E131 Jeff Way on Spirituality in Surgery, Managing a Busy Practice and Advocacy
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Chad Ball 00:02
Welcome to the Cold Steel podcast hosted by Ameer Farooq and myself, Chad Ball. We consider it an absolute privilege to bring you guests from around the world who are truly experts in their craft. Our mission is to offer you a combination of not only master classes of clinical surgery topics, but also insights into achieving personal growth, productivity and fulfillment, as both a surgeon and, perhaps more importantly, as a human. We touched on some "taboo subjects" today on the podcast: money and religion. Dr. Jeff Way is a Trauma and General Surgeon in Calgary. We asked Dr. Way about his interest in spirituality and how that affected his career both inside and outside the operating room. We also got his thoughts on managing a very, very busy surgical practice, as well as his work on a provincial and national level with the government on health care and on physician billing. Can you tell us a little bit about where you grew up and where you did your training?
Dr. Jeff Way 00:56
I grew up in Newfoundland; born and raised in St. John's. I went to medical school there. I graduated in 1980, following which I did a rotating internship, and then I did my surgical residency, from which I graduated in 1986. Following that, I went to Winnipeg for 2 years, where I did ICU and trauma, and subsequent to that, I moved to Calgary in 1988, where I've now just entered my 35th year of practice.
Chad Ball 01:30
What took you to Calgary from Winnipeg at that time?
Dr. Jeff Way 01:34
I was finishing up there and wondering what I was going to do, and I was actually looking at going to Belfast. It was still in a time of great conflict in Northern Ireland at that time, and being from Newfoundland, I was kind of connected. And I was going to go to Belfast for a fellowship in more trauma, when I saw an ad in the CMAJ for a surgeon to come to Calgary to start up a Level 2 Trauma Centre at the Rockyview General Hospital, and I applied for that and came here, and the rest is history. And we started the Level 2 Trauma [Centre] at the Rockyview at that time, and then subsequently with the changes in Calgary and the amalgamation of the programs, as you know, trauma all ended up being concentrated at the Foothills Hospital, of which I had been a part of that trauma program for many years.
Chad Ball 02:35
Yeah. You know, I was hoping that the history of trauma in Calgary in particular would come up, so I'm so glad that you brought it up. What were those early days like? I mean, you were a fixture on the trauma service scene until essentially last year — you know, I would guess that's 25 or 30 years — how did you see the evolution of injury care in Calgary and in the country in particular?
Dr. Jeff Way 02:56
In those days, everything went to the nearest hospital, basically. And unless we had — so, the Rockyview [General Hospital] basically did everything from the south end of town and all the highway injuries that came in. There was no coordinated effort whatsoever. When I first came here, I was a new, young trauma surgeon, and I remember one young boy who had a head injury, a ruptured spleen, and I had a neurosurgeon come from the Calgary General [Hospital], those days, come, and we cracked a skull, where I did the spleen all at the same time at the Rockyview. Shortly after that, we then amalgamate with the Holy Cross Hospital, and so those of us at the Rockyview also went to the Holy [Cross Hospital], so we dealt with all the stampede injuries. I remember looking after a guy who had been stomped on by a bull down there, his liver was just smashed. And there was no coordinated effort all; it just went to the closest place. Subsequent to that it, all amalgamated to the Calgary General and the Foothills. And then with the time where we sold the Holy [Cross Hospital] and blew up the [Calgary] General, all the trauma went to the Foothills, and shortly after I then joined the program at the Foothills Hospital.
Chad Ball 04:28
Yeah, it's interesting; the history of trauma care in any given city across the country is always unique, and it's always interesting, and the culture and the politics and the government, and how those things kind of intersect. I think we'll come back to that theme, in terms of physician services, in a little bit here, but the next thing that we wanted to explore: you're known as a really deep thinker in Calgary and you got lots going on in a lot of different domains. And one of the things that intrigues a lot of us is the graduate work you did — and forgive me if I'm mismonitoring it — but in religious studies, can you tell us about what that voyage was like? What triggered you to do that, especially at that time point in your career, and maybe how it informs your practice and how it changed?
