The BOSS Business of Surgery Series Podcast

Boss Business of Surgery Series – Episode 56

Community Surgery: Scope, Boundaries, Ego, and Building a Practice That Fits Your Life

with Dr. Kathy Ma

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrees talks with Dr. Kathy Ma, a community orthopedic foot and ankle surgeon, about what life actually looks like outside the academic ivory tower — the advantages, the hidden pitfalls, and the mindset shifts required to thrive as a community surgeon.

Dr. Ma shares her journey from physical therapist to orthopedic surgeon, her early years navigating the limitations of community hospitals, and the hard-earned lessons that helped her redesign a practice aligned with her skills, values, and family life. This is a candid conversation about ego, isolation, transfer decisions, boundaries, and redefining what “enough” looks like in a surgical career.

In this episode, you’ll learn:

• Why most surgeons misunderstand what community surgery really involves

• How assumptions from academic training create friction with community surgeons

• Why patient transfers are often about system limitations, not surgeon skill

• How lack of pediatric, ID, ICU, or in-house coverage affects surgical decision-making

• Why whisper networks and indirect criticism are especially damaging early in practice

• How people-pleasing and self-blame cause surgeons to hold onto cases too long

• The difference between being capable of a surgery and being the best person to do it

• How ego quietly influences decisions to keep complex cases

• Why surgeons must consider post-op resources — not just the operation itself

• How isolation uniquely affects community surgeons

• The emotional toll of watching predictable poor outcomes, even when care is appropriate

• Why doing fewer complex cases can actually improve patient care

• How “mission-first” thinking clarifies difficult transfer decisions

• Why being the hero is often fueled by dopamine rather than good boundaries

• How surgeons unintentionally violate their own limits

• Why disappointment is unavoidable — and necessary — for sustainability

• How learning to tolerate disappointment protects against burnout

• Why sleep, family time, and white space are not indulgences

• How opening an ambulatory surgery center transformed Dr. Ma’s practice

• Why outpatient surgery accelerated after COVID

• How efficiency and autonomy restore joy in surgical work

• The difference between being visible and being valuable

• Why community surgeons don’t need podiums or publications to have meaningful careers

Key themes:

• Community surgery is not “less than” academic surgery

• Patient safety includes system capacity and surgeon sustainability

• Ego and identity drive many early-career decisions

• Boundaries are learned skills, not character traits

• Disappointment is the cost of sustainability

• Being needed is different from being indispensable

• You don’t have to do everything to be an excellent surgeon

• A fulfilling career doesn’t have to be loud or highly visible

• “Enough” is a valid destination

Advice for academic surgeons:

• Don’t assume why a patient is being transferred

• Pick up the phone and talk directly to the community surgeon

• Recognize the hidden system constraints outside tertiary centers

• Understand that many “no’s” come from administration, not surgeons

• Direct communication builds trust and protects patients

Resources:

• Boss Business of Surgery Series: https://bosssurgery.com 

This episode is essential listening for surgeons considering community practice — and for academic surgeons who want to better understand the realities their community colleagues face. Dr. Ma’s closing message is both grounding and reassuring: you don’t need a grand, visible career to have a meaningful one — doing good work, caring for patients, and building a life that fits is more than enough.

Episode 17: Pitfalls of different surgery practice models with Dr. Matt Endara

The latest podcast episode is with Dr. Matt Endara- a plastic surgeon who has experienced multiple practice models. I thought this would be a great time to talk about different models given that many of you are looking for jobs. 

On this episode, we talked about how you get paid: 

Many hospital-based practices are rvu based. This is a productivity model with rvu (relative value unit) as the benchmark for determining your productivity. Each case, note, procedure have an assigned rvu value. The amount you get paid per rvu is dependent on the region you are in, and can be negotiated. 

Private practice models are run by individual surgeons. They can be small or large, depending on the specialty or the area. It is important to understand the overhead (expenses) and income generated to know if you are joining a viable practice. Many private practices are joining practice management groups which handle the HR, regulations, bills/insurance denials, negotiating contracts with insurance companies. This hybrid allows control of the practice without some of the headaches (Dr. Vertrees' practice is this model)

Aesthetics is often fee-for-service models without going through insurance. Many plastic surgeons will have a mixed model with aesthetics (fee-for-service) and insurance based practice (Dr. Endara's practice is this model). 

