In this episode of The Intentional Surgeon, Dr. Sharon Stein speaks with Gil Spitz—former classical musician, athletic training specialist, and founder of Surgical Strong. They reframe surgical practice as high-performance endurance athletics, explore modality-specific physical strains (open, laparoscopic, and robotic), and break down actionable strategies to prevent chronic pain and extend surgical career longevity.

Key Takeaways

1. Surgeons as Precision Athletes: Operating requires holding asymmetric, isometric postures for hours. Maintaining fine motor control under this physical strain demands task-specific strength training rather than generic fitness.
2. Modality-Specific Strains & Solutions

• Open Surgery: Demands strong posterior spinal muscles and unilateral hip stability to offset weight-shifting onto the non-dominant leg.
• Laparoscopic Surgery: Drives severe shoulder, trapezius, and elbow strain when working away from the midline.
• Robotic Surgery: Seated positioning removes gluteal/core engagement, creating spinal compression and pelvic twisting from asymmetrical pedal use.

• Intraoperative Micro-Breaks: Taking a 90-second micro-break every 60–90 minutes flushes metabolic waste, restores muscle perfusion, and preserves fine motor precision during long procedures.
• Active Recovery & Down-Regulation: True physical recovery requires actively shifting out of sympathetic "fight-or-flight" mode post-op to allow muscles and connective tissue to heal.

Featured Quotes

"Surgeons are precision athletes. There's nothing more athletic than using deep kinesthetic knowledge to recreate specific, precise physical outcomes inside another human being." — Gil Spitz

Learn more at www.surgicalstrong.com

Surgery is a team sport, yet many departments operate as isolated individuals sharing a call schedule. In this episode of The Intentional Surgeon, Dr. Sharon Stein welcomes Dr. Faisal Aziz (Chief of Vascular Surgery at Penn State Health) to discuss how his division built a true "one team" culture where surgeons stay long-term and support each other at 2 AM.

Key Discussion Points:

• The Recruitment Post That Sparked the Call: Why Penn State’s group stands out as a unified team rather than a collection of independent contractors.
• Culture Eats Strategy: Applying Peter Drucker's rule and Jim Collins’ Good to Great framework to surgical leadership.
• Hiring for Character First: Why technical skills can be taught, but integrity and humility cannot.
• Uncovering True Culture: Practical strategies for applicants to assess a department's real culture—from observing how staff are treated to Dr. Julie Freischlag’s "3-second pause" technique.
• Vulnerability in the OR: How senior leaders asking for help builds psychological safety, breaks down ego, and improves patient care.
• Cross-Generational Skill Exchange: Bridging the gap between open-operative mastery and modern endovascular/robotic techniques through mutual mentorship.

Featured Quote:

"I can teach surgeons how to do complicated operations. What I cannot teach is how to be kind, or how to have character and integrity. It is much easier to hire for character and invest in technical growth than to hire competence without integrity." — Dr. Faisal Aziz

Thank you and chat tomorrow!

Technical prowess and clinical knowledge are the bedrock of any surgical career, but they are only two pieces of the puzzle. The third—and arguably most impactful—element is communication. Despite its outsized influence on resident evaluations, operating room efficiency, and patient outcomes, intentional communication is rarely explicitly taught in medical school or residency programs.

In this episode of The Intentional Surgeon, Dr. Sharon Stein breaks down why communication isn't just a "soft skill," but a critical clinical tool. Dr. Stein also introduces The Launchpad, a new program designed to empower graduating residents with the communication, prioritization, and negotiation skills needed to navigate high-stakes career decisions.

In This Episode:

• The Communication Gap: Why attendings often complain about consults or presentations due to formatting and communication disconnects rather than a lack of clinical knowledge.
• Decoding Communication Styles:
  • The Punchline First: High-yield communicators who need the core verdict up front (e.g., Do I need to check a box, get out of bed to operate, or listen closely to offer expertise?).
  • The Logical Processors: Thinkers who require a structured, step-by-step chronology.
  • The Relational Communicators: Team members who build rapport through personal connection before diving into clinical details.
• The Power of the Open-Ended Intake: Why asking new patients "In your own words, what is going on with you?" unlocks crucial insights into both their communication style and their baseline understanding of their diagnosis.
• Building Trust Through Airtime: How allowing patients and colleagues to speak uninterrupted for the first minute fosters psychological safety and accelerates clinical trust.
• Mirroring to Meet Needs: How recognizing a patient’s need to process information slowly allows you to adapt your delivery style, reducing anxiety around difficult diagnoses.
• Continuous Skill Acquisition: Why seasoned surgeons can and should learn new communication models just as they learned laparoscopic or robotic techniques mid-career.
• The Launchpad: A dedicated 6-month program equipping graduating residents and fellows with essential tools in communication, prioritization, and negotiation as they navigate their first job search and career launch.

Key Takeaway:

"We spend years perfecting our technical craft, yet so much of our daily success hinges on how effectively we communicate. When you learn to deliver information in a way that aligns with how the other person’s brain processes it, you transform your relationships with your residents, your OR teams, and your patients. Communication isn't a fixed personality trait—it's a learnable surgical skill." — Dr. Sharon Stein

Resources:

• The Launchpad Program: A 6-month, interactive coaching initiative starting this September for graduating residents and fellows looking for their first surgical position. Learn how to identify your priorities, master negotiation, and communicate effectively to land in a practice environment where you will thrive. Register here.