Dr. Jeff Way 05:15
Yeah. You know, it's interesting, Chad. I was away at a nephew's wedding 2 weeks ago in Camrose, Alberta. And when I was checking out of my hotel, there was some family in the area just sitting down, and I heard them talking about their little girl who was 5 years old and said she wanted to be a doctor, and they were just, you know, kind of making fun of her in a little way. And when I finished checking out, I just went over these people and I said, "Hi." I said, "I just heard you talking about your daughter," and they kind of looked at me, who's this guy? And I said, "My name is Dr. Way. I'm a surgeon in Calgary," and I said, "If you were to ask my mother, she will tell you that when I was 5 years old, I was going to be a doctor. That's what I was going to do." And I said, "So don't belittle your daughter who wants to do that. Someday she may be." And another story: I had a patient who had this hernia, and post-[operation], when it came for his check, he said, "Dr. Way," he said, you know, "You don't know me, but you just did my hernia," but they said, "My daughter's in high school, and she wants to be a surgeon". And he says, "Is there any way you can get her into the operating room?" So I thought, you know, I'm going to jump some hoops here, and I did that; I got her into the operating room. And a few years ago, he showed up at the office and said, you know, my daughter just graduated medical school at the [University of Alberta]. And he just wanted to thank me for getting her into the operating room all those many years ago. Anyway, I was always going to be a doctor, and my family always thought I was going to follow in the steps of Sir Wilfred Grenfell, who started the mission. He was admission doctor up in northern Newfoundland and Labrador, and he's well written about, known about, for his work, and everybody thought I was going to follow that route. However, I did not. I followed the route of, went through and went and did surgery first, and then on and came to practice. But this was still always lingering in the background, so a number of years ago, I started on — and the online and the Internet helped with this — that I started out to do a master's in Divinity. And I was almost finished; I had 3 courses left, which were Hebrew, Greek and Preaching, and I thought, you know, I don't really need this. The Hebrew — boy, it was tough. I started the course and it was tough. So anyway, they had come up with another program called the master's in Christian Studies, which basically, I had already completed all the prerequisites, and so, I just switched over to that program. And so I just had accomplished a lifelong goal, and it was very worthwhile. What was your particular thesis or area that you studied, and did it in any way inform or change the way that you practise? You know, it did a lot, actually. We did ethics, and I had to do a paper on ethics, and I did this — you know, we use biologic mesh on people, and we never discuss with them what the mesh is made of. So, I went to about 28 different religious groups and talked to them about the mesh and porcine and what-not, and, except for one group, who would not even, you know, would not do anything — everyone else, even though they won't eat meat, if you're going to put this in to save their lives, it's okay. And that was very interesting. And over the years, since I've had to use biologic mesh, I've always made sure to have that discussion with people about that. And so that was one thing I learned. The other was cross-cultural. You know, we did a lot of work in missions, and as you know, I've travelled the world and done work with Samaritan's Purse in many countries and areas. And, you know, I was in one country, and it was a conflict zone, and we were seen with a lot of suspicion, and after we were there for a week or so, they started to accept us, and we remember that one of the political people brought me their daughter, who was having some concerns, and I thought she was anemic. And we didn't have access to blood tests or anything, so I was looking at her eyes, and I was opening her hand up to look at the creases to see if she was anemic or not. They thought I was a witch doctor for looking at her hands like that. So you have to be just a little tuned in to things. We had another young girl, 7 or 8 years old, who got fragged by an IED, and the entry wounds were in her flank and had exit through the perineum, and she had blood coming from all the orifices, and we were examining her. And again, even some of our own people were questioning us about some of the appropriateness of what we were doing. So we just had to adapt and learn to treat these people and still do what we needed to do, but just learn to do it differently. And that was pretty brought out in the cross-cultural studies we did and mission work that we did; it was very interesting to look at those things. The other big one was wellness and looking after each other. You know, I don't think we do enough of that, as surgeons. We don't help each other. We don't look after each other. Because we can go through some tough times, and I think we need to be there for each other more. And then, of course, spirituality. And no matter whether you believe in God or not, or whether you're spiritual or not, most people, at some level, have a degree of spirituality. And if you look at the blue zones in the world, where people have longevity, one of those issues there, or one of the things that's been identified is a level of spirituality or belief in something higher. And so, I learned a lot.