(although we didn't talk about it- Kaiser is an example of paying by the hours worked with possibility of partner. We also did not cover private practices where you "buy in" and have the potential to "make partner". Definitely get a lawyer and an accountant to review the options for a job like this).  

What are some of the pitfalls to look for?: 

- Family-run business or mom-and-pop businesses that don't know their numbers. They may have a viable practice, but noone really knows

- The payor mix in the area. If there are a lot of uninsured, you may have challenges maintaining a viable practice

- What will you get paid after the guaranteed income is up?

- Do you know what are the trade-offs for big city practices and smaller community hospitals?

- Are you keeping up with the times (new technology) and protecting against lack of diversity (pandemic-proofing your practice)

Please rate and review the show! 

 Do you have a topic you want covered? Send me an email at [email protected]

Dr. Endara can be found at https://perfectenn.com/about

Boss Business of Surgery Series – Episode 58

Leadership, Limits, and Letting Go of Over-Responsibility

with Dr. Lara Hochman

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrees speaks with Dr. Lara Hochman, surgeon, coach, and physician leader, about one of the most common — and most exhausting — patterns in medicine: over-responsibility.

Dr. Hochman shares how high-achieving physicians are trained to absorb responsibility far beyond what is healthy or necessary, often confusing leadership with self-sacrifice. This conversation explores how over-functioning quietly drives burnout, resentment, and emotional exhaustion — and how learning to set limits does not mean lowering standards or caring less.

Instead, this episode reframes boundaries, delegation, and emotional regulation as core leadership skills that protect patients, teams, and physicians themselves.

In this episode, you’ll learn:

• How physicians are trained to over-identify with responsibility

• Why being “the reliable one” often leads to silent burnout

• The difference between leadership and over-functioning

• How taking responsibility for everyone else’s emotions drains energy

• Why fixing problems for others robs them of growth and accountability

• How guilt shows up when physicians start setting limits

• Why boundaries initially feel uncomfortable — even when they’re necessary

• How resentment is often a signal that limits have been crossed

• Why saying yes too often creates downstream consequences

• How emotional regulation changes team dynamics

• The cost of rescuing colleagues instead of collaborating with them

• How to recognize when responsibility has tipped into self-abandonment

• Why “I’ll just do it myself” is rarely neutral

• How perfectionism and people-pleasing reinforce over-responsibility

• Why boundaries are not ultimatums — they’re clarity

• How to tolerate others’ disappointment without taking it personally

• Why leadership requires letting others feel discomfort

• How practicing limits builds trust rather than eroding it

• Why sustainable leadership includes rest, recovery, and self-respect

Key themes:

• Over-responsibility is learned — and can be unlearned

• Leadership is not self-sacrifice

• Boundaries protect relationships

• Resentment is valuable data

• Emotional regulation is a leadership skill

• You can care deeply without carrying everything

• Letting go creates space for others to step up

Resources & mentions:

• Boss Business of Surgery Series: https://bosssurgery.com 

• Coaching and leadership development for physicians

• Become the Boss MD

This episode is essential listening for surgeons and physicians who feel chronically overextended, emotionally responsible for everyone around them, or quietly resentful despite loving their work. Dr. Hochman’s message is both grounding and freeing: you can be an excellent leader without carrying what was never yours to hold.

Episode 74: From immigrant to owning 4 surgery centers with Dr. Angelina Postoev

Dr. Angelina Postoev MD. FACS is an entrepreneur and triple board certified surgeon by the American Board of Surgery and the American Academy of Cosmetic Surgery. She is the president and co-founder of IBI HealthCare Institute  Surgery Centers with locations in Buckhead, Atlanta and Loganville , GA since 2011. She completed her residency at the Cleveland Clinic Foundation, one year of surgical critical care at the Ohio state, and finally one year of Cosmetic surgery fellowship. Dr. Postoev is also a clinical professor of surgery, and educates the importance of promoting women in healthcare and business. Dr. Postoev has over 12 years of experience that she brought to IBI HealthCare Institute.

