All right. Thank you, everybody, for bearing with us for some technical difficulties. I am supposed to let everybody know that this session is being live streamed. So if I forget, someone remind me. But when we get to the Q&A portion, please make sure that if you're asking a question to go to the microphone that's about halfway in the middle of the room on my left-hand side or your right-hand side so that those at home can hear the question being asked. At home audience questions. Questions from the at home audience will come through the iPad that's provided to us up front that we will read off of the iPad. All right. So this session is the art and politics of sports medicine, leadership and lessons that you don't learn in training. The first is wearing glasses for your first time for a presentation now that I'm old and have to get readers. So I just want to do a couple of intro slides before we have our experts come up. Some of the challenges. Actually, let's do this. A lot of us have been doing this. How many in the audience are trainees, residents, fellows, med students? Okay. So then how many are faculty? Okay. So maybe about two-thirds, one-third. So I think the faculty in the audience, particularly those who are more than a couple of years out, hopefully some of the things that we mentioned today ring true but can also spark a little bit of some debate as well. Some of the challenges, particularly when you're finishing training, are rising in the ranks. Personally. How do you personally rise in the ranks? Some leadership opportunities for yourself as well as as a field. There have been some challenges for PMR sports medicine in the last year that we'll speak about. What about politics due to agendas? Some personal politics, some professional politics. And sometimes just being at the right place at the right time. I think some of our speakers will mention that they've had some opportunities due to their expertise, their hard work, but also maybe being in the right place at the right time. Another question is how important is this to you? So remember, one door closing might mean another door opens. True. But then I kind of look at it a little differently, or maybe it means you have to figure out how to knock a door down. Dwight says it very nicely. When a door closes, another one opens makes absolutely no sense because it's not acted upon unless acted on by an outside force. The key is knowing how much to push and when to push. And that's a lesson I personally am still learning. So the plan for the session is we'll have Dr. Rubech go first, building your brand as a physiatric medical director for professional athletes. Then Dr. Boyette will go next, lessons learned as a former elite athlete practicing as a sports medicine physician. Batting third, since everyone knows I like baseball, Dr. Moutner, professional team sports and politics, challenges and obstacles that you don't learn in training. Dr. Wade is fourth, developing institutional leadership in academia and PM&R and sports medicine. And then I'll go last, climbing the ladder and finding opportunities essentially outside of your home institution. I'm going to do one slide for every speaker, but really one slide does not do anyone justice. For those of you who know these individuals, I'm very lucky to know them, not only professionally, but a lot of them are my friends as well. Dr. Rubech is the director of primary care sports medicine for the New York region at Rothman. She's the lead team physician for the U-17 youth national soccer women's team for the U.S. She's the head team physician for breaking for Team USA, Paris 2024. She's a current board director for AMSSM. She's the medical director for Broadway. She's the medical director for AEC Rockettes. I believe if I'm saying this correctly, she is now the president-elect for the Professional Association of Medical Artists. I say that right, Pamela? Not at all. Okay. So she doesn't do a lot. So next, Dr. Boyette is the CMO for Spalding Rehab Network. She's an associate professor of PM&R in Harvard Medical School. She's a former elite para-athlete, having competed in three Paralympic Games and bringing home a total of seven medals, which is unbelievable. She's a two-time winner of the wheelchair division for the Boston Marathon in 2004 and 2005. She's a member of the IPC Medical Commission and the IOC Medical and Scientific Commission. She's done the board of directors for the Boston Athletic Association, and actually, I need to change that because she just got elected chair of the BAA that I think is on Instagram now, thanks to Dr. Rubesh, and the USOPC. That came out yesterday, I heard. And she is a board of trustee for ACSM. Dr. Mautner is a professor in the Department of PM&R and Ortho at Emory. He's the sports medicine fellowship director since its inception, close to, what, 15 years now, 16 years? Something like that. He's a head team physician for the Hawks. He's INC for the Atlanta Hawks, sorry, that should be the Falcons, excuse me. Team physician for the Braves at Emory, Georgia Tech, and he's a former board of director for AMSSM. Dr. Wade is the director for the UC Davis Health Sports Medicine. She's a professor in the Department of PM&R. She's a preventative medicine curriculum leader for UC Davis School of Medicine. She's sports medicine fellowship director and sports medicine section chief at UC Davis. She's a team physician for the Sacramento Republic pro soccer team. She's a team physician for UC Davis and American River College, and she's a past team physician for numerous high-level sporting organizations, including Team USA Track and Field, the Sacramento Kings, Sacramento Monarchs, and Sacramento Ballet. And I still think this is some of the coolest stuff, the medical director for multiple marathons and ultra marathons, including the California International Marathon and Racing the Planet. Does anyone here know what Racing the Planet is? Look it up. It's so cool. I could not be in a medical person for that, but it looks so cool. And then I'm at UF. I'm our associate program director for our residency. I'm the director of the UF Health Throwing Clinic. I'm a volunteer team physician for the U17 Women's Youth National Team. I'm a medical commission member for the World Baseball and Softball Confederation, and there's a few other things on there as well. I put this slide up for a couple reasons. One, it tells me to end my intro, but it also tells you that the people that are going to be speaking here are not just doing it based on their opinions. They also have the expertise. They have the history. They are in the room, so to speak, with high-level organizations. And it has not been easy for them. It is not going to continue to be easy for them. And we hope that this provides some enlightenment and guidance, particularly for our trainees and maybe younger faculty members who are less than five years out, so that you can continue to take the reigns from what we have done from the folks who have done it for us beforehand. With that, I will turn it over to Dr. Rubech. I'm going to bring up your presentation right now. Jason, thanks for having all of us speak. I feel like he always kind of has his thumb on the pulse of what people are interested in, because whenever I'm in a room that he's planned, there's like lots of seats that are filled. So my talk is going to pretty much tell you why I'm nothing special and why everybody can do what I do. So you can take all the secrets, and pretty much everybody starts somewhere, right? I will argue with you a little bit about going through doors. I do think that sometimes you want to go through doors carefully, because you don't know what's on the other side, and you don't know why it might have been left open. So you do want to always kind of know, nobody always knows the entire context, but you do want to kind of be careful and tread cautiously, and also respectfully, because this is a small world. PM&R is a small world. Sports medicine is a small world. My little niche in performing arts medicine is a really small world. Perfect. Thank you. So it's the Performing Arts Medicine Association, PAMA. So if anybody's interested in performing arts, I would love to have you join us in London in July. So I'm speaking on building your brand as a physiatric medical director for professional athletes, but really it's how to get where you're going and let people know where you are. So I have no disclosures, but so when we get started, we all go through residency, we all go through fellowship, and you're just a sponge, right? You want to learn as much as possible. I actually trained in Chicago, and I stayed where I trained for fellowship at UIC, which the guy who is a former fellowship director, Terry Nicola, was one of those people that had built a door. He'd built that fellowship, and he was getting tired of being the fellowship director, and he was kind enough to say, I'm not going to make you be the assistant fellowship director for five years before I officially step down. I would like for you to take the reins. And what I didn't understand at the time is all of the paperwork that's involved with being a fellowship director. But that did allow me to be in a couple of rooms with some really amazing people that I got to learn from and ask questions, knowing that I was the one who didn't actually know what I was doing at that time. Also I got to be a team physician for a Division I college, and it was 400 athletes. It was not a high budget Division I, but it was 400 athletes that my clinic was in the basement. So did I learn a ton when they would come down with their broken fingers and dislocated shoulders because I was the only one in that room? Absolutely. And it was great because there weren't a lot of agents or coaches that were freaking out about their contracts. And it was a teaching hospital, so there wasn't a big budget. There was no building my brand, right? They were like, get to work. And so, but it's all about teaching and teamwork, and so it was a