Chad Ball 11:36
I'm curious: do you ever feel kind of embarrassed to talk about this with other surgical colleagues? Or, do you ever feel a little bit — because, you know, religion and politics is not things, typically, Canadians talk about — certainly not things that we talk about in the operating room — or, my sense is that it does make people feel uncomfortable. So, did you ever feel kind of embarrassed or — not ashamed; that's not at all the word I would use — but did you ever feel like, this isn't something I can tell the rest of my colleagues?
Dr. Jeff Way 12:08
I think early on, that would be correct. I think that's one of the reasons why I didn't follow that route early on, but as you get older, I think you become a little more confident in yourself. And I went on and did this. So now, no, I don't feel that at all. I mean, and you know, you'll see patients, and patients will often be wearing a cross or there or other sides of their religious affiliation. And you're able to talk to them about that and say, you know, particularly when — let's face it, we give some people some very bad news and very bad prognoses and bad diagnoses, and it's helpful to be able to talk to them about that. And I'll often ask people, you know, "Do you have someone? Is there anything I can do?" You know, some people ask me, they will say — and they've, you know, nowadays, they look you up on the internet, so they know what you do and where you've been — and they'll often ask me to pray for them. And, yeah, I can do that. And they feel very comfortable.
Chad Ball 13:22
One of the things that I really related to is talking about this idea of spirituality and how that interfaces with your own practice of surgery and how you deal with complications, and perhaps even how you relate to your patients' complications, or how you help your patients deal if there's tough situations. I'm curious if you're comfortable sharing this with us? How was your own spirituality impacted the way that you practice surgery? Is it a big part of your life? Do you have any spiritual practices that you do every day? If you're comfortable sharing that with us, that would be amazing.
Dr. Jeff Way 14:05
Absolutely. I think it gives us hope. So yes, I do. I go to a men's bible study every week during the year on Thursday nights. A lot of guys look to me for help about things. When I was in the middle of my residency, I found a little lump in my leg, and it was taken out, and I watched Terry Fox leave St. John's and run across Newfoundland; it was only a couple years after that. And the initial diagnosis on that was a sarcoma, and, you know, that was, you know, you had to have hope; you had to have belief. Anyway, 10 years later, I was here in Calgary, and then I got married and I was looking to get life insurance and I had this diagnosis. And, you know, it just wasn't making sense, so I had the slide sent out and I had it reread, and it turned out it was a nodular fasciitis. But for 10 years, I lived with a diagnosis of a sarcoma, and my hope and my belief had gotten me through that time. And so, over the years, when I've given people a bad diagnosis, I say, "I understand how you feel; I truly do." And people need hope. People need to have something to believe in. You know, I was in another country and again, they brought us an infant, who was probably about 12 or 14 months old. And this infant was totally limp. It was not breathing. I could not hear any heart sounds. It was grey. And believe me, I inflicted significant pain on this infant in order to try and arouse it. And there was nothing. I mean, there was nothing. To me, this child was just done, which we were a little concerned about because we were in a pretty precarious situation. And, you know, we had a pastor there with us who prayed over this child, and the child just kind of woke up. I was kind of amazed at that. What really happened, I don't know, but to me, there was no life in this child. And unless I had been there and saw it for myself, I would have a hard time believing that story. So, you know, spirituality is important. It's important to a lot of people. And people need hope. And that's all we can give to them sometimes is hope.