An immigrant of Europe, Dr. Postoev moved to Ohio with her family at the age of 15. She was academically accelerated when she arrived in the states and began her collegiate career at 16 vears old at Ohio State Universitv. After completing residency at the famed Cleveland Clinic Foundation Dr. Postoey opened her own practice. She and her team are widely known for staving at the leading edge of the latest developments in Bariatric surgical to non-surgical approaches. She has been successful operating multi location practices to connect with patients directly and educating them on the best treatments for their overall health needs.

Dr.Postoev has her sights set on expansion and will be opening a fifth practice location in the Orlando, FL area. She has created a national reputation for herself as

an expert general, and cosmetic surgeon.

Patients come from all over the country to consult with Dr. Postoev. She is one of very few doctors with a unique skill set in her specialties. Dr. Postoev is driven to educate and truly advocate for the patient.

Boss Business of Surgery Series – Episode 80

When Your Body Says No: Burnout, Boundaries, and Listening to the Signals

with Dr. Weilli Grey

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrees speaks with Dr. Weilli Grey, surgeon and physician leader, about what happens when the body starts sending signals that the pace, pressure, or expectations of work are no longer sustainable.

Dr. Grey shares her personal experience of physical symptoms, exhaustion, and warning signs that were easy to rationalize away — until they couldn’t be ignored. Together, they explore how physicians are trained to override discomfort, dismiss symptoms, and keep going, often at the expense of long-term health, clarity, and joy.

This episode reframes burnout not as weakness or failure, but as information — a signal that something needs attention, adjustment, or protection.

In this episode, you’ll learn:

• How physicians are conditioned to ignore physical and emotional warning signs

• Why burnout often shows up first in the body, not the mind

• How fatigue, pain, and anxiety become “normalized” in medical culture

• Why powering through symptoms delays recovery rather than preventing it

• How chronic stress affects sleep, cognition, and emotional regulation

• Why high performers are especially skilled at minimizing red flags

• The difference between resilience and self-abandonment

• How boundaries protect health before crisis hits

• Why listening to your body requires unlearning medical training norms

• How guilt shows up when physicians slow down or step back

• Why rest is often the most uncomfortable — and necessary — intervention

• How identity tied to productivity complicates recovery

• Why saying “something isn’t right” is an act of leadership

• How early intervention prevents forced endings later

• The cost of waiting until you are completely depleted

• How tuning into physical signals rebuilds trust with yourself

• Why sustainable careers require ongoing recalibration, not endurance

Key themes:

• The body keeps score

• Burnout is information, not failure

• Symptoms are signals, not inconveniences

• Listening early prevents crisis later

• Boundaries protect health and longevity

• Productivity is not the same as worth

• Self-trust is rebuilt by paying attention

• You are allowed to adjust before breaking

Resources & mentions:

• Boss Business of Surgery Series: https://bosssurgery.com 

• Become the Boss MD

• Coaching and burnout recovery support for physicians

This episode is essential listening for surgeons who feel persistently tired, disconnected from their bodies, or uneasy about how much they are pushing themselves. Dr. Grey’s story is a powerful reminder that your body is not betraying you — it is communicating with you, and learning to listen can change everything.

Episode 85: Pursuing your passion project and staying in medicine with Dr. Sujin Lee

The latest BOSS podcast episode features Dr. Sujin Lee, a neurorehab physician in private practice and a certified coach. She has a passion for helping physicians pursue their passion projects by learning more about entrepreneurship and how it is possible while also still pursuing medicine.

So many of us are struggling, but you don’t have to leave medicine. The best way to stay in medicine and pursue your passion projects is to learn more about boundaries, your values, and self-compassion.

She shows us that It’s possible to help others on a bigger scale, and the secret is learning the entrepreneur mindset.

“ Nobody went to medical school by themselves. Nobody went through the residency by themselves. The reason why there's a program, the reason why there is a school is because they know it's hard in the entrepreneur space, especially a physician entrepreneur space, there's not that many community. So finding that community is very helpful.”