teaching hospital, and there were a lot of teaching opportunities. And I didn't know everything, but there were a lot of residents that were interested. There were nine residencies that ended up rotating with me as a PM&R sports doc, and three fellowship programs. How many, have any of you trained or worked in Chicago? It's like the best place ever, right? Because it's very collegial, all the programs work together, and so if you don't have everything you want at one program, then you send your fellow to the next program that has it. And everybody was happy because what we wanted people to do was learn what they wanted to learn and get where they wanted to go. So I was, again, I was a brand new attending, and I knew I didn't know everything, so what I was allowed to do was speak for local organizations or do some physical therapy talks. And maybe I knew a little bit more than them on some things, and then they would teach me a lot about what they knew because I didn't go to physical therapy school. But there was a lot of listening and learning. So my first couple of years I went to all of these conferences. I did AAPM&R because it's all physiatrists. I did AMSSM because it was primary care sports medicine physicians, but not just physiatrists. I went to ACSM because it's multidisciplinary sports, and Performing Arts Medicine Association, multidisciplinary performing arts. And I volunteered. I showed up in the room. I was standing in the back, and if there was something that people were like, we need somebody to do that, by the end of the day, I would say, I have time, and I'm not the smartest person, but I'm willing to do the work. If I can do the bulk of it and you can fix the rest, I know I'll learn from that. And there are a lot of really busy people in the room, right? So if you're able to do that, that kind of gets you into the room where they are, and then you learn from the experts. I also changed my clinic days. So I don't know if you guys know Hutch, Mark Hutchinson in Chicago. He loves to teach. He's an orthopedic surgeon. I switched my clinic days so that I could be with him because my MRI reading skills weren't great, and I knew I could, even though I wasn't attending, I could say, I really don't know if this is a meniscus tear. Could you help me? And he would be patient with that. So those first three years, I was still a sponge because you don't get to take care of elite athletes unless you know what you're doing. So when I was in Chicago, I was taking care of the barely Division I UIC Flames, and I'd gotten to know the medical director of Hamilton on Broadway because I went to the PAMA organization. And when they opened up in Chicago, he said, hey, I know a doc who could take care of your group. So I became their medical director. And then I had also done work with the local, when US Gymnastics would come into town, I did some work with them. And all of a sudden, they needed a doc who had been vetted to go with their trampoline and tumbling team to the world, to the championships in Bulgaria. And I was like, I can pack my suitcase. So I said yes. And I had never taken care of trampoline and tumbling, and I had never had a tailored dislocation, but I went ahead and did that. But then I ended up moving to New York. So I was devastated. I was losing this group that I had built, and I loved Chicago so much. But also when I was going to PAMA, I had met a lot of performing arts, of physical therapists and athletic trainers. And Radio City Rockettes heard that I was moving to New York. And there just happened to be time for a transition. So it's New York. There's a lot of amazing physicians. But they were comfortable with me. They'd known me for a few years. And so they were willing to give me that opportunity. So I had a new team. So I lost my college team, but I gained a professional one. You can tell which one I am, because I'm the one not wearing the antlers, right? That's the only difference. But you have to proceed with caution. So when you're taking care of elite athletes, and especially when you're taking care of performers or professionals, they don't always want people to know that they're seeing you. And so you can say you're going to a show, but they don't know that you're taking notes for the star on how they can be careful with their back or their elbow or something like that. If you're at an opening night, and you know how hard the star works to get there, you can just say you're at opening night. You don't get to say who you are taking care of. So when you're building that brand, you do have to proceed cautiously. because if you overshare, then you will never get an opportunity to take care of them again. I take care of the U-17 women's national team for soccer and that was, I was able to go on a trip and when you take care of people, you do all the work, right? You don't just do the doctoring, you do the icing and the carrying of the heavy things and the, everything that they need, you're happy to do. Ready here, ready to work, right? So, but I can't post anything. They're 17-year-old girls. So, I'll post with some of my colleagues, but that's all I can do and I'm happy to do that. I'm very proud to do that. Let's see. Oh, nope. This is a glitch, so I'm gonna go back. Let me see if I can go, maybe I can try it this way. It's, it might be just the connection. It's clear on the, let me see. I'm just gonna try to push some buttons here. That's always smart. It was, yeah. It's going, don't move. So, it's a little glitchy, but I always, the only thing is, so yes, you get to maybe take care of them at the Macy's Thanksgiving Parade, but the next one is, you can kind of see I'm backstage. Essentially, so you're at Macy's Thanksgiving Day Parade one day a year, but the other days, you're working backstage and just making sure that they're not falling over. And then I did just ruin everything, but if you have a seizure disorder, please close your eyes. But really, most of my day is kind of spent in the clinic looking at the placement of heels or how did they tape their toes. And sometimes, you do get to brag about your athletes. So, I'm almost done anyway, and you can close it down. But this is, we actually have two Olympians that have qualified for the Paris Olympics for breaking, a B-girl and a B-boy, and we have maximum opportunity to maybe qualify two and two. And I actually might not be at the Olympics with them. That might not be what they need, but the fact that I get to help take care of them and I get to share with other people that I take care of them, it's kind of fun. So, that's kind of my thing. And if you can really quickly take a picture, that's my email. That's it. There, it's live. OK. All right, good afternoon. Always difficult to follow Dr. Rubish, but great to see this room so full. Thank you, Dr. Zaremsky, for the really great invitation to be a part of this session. For my talk, we'll zoom out a little bit and adjust the topic a little bit of a pivot to thinking about the experience of former elite athletes, my journey as a former elite athlete, and how that's translated into opportunities in clinical sports medicine. Hopefully resonates with some in the audience who may also bring that lived experience of their own athletic journey into their career as a clinician and the importance of that. Some topics we'll touch upon. The first is having a background as a competitive athlete and bringing that experience to your work and taking pride in that. Not shying away from it, but understanding how much value that adds to your perspective as a clinician. We'll talk about how those experiences as an athlete. This talk was titled and framed about elite athletes, but honestly, whatever level of athletics you're involved in, how those opportunities and those networks can actually be really beneficial to you when then you do aspire to build your career as a clinician. I'll touch upon the importance of getting out of your comfort zone and really leaning into the stretch goals and stretch opportunities, and understanding that no career journey is linear, and I think all of the speakers today are gonna touch upon that to some extent. I first wanted to tell you a little bit about my journey, and I'll be brief with this, but I do think it certainly frames my perspective on now being a sport medicine clinician. It's really important to always remember that our experiences both in and out of medicine shape us as people, and they shape our perspectives. My journey included acquiring a spinal cord injury at 16 months of age in a traumatic farming accident, learning very early on how to get around, even with homemade devices like this little scooter that was built by our neighbor, figuring out how to find my people in the world of adaptive sports, which actually took quite some time. I really didn't start to become a part of that community until eighth grade, and that was because at the time, so many adaptive sports programs around the US were based in major urban centers, which were quite a distance from where we lived, so it took a lot of work to find those opportunities, and once I found those opportunities, then learning that I actually could self-identify as an athlete, so really an evolution in how I thought about myself, and the way that really set me on a different path towards understanding my own, frankly, capabilities. And because of this part of my lived experience, this brings a passion for me regarding thinking about equity in sports and equity in sports medicine, and that has been translated to opportunities like being a part of the recent AMSSM CRN Summit that focused on sports equity and sports medicine. So whatever your lived experiences is, whatever your life journey has brought you, whether it's competing at recreational levels of sport or elite sport or other things that give you a frame towards the sports industry and sport in general, embrace that background and embrace those experiences and bring them into your work as a clinician, really important theme. Once I reached the