Well, hello, Dr. Dodds. It's so nice to interview you for the ANNA Oral History Project. Well, thank you. Appreciate it. I will say, and I've known you a long time, and I always knew that you were involved in ANNA, but I never knew to the extent or how you got so involved in ANNA. So what is the story about how you got introduced to ANNA and then how you got so involved? Yeah, my introduction to ANNA was through the Learning Center, and it's the old Learning Center, not the new Learning Center, which is significantly smaller than this one, but the same idea. And I think I got invited there by one of my former residency directors was the course director and invited me to be an associate master instructor. And so I did that, and I got to know one of the nurses that actually helped Dr. Sweeney kind of establish the Learning Center, and this was probably within its first five years of being there. And I got to know one of the nurses very well who worked with the Learning Center and just kind of was very inquisitive about how it worked. And I guess I must have done a good job of teaching because I got invited back several times. And that was kind of my first introduction to ANNA was through the Learning Center and being allowed to teach at the Learning Center. I see. Can I ask what year that was? Oh, boy. 1995, I want to say. So that's a nice long history there with it. Yeah, for sure. And so you were already a member of ANNA, and then you got more involved as you started to teach there. Yeah, I did. I joined ANNA and AOSSM kind of straight out of fellowship, you know, like a lot of people do, and then kind of gravitated towards ANNA because of the involvement they gave me. It was a much smaller organization then also, and so it felt more like a family. And I felt like I got a lot of support through ANNA, and I was given a lot of opportunities that I wasn't quite given at AOSSM. I think it's partly because of the size of the organizations back then. Yeah. Can I ask, were there many women that were teaching at the Learning Center when you started? When I started, I think I was the second woman admitted to the Arthroscopy Association, second or third, and I was pretty sure I'm the first woman to have ever taught there. Oh, look at that, another milestone. There you go. And then, well, let me ask you this. So you've been teaching there for almost 30 years, and then obviously there have been more women entering into orthopedics. Are you still teaching there? Yes, I'm still teaching there. Not as often. I was doing about four courses a year. I've narrowed that down to one or two a year currently. I cannot tell you. I'm sure I've done more than 40 courses there. How do you think it's evolved and changed over the past couple decades? The biggest change is the new Learning Center, and all of the stuff that we were able to do at the new Learning Center that we weren't able to do at the old Learning Center, and that is because of the size. We can increase the size of classes, the ability to do instruction and teaching in the large lecture halls. It's just a much more fluid, and you can accomplish so much more. So I think that's probably the biggest change that I've seen. Also, I've been involved in some projects through ANA, things like the Copernicus Project, where we've been working on problem-based learning and using the Learning Center to learn how to teach, which is a pretty cool thing. Yeah. When you started the Learning Center, did you imagine that it would grow to the extent that it has now? No. I said I think we could have maybe 20, 25 students at a time, and there was really no thought of moving on. It was kind of small, and the arthroscopy was kind of small back then, too. So I think you weren't really knowing what direction arthroscopy would go, if it would blow up and everybody would be doing it, or it would remain this specialty where only a few people did it. Yeah. And you trained in Iowa, right? Yeah, I did fellowship in Iowa, residency at University of Wisconsin. And how was the training during your residency and fellowship in arthroscopy? Do you think you learned more, obviously, after or during? My residency training was very good. I trained with some of the early arthroscopists, and Bill Clancy, who was kind of one of the people who brought the ACL reconstruction that I currently do now over and really helped perfect it in the United States. So I trained with him. So we did quite a bit of arthroscopy, and we also did quite a bit of a sports. It was a fairly heavy sports program. So residency, I did get a lot of arthroscopy experience. Fellowship, not as much. That was just beginning to evolve in shoulder arthroscopy. Knee arthroscopy was really all that was going on during residency. And then fellowship, we started playing around a little bit with shoulder, not playing around, but shoulder arthroscopy. And that I actually developed some in fellowship, but also it's stuff I've learned since by, you know, I even took some of the courses early on myself because I wasn't great at shoulder arthroscopy to help my skills, and