Chad Ball 17:00
That's a powerful topic and a powerful anecdote. And I think we could talk to you for hours — and some of us have — about your trips around the world, and particularly in places like Iraq and some of the experiences you had there. But we also wanted to switch gears a little bit here and bring it closer to home. And for the listeners who don't know you as well as we do, I'm convinced you must run the busiest — if not one of the busiest — general surgical clinics and offices in western Canada. The efficiency and the volume that you see is unmatched, at least in my observations and travels. I'm curious: what are your philosophies that surround your clinic, business or experience? And what prompted you to go in that direction, you know, out of the gate and then build that business? Because it's something that I don't think it's necessarily unique, of course, but it's certainly at a volume and an efficiency level that we just don't commonly see elsewhere.
Dr. Jeff Way 18:05
You know, Chad, when I came to Calgary at the Rockyview, there were 4 other surgeons there. Everybody had their own office, and that's just the way it was. You were an independent community practitioner. So I came here, I found a place to rent for an office space, I sat on the floor. The first thing I did was I had to get a phone. So I got a phone, which I plugged in, in those days. And then I had a phone book, and I started phoning around to find furniture and, "Okay. I need this. I need a typewriter," you know, "I need a desk," you need paper, you need things. So, I just kind of bought what I need, but we don't learn — we didn't learn this stuff in surgery school. You didn't learn this anywhere. I did read — there were often occasional articles about running a practice and what to do and how to set it up, and I read those things. But you had to set it up on your own. And then I just kind of looked around at the people who were in practice and just learned from them. And they had busy practices and we did — the people had a full service community office, and they did home where I trained, as well. And people did lumps and bumps in their offices and and saw patients. So, I just built an office, worked hard and, you know, I would say the 3 A's of practice are availability, affability and ability, and working hard and being available. The guys in [the Emergency Department] knew: oh, we can call Jeff. And the call schedules weren't like they are now. They would just call — GPs would send you patients from their office who had belly pain. And every office in those days had a [laboratory] and an X-ray down the hall. And so you would see a patient with belly pain, you would order some bloodwork, get, in those days, 3 views of the abdomen, chest X-ray, look at them all — they have appendicitis. You'd make that diagnosis in your office, and then you would book them for surgery that night, and after you finished your office, you can go over and do the appendix. And it was just different. And so, by being available and working hard. The other thing I've often said was that surgery is just 10% inspiration and 90% perspiration. Because we work hard. Every one of us work very hard, and not just the surgery specialties and many specialties, but a lot of what we do is just hard work.
Chad Ball 20:34
I'm curious; again, to take the listeners [in mind], you have multiple partners in your clinic, you have a relatively large staff, your patients absolutely love you from start to finish in their interactions with you. But in spite of all that sunshine, there has to be some challenges that go along with running a business like that, running a clinic like that, and I'm curious what some of those challenges are for you and how you how you deal with them.
Dr. Jeff Way 21:03
Yeah. You're absolutely right, Chad. I kind of told you about starting it out. I was by myself; like, it was just empty office space. I was just sitting on the floor. You know, that just doesn't exist anymore. But there are no doubt the challenge is, there's staffing — and you're right; we have a big staff. I have 3 examining rooms, and I have 3 nurses in many of those rooms at all times. So, you know, they do everything else. I just come in and do the doctor thing. And they've worked with me for a very long time, so they know things. They come in and say, "Oh, here's what's going on here." They'll get the dressings off the wounds, they'll look at it all and they'll — "Come on, tell me what's going on." And you know, so, it's very efficient. I am able to just do what I need to do, and they look after everything else. In addition to that, we have a big front office staff, we have a office manager who sort of oversees the whole works. I also have a nurse manager who oversees the nurses and does all our surgical bookings. And then, of course, we have our reception staff. And there's no doubt it's built on volume. In our fee-for-service environment, and running a community practice, it's certainly built on volume. But you know, the other thing is just: we're there to help. And people know they can call us. You know, if I'm in the office, we tell people, "Just call. Come in. We'll see you," and my staff know that. And people just show up, and you don't have to book for a month out; we're just there. And on that note, as well, you've heard me say, when you were a resident, we'd show up in [the Emergency Department]. We're called. So many of our colleagues will call them for consult and say "Oh. What do you need this for?" You know, I've always said — you just show up in [the Emergency Department], you say, "Hi. We're from Surgery. How can we help?" And just show up and do your job and everything else falls into place, and that's similarly out in practice. Just be there. [inaudible], some of the consults we'll look at, but they don't know; they're calling and asking for your help. So just see the patients — and again, that's where you become available and affable, and you build a big practice, and it gets busy.