levels of elite sport, that then yet brought another set of opportunities and perspectives. So when I competed, Jason listed some of my accomplishments on the field of play, and as you saw, I am now, I almost, I need readers too, Jason, I'm getting up there. So that was a long time ago, yeah, thank you. It was a long time ago, and in my view, some of my sort of peak years in sport were in like 2003, 2004, 2005 timeframe, and at that time, the Paralympic movement, both in the US and globally, was at a much different stage of development, and frankly, most Paralympic athletes, even if you were the best in the world, frankly, didn't have the best access to sports medicine care until you reached that final pinnacle, and what that taught me and the impact on my career is the importance of thinking about the holistic health of the athlete, thinking about which athletes aren't being served well, where do we need to lean in and develop new programs and services? Everybody wants to take care of that famous pro athlete, right? But there's so many athletes out there who need us that may not be getting as much attention, and especially as a trainee or in your early career years, thinking about where the need is, which athletes are actually still fairly underserved in terms of their access to care can offer really good opportunities to build experience, build relationships that then, you know, lend themselves to working with the pro athletes down the road. The other point that I want to touch upon is that all of those experiences lead to relationships that then lead to those open doors down the way. So I think it was Melody touched upon the point of treating everyone well, no matter what stage of the journey you're in, because even if you are there wearing the hat of the athlete, wearing the hat of a trainee, or, you know, the most experienced clinician in the room, all of those relationships somehow play out into the future. And so many times, the people that we met 10 years ago, circle back in our lives, and those relationships often open doors to the thing that we're seeking at that time. So for me, some of those full circle moments included being able to use my background as an athlete to then become more involved in sport leadership more broadly. One breakthrough moment for me was when Boston had the Olympic bid, briefly, for the 2024 games, until the city then lost the bid about six months later, and it went to Los Angeles, and everyone knows that the Olympics and Paralympics are coming to LA now in 2028. So when Boston had the bid for a brief period of time, I raised my hand and I said, hey, I'll show up to talk, so I'll come and bring my perspective. I'll be that athlete in the front of the room talking about how great the city is and why the Olympics and Paralympics should come here. And in that brief six-month period of time, I met so many people, both within sport medicine, but also just sports more broadly, and that one window of time has led to so many opportunities down the road. Additionally, the picture in the bottom left is our medical team at the Rio 2016 Paralympics, and having the opportunity to bring my lived experience as an athlete to then help to really grow the overall medical program at the Paralympics was a really unique opportunity that, again, represented one of those full-circle moments in my life and something I was super proud of. And the last point that I wanted to touch upon was always remembering that your voice matters no matter what part of your career you're in. So because of some of those relationships that I had the opportunity to build earlier in my career, that then, down the road, led to opportunities to be at the table, have a seat at the table in some broader discussions pertaining to Olympic and Paralympic sport. One of them was having the ability to join the overall Board of Directors for the U.S. Olympic and Paralympic Committee. When I joined at the time, the organization was called the U.S. Olympic Committee, and by having a seat at the table and raising a hand from time to time, and again, developing those relationships, we developed the will at the board level to actually change the name of the organization to U.S. Olympic and Paralympic Committee, and also developed the political will from being there at the table to move towards equity and medal payments. So if you win a gold medal at the Olympics or the Paralympics, you make the same amount of money. So when I first joined this board, I can tell you, for the first couple of years, I had the worst case of imposter syndrome. Like all these other people around the table were CEOs, athletic directors of D1 universities, et cetera, and I think in the back of my head, I knew I belonged there, but I was not yet ready to use my voice, and I'd have to, before every meeting, I'd have to sit in my hotel room and give myself a pep talk and do that power pose before I then actually go into the meeting, and it took a couple of years to really feel comfortable weighing in, making a comment, using my voice, and now looking back, it's incredible to me to think about how that in and of itself was a skill set that I had to develop through these various experiences at different points in my career. So key points to end with. The first is the importance of stretch goals. So I learned that many of these experiences over the years, when they first came, when I first walked or wheeled through that door, it was uncomfortable, right? It was something new. It was something where I felt like I was really being pushed to develop a new skill set, and now when I look back at those opportunities, I realize that those are the ones where I really grew, right, I really grew as a leader, definitely became more comfortable in my own skin, really started to understand the power of my own lived experience as an athlete and the way that that perspective could be a powerful voice in so many different contexts. And the other is avoiding the assumption that your career journey will be linear because it will not be. I think probably everyone speaking today can say that if someone asked them 10 years ago where they'd be today, they probably would have had a different answer, at least to some extent. And all of our career journeys are these long winding roads where you maybe do walk or wheel through that door, maybe you're terrified by what you see and you back out, or you realize you love it and you lean in more and you continue to grow in that direction. And being open to that conceptually I think is super important because it'll give you that self-assurance and that strength to say like, this is new, I wasn't expecting it, but it seems awesome, so I'm gonna give it a try. And with that, thank you. This is my contact information, not seizing, and so feel free to reach out at any point in time and I will now pass the mic I think to Ken. Thank you. year and for the first 10 or 12 years, I wasn't involved in any professional sports, right? And so, I meet a lot of residents and people applying to our fellowship who we interview every year. And one of their stated goals is, I wanna be a professional team physician. And it's a long road. And as Sherry just said very well, it's usually not a linear road and there are ups and downs and it takes luck and perseverance and being a good at what you do to kind of get there. You know, I could spend this 10 minutes, you know, bashing the NBA, but I'm not going to. Maybe after I've had a few drinks tonight, that would be a different conversation up here, but I'm gonna try and be productive here. So people ask, you know, me all the time, like how do I become professional team physician? And so, I think it starts early. And so, I think it starts even in residency training and most of y'all are probably residents or above, probably not many medical students here. But you know, I think it matters. And I think if this is a stated goal of yours, that's okay. I think being in the residency program where you can be around people who take care of professional athletes is your first window to kind of see what it's like and to see whether you like it or not. It's a very different environment than taking care of high school and collegiate athletes as many of you who are in clinics with me would know or who do this yourselves. There's lots of other politics involved, which we'll get into. And so, you might get into it thinking one thing and realizing that it's really just not for you. And then I think when you're going to pick your fellowship for all the trainees in the room, I think it's important. You know, I remember I did my fellowship down in Birmingham and we saw lots of professional athletes and worked with some of the professional teams in Birmingham as well as consulted with a lot. And you know, somebody down there told me if you wanna become a team physician, work with professional athletes, the best thing to be on your resume is that you've actually done it before. And so, I think it is important to pick a place to train where you can have that experience. And even if you're not gonna be making decisions on whether we get an MRI on Trey Young or not, you can at least be in the room when some of those decisions are being made and kind of see how that thought process goes. And you will be covering games. I mean, our fellows cover Skyhawks and our G League and cover our AAA baseball team independently. And so, you get to kind of cover some level of professional sports and kind of seeing what that atmosphere is like. You know, most professional organizations, unlike some of the other places where you can start taking care of high schools or colleges right away, most professional organizations have a five-year post-board certification or fellowship certification. So, you need to be five years out of your sports medicine training to be able to have that title and even have that role. So, you know, of all the things that they do that I agree and don't disagree with, I think there's a lot of value here, right? And so, number one, you're not