then I ended up teaching them. Yeah, how cool is that? All right, let's see here. Let's move on to our curriculum. So what is one of your favorite lessons that you learned through Anna that you'd like to pass on to the next generation? For me, it's about teaching and leaving something behind. And for me, Anna has always been not so much what I can do, but what I can give to the next generation and what I can teach them and what I can show them, any tricks, anything that makes their patient care better. And I think that's got to keep perpetuating. You know, we can't just stop with ourselves and say, okay, you know, I know everything and nobody else needs to know anything. But, you know, just that idea of, you know, perpetuating knowledge and perpetuating skills and improving on those skills, I think is definitely something that Anna has always strived for. Do you think, I know the new move towards simulation for resident education, what do you feel about that? I think it's a good start. I don't think it's ever going to replace cadavers, but I think to get some of the basic skills down and get some of the spatial orientation and just familiarize yourself with the instruments and things, I think is better done and more cheaply done on a simulator. But I've taught too many courses where you spend the student or spends the entire time just trying to figure out how to put a scope in a knee or how to triangulate. And they're not getting nearly as much value out of that course as if they had done some simulation and been able to work just to get those basic skills. But I don't think it'll ever replace cadaver work for me. You know, there's just so many things, so much variation and anatomy and things that you don't see on a simulator, that I think it's super important that the cadaver work sticks around. All right, so what is the best piece of career advice that anyone's ever given you? Oh, that one is a little different. I think that one has to do with being female to some extent. And that was given to me by an OB-GYN person when I got out of practice. And she said to me, you know, nobody ever said you have to work five days a week, 14 hours a day. So I early on, I worked, you know, very hard. But then after I had my children, I never went back to full time. I would always take half a day off to do things with them and make sure, you know, I stayed somewhat well rounded. So I think for me, it is it's about that balance and knowing that career is very important, but you don't have to put everything into your career. You can put a lot into it. You know, I think it's so interesting how women might notice that first. But I think this next generation, I don't know if you've noticed with the men coming in that they also seem to notice this, too. Yeah, I agree. I think it's it's a more sensitive generation that we're raising. And I think they they're getting it. I think there's still a tendency for the males to feel like they need to do more. And but I think, you know, they need to participate in the families and the outside activities just as much as the women do. All right. Here's one. Maybe you already know. What piece of advice would you give your younger self? Oh, let's see. Younger self, I think for me, that would probably have to do with interacting with other people. When I came out, you come out kind of like a ball of fire and you come out with all these ideas and all the all these great things that you've learned and you want to implement them immediately. But you need to step back anytime you go into a situation and just say, OK, just observe and see what's going on and where you can be most helpful, because you can. There are ways that people do things and they may be even better than anything you've ever thought of. But you need to always step back as soon as you get into a new career situation and just just wait. Don't jump in, you know, with both feet, kind of tiptoe into the water a little bit. And then things will come to you, I think, a whole lot more easily when you know what the expectations are and and kind of what direction things are going. And maybe you can change that direction, but you're not going to change it all at once. So I think you might have kind of touched on this, your favorite memories about Hannah. Do you have a couple in particular? Yeah, probably my first time on the board. I've been on the board of directors twice. And the first time on my as a board member, Rick Angelo, who was the president at the time, decided to have an awards ceremony at the annual at our at our president's dinner. So he I think we were out in California doing it or something. So he made it just absolute Hollywood. And so he gave awards and I actually got the perseverance award. I was doing an Anna project on complications in arthroscopy and it was not going well. And the whole database was was just not going well. And I kept at it and kept at it and kept at it. And and yeah, all the board of directors, everyone got an award and I get the perseverance award. Good for you. Can you tell me a little bit about the project? Is