You can find more about her through  her website sujinleemd.com FB page https://www.facebook.com/sujinleemd IG https://www.instagram.com/sujinleemd/

Boss Business of Surgery Series – Episode 81

Bias, Triggers, and Owning a Surgery Center

with Vivian Asamoah, MD

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrees speaks with Dr. Vivian Asamoah, surgeon and physician entrepreneur, about the layered realities of owning a surgery center while navigating bias, emotional triggers, and leadership challenges that are rarely discussed openly.

Dr. Asamoah shares her experiences building and leading in spaces where authority is questioned, assumptions are made, and scrutiny is heightened — especially for women and underrepresented physicians in ownership roles. Together, they explore how bias shows up both externally and internally, how emotional triggers are often shaped by repeated exposure to inequity, and how awareness is essential for sustainable leadership.

This episode weaves together ownership, emotional intelligence, and equity, offering a grounded look at what it truly takes to lead without losing yourself.

In this episode, you’ll learn:

• How bias shows up in subtle and overt ways in surgical leadership

• Why ownership can amplify visibility — and scrutiny

• How repeated bias creates emotional triggers over time

• Why triggers are signals, not flaws

• How emotional regulation supports effective leadership

• Why self-awareness matters more as responsibility grows

• How bias influences interactions with staff, vendors, and peers

• Why women and underrepresented physicians are often questioned differently

• How ownership changes power dynamics in healthcare

• Why silence around bias compounds its impact

• How naming experiences restores clarity and agency

• Why leadership requires internal steadiness as well as authority

• How boundaries protect energy in high-responsibility roles

• Why reacting less does not mean tolerating more

• How to separate personal worth from others’ projections

• Why owning a surgery center demands both business and emotional skills

• How intentional leadership improves culture and outcomes

• Why sustainability depends on self-trust and regulation

Key themes:

• Bias is systemic, not imagined

• Triggers carry information

• Ownership increases responsibility and visibility

• Emotional intelligence strengthens authority

• Awareness precedes effective response

• Boundaries protect leadership capacity

• Naming experiences reduces their power

• Sustainable leadership requires internal alignment

Resources & mentions:

• Boss Business of Surgery Series: https://bosssurgery.com 

• Become the Boss MD

• Resources on physician leadership, equity, and practice ownership

This episode is essential listening for surgeons considering ownership, currently leading high-responsibility ventures, or navigating bias in professional spaces. Dr. Asamoah’s perspective is both validating and empowering: you can acknowledge bias, regulate your responses, and still lead with clarity, authority, and integrity — ownership doesn’t require self-erasure.

Episode 88: Creating Your Own Life and Career Path with Dr. Gabriel Bietz

"Patients don't need more information, they need more interpretation of the information we have."

The latest BOSS podcast highlights Dr. Gretchen Schwarze and her groundbreaking work on counseling patients in difficult situations to help them make the decision that is best for them. 

She describes her Best Case/Worst Case research and a simple way to talk through the challenging conversations we have with patients who have a high risk of surgery. 

She describes the project on the episode, and her simple diagram and guides can be found here:
https://patientpreferences.org/best-case-worst-case/

Episode 94: Making Changes to Find Delight in Your Career with Dr. Jess Mcmichael

What do you want to feel in your career?

In the latest BOSS podcast, Dr. Jess McMichael realized she wanted to feel delight when she saw her daughter playing- and realized she had lost that feeling over time. 

She decided to make major changes in her career as an orthopedic surgeon.

We often worry about what other people will think when we make career changes. 

She shares what she learned when she navigated a successful shift in her career. 

-- 

Dr. McMichael is an orthopaedic surgeon, wife, mother and coach. She graduated from Saint Louis University School of Medicine Orthopaedic Surgery residency in 2009. As a surgeon, her zone of genius is fracture care and complex pediatric limb reconstruction. As a coach, Dr. McMichael guides women surgeons on a path of ever-increasing personal power. Her mission is to create a modern landscape of surgery characterized by optimal patient safety, innovative surgical education, and satisfied surgeons.