gonna walk into this day one out of training anymore. Number two, it gives you time to kind of learn the ropes. I mean, most people say a mature practice probably takes about five to seven years to kind of get there anyway. And then, you know, lastly, I think at that point, you've had enough experiences that you probably realize if you really want to do it or not. Because like I said, I think some people will go through this and kind of get to the point of saying that it may not be worth it. And there are pros and cons to it, to why we do or don't want to do it. I, for one, you know, always wanted to do this. I've been doing it ever since I was probably in high school. And so, I understand that goal early on. And at year 10, when I hadn't done it, you know, I had accomplished a lot of things in my career, but it was still kind of, you know, on my checklist. And so, you know, I think it's okay to kind of continue to dream big and kind of hope for those things. You know, all these things I mentioned are really important, but honestly, the healthcare system you work for is probably the most important factor here. Because what's happened in professional sports has been a lot of partnerships with healthcare organizations. So it's very, very rare now for a private practice doctor to take care of a professional team or be involved with a professional team. And a lot of professional team sports are being taken over by healthcare systems and therefore the doctors that work within those healthcare systems. And so, that's the strategy if you're thinking about doing this and going into practice and where you're gonna position yourself. You know, if you're in a private group in a town outside of a big town and you think you're gonna try to take care of that team, you know, a lot of times it's not gonna work that way. And even though, you know, it gets complicated, but the marketing and the medical directorship or the medical contracts are separate and are theoretically not intertwined, there's definitely some overlap there. And so, with Emory, you know, we are not the sole sponsors of any of our professional teams. We allow other healthcare systems to give money and to put billboards usually bigger than ours and give more money than us, but we do have a partnership stake and we did something really smart with two of the three professional teams that we take care of, we actually built joint facilities. So, we're kind of locked into a lease, we're landlocked with them for 25, 30 years on these leases. So, it would be hard for them to switch to a different healthcare organization at this point. So, what are the opportunities? So, you know, within professional sports, there's lots of things you could do, right? So, you could be a head team physician, you could be a head medical team physician. So, for most professional team sports, there's a head orthopedic physician, there's a head medical physician, and usually one of those two will be the head team physicians. Historically, for, you know, decades, it was always the orthopedic guys who kind of reigned supreme and were the head team physicians. And slowly but surely, I think a lot of professional organizations are realizing that head team physicians are much more valuable to be people like us in the room who understand orthopedic and medical and are really good at triage and out to specialists and collaboration, just like, you know, we do in our training and on our rehab floors when we were residents. And so, depending on your role, you may have different responsibilities and different levels of involvement. So, it's important to kind of understand those roles. And if you're the head medical physician, you know, you should and you need to be able to deal with the medical issues of the athletes, at least to some degree, and help to triage when appropriate as well. And then lots of times in team sports, you know, if you want to be involved but maybe you don't want to cover so many games a year or travel or do this and that, you could become a consultant. And so, there's lots of great opportunities to at least get your foot in the door of being a consultant for these teams. And so, for example, I mentioned concussions on the endopatrists or neurosurgeon, I think, to be an INC now for a professional football team. And so, opportunities for people in this room to do this with their professional organizations that they may be around. Groups in town, especially like Georgia Tech, I don't cover any games for Georgia Tech, but I consult with ultrasound and orthobiologics. So, I do a lot of them, seeing them in my office, taking care of teams within the NFL. So, that's another role you could do. There's lots of spine opportunities, whether it's like retired NFL spine society where you take care of retired NFL players or with professional teams where sometimes the orthopedic and the primary care sports medicine doctor may not have the spine knowledge. And so, you could be a consultant in that way as well. And with women's health, it's the same thing where there may be a women's team that needs someone who's really a specialist in red ass and women's issues. And so, there are lots of ways to kind of be consultants in that realm. So, what are the obstacles in politics? So, these are kind of like my words of advice. I think this is my last slide or getting there. So, number one, stay in your lane. So, like I said, different organizations I'm involved with, I have different roles. And so, with the Braves, where I am more on the medical side and not on the orthopedic side, I handle most of the medical needs. And if they ask my opinion on orthopedic issue, I'll give it but I will stay in my lane because once you start jumping out of your lane and if it's not what the team is asking you to do, you're giving them a reason to not have you around. You're giving that orthopedic doctor who no matter how good you are, they may not think of you like that and they are very protective of what they do. And they don't want a bunch of us coming in there and kind of taking over. So, interestingly, the Braves who've been run by orthopedic surgeons forever, this year, they just decided that, they named one of my partners, Lee Kinnear, their head team physician, who's a medical doctor, who's a PM&R Sports Medicine doctor and they're not gonna require orthopedic surgeons to even stay at their games anymore, which they've never done before and just have one doctor at their game being mostly three physiatrists and one pediatric sports doc who cover them. Communication is key. So, if you were at our session earlier, everyone mentioned communication, but with professional sports, it's more layers, right? You have agents, you have the trainers, you have the coaches, you have the front office. And so, it may not be your job to talk to everybody, but you need to make sure the messaging is what you want it to be, because ultimately, especially if you're the head doctor, it all falls on you. And so, making sure the plan, the rehab plan, the diagnosis, what they're gonna tell the media, all those things are things that you have some control over and so communication is key. Obviously, now with cell phones and emails, it makes it a heck of a lot easier, but you gotta make sure everyone's on the same page and that you're not having people who may work with you or under you giving different messages to the players and to the coaches. So, no matter how good you are, you're not as valuable as you think you are. And I would say that although we would like to think that these professional teams always want the best care of their athletes, from my experiences, that's not always the case and it doesn't always happen. And so, they will replace you even with someone maybe not even as qualified as you for reasons that you couldn't even imagine and that you would never even think of. And so, you just have to realize that you may not be as valuable as you think you are. And along the same lines, never get comfortable. So, I've been with the Hawks eight years, so you may think, boy, that's some continuity, but this is my fourth performance and training staff that I worked with in my eight years with the Hawks. So, every couple of years, they've hired new medical directors, heads of PT, the athletic trainers. And every time, you have to kind of prove yourself again because most of them don't know who you are and you're coming in and you have to kind of prove that you are valuable to the organization and you know what you're doing. And so, it's never a good idea to get comfortable and assume that you have this job forever. I mentioned before, check your ego at the door. It's a humbling business. In professional team sports, like no other, you will have so many people getting second opinions. And those second opinions are people who may very well not know as much as you as the first opinion, right? But the agents understand, the agents want them to go see these doctors. I get orthopedic doctors from all over trying to give me advice on how to do PRP on people. I mean, it happens a lot of the time. I have patients who fly out to the West Coast to get PRP done instead of having me do it on my professional teams. And so, you can't have an ego with this stuff. It's gonna happen. And if you start kind of making a fuss about it, then they're not gonna like you very much. Two more, be responsive and accessible. This is probably number one, right? I mean, our wives will hate it, our husbands will hate it. I mean, you need to always have your phone on you and I have a hall pass for our family dinners and it's my chairman of my department and my head athletic trainers. And so, if they call, if they need something, you're gonna have to be accessible. But at the same time, having done this for a while, I think at some point it's okay to set some boundaries. I still have my ringer on silent in the middle of the night. They know if they really need to get ahold of me, they can call me twice and it'll ring through, but it rarely happens. And so, you do