Alex Jahangir, MD, currently serves as vice chair of orthopedic surgery and director of the division of orthopedic trauma at Vanderbilt University Medical Center in Nashville, Tenn., and recently received the William W. Tipton Jr., MD, Leadership Award from the American Academy of Orthopaedic Surgeons.
Becker's recently connected with Dr. Jahangir to discuss his perspective on leadership and physician advocacy.
Note: Responses have been lightly edited for length and clarity.
Question: When deciding on what specialty to focus on, what drew you to orthopedic trauma surgery?
Dr. Alex Jahangir: I think a lot of us entered medicine to want to help people. As I went through my med school and then residency, what I realized was for better or worse, physicians are recognized as leaders in the community by the nature of our position. It's how we use that position that really defines if we're able to be successful in that objective or not. As I started looking at subspecialties and orthopedics, trauma was one that stood out to me as one that I could really, truly help anyone, irrespective of background, who shows up. I have treated the most famous country music singer to a person in prison for first degree murder in the same clinic. Trauma doesn't discriminate; everyone's impacted by trauma. Furthermore, I felt that the field of orthopedic trauma really allowed me to have an impact as far as becoming a subject matter expert in things that impact all of us. Whether that's safety — motorcycle helmets, seatbelts, gun violence — access to healthcare, these social issues that also impact our well-being and our health are things that I see every day in the subspecialty of trauma.
Q: As a trauma surgeon, the relationship between you and your patients is much different than that between a patient and their primary care provider. In this specialty, how have you found you're able to form and strengthen relationships with patients?
AJ: When you wake up in the morning, you more likely than not have no idea you're about to meet me. You could be going to work, you could be minding your own business and then chaos happens — a car wreck, you're working on a ladder and you fall. Unlike most provider-patient relationships that are built on time, trust and research, when you get involved in a trauma, there's none of that. You're going to get picked up by the ambulance or a helicopter, they're going to bring you to a trauma center that you probably didn't even know existed, and you're going to meet some person and that person is often me. What I've found is that the most important thing in a relationship and having success for the outcome is building trust, but building trust quickly in a moment of crisis is very different than building trust over time. I have to show myself as trustworthy and that I'm honest with them, all within a very short window, because I know that if their surgery is a success, their recovery may go well but would go much better if that person knows that I and my team are trustworthy and will be with them the whole time.
Q: You've held a variety of leadership roles throughout your career. What was the process like taking on these roles?
AJ: What started it for me was mentorship. My first two weeks working as an attending at Vanderbilt University Medical Center, I had the great fortune of meeting Wright Pinson, MD, our deputy CEO. Early on, he started the transplant program and now runs a huge health system. One of the first things he told me is as physicians, if you really want to lead big, you have to understand what you're doing. I actually obtained a more formal education at business school because I think the way we're trained as a physician and through business school are very different. The other component of it is being able to recognize you may not be the smartest person in the room but you have to be willing to learn from others, do any job that's needed and do it with integrity and with a "north star" that will help you have success in a way that will benefit others. When I led the city's COVID-19 response, you've got to ask yourself, "Why is an orthopedic surgeon leading a COVID-19 response for a city of two million people?" For me, in those moments where I felt like I really didn't know what to do, I remembered that we just want these responses to be led by science, experts and always be transparent. No matter what decision we had to make in moments of uncertainty, I always went to that north star — am I leading this by the science and experts that I have, and am I being honest with the public and the mayor? I do the same thing in all of my jobs — if my north star is what is the best thing for the people we take care of and my colleagues, then it works out.
Q: What is your perspective on the role of advocacy and policy in being a physician or healthcare provider?
AJ: In Nashville, literally a mile from my house, we had the Covenant shooting, so let's take that example. What I know as an orthopedic trauma surgeon is I've seen the pain that the patients who have these injuries go through, I've seen the pain of their families. That's my expertise, and that's what I will speak to and share those stories. I think our secret weapon in advocacy is we have stories, we have experiences. When we speak to those and stay true to those stories, the message gets delivered. If your north star when you're advocating is for your patients, then it's really hard to say you have an ulterior motive if you're just speaking about what you've seen and what you think would make your community better.
Q: Becker's recently covered you receiving the leadership award from the American Academy of Orthopaedic Surgeons. What did receiving this honor signify for you and your career?
AJ: This award means a lot to me because our profession is filled with lots of people who really have become leaders in our community. You have orthopedic surgeons who are senators, who lead big international responses. This award is truly the greatest honor of my professional career. Our training shows us that we have to be leaders, and to be able to do what I think anyone else would have done and be recognized by your colleagues as being a leader is humbling. What's neat about this award is that some of the people who received it before me were people who have mentored me through my career. It's truly an honor, and I think we all must be willing to use these leadership skills to fulfill the initial reason we entered healthcare, which is to make our communities better. To be recognized as somebody who may have done that already is pretty neat.