[email protected]

https://www.thecleanbluetowel.com/

Social media 

https://www.linkedin.com/in/jessica-mcmichael-md-8a395646/

https://www.facebook.com/groups/390563148592697

Episode 102: Diversifying Your Medical Career with Dr. Andrea Austin

This is part 2 of our joint podcast, find part 1 here:

Part one

Dr. Austin and I talked about the challenges our ED physicians are facing in the current environment of private equity, discouragement post-COVID and other challenges. 

She shared how a toxic job opened her eyes to the importance of a diversified career, gender parity in leadership, and how to recover from a toxic job. 

She found a new mission to revitalize other doctors with her podcast, "The Revitalizing Doctor" and her group coaching program "Revitalize Women Physicians Circle." With Dr. Linda Lawrence, their goal is to create gender parity in medicine, break through the, the leadership hurdles.

In this episode, you will be able to:

• Discover the evolving career opportunities in emergency medicine and gain insights on how to navigate the changing landscape.

• Learn effective strategies to combat burnout and create a healthier work environment in healthcare.

• Explore the importance of physician involvement in leadership roles and decision-making processes for driving positive change in healthcare.

• Uncover practical tips for recovering from a toxic work environment and reclaiming joy in your medical career.

• Gain inspiration and insights on diversifying your career path in medicine, with a focus on achieving gender parity.

My special guest is Andrea Austin

We are honored to have Dr. Andrea Austin as our guest today. As a former Navy emergency room physician and current simulation director, Dr. Austin brings a unique perspective to the table. Her journey towards finding work-life harmony in medicine is both inspiring and relatable. With her experience and expertise, she has valuable insights to share about diversifying career paths in medicine and achieving gender parity. Dr. Austin's ability to navigate the ever-changing landscape of medicine, while staying true to her passions and values, is truly remarkable. Her story serves as a beacon of hope for medical professionals seeking to carve their own paths and create a fulfilling career. We are excited to dive deep into Dr. Austin's experiences and tap into her wisdom as she sheds light on achieving gender parity and work-life harmony in the medical field.

The key moments in this episode are:
00:00:02 - Introduction,

00:00:41 - The Importance of Diversifying,

00:02:07 - Making a Career Change,

00:06:26 - Exploring Different Opportunities,

00:10:11 - Challenges in Emergency Medicine,

00:16:24 - The Importance of Physician Engagement,

00:17:54 - Stepping Up into Leadership,

00:19:32 - Getting Doctors and Surgeons Involved,

00:22:31 - Embracing Expertise and Giving Room for Growth,

00:26:16 - Recovering from Toxic Workplaces,

00:32:13 - Excitement for Practicing Emergency Medicine,

00:32:27 - Letting Go to Enjoy,

00:32:53 - Reasons to Diversify Career Paths,

00:33:30 - Creating Gender Parity in Medicine,

00:35:13 - The Power of Collective Support,

Episode 123: Finding a Flexible Job and Helping Women with Fertility Issues with Dr. Erica Bove

Have you heard these myths about balancing medicine and fertility?

• Myth 1: You have to sacrifice your career for your family.
• Myth 2: Fertility treatments always work.
• Myth 3: You can't have it all. 

Join my special guest today, Dr. Erica Bove, as she shares her story of practicing medicine on her own terms while navigating fertility challenges. From breaking free of traditional constraints to empowering women physicians, her path to achieving work-life balance and informed fertility decisions will inspire you.

“This was the first time in six years I had cried. And I remember having this image of this open, gaping wound.” -Dr. Erica Bove

Key Takeaways

• Discover the transformative impact of coaching on increasing self-awareness and personal growth.
• Overcome the barriers of perfectionism and self-doubt to unlock your full potential in both your professional and personal life.
• Learn effective strategies for balancing the demands of your career with your personal priorities and well-being.
• Gain insights into the unique fertility challenges faced by female physicians and how to navigate them with confidence.
• Understand the importance of proactive fertility preservation and make informed decisions about your reproductive health.