wanna be accessible, but you can also set some boundaries. And then my last advice, which Melody talked about this a little bit, a few years ago, someone from a news organization called me to comment on a picture for the, I think for the Mets at the time. And I made a comment, it was probably five or six years ago. And then the next day I got a call from our athletic trainer that the GM of the Braves read this comment that I made and was worried that they were gonna get in trouble for tampering with this player who was soon to be a free agent that I was commenting about his elbow injury. And so, you just wanna be careful. And obviously I learned a lesson then, which I would never do now in terms of what you post and what you say, especially with the professional organization that you're on the hook for and involved with. And so, a few final things, compensation came up earlier today. I do think that probably those who do professional team sports, it's perfectly well to be compensated. And most people get compensated a pretty decent margin, but hour for hour, it's not gonna be equal to what you'd make in a clinic setting, right? But it should be enough that it's worth your time. And I'm happy to have offline conversations about compensation if people wanna ask you more specific questions, but it varies kind of all over the maps, different healthcare systems, different cities, different times you spend with the team, amount of travel you do, lots of different plans out there. I think work-life balance is important to consider. Unlike college where, as our friend Carly likes to say, where she says it's work-life integration, in the NBA or in the professional leagues, it's kind of tough. They don't want your kids in the training room. And I've been doing this for 16 years. You include my two sports pro teams together. And I think once I had no one to watch my eight-year-old and he had to come with me to a game and come in the training room. And it was fine, but I don't even ask because it's just not that kind of environment. Unlike in college where it seems like, or high school where it seems like it's just more allowed to kind of be a little more looser like that. And then lastly, liability is something important to consider. And this is where the next five or 10 years are gonna be really interesting to see what happens. Most are aware of some of the big lawsuits that have happened recently with mostly orthopedic surgeons and some of the professional teams that they take care of. And some of these doctors have been pretty right in the way that they've treated athletes and have yet still had to pay out millions of dollars in sums of money to the point where it's kind of becoming a question of whether it's even worthwhile for these physicians to be taking care of these professional athletes with the amount of liability that is on the line. So if you're doing this, or if you're interested in doing this, you really need to look into what that liability looks like within your organization, within your healthcare system, within your team, within the professional organization, within your state. So there's lots of different things to consider with that. And I think it'll be interesting because I know in some of the other organizations that the teams are really starting to, or physicians are really starting to put up a fight of how do we better make ourselves not liable for these multimillion dollar potential payouts. So I was gonna start, I was gonna kind of go over my slides, but videos are not a good idea on this screen, I just figured, so I will let Brandy go next. Thank you. All right, thanks team. You guys ready? If you need to stand up and stretch and move a little bit. My feelings are never ever heard if I see movement in the audience. Even if you move towards the door, I won't check you. There's a couple people going out. Oh, back. Thanks so much to Dr. Zaremski for setting up a very deep bench on this panel here. So I'm very happy to be a part of it. I'll be moving a little bit more towards our time in academia. So I'm a professor at the School of Medicine at UC Davis and I direct our sports medicine program there. So I will just jump right on in. So I didn't put any pictures or videos in my talk, so we're ready to go, but I came up kind of with a top 10 list. I didn't number them because I couldn't give them a ranking of importance, but these were kind of my top 10 thoughts that I have on art and politics in sports medicine. So number one, there are no small roles, only small actors. And so I'll borrow that from Melody's world of performing arts medicine. And this famous line was spoken by Konstantin Stanislavski, and he was basically the father of modern acting. And he had a rule that basically any role that you played in his performances, you had to embrace with full gusto and your full worth in everything. So there were no small roles, only small actors. And as a member of a department that when I started at UC Davis, there were only, I think, 10, maybe 11 faculty members. We were a very small department, not a division of someone else's, but our own PM&R department. But I saw that this small department had big potential and a leader that had a vision. And so I really felt like, this was 2006 when I started there, and there was one person at the time that was doing sports medicine from PM&R, and he was in, Brian Davis, if any of you know Brian, and he was in the sports medicine clinic a half a day, once a week. And that was the PM&R presence in the main sports medicine clinic when I started in 2006. Now, fast forward to 2023, and we have eight only in sports medicine. So our department has grown, but from a faculty of all of our PM&R faculty being 10, and now we have eight that are PM&R sports medicine docs in that same clinic. And so now there are more of us than anyone else there because we saw the vision and we made ourselves valuable, and we took the roles when they were available and grew with the vision. So you want to not be discouraged if there's a small starting space, if you are looking and have vision and talk to the other leaders that are there that have potential for growth. And in the same vein, my number two bullet point will be be a trained observer. So you want to watch for where opportunities might be. Take a look at what's happening in the room that's clearly stated and what the undercurrent is of many of the rooms that you're in. And so learning a little bit about clinic politics, department politics, pay attention to who the leaders are, what they're doing, and finding out what some of the strategic goals of organizations are. And if you align some of the growth or programs that you want to see happen and your role in those programs, if you can align that with institutional or departmental goals, and then other departments that may have a bigger footprint on the scene. So if there's a gang that's bigger or wields more power in the organization compared to your gang, like orthopedics or neurosurgery, if PM&R is not kind of that top billing, you want to find out where you can make strategic alignments by observing who is making those moves. Because sometimes you'll think that it's one way that you should go to get something to happen and it's actually quite a different pathway that you should take that would be more appropriate. And you only learn that by listening and paying attention. And so I can be quite verbose and some of us who are extroverts can be quite verbose, but sometimes you just need to shut up and listen, figure out what's going on. Also, we got a new CEO of our health system and the CEO came to each of the departments to hear a presentation of what's happening in the department and this physician actually came and sat right next to me when he came to the PM&R program. And I, as a trained observer, checked him out head to toe. And when he asked us, are there any questions after we gave our little presentation that the chair did, that was great. I said, I raised my hand, I said, do you run or cycle? Because I looked at your watch and I noticed that you have watch X, Y, Z. And so which one of those sports? And he said, well, actually I'm a triathlete and went on to do that. And so though he was in a sports medicine doc, I said, oh, I noticed what sport he was in. I let him know PM&R is doing sports medicine. And then that became a strategic, when he needed help or thought of something, his first step was then to PM&R for those things. So just being a trained observer and noticing that. And of course, what CEO or leader doesn't want someone to ask them about what they do with their recreational sports, right? It just gave him an opportunity to talk about himself a little bit. And sometimes that can be making other people feel like they're the most important person in the room can really help them to remember you. They remember the way that you made them feel. And that helps you be someone they want on their team or they want on their committee or they want in their space. So that's it. And we really wouldn't be anywhere. As I said, I came in and there was only one PM&R sports medicine doc who was in the clinic half a day a week, but there were allies in that department. Many of you know, Jeff Tanji, who was a founding member of the AMSSM and he was in that clinic and he welcomed me with open arms and welcomed the field of PM&R in sports medicine with open arms. And so having allies that can be there, I had some fantastic mentors. We talk a lot about allyship and mentorship between Mike Fredersen at Stanford and Brian Craback, who used to be at Hopkins when I was there for my fellowship, now at U-Dub. You've got these people who are in your lives and it's really important to watch your mentors and pay attention to how they do things so you can learn the things that they do well, but our mentors aren't always perfect at everything. You also might learn things that they don't do well and figure out if you need another mentor for that other thing. And so I think it's important to use