Chad Ball 23:28
Well, one of the things — I worry it's a bit tangential — but one of the things I worry about with central triage that certainly exists in a lot of cities, and as you know, is coming to Alberta in a very big way and is already in the Edmonton region, is the loss of that personal connection. You know, the referring physician sends off the fax through electronically or old school fax, and it's sort of divvied out, but, really, no one's married to that patient out of the gate, and that ability to say, "Yep. Send them over. I'll see him right now. How can I help?" It seems to be potentially lost. What are your thoughts about that new model that seems to be permeating practice across the country?
Dr. Jeff Way 24:14
Yeah; you're absolutely correct. There are going to be some challenges and concerns about that. But, you know, we kind of emulate that in our trauma service. And we have been very fortunate in our trauma service in Calgary. We are the southern Alberta trauma referral centre. It's kind of like a central triage; no matter where you are in Alberta, you call the 1-800 number and RAAPID line, and you are sent to either Edmonton or Calgary. And we just see it all. You show up. We have, you know, over the years had 8 people doing trauma. And we are kind of like a central triage. We've been very fortunate that we've had 8 people who work together, and when we take over trauma, we just take over, look after the patients, and we've all done that. And that says a lot for the development of the trauma in this city, and the people who've done that. And I think that if people can emulate that, we will be well done. That's not the case in all services. The level of commitment is not there. But we have had it on trauma and we've done very well. So if people could emulate that, it would be good.
Chad Ball 25:33
Yeah, it's a privilege to do that, for sure. One of the other areas we wanted to explore with you is, you know, you've been deeply involved on the physician — I may use some incorrect terminology here, and I apologize if I do — but on the physician side, of a longstanding discussion and committee work with government; in particular, not only in how physicians are paid, or how they're renumerated, whether that's fee-for-service, or, you know, alternate plans or straight salary, but also, in addition to the the money side of it, into the delivery of care models that are both coming and have occurred over many years. I'm curious if you could frame your work for us, and then give us a sense of where we've come from and where we're going.