was that a database you set up for users? Correct. Yeah, this was before really any database that had been started, any registries or anything anywhere. And I was given and decided to invest some money into a database. And this was Buddy Savoie's idea. He wanted to determine exactly what the complications rate. And it was an arthroscopic surgery because there really hadn't been any studies on that. Now, there's a whole lot more. But at that time, there hadn't been many studies. And I think the one we had before that was from like 1993. And this was probably in 2000, whenever Buddy was president. So that was probably six or seven years ago. And he said, you know, Julie, I got a project for you. And so he said, you need to figure out how we're going to determine prospectively what the complications rate are. Complication rate is in arthroscopy. And so I formed this thing I call the KSAC, which is the Knee and Shoulder Arthroscopic Complications Database. And we collected prospectively data. We had volunteer surgeons that would put in their data. And we collected prospectively data from about 800 surgeons for arthroscopy cases and to help determine what the complication rate was. So the problem was the database was not real well done. It's back before, you know, any of these newfangled databases were. And I had a programmer trying to put it together with us and he didn't speak the same language that we did. And so we got some information out of it, but not nearly as much as we had wanted to. But it was, you know, it was just trying to show the insurance companies that complications do happen. It was there. Insurance companies were calling these never events when people would have an infection. And Buddy said, you know, we got to show these insurance companies that these things do happen and that, you know, we should be compensated if we have to take a patient back for an infection or a blood clot or had to treat them for a DVT because these things do happen. So we got some data out of it, not nearly as much as I'd hoped, but pretty, pretty robust database. It's interesting how it was more difficulty with the I.T. than with the surgeon cooperation, because, you know, some people don't want to report their complications and they don't want to. Right. And, you know, it was a volunteer basis. So, you know, I sent letters out to all the arthroscopy members at the time and actually AOSSM also. But, you know, we got a pretty good group of surgeons from all over the country to prospectively report. And they'd have to report in at two weeks and six weeks and three months or two weeks and six weeks whether or not they had any postoperative complications. So we're looking mainly at acute complications like DVT and PEs and infections and broken instruments and anesthesia complications. That's neat. All right. Would you change anything about your experience with Anna? No, not really. I mean, it's no, it's been very welcoming. I've been very involved. I really strive to get a lot of other people involved, especially women. I mean, that's been a big goal of mine was to to reach out to other women and get them on the podium and get them get them going. But, no, I mean, it's been a great experience. They've put me in some leadership roles and learned a lot from that. So, no, it's been great. Oh, this is I think I think I know what you're going to say about this, but who are some of your most influential mentors? Within Anna? You know, anywhere. And yeah, what are some of the things you learned from your mentors that you took with you? Was incoming president at the time. And he said, you know, Anna is a meritocracy. Just work hard and you will get the responsibilities that you deserve. And so I really respect him for for letting me know that. So I had tons of projects and things that I was given, like by each president, kind of something, a project, little project to do. So, Rick, in kind of giving me that information, you know, he's always he's been a great friend. Trying to think of before that I really didn't have many mentors. I'm not in a there's no one in my family that's in medicine. You know, there weren't definitely not a lot of women mentors back when I started 30 years ago. So but within Anna, you know that most of the guys in the presidential line, you know, have just been great and a lot of fun. And, you know, Rob Hunter and Buddy Savoie, you know, have been been great leaders. And, you know, just just kind of pearls of wisdom here and there. Yes. And you're sounding cut out in the beginning, but I think you you had said Rick Rue was the. Yeah, Rick Rue was the one that gave me the info on the meritocracy of Anna. Yeah. And now I know his daughter's an orthopedic surgeon, I think. Yeah. Yeah. JJ's an orthopedic surgeon with two children. All right. So what excites you about being an orthopedic surgeon? I think just the ability to help people and and, you know, that's so cliche, but it's very true. I like to pride myself in taking the difficult patients and the people that other physicians have kind of blown off and said, I can't