About Dr. Erica Bove

Erica Bove, MD, is a double board certified OB-GYN and Reproductive Endocrinologist (REI) physician at the University of Vermont, as well as a certified life coach through The Life Coach School. She is also the founder of Love and Science: Thriving Through Infertility. She has a keen interest in marrying an evidence-based approach with intuitive knowing in the context of a trusting relationship.

She is beyond excited to bring coaching skills and paradigms to help women professionals thrive while undergoing fertility treatments. She is an expert in the field of sex and intimacy, as well as embodiment and mindful self compassion. She believes that the best outcomes are obtained when the whole person is seen and understood.

Her mission is to heal and support the healers and to create a legacy she is proud of.

If you're curious:

• Undergrad: University of Notre Dame
• Med school: University of Vermont
• Residency: New York Presbyterian Hospital-Columbia
• Fellowship: University of Michigan

Find Out More

• Linked In: www.linkedin.com/in/erica-bove-0701a0173
• IG: https://www.instagram.com/loveandsciencefertility/
• FB: https://www.facebook.com/profile.php?id=61553692167183

Key Moments

00:00:00 - Empowering Women in Medicine

00:02:38 - Recognizing Unmet Needs

00:06:04 - The Power of Coaching

00:09:57 - Challenging Limiting Beliefs

00:11:41 - Rethinking Success and Reality

00:12:15 - Internal Success Metrics

00:13:18 - Creating Job Flexibility

00:15:24 - Job Transition and New Opportunities

00:21:02 - Fertility Coaching Practice

00:24:06 - Addressing Emotions and Priority Shifts in Infertility Journey

00:26:06 - Increased Risk of Infertility in Surgeons

00:28:00 - Fertility Preservation and Support for Surgery Residents

00:29:51 - Proactive Approach to Fertility Awareness

00:33:28 - Creating a Supportive Culture in Medicine

Boss Business of Surgery Series – Episode 144

Challenges in Rural Surgery Can Affect the Entire System

with Katherine Pellizzeri, MD

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrees speaks with Dr. Katherine Pellizzeri, surgeon and physician leader, about the realities of rural surgery — and why challenges faced in rural settings ripple far beyond individual hospitals, affecting referral patterns, access to care, and the health of entire systems.

Dr. Pellizzeri shares on-the-ground insights into staffing shortages, resource constraints, call burden, and the moral weight rural surgeons often carry when they are the only option for miles. Together, they explore how rural surgeons routinely absorb system failures, how burnout and attrition in rural settings destabilize broader networks, and why solutions must address structure — not just individual resilience.

This episode reframes rural surgery as foundational to system stability, not peripheral to it.

In this episode, you’ll learn:

• Why rural surgery is critical to the health of regional care systems

• How staffing shortages compound risk and burnout in rural settings

• Why rural surgeons often carry disproportionate call and responsibility

• How limited resources shape clinical decision-making

• Why transfers are frequently system-driven, not skill-related

• How rural hospital closures affect urban and tertiary centers

• Why recruitment and retention are persistent challenges

• How moral distress develops when options are constrained

• Why rural surgeons often normalize unsustainable conditions

• How isolation impacts judgment, well-being, and longevity

• Why “just be more resilient” is not a solution

• How system-level failures get absorbed at the bedside

• Why losing one rural surgeon can destabilize an entire region

• How rural surgery exposes cracks in healthcare infrastructure

• Why collaboration between rural and tertiary centers matters

• How better support improves patient safety and physician sustainability

• Why policy, payment models, and staffing structures matter

• How valuing rural surgery protects access for everyone

Key themes:

• Rural surgery is system-critical, not optional

• Isolation magnifies risk and burnout

• System failures land on individual surgeons

• Sustainability requires structural support

• Transfers reflect resources, not competence

• Workforce stability protects access to care

• Rural and urban systems are interconnected

• Supporting rural surgeons supports everyone

Resources & mentions:

• Boss Business of Surgery Series: https://bosssurgery.com 

• Become the Boss MD

• Resources on rural healthcare, workforce sustainability, and physician leadership

This episode is essential listening for surgeons, administrators, and policymakers who want to understand how rural healthcare challenges cascade across the system. Dr. Pellizzeri’s perspective makes one thing clear: when rural surgery is under-supported, the entire healthcare system feels the strain — and strengthening rural practice is a shared responsibility.