Dr. Jeff Way 26:25
Yeah. Thanks, Chad. You know, when I first started to practise in Calgary — again, I was a community physician; I was not a part of the university — and I was doing all the lumps and bumps in my office. We get this little tray fee, and, you know, the trade fee just didn't cover the costs of the supplies and equipment. So again, you're built on volume. And, you know, rather, I used to go to the admire Surgery Clinic at the hospital, and continue to do so, but I could do the same number of procedures in my office, and at the same time, I see other patients. And so it was economically better to do that. I figured out that if you hire staff, that allows you to do more; you may need to see 3 or 4 more people to pay for that stuff. When you see #5 and #6, that's money in your pocket, and I figured out that business model. In any case, I hired my own research assistant back in the mid-90s and early 90s, I guess, and I published a couple of papers, but one of them was on the cost analysis of doing procedures in your office. And that was a published in the Canadian Journal of Surgery. That obtained interest from the government, and I ended up with a meeting with the Deputy Minister of Health over that. And subsequently, the AMA, Alberta Medical Association, heard about this, and I was asked to become involved with them more. Although I was always a member right from the day I arrived in Calgary, eventually then was nominated to the board. I was on the AMA board in the mid-90s, and after that, since then, I've sat on fees committees, chaired fees, scheduled medical benefits committee, and I'm currently Co-Chair of the AMA compensation committee, and I'm also one of the 2 physician representatives on the Physician Compensation Advisory Committee of the Alberta Health. So it's a lot of meetings and a lot of discussion around physician compensation. And every time I have the residents, I ask them, "How do you see yourself getting paid when you're finished?" They all kind of look at me, and they all think that they're just going to show up somewhere, kind of get paid as they do as a resident who's just going show up, get paid, go home. And the concept of fee-for-service is really foreign to them. And, you know, again, we, in our training programs, we really don't teach people about the economics of medicine and surgery, and how you're going to get paid, and how this works, and Business 101, and running an office and what's involved with, you know, having to find and getting a billing program and all of these things, we don't teach our residents this. So it's a huge learning curve. And what I find now is, they don't want to come out on the treadmill of piecemeal work of fee-for-service. They want something else. And, you know, it's in the news lots right now with the Premiers' meeting, health care, we see it — we all see it very well. We see health care imploding and crumbling around us, and we've been saying this for years, but it is really coming down to that: practices are not viable. You know, because of my work, I hear from a lot of physicians, family doctors having to close practice. They can't make a goal of it, financially. There are some real challenges out there, right now. And some of the areas that I think we're going to need to look at are, you know, are we going to need to look at the CPT, or the Current Procedural Terminology; it's used by the American Medical Association. I mean, it's a fee schedule that's used nationwide, and has modifiers to geographical locations and different things, and is that something that we need to look at? I mean, we do explore these things at the AMA. We've talked to them, but no decisions are made. It's just all looking at this. Do we need to have a different model altogether? Do we need to be on — is it stipends we need to be on? Do we need to be on salary? How do we look at that? How do we then protect us, as ourselves, as employees, if we were to go that route. On-call issues; it's another problem. You know, people are on-call all night long; you may or may not have much work, but then you're not working the next day, and yet you still have your overhead. We're facing challenges, as you know, with codes and decreased rates for working in the hospital while yet, you still have an office and have overhead back at another site. These are challenges and we are trying to educate people and let them know that it's not simple, one form of payment's not going to fit all, and we're going to have to explore new ideas. On-call at night, should we be paying people to be there, be available, show up? You know, one of the areas — you know, a few years ago is, you know, there were some concerns about call issues in Alberta and the College were going around and phoning everybody at Christmas-time to see if you had the message on your machine about how to reach someone. And, you know, the question is: there is somebody on call for every service; that person just needs to show up and see the patient. And, as you know, we'll see people, you know, who had some huge operation at another hospital, got discharged that morning and show up at a different hospital at night. We kind of shake our heads about that, but we still just need to show up and see them and not worry about that. The patient doesn't care, they just want to be seen. We'll sort out any acute problem, and then we can figure out where they go later. But again, this has funding issues. And people need to — we're going to have to look at it differently, and, you know, there are lots of options out there, but it's hard to get consensus at this point.
Chad Ball 33:08
Yeah, there's no doubt. You know, it's interesting, having spent, as you know, a fair bit of time in the US and a very different practice model, you know, there is obviously some pros to being a straight salary system, particularly from building programs and longer term vision and moving resources around a little differently. There's also clear benefits to fee-for-service, and the history of that in many regions as well. It's interesting to me that you commented that maybe some of the recent graduates are not interested in the fee-for-service treadmill. What's your sense, being so deeply involved in this, of what they want? Like, from a purely structural point of view, where do you think this ends up?