help you. And being able to help them, whether it's surgically or non-surgically, just by listening to them and doing kind of that extra mile and and really putting the extra effort into trying to to figure out their problem. I like I like puzzles. I've always liked puzzles and a lot of patient interviewing and and diagnostics are just pieces of the puzzle. So I think, you know, I've had I've liked puzzles ever since I was a small child. So that's I think that's probably, you know, where that that comes in in my career now. This says difficult cases happen. So what motivates you to keep coming back for the challenges? Yes. Difficult cases happen. And I think, you know, one of the things that that when a case doesn't go as well as as I like it to, you know, when I get done, I kind of, you know, you go, oh, that didn't go well. But at the same time, you go, you know, the patient didn't die. I didn't cut off their leg. You know, I think we can get through it. It maybe didn't go well, but usually the result, you know, is good. And, you know, occasionally there are bad results, but, you know, you just have to put them on a scale of how bad they can be. And I'm not belittling belittling anything as far as bad results. But at the same time, you know, it you just have to put them in perspective and you have to put them in perspective of all of the cases you've done in your lifetime. I've seen you talk about the most interesting thing you talk about is when you do a scope for a Baker's cyst and you find all these things in the bed. And like I didn't even know you could get in there. Yeah. Crazy things in the Baker's cysts. Yeah. No, that's been a great passion of mine is is, you know, looking in Baker's cysts and getting back there and figuring out the anatomy to figure out how to get back there. And just, you know, scoping the posterior knee and just looking at the variation anatomy in the posterior knee, you know, has been has been pretty cool. Yeah, you find some interesting variations there, right? Like, yeah, for sure. What did you say? I think one time you said there was something kind of strange you found in Baker's cyst. No loose bodies. I haven't found any like fish or anything back there. A lot of people with chondrocalcinosis will have these kind of huge calcified rocks back there. Yeah. Yeah. That's pretty fun. And a lot of loose bodies in there. Yeah. So, yeah, it's always surprising. I mean, how many people do you think do that scope of Baker's cyst? Hopefully more now that they've talked to me. Yeah. Right. That I put my stuff out there a little bit, you know, because there are some that are symptomatic and won't get better and it's a whole lot better to scope them than to open them. So, yeah. Yeah. That's kind of neat. Okay. So tell me, who influenced you or what influenced you to become an orthopedic surgeon? It was actually kind of by chance. I really didn't, like I said, didn't really have any mentors. My entire career was kind of like I'd go so far and then I'd go, okay, what am I going to do now? And then I'd go so far and I'd go, what am I going to do now? So, you know, I got through getting through high school, like, okay, what am I going to do now? Okay. I'll go to college. Okay. I'm getting to be third year college. Okay. What do I do now? Well, let me take the MCAT. Okay. I did okay on that. Okay. What? Let's see. I guess I'll go to med school, get third year, fourth year med school. It's like, okay, what do I like to do? Meh. I don't know. So I did my rotations with really no idea what I wanted to do. So got to my ortho rotation and kind of went, you know what? These guys are pretty cool. And these are people I can definitely relate to and, you know, like most orthopedic surgeons being an athlete and an injured athlete in high school, you know, you got, I was reading the physician in sports medicine that, you know, journal that was in every doctor's office because it was a freebie back when I was, you know, waiting for my, my knee stuff to get done. And, and so it was just kind of a gradual interest, just the more I kind of delved into it, the more that I would see things I liked and see things I could relate to. What was your sports history in high school? Oh, I'm one of those, this is, this is a good story. I'm a 16 year old ACL tear, complete medial meniscectomy, but they didn't recognize the ACL tear back then. So they just did an open medial meniscectomy. So I'm a great natural history for ACL deficient. I did get my ACL done in residency when I, I realized they really didn't know what they were doing. So I got my ACL done, but I was medial meniscal deficient for 35 years and then ended up with a knee replacement. But, you know, like I said, the natural history of, of complete meniscectomies is not always doom and gloom. Yeah. So what, what do you think of that? You thought, you thought you did pretty well, things considered? Oh geez. Yeah. I mean, I, you know, I, I, yeah, I mean, and I counsel a lot of my patients that way that, you know, or they're talking about meniscal allografts and, you