Boss Business of Surgery Series – Episode 151

Challenges in Rural Surgery

with Jill Ties, MD

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrees speaks with Dr. Jill Ties, surgeon and physician leader, about the lived realities of rural surgery — and why the challenges rural surgeons face are not isolated problems, but structural issues with wide-reaching consequences.

Dr. Ties shares firsthand insights into practicing in resource-limited settings where surgeons are often expected to be everything at once: clinician, administrator, problem-solver, and safety net. Together, they explore how staffing shortages, call burden, limited specialty backup, and geographic isolation shape clinical decisions, contribute to burnout, and threaten long-term sustainability.

This episode centers on truth-telling about rural practice, and why supporting rural surgeons is essential to protecting access to care across entire regions.

In this episode, you’ll learn:

• What makes rural surgery uniquely demanding

• Why rural surgeons carry disproportionate responsibility and call

• How limited specialty backup affects decision-making and risk

• Why transfers are often driven by system constraints, not skill

• How staffing shortages compound burnout and safety concerns

• Why rural surgeons normalize unsustainable conditions

• How isolation impacts judgment, morale, and longevity

• Why recruitment and retention remain persistent challenges

• How administrative expectations often outpace available resources

• Why moral distress develops when options are limited

• How losing one surgeon can destabilize an entire community

• Why rural hospitals are critical to regional healthcare ecosystems

• How system failures get absorbed at the bedside

• Why resilience messaging misses the real problem

• How collaboration between rural and tertiary centers matters

• Why structural solutions are necessary for sustainability

• How valuing rural surgeons protects patient access

• Why rural surgery deserves visibility, investment, and support

Key themes:

• Rural surgery is essential, not peripheral

• System constraints shape outcomes

• Isolation magnifies risk and burnout

• Transfers reflect resources, not competence

• Workforce stability protects access

• Sustainability requires structural change

• Rural surgeons carry invisible labor

• Supporting rural practice supports the whole system

Resources & mentions:

• Boss Business of Surgery Series: https://bosssurgery.com 

• Become the Boss MD

• Resources on rural healthcare, workforce sustainability, and physician leadership

This episode is essential listening for surgeons, administrators, and healthcare leaders who want a clearer understanding of rural practice realities. Dr. Ties’ perspective underscores a critical truth: when rural surgeons are stretched beyond capacity, entire communities — and healthcare systems — feel the consequences.

Episode 7: Gaining Control of Your Career as a Locums Surgeon with Dr. Susan Trocciola

This episode is for you if you are in the following positions:
- You had a supportive residency, but your first jobs...not so much

- You want to know red flags to look for when you are searching for a job

- You are finding yourself the first assist to a partner, not the attending in charge of the case

- You wanted a mentor, but you are finding that you are not the chosen successor

- You want more time off and more autonomy

- You are curious about locums as a career 

Dr. Susan Trocciola is a cardiothoracic surgery who has taken her career into her own hands after some rough first jobs.

She has critical lessons for all of us about not accepting anything but what we know is true for us. 

Find more information about BOSS at www.BOSSsurgery.com

Boss Business of Surgery Series – Episode 16

Finding the Joy in Surgery Again by Abandoning the Path

with Serene Shereef, MD

In this episode of the Boss Business of Surgery Series, Dr. Amy Vertrees speaks with Dr. Serene Shereef, surgeon and physician leader, about what happens when the path you were taught to follow leads you away from joy — and how stepping off that path can be the very thing that brings meaning back.

Dr. Shereef shares her journey of questioning traditional expectations, confronting burnout and misalignment, and ultimately choosing to practice surgery in a way that better fit her values, strengths, and life. Together, they explore how rigid career paths in medicine often leave little room for individuality — and why abandoning “the right path” can be an act of clarity, courage, and self-respect.

This episode is about redefining success, trusting yourself, and rediscovering joy by choosing alignment over approval.