those relationships in that way. Next, opportunity knocks, opportunity also hides. And so we talked a little bit about this door being closed or being open and what you should do with it. Sometimes it's right in front of your face and sometimes you've got to look for it a little bit. And so you need to prepare for the roles that you want, not just the roles that you have. And with that preparation, if you want to be a head team physician and you're a PM&R doctor, and maybe you need to brush up on some of your primary care skills or other things, go and seek that CME and then make it obvious to people that you have that additional training. So primary care, CME, wilderness medicine. So I do, if you haven't yet Googled or looked up Racing the Planet, take a look, it's tons of fun, but I'm basically the only doctor for a long stretch in the wilderness of people running a marathon a day for seven days in a row through the desert or the Arctic Circle or Antarctica or the Sahara Desert or the jungles in Ecuador. So, you know, it's just me. And if I didn't know how to drop an IV or suture something up or get it done, then I couldn't be that doctor that's there. So the Wilderness Medicine Society has fantastically fun CME. And so if you're looking to do things like that, get trained for it so you can open the door and have the skillset to be there. Because if you get in the door and can't do it, then you're shutting the door for all the rest of the PM&R doctors that are going to come behind you until someone else comes with a ready to play, so to speak. So you want to be trained and be ready to play when you show up. And also in preparing for these roles that you want, you have your vision and your vision may not align with those who are in charge what their vision is. So you need to help shift their vision to see more of what you are doing. You know, I am a black woman who is in sports medicine. I'm from an underrepresented group on two sides. And I was interviewed by a group who said, you know, a lot of times you walk in the room and you're the only one. You're the only woman. You're the only person of color. You're the only whatever. What do you think to yourself when you walk into those spaces where it doesn't really look like you belong? And my response was, I belong everywhere. And that's truly what I had to believe about myself when I entered that room. We talked about the power pose, but when you believe that, it's the same with PM&R as kind of like the underrepresented group in sports medicine if you want to think about it in that way. And so you have to be prepared. There's a saying, you've got to know twice as much and work twice as hard to get half of the recognition in the community, I say, so to speak. And that applies to our community as well here in PM&R. So I think about that and be prepared to present yourself for it. And then saying yes to growth. And so sometimes opportunities come up and they don't necessarily fall within your plan of what you were going to do. We had some allusion to, you know, this is not a linear path. This is not a straight line. And so a couple of times when I can think of where I said yes to something that seemed a little bit strange. So even as an undergraduate, I took, I was looking, I needed like one more unit to fill my class and so, or fill my classes. And I had been a dancer. And so there was a class at Stanford that was on like learning how to teach low impact aerobics. Right, so this was in the early 90s, like high-low aerobics was a big deal. And I was like, I'm gonna take this class to learn how to do, you know, high-low aerobics. And I ended up getting a job over the summer teaching at a bunch of different gyms, teaching, you know, high-low aerobics and different things. And then it came time for my gap year. And I had a job offer in a lab, but I also had a job offer at this wonderful resort spa in Mexico as a fitness instructor. And they saw that I had the certificate from Stanford University, which really was like a one unit class, but it had Stanford's name on it. So it opened some doors for me. And I went and got to live for a year at one of the most well-known resort spas in Mexico, Rancho La Puerta. Then came back and went to medical school, did PM&R. There's a new group that's coming up, come the American College of Lifestyle Medicine, which we are hearing about. And so my time living at Rancho La Puerta, which was a vegetarian health resort, was a perfect opening, you know, opening door for me to be in the American College of Lifestyle Medicine. And then just two years ago, our school of medicine decided to revamp their whole curriculum and have preventive medicine as a thread woven through all of the years from the MS1, 2s, and then in the clinical years. And now they pay a certain percentage of my salary as the preventive medicine thread leader for the entire school of medicine. And so we're actually getting to teach our entire classes about using food and nutrition as ways to treat and prevent chronic disease. And that all came back to this one unit class that I needed to take to move forward. And so you just don't know where your experiences are. And that goes into my next line of become a spin doctor, right, because that experience, I can tell you that when I was interviewing for medical schools, I interviewed at a school that I didn't get into, which is a big school. I won't say which one it is, but I'll say it's not as prestigious as the school I actually attended. But I went to this other interview. And when they asked me what I was doing during my gap year, and I said, I'm living in Mexico and I'm working at this resort. And they said, oh, well, you're in Mexico. What clinics are you working at? What outreach are you doing? And I was like, I'm just working, you know. I wasn't prepared for what they were asking in order to make my experiences count towards what they were looking for. And so I looked like there was a deficit there. And I thought, uh-oh, next time I go for another interview, I better know how to link what it is that I'm doing now to what it is I want to do in the future. And maybe that's why the school that I went to is more prestigious, because that interview was later. But you really want to prepare and be able to spin the things that you're doing into the things that you want to do, right? And have your elevator pitch ready, right? Because you never know when you're going to be in the room with someone that can do something for you. One of the most important things I ever learned from my parents, my dad had a saying, he said, honey, you need to read a lot so that you can have a great vocabulary, so that you can talk yourself into or out of any situation as you see fit. And using that, moving forward, you want to be able to have that 30-second pitch, that one-minute pitch, that two-minute pitch. Because when I ended up in a football suite watching a game with the dean of the School of Medicine, and I had her attention for two minutes, I was able to pitch an idea that I had ready for a new program that I wanted to get started. And that's how you get into that room. And so, our last four of these we'll roll through. So you want to create and collect the evidence of your excellence, because people don't always see what you're doing. And so, I keep a sticky note on my computer, and every time I say yes to do a talk, or to do something else, or to do a media interview for our School of Medicine, or to be interviewed by someone for something, when Merit and Promotions comes around, nobody sees that, and then I can't remember, and then I can go back and say, oh, actually, I did 17 interviews in the past two years at the request of our UC Davis marketing office, and for each one of those interviews, it usually takes X amount of time to prepare, and X amount of time to do, so that translates into X number of hours of service that I've done to the university, and we have some merits for service that can be grown. So, collect the evidence of your excellence, track it and document it so you can quantify your contributions. I mentioned this before, but collaborate across departments. Those are the committees that you should say yes to when there's people in other departments, interdepartmental committees, because that's how you start to build your network, and that's how your network starts to grow so you can take additional leadership positions, and align your goals with where the institutional goals, if you look at those five mission points of light, or whatever it is that your institution has said, figure out how to, when you're doing your presentation for what you want to do, line up your things with institutional alignments, and make it very clear. The institution says this, and in line with that, our program of XYZ, don't make them make the connections, make the connections for them so that they can't deny it and they can only see it. Take credit when you've done something well, and give credit when there have been people who have helped you along the way. So, nobody likes an attention hog, but also if you just sit in the background and give attention to everyone else, especially if you are not the person that is normally seen, the underestimated, the underrepresented person, make sure you take credit, but also give credit to those who are coming up behind you, because they will remember it, and you've got to reach forward and reach back at the same time as we're moving through these professional obligations. Know your worth, that's not just about compensation, but sometimes it is about compensation, but also know that you may not get compensated for everything, I won't review what Ken said, but if there is an opportunity, like a large organization is doing a international sporting event in your city, and they ask you, will you be the medical director for this, or can your institution partner with this? If it's extra on top of what you're doing, and it's not really an institutional goal, and you know you're gonna need people to help with you, figure