know, osteotomies and all these, you know, procedures when, like I said, I went from age 16 to age 59 with no medial meniscus with, and was fully active, no pain. My patellofemoral pain is what finally got to me. Is that right? Yeah. So are you a coper or you, or you just really didn't hurt? Really didn't hurt. Yeah. I mean, the knee, yeah. The anterior knee pain was, um, you know, that you do end up, it's like getting up and down from a seated, seated position. And that's kind of when I said, okay, I need something done because my other knee isn't great either. But yeah. But that's, yeah. And I, I, it's, it's, I mean, yeah, it just really, and if it did hurt, you just keep going because it doesn't hurt that bad. Yeah. You're a coper. Yeah. Whenever I think about, I had a couple of mentors that had an open medial menisectomy and I just always think of like, oh, we don't need this. I turn over the, that's just like, oh, we don't need that. Yeah. Yeah. Spare parts. Yeah. Spare parts. Appendix, meniscus, you know, they're all out. Yeah. They're just, yeah. So those are the ways to save it now. Yeah. It's interesting. For sure. Um, all right. Now, what would you say to potential new members who are on the fence about joining Anna? Um, I think it's a, it's a great way to get involved in an organization where, um, people are more family. I mean, it's always been an Anna family to me. Um, and so I, I really encourage new members to, to join in. Um, they do a great job with the mentorship program and trying to hook new members up with older people and older members, um, that, you know, or even they're just for answering questions. I think you're, you're going to find a friend, um, and probably a mentor and probably somebody that, you know, you can use for, uh, patient care issues or even personal issues. I think we've talked a bunch about this. What do you feel is your greatest contribution to Anna? Um, I think it's a, that's a good question. Um, it might be my learning center, you know, experience and all the teaching I've done at the learning center. Um, I did get the Steven, the very first Steven Snyder education award, um, to honor my teaching ability. So, and then, you know, being on the board of directors, the first woman on the board of directors and, and doing two terms on the board of directors is, is pretty special to me. And, um, being allowed to kind of help plan the future of Anna and, uh, you know, what direction we want to go for the, for the members and, and seeing that through. And just to spell this out, cause you know, you're really, um, passionate about teaching and leadership, but what percentage of your career has been academics versus private practice versus, um, employed? Yeah. So I was the first 15 years I was with Michigan state, uh, employed position by Michigan state. There wasn't a ton of, well, there's, uh, no residency, um, through the, the department I was in. So, um, there was actually no orthopedic department when I came. Uh, so there wasn't a lot of teaching ability there. Like I said, I did most of my teaching nationally, either with, uh, um, the learning center courses or lecturing. And then, uh, research, I was fortunate enough to the year after I came, Steve Arnosky, who is one of the top researchers in musculoskeletal, uh, tissue research, um, came to the veterinary school and he was an endowed professor. And so I worked a lot in the comparative anatomy lab. And so we did a lot of animal studies that translated to human studies. So I was mostly private practice or university employed and really had no set aside research or teaching time. Um, and it, and really not rewarded for academics or, you know, teaching, um, or research, but, you know, I just found it very rewarding. And so I did it in spite of the fact that, that it was kind of on my own time. Yeah. That's a tribute to you. It's interesting to how Anna kind of, um, that's sort of the flavor of Anna that you don't have to be a condition to be in the leadership or to sort of plan the future of the organization, right. That kind of welcomes all comers. Yeah. I think that is a, when you look back at the presidential line, uh, very few of them are academic. They're mostly private practice positions that, um, you know, are interested in teaching. Maybe, you know, don't do a ton of research if they do a lot of it's just patient care research, maybe not as much basic science research. Um, so, uh, yeah, I mean, I, I, in a way it's a little bit more personable and I think it can relate a little bit better to, I mean, most orthopedics. Surgeons are not academic or in academic centers. And so I think, uh, the, the leadership can relate, um, well to the membership that way. I always think about sort of the efficacy versus effectiveness of a treatment. And a lot of times it's really effectiveness, like abuse in the world that is really what matters if something's going to be useful for you or not. Yeah, I agree. Um, all right, let's see here. Oh, what do you think was the most impactful innovation to orthopedics during your career so far? Uh, the innovation