In this episode, you’ll learn:

• Why following the prescribed path can quietly drain joy

• How burnout often signals misalignment rather than failure

• Why questioning the system can feel both scary and liberating

• How identity becomes tied to expectations instead of values

• Why abandoning the path doesn’t mean abandoning medicine

• How guilt shows up when physicians choose differently

• Why joy is a legitimate metric for career decisions

• How curiosity opens new professional possibilities

• Why fulfillment often requires letting go of external validation

• How redefining success restores energy and purpose

• Why there is no single “right” way to practice surgery

• How flexibility protects long-term sustainability

• Why listening to yourself matters more than following rules

• How courage builds through small, aligned decisions

• Why joy returns when integrity leads

• How self-trust replaces certainty

• Why choosing alignment protects against burnout

• How abandoning the path can actually bring you home to yourself

Key themes:

• The traditional path isn’t neutral — it shapes well-being

• Burnout is information, not weakness

• Joy matters

• Identity is allowed to evolve

• Alignment restores energy

• Permission must be self-granted

• There is more than one way to be a surgeon

• Choosing yourself is an act of leadership

Resources & mentions:

• Boss Business of Surgery Series: https://bosssurgery.com 

• Become the Boss MD

• Resources on physician career alignment and sustainability

This episode is essential listening for surgeons who feel disconnected from work they once loved, or who quietly wonder whether another way of practicing might exist. Dr. Shereef’s story offers reassurance and permission: you don’t have to stay on a path that costs you your joy — abandoning it may be how you find your way back.

Episode 38: Creating a Schedule That Works and Taking a Year Off with Dr. Beth Johnston

Hello Surgeons!

Do you feel trapped in your job? 

Have you thought that it would be possible to determine your schedule- and maybe take a year off? 

The latest BOSS podcast episode features Dr. Beth Johnston. She is a general surgeon, and she and her husband, a cardiologist,  have done just that. 

She created a schedule that worked for her and allowed her to be flexible. She and her husband then found a way to take a year to travel and made their jobs work for them. 

She valued time off, and she found a way to make it happen. It's a truly inspiring story. It starts with valuing your time, realizing what is important to you, and finding a way to make it happen. 

Your job may be more flexible that you think.

Episode 40: Surgery Training and Practice are More Flexible Than You Think with Dr. Feibi Zheng

Dr. Zheng chose to take a non-traditional path in training after a patient had a bad outcome due to what she thought was a failure of the hospital system. She went to Duke during research/personal development time and got her MBA with a focus on health sector management for 2 years. And that was just the beginning. She created a start-up business on gaming for skills acquisition and knowledge transfer. She returned to complete her residency, but continued her nontraditional path, working part time as an endocrine surgeon and as Medical Director at Intuitive Surgical. She credits strong mentorship and knowing her value for her success in achieving the career that she wanted. She decided that her career can work around her needs, not the other way around.

Episode 22: Lessons Everyone Should Hear on CVs with Dr. Emily Steinhagen

This week's episode is such a great one- and one that we ALL need. That is, unless your CV is up to date and awesome- and if that is the case, send it to me! I would love to see your example!

Dr. Emily Steinhagen and I talked about tips for creating a fantastic CV and keeping it updated. There are 5 key strategies:

1. Know what to put on your CV- and don't undervalue your experiences. Keep a master CV with everything on it, and tailor it down from there. Consider all experiences, because skills you develop may be relevant to a future job. Your CV is not just a document, it is a file that includes the supporting documents like papers and letters of recommendations. 

2. Use your CV to further your career. You can use it to identify gaps you might have in your career, and the CV can also work as a way to communicate your skills. 

3. Attention to detail! Declare a personal font, be consistent with your abbreviations. Your CV says something about you, and a sloppy CV is not the message you want to send. Add your name and date of the CV to every page. Send only pdfs of your CV so they cannot be modified. 

4. Tailor it to your job. When applying for a job, see if your institution has a specific format. If not, the AAMC has an example here. 

5. Maintain your CV. Create a system to maintain your CV using your calendar, email or scheduled alerts. Use tools like Publon.com to track your reviews of research papers. 

 Please rate and review the show!