out where the deep pockets are, and if somebody has deep pockets, ask, right? So, I had a large international organization come in, say, can you do this? And I thought, oh God, this is gonna be a lot of work, and I'm gonna need some other doctors to help, and they're not gonna do it for free, and I was like, all right, how much is this really worth? I need the doctors to get paid $300 an hour, I need my therapist to get paid this much, I need this, even just to take time out, and make that pitch, and it ended up being a very large amount of money, and they were like, yes, absolutely. They didn't even come back with a question, so know your worth, and ask for it when you know there's deep pockets that can pay for it, but if you know the pockets aren't deep, then say no to things if they don't align with your passion, right? So, if you can't get paid for it, you better be passionate about it, or it's a waste of time, because some of us, once you get to a certain level, you're overwhelmed with opportunity, and so then you can be a little bit more strategic about choosing what you need, and then this last piece of information for work-life balance, integration, whatever you wanna call it, I remember going to a talk, a lunchtime talk about work-life balance before I was married or had kids, and most of the talk I felt was actually quite useless, and wasn't helpful, but there was one thing that someone said, and that was pay for as much help as you can afford, and don't feel bad about it, and so as you're moving forward, as a trainee, you have no money and more time, so then use that time in order to get these opportunities, and once you've progressed a little bit, and you have more money than time, then use that money to buy yourself more time, and that's it. Thank you. So, because we got started a little late, I'll try to do my slides in the next 10 minutes or so. So, we may go over a couple of minutes. The Q&A might be pretty short, but I'm sure some of us can probably stick around or go in the back for some Q&A. Okay, so, I'm last up. Climbing the ladder, finding opportunities for involvement in leadership in sports medicine in your institution, or outside your institution. Can we get it up on the screen here? Yeah, the mic's not there. There we go. Okay. So, you know, the question is some challenges, particularly, you know, how do you rise in the ranks? You know, when you show up, you're done with your fellowship, you're like, I'm here, and folks are like, great, go see patients. What leadership opportunities are there for you when you're a first-year faculty member? Probably none. Are there politics due to agendas? You may not even know that as a young faculty member. Is it right place, right time? Yeah, sometimes it is. So, my story, I had a little bit of right place, right time. So, I graduated in fellowships in 2012. I got hired at UF Health. At the time, we were a division under orthopedics. So, my division chief, who is now my chair, because we're our own department now, brought me in. On the ground floor, we tried to grow our non-operative sports medicine service line, and there were lots of positives. My mentor and boss is at UF, Kevin Vincent, and colleagues, one of my former colleagues is in the room here, research support. If you're a non-surgeon, which everyone in this room is, you have to figure out a way to say, I'm the expert in this, and I should be speaking on this. You should be saying, patience me on this. But they don't show up just because you say it. You have to prove it. So, there are ways to do that. One of them is developing a research line. So, there's other ways as well, advocacy, volunteerism, experience, Dr. Rubech talked about some opportunities that she got as a very young faculty member at UIC, a little bit of right place, right time, a lot of hard work, and she can show that she's an expert because she has all this experience in certain coverage events, just as everyone else has said. So, I put this slide up again, is how important is it to you? Some individuals, when they finish their training, going, I want to go to work, I want my paycheck to now be four to six times what it was just three months ago, and I'm happy seeing patience. And some folks want to say, okay, now that I've completed my training, I want to become a leader as an associate or program director at the fellowship level or residency level. I want to become a consulting or team physician and eventually the head or lead team physician at certain levels of sport. Well, you have to decide how important is it to you. As we know, sports medicine, a significant portion of sports medicine is spent outside of the clinic. So, opportunities may come when you least expect them. You may be wanting something to happen, but how do you make it happen? Sometimes you make it happen, sometimes right place, right time. So for me, my first couple of years I was establishing a practice, one of the main reasons I was hired was with one other person who was brought in was to grow and establish a outreach high school medical program. In the greater Gainesville area, there's 20 plus high schools, but everyone thought UF just took care of the Gators and nobody else. And that was an area that was seriously lacking. So that was one of the main responsibilities that I had outside of clinic. After a couple of years, I took advantage, there's a three-year rule. If you want it, for any of the trainees here that ever want to get involved, you're foot in the door with the USOPC, which is different than an NGB. Then after three years of post certification from your fellowship, you can apply to do a two-week rotation at the USOPC. So I met folks there, some national, some international with interests similar to mine. Through that and some other opportunities, I was able to present at the IOC conference that's in Monaco every three years. Last year was every four years, or two years ago was every four years for the COVID, but otherwise it's every three years. I also got through opportunities, ironically enough, with Dr. Hutchinson, who Dr. Rubesh mentioned before, as well as my boss through another organization to help co-run what's called the CAQ sessions at ACSM. So I started emailing tons of people who are national and international experts to come speak and they would just see my name and my email signature all the time. This is a theme, by the way, for the next couple of slides. So in 2017, I was at another meeting. This was at AMSSM and this was the sports information group meeting for PM&R. Just so happened that meeting was Ken Moutner, John Finoff, who was our chief medical officer for the USOPC, and Kathy Deck, who's not able to be here today. Kathy is a former past president for AMSSM. Ken was a former program chair for AMSSM and board member, and we know about John. And I finally spoke up. If I'm not comfortable in a room, I'm not going to talk a lot. If I know people, I may talk a little more. I spoke up and I said, how are we going to get opportunities beyond the select couple of individuals who have been able to get their foot in the door? Because I said that, what I was told, and Ken can tell me this is right or wrong, Kathy suggested to Ken and one other individual to give me an opportunity to help with leadership for the annual meeting with what's called instructional course lectureship, which basically they used to have four lectures every morning for five days. So I was now in charge again of emailing tons of people around the world to come give lectures. And that's actually when I began chatting with a young physiatric sports medicine physician named Melody Rubesh about some of the same things. 2018, I did a good job. They said, why don't you come back and be chair? And this is something that Dr. Waite just talked about, and they want to bring Carly Day on, and Carly wasn't the head team physician yet for Purdue. And I said, why don't we be co-chairs? I mean, it's good to spread the wealth. And we both start emailing folks from around the country and the world and did the same thing. And over the course of eight years, my name got out there, so to speak, because in two different organizations, I was just saying a crap load of emails. It was a lot, and logistically for planning, and I got good at this stuff. But that's how my name got out there. And I think because of that, I got some more opportunities to do some other things. I was able to be the chair for AMSM in 2020. Now originally, I'm going to say this was a negative, but we turned this into a positive. So it's how you look at things and the opportunities you have. Everyone knows what happened in March of 2020. AMSM was the very first large-scale meeting in any healthcare organization that was going to have a meeting with the world shut down. And after 18 months of planning, our team turned AMSM into the first virtual meeting with 6,000 views in six weeks. So that was another thing that we started to take advantage of opportunities, and your name got out there. And it wasn't just locally, regionally, nationally. This was truly international because everything was online. And there's some other opportunities that occurred, I think, because of that as well. So now what? I saw this kind of ladder scheme. There's a lot of these schemes out there when you Google it. But I really like this one because the top one is being a team player. And I kind of feel like being a team player should be at the bottom and the top. But making a plan is great. But where does the line go? Humans make plans and God laughs. So you have to be prepared to change that plan daily. But it's good to have a plan. You should have a short-term goal and long-term goals. So my role, in my opinion, in our role, those of us speaking here and some of us that are more senior in the audience, is to pave the road for our younger members who are interested, in this case, in sports medicine, whether it's mentorship or sponsorship. And it took me about three years to understand the difference of those definitions. But