Dr. Jeff Way 33:57
That's a very good question, Chad. And I don't — there is no clear answer. At the end of the day, in our current system in Canada, the taxpayer is who funds us, and all governments are strapped for dollars right now. And this isn't just in medicine, this is in nursing as well. And they're going to want maximum work for the least amount of pay, and that's reality. And so, how do you deal with that? And the fee-for-service model, right now, in terms of the challenges we have with overhead, you're looking at inflation; it's very difficult. And is the model we're going to be where everybody works based out of their — specialists in particular — based out of the hospital, you know, where overhead is, you know, probably less than it is in community practice, it's going to be challenging. At the same time, you're looking at, the fee-for-service treadmill promotes volume, and that can be a good thing, and in some instances, we know that can also not be a good thing. Because you also got to have quality that goes with that. It's not just volume, it's also got to be quality. And so, there are some real challenges, and the answer is not there right now. But we have to start looking at different payment models. And we have to do that as a profession, and we have to work together with our association and the government, and we need to be forward-thinking about this. And I think that the historic treadmill, a fee-for-services, is not going to work for everything. It still has some roles in certain areas; there's no doubt about that. But in many areas, we need to rethink some of this, and that's very difficult to get everybody there together. And, you know, you look at Alberta here right now, and we have some challenges. We do not have an agreement with the government. And, you know, we hear if, you know, groups wanted to move out in the role, and I think that would be unwise. I think [inaudible] strengthen us in our association. And I'll just plug in for your provincial associations right now, and to be members, and to work with your association. I think that that's our strength.
Chad Ball 36:43
I'm curious: when you're in those high-level meetings with government officials, whether they're appointed or elected, and you're trying to communicate the reality — and I mean this in the best possible way — that you and I live in, but realities from the trench, whether that's service coverage, delivery of care, or financially. What are your strategies? Like, how do you communicate that to somebody who may or may not be as savvy in terms of the real-world rubber meeting the road sort of scenario?
Dr. Jeff Way 37:18
Well, they certainly hear from us about issues, but at the end of the day, Chad, you know this from your research. A lot of it is going to be data driven. And so this, again, is why it's very important to be with our associations and gather information. And then we can show where our concerns are, we can show how our compensation compares, and that's very important. That said, they hear loud and clear about issues facing physicians right now. And although most of my work is about the people I work with, it's all about our fees, and how we're compensated. That said, we do look at the bigger picture. And there are some people there who really do know and understand the situation across the country. And it's just trying to mobilize people to all come and try to think outside the box and look at different ways of doing things, but that's difficult, particularly in the current environment.
Chad Ball 38:35
We always ask our guest, as a closer, and we'd love to get your thoughts: if you were to go back and ask yourself a question, or maybe give yourself a piece of advice when you were a trainee, or maybe just starting out in practice, what would you tell yourself?
Dr. Jeff Way 38:51
You know, Chad, you know this: I love what I do. I've always loved what I do. And I would do it all again. I think, you know, I worked hard, as many of us have; we showed up, we were there. And, you know, your timing your training, you get to see — spend as much time as you possibly can, sing as much as you can, because the day you finish, you're out on your own. I did a locum. I did a locum up in Labrador City; first place I worked on my own. And there was nobody else to ask anything. It was just me. And you know, you've got to spend as much time learning as you possibly can. Be in the operating room. Be with people. See everything you can. Learn as much as you can. Work hard, show up and do your job. And that's what we're there for, and people depend upon us, and we need to be there for them. And you know, it's a privilege to do what we do. We get to see people at a point in their lives that nobody else does. And they come in, and I've always found it amazing: you walk into an emergency department, you meet somebody who you've never met before, and in 30 seconds, you tell them that you're going to take them or their loved one into the operating room, you're going to open them up and you're going to fix the problem. And they just look at you, and they say "Thank you, doctor," and they put 100% of their trust of themselves and their loved one in you. Who else does that? Who else is privileged to have that? And it's a great privilege to do what we do. And it's our job to look after people.
Ameer Farooq 40:58
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