actually shoulder arthroscopy, um, came about, uh, when I was just started fellowship. And so, I mean, that is a whole new, weird, weird, new, weird, new world. Yeah. So, um, so like I said, just the whole avenue of shoulder arthroscopy, I'm trying to think of what else. Um, I do think the simulators are, uh, are a huge asset and they're just being developed and being utilized, but I think, you know, that is, that's huge. Yeah. Yeah. I, I did another interview last week and we were talking about shoulder arthroscopy when it first started. It was just so, even managing the sutures was just so hard and it's just such a long way. Yeah. So we did, um, the, really the only things that were done arthroscopically were shoulder decompression or decompressions. That's all you ever did through the scope, um, because that's all we had tools to do. So early on, and we, there was no radio frequency. It was all underwater bovie, we call them underwater bovies. So yeah. And they were a special bovie tip and bovie setting and, and, uh, and that was the only thing you had to, to control, uh, bleeding and there was no, there were no pumps. And so, you know, you had to have the, put the bag up to the ceiling to try to stop the bleeding. Um, there were no preemptive blocks and so, you know, patient's blood pressures were going all over the place. Yeah. Um, only beach chair position and no positioning tables. And so you put them on a regular table, sat them up and slid them way over the side and hope they didn't fall off the table. That's right. Yeah. And now some of the tools, so they go back and forth, like some of the shoulder tools have really been adapted to, like, for example, for meniscus repair, like it's sort of, it's going back and forth, but it really helps you to know both. Yeah. Yeah. Right. Right. It's the skills transfer over. So yeah, it makes you a better surgeon to be able to practice both. Yeah. What would you say to an incoming president of the country, of the United States? No, I think we'll do it. Um, probably the most important thing is just listening to the members, uh, and making sure that the, the members needs are met. And I know they do assessment surveys and that kind of stuff, but I think, you know, talking one-on-one to the members and making sure that, that they see the future of Anna, you know, going the right direction. And, uh, like I said, I, um, just the president needs to be involved with the membership and, you know, constantly kind of checking the temperature of the organization. I don't know these statistics. Do you know that, um, the size of Anna when you started compared to now, like how many times? Oh, here it is. Yeah. Um, what I think we're over 5,000 members now. And I think when we started, we were like 800 to a thousand. Wow. Yeah. Yeah. That's huge. What would you say to incoming or potential members about their future of arthroscopy and minimally invasive surgery? Uh, I think the sky's the limit. Um, I think we're learning a little bit more what works and what doesn't work. I mean, early on it was kind of, you know, just shoot everything out there and see what sticks. And, uh, but I think, um, part of it is honing down what we now know and what we've been doing and critically evaluating what we've done. And then, but, uh, you know, I think just the ability to, with all the new instruments and the more powerful shavers, I mean, when we first came, when arthroscopy first doing arthroscopy, the shavers would just kind of bat at the tissue and, you know, there was really not a lot of power to them. Um, you just kind of pretend it was eating something. Um, so yeah, but, um, yeah, I mean, I think it's here to stay, um, obviously. And, uh, yeah, it'd be interesting to see 20 years from now what we're doing then that we weren't doing now. Yeah. Sometimes in arthroscopy, there's this question of like, you can do it, but should you do it kind of thing? Like I'm thinking of maybe meniscus repair or that kind of thing. Cause you're, some of our tools are so good, but it biologically isn't even. Yeah. Right. I think, um, that's the other thing is just, you have to, you know, make sure that, that you're, yeah, it's, we do it because we can, not because it'll work. And that's a really bad, bad way to do things. Yeah. How do you think rehab and biologics are going to be like sort of woven in to sort of help answer that question? Yeah. The, the biologic stuff. I mean that I think it's, it is definitely the future and just enhancing healing. And, uh, I don't think we know yet. Um, but you know, consider where we've come in the last five to 10 years. I mean, there was nothing 10 years ago and now it's, it's not just, you know, breaking down to PRP or it's kind of PRP, how many cells, you know, what concentration, when is the best time to harvest PRP? You know, the variation in the cell counts during the day. Um, and you know, all the different places to harvest stem cells too. I mean, it's just, it's crazy where you find them and you know, who would have thought that there would be, uh, you know, a pluripotential