominate the intersection of these three worlds:

1. Patient-Centered Care: This is the “right to play.” 10,000+ surgeries isn’t a vanity metric; it is a decade of standing at the table, refusing to settle for “standard” outcomes.

2. Clinical Research: Data is the only language administrators fear. If you don’t track your own outcomes, they will use their subjective metrics to tell you how to practice.

3. Innovation and Entrepreneurship: Designing the tools of the future (implants and systems) is how we scale our impact beyond the patients we personally touch.

The Foundation of Grit

I learned the definition of Grit long before I ever stepped into an Operating Room. I watched it in my mother in Terre Haute. She grew up in poverty and realized that education was the only ladder out. I watched her work three jobs simultaneously while earning a Master’s degree in Mathematics.

She didn’t have “hobbies” either. She had a goal.

That is where my “no hobbies” philosophy comes from. It’s an obsession with excellence that doesn’t punch out at 5:00 PM. It’s what allowed us to grow the Indiana Orthopedic Institute from a team of two to 85 employees in just 36 months. We didn’t do it by following a corporate handbook; we did it by being the most efficient, data-driven team in the market.

When Grit Meets Science: The Tourniquetless Revolution

To understand how Grit and the Triple Mission work in tandem, you have to look at how we challenge “settled” science.

For decades, the orthopedic world accepted the tourniquet as a mandatory tool in Total Knee Arthroplasty (TKA). It was “the way it’s always been done.” But the data suggested otherwise. In our review, “Tourniquetless Total Knee Arthroplasty: History, Controversies, and Technique” (published in the Journal of the American Academy of Orthopaedic Surgeons), we challenged the status quo.

We found that while tourniquets provide a bloodless field, the “benefits” of improved cement fixation or decreased overall blood loss were not supported by the literature. More importantly, we saw that going tourniquetless - paired with meticulous technique and tranexamic acid - led to less postoperative pain and improved early function for the patient.

It took Grit to walk into the OR and change a technique I had performed thousands of times. It took the Triple Mission to turn that clinical change into a published study that influenced surgeons nationwide.

We don’t change for the sake of change; we change because the data demands it.

The “Aha” Moment: The Only Revenue Generator in the Room

A few years ago, I was sitting in a hospital boardroom. I was still in my scrubs, fresh out of a difficult surgery. I looked around the room: administrator, administrator, bureaucrat, administrator.

I finally said it out loud: “Do you realize I am the only revenue generator in this room? I am paying for all of your salaries, yet you are the ones setting the time for this meeting and pulling me out of the OR.”

That is the reality of healthcare in the United States. The earth is shaking underneath us. Surgeon compensation, adjusted for inflation, has fallen 38% over the last 20 years. Bureaucracy is at an all-time high.

The system is unsustainable.

The Blueprint for the Next Generation

To the surgeons and leaders reading this: The hospital systems will not save you. The insurance companies will not protect the doctor-patient relationship.

You have to build the solution yourself.

• Be a Scientist: Use research to prove your value. (If you aren’t publishing, you aren’t leading).

• Be an Entrepreneur: Reclaim the economics of your practice. Vertical integration and ASC ownership are the only paths to professional autonomy.

• Lead with Grit: Treat every patient like family, and every administrative hurdle like a revision surgery - stay still, stay focused, and outwork the problem.

We are building a new template at the Indiana Orthopedic Institute. It is a model based on high-quality, lower-cost care and a radical commitment to the Triple Mission.

I don’t need a hobby. I have a purpose. And we are just getting started.