part of that is to provide opportunities for those who are willing to do the work. Specific examples. If you're given an opportunity to do things such as review cases for AAPNR, review research abstracts for other organizations, volunteer for anything. The very first event that I ever volunteered for, so I did my residency at Tufts, Harvard or Spalding at the time, had the majority of the sports connections. I volunteered for Dr. Jim Kono to cover a five- to seven-year-old ice skating event. I can't skate. But I did it because it was that important to me. Again, it goes back to how important is it for you? Start new initiatives locally. For me, as a lot of you know in the room, I would go to baseball fields and just speak on Lily Galbo and workload and I've memorized this stuff at this point, so you don't need a PowerPoint. Everyone that has spoken so far has done similar things and I would suspect many of the faculty in the audience have probably done that as well. So what are my lessons to you? Say yes until you're told not to say yes. Usually that's going to be somewhere around your third to fifth year of being a faculty member. For those of you that know me, I have failed this over and over again. I recently said no to something about six months ago and my wife was flabbergasted. She's like, that might be the first time you've ever said no. So you have to know what your bandwidth is. If you say yes, commit 100% to doing that job or that project and do it well. We would rather you not say yes than do a crappy job. If you say yes and do a good job, as I think I've given you some examples just for me, you get more opportunities. They might be opportunities that you want and then you can say no, but you get more opportunities. You will say the wrong thing over and over again and I do it all the time. A really good example is I got an opportunity to help cover U17 soccer through Dr. Rubech on the women's side and it was my first international trip. And I think I asked 100 questions in like a 10-minute Zoom call and Melody was texting me going, dude, relax. They know it. It's okay. So I felt like I was a fellow again, which for me is many years ago. That's okay and a lot of us know that. Be respectful, be professional, but ask questions, but just know you're going to say the wrong thing from time to time. I will also say this. Don't be afraid to stand up for something if it's what you believe in. Something that Ken has said and I think I've gained more respect for Ken and I don't know if Brian Murtaugh is in the audience. Some of the challenges they've gone through in the last year from the NBA perspective has been immense. And I've been in some rooms, some of us up here have been in some rooms because of that issue and I am continually impressed of how professional Ken and Brian have been while handling a quite unfortunate issue. And when you're in the role of leadership, when you're at the role, when you're at the top of the pecking order, the top of the iceberg, whatever you want to call it, you have to remember you have to look out for the entire team. Remember what you took to get there. You have to do what's right for the organization, right for the team, right for your staff, but you also have to remember you're considering the entire team, not just a select few. Nothing ventured, nothing gained. For years, I'd talk to different colleagues and one of my good friends is Dr. Rubesh beyond sports medicine and she thought I might be a right fit for something. So she gives me a call going, hey, do you want to help out and be one of our volunteer team physicians for U-17 women's soccer? And I'm like, you mean baseball? They're like, no, soccer. I said, okay, well, let's do it. I did my first trip and from what I was told, I didn't do too bad. So sometimes you get opportunities from making these relationships and working hard and getting feedback from sources you might not even be aware of. And with that, it is 5.05. Are we allowed to do a question or two or is that like we're cut off? Okay. So I'm going to have our panel come up here. Somehow through the Zoom, I got an email for a question already. So I'm going to read the question and I'll let anybody take it. So this question is from Marlena Mueller. How do you recommend advocating for yourself, promoting your skills when covering teams that also have a primary care physician and or an orthopedic physician? I will leave it to the group. I feel like Dr. Rubesh is going to be great at answering this question. I will be happy to. How do you recommend advocating for yourself and promoting your skills when covering teams that also have a primary care team physician and orthopedic team physician? Yeah. I think, you know, you bring an interesting perspective because you have both, but so do they, right? Especially if they've been in those, I feel like we keep saying rooms and doors, so I'm just going to keep the theme going, but they have an idea as well. And the main thing is you don't need to knock other people down to get that opportunity. That's something you really want to make sure you play well with others. We bring in a unique skill set, but so do they. So you actually bring something, maybe a little bit of both, but I would say there's room for everyone. I think all of us can say there's too much work to be done, right? There's a lot of work. We're looking for people who play well with others and who aren't trying to just be the one person. They don't want to be the one. You just want to be one of the people. So bring what you have and it's going to be enough. And it's not just what you know, it's how you say it. So that's what I would advise. And if anybody has any questions, you can go to the microphone on my left, your right, halfway through the room. I'll piggyback on that and just say to make yourself available when you know there's a lot of coverage, like certain sports run a long time and there may be holidays or certain times. If you can make yourself available during the times that nobody else wants to work, just say, hey, I know you guys cover a lot. I'll be around Thanksgiving. Let me help out that time. And that's sometimes how you get your foot in the door, by being available and offering yourself to help at times when you know they're overwhelmed. So we're going to do one more question. If no one has one, I just have one prepared. We'll start with Ken on this one. Handling challenging situations, and obviously this goes for some of the MBA, but speaking more broadly, how would you advise learning when to sort of dig your heels in? Or as Dr. Rowe said this morning, what hill to die on and not? How would you advise a younger person of how to handle situations that might be challenging that have nothing to do with medicine? It's a good question, and I think it takes experience for sure to kind of understand some of the situation that you may be involved in. I guess my advice would always be, you don't have to be the loudest voice in the room. You want to listen to other people before you, and these are similar ways to kind of any leadership manual you'll read or look into, but you want to listen to all the individuals involved while processing your decision. And like Melody was saying before, for the most part, everyone has good intention. Everyone brings something to the table, and it's our job, especially our job as sports physiatrists, like Brandy was saying, as an almost underrepresented, and need to kind of prove ourselves every day to kind of rise above it, right, and do a good job. And those conversations are part of that, is learning not to be the loudest voice, you know, not to, you know, it's a fine line between being assertive and being, you know, arrogant or kind of rubbing people the wrong way, and you have to kind of find that line, because you want to be assertive. You want to let your voice and your opinion be heard, but at the same time, you don't want to shut other people down, and, you know, I think there's an art to that, and unfortunately, it's hard to kind of know that in year one. I think you have to kind of, you know, go through it a few times. And I was going to ask Dr. Blatt her thoughts on that, especially because you have the international perspective as well. Yeah, I think it's important, if you're running into a challenging situation, especially where you feel like there may be, like, the political aspect might be greater than the clinical aspect, I think it is important to take a step back and to understand, you know, if I continue to speak up, if I continue to be, like, the loudest voice, like, is it actually going to lead to change? If it's not going to lead to change, I found it helpful at times to take a tactic where you actually just pause and then do a little bit more strategic planning and thinking about what allies can you align with? Maybe other people, even people outside of medicine, right, where, you know, other people with influence, right, in these sports leagues or in the Olympic space, and forming allyships and partnerships with people where maybe they can actually help you to come at the problem from a different angle, because they're in different rooms and have sort of different leverage with the organization. And I think that can be a powerful way to try to impact change if you feel like your individual voice isn't going to get there. So it's 5.11, so I think I'm going to get yelled at, so we're going to end there. If anybody has questions, if any of the expert panel can stick around, I'll let them decide, but thank you very much for coming, and enjoy the rest of the conference.

art and politics of sports medicine

leadership opportunities

lessons not learned in training

building a brand as a physiatric medical director

professional athletes

importance of background and experiences as an athlete

challenges and opportunities of working with professional sports teams

effective communication

staying in one's lane

responsiveness and accessibility

never getting comfortable

rising in the ranks