cell in fat. I mean, fat is fat and it's like, really? So, yeah. Um, but I think, you know, and, and as they were kind of refine what within the cells were the signaling markers. I mean, I can just see them just harvesting signaling markers and, you know, putting one stem cell there and there and just, or a pluripotential cell and just, you know, throwing a bunch of markers at it and say, okay, do this or do this or don't do this. You know, just, you'd make a concoction of them. And, uh, and that allows you to either control the growth rate or healing rate and not overheal. So yeah, I think it's getting there, but it's, it's still got a ways to go. Yeah. Um, what is your perspective about treating patients by age, you know, now compared to maybe 20, 30 years ago? You know, when you, yeah. As far as, uh, how we treat older people differently, you mean? Yeah. Yeah. Um, well the population is definitely more active, uh, at an older age now. So the expectations are higher to keep these, you know, people active and doing things. Uh, you know, they, I think before, you know, if you were 40 years old and wanted to keep running, somebody would just say, oh, stop running. Or if they wanted to stay active, you know, you'd be a year too old for that. And so, uh, there's also kind of this quest for the fountain of youth and people want to avoid aging, which is, you know, maybe where the stem cell or the pluripotential cells or that kind of stuff maybe will help slow cartilage deterioration in some people to allow them to stay active longer. But, um, yeah, I mean, there's definitely a trend towards not, uh, not telling people to act their age. Right. If you, if you take that question to the career of an orthopedic surgeon, what, what are your feelings about sort of the evolution of a career of an orthopedic surgeon? Um, meaning, give me a, give me an example. I give like, as you, you know, what, what I'm sort of, how would you plan the next like 10 years of your career or, or how do you plan for retirement or not retiring? Or how do you know how long you want to keep going? Any personally or, or any, or just in general? And you can answer either way. Um, yeah, that's, that's a tough question. Cause I think it's very different in a lot of people. Um, you know, I ended up, I have another career that, uh, that I had, you know, kind of said, okay, this is what I want to do when I slow down orthopedics and not everybody has that. And so, you know, for me, you know, I actually have slowed down my clinical practice a bit. Um, and, uh, and working a few less hours in orthopedics and a few more hours in my hobbies and other interests. Um, in general, you know, I, I think people also are retiring earlier now than they used to, uh, partly because of the, I think increased hassle with insurance payments and all the regulations and things. And, and, uh, I think people are just kind of ready to, to, to move on to something else where there's maybe less hassle. Um, so. Yeah. Yeah. And what do you think Anna can do to help, um, you know, maintain a good environment in this culture that we're in for medicine? Yeah. Yeah. I mean, Anna, I I've worked, I'm on the advocacy advocacy committee now, and, uh, you know, we've had some amazing advocates, Bill Beach and, and Lou McIntyre and, and Eric steeple. I mean, it, I've just, uh, done an amazing job of, of fighting for, you know, what we want to do. travel with, uh, Lou and, uh, bill each, um, to DC to, uh, the, um, FDA one time to talk to them about coding and, and it was that whole classifying the shoulder is one big joint as opposed to different compartments. So, um, that was a very interesting thing to, to go talk to CMS actually about coding and things like that. So I guess it was CMS and not FDA. Yeah. Did you feel that, um, that it was effective? Um, I think we got in their ear. I don't know how much they listened. Um, but, uh, yeah, I think, uh, you know, we, we had to, you know, we took the little shoulder model along and tried to explain to the, the, uh, the head of CMS that was kind of determining the coding and things like that, you know, and the fact that we took the time to do it and go there, I think does mean a fair amount. I've also been involved with, uh, the board of specialty societies as the Anna representative and, and we've gone to Capitol Hill a couple of times with that, uh, for general orthopedic needs, but also, uh, was lobbying for, um, the, uh, government to help fund our, so most are, you know, um, our course for the military, uh, orthopedic surgeons. And so we lobbied, uh, some of the people in Congress to vote, to put us on, on the budget, um, of the defense department to educate orthopedic surgeons. Oh, cool. Yeah. You've had such a long and storied career. Pretty varied. Yeah. Well, it's been a very enlightening discussion. Really enjoyed talking to you about it. Thank you so much. No thing. It was good to talk to you. Yeah.

Dr. Dodds

ANNA involvement

orthopedic surgery

mentorship

arthroscopy evolution

biologics advancements

patient care impact

advocacy efforts