Leesa Galatz, MD, FAAOS, has served as Mount Sinai Professor and System Chair of the Leni and Peter W. May Department of Orthopaedic Surgery and the Icahn School of Medicine at the Mount Sinai Health System in New York since 2015. At Mount Sinai, she is on various hospital committees, such as finance and contracts, and is the first female system chair of orthopaedic surgery. She was previously director of the Shoulder and Elbow Fellowship Program at Washington University in Saint Louis. She has served on the boards of AAOS, the American Osteopathic Association, and American Shoulder and Elbow Surgeons (ASES), and she is currently on the Board of Trustees of The Journal of Bone & Joint Surgery. She has been a coprincipal investigator on three National Institutes of Health grants. She was an American-British-Canadian Traveling Fellow and ASES Traveling Fellow. With more than 200 publications, she is a highly esteemed clinician and researcher and beloved teaching faculty.
In an interview with Betsy Nolan, MD, FAAOS, Dr. Galatz shed some light on what it takes to achieve this prestigious and unprecedented level of career success, as well as some advice for young orthopaedic surgeons.
Dr. Nolan: How would you describe your career path?
Dr. Galatz: I am originally from Las Vegas and went to college at the University of California at Berkeley. I went to George Washington University (GWU) for medical school and stayed at GWU for internship and residency. I then did a shoulder and elbow fellowship at the University of Pennsylvania. After that, I really wanted an academic career, and the job at the Washington University in St. Louis was an excellent opportunity. I developed an interest in basic science as well as clinical medicine. It was an opportunity for me to be able to do both of those things. I moved there and developed a busy practice in shoulder and elbow surgery and did research 20 percent to 25 percent of the time. I was there for 16 years. My chair, who recruited me, was retiring at that point, and other opportunities opened, which gave me a chance to consider what I wanted to do going forward. I interviewed for the position at Mount Sinai and have been here for 4.5 years now.
How would you say your mentors have supported you, and is there anyone in particular with leadership qualities you tried to emulate?
When I began my practice and research at Washington University, Joseph Iannotti, MD, PhD; Gerry Williams Jr, MD; and Matt Ramsey, MD, were very supportive in getting me involved nationally in meetings and courses. I was grateful for those opportunities to speak at national and international meetings, which also provide an important opportunity for networking. I was well supported by my colleagues at Washington University, especially Ken Yamaguchi, MD, who was chief of the shoulder and elbow service. I think in terms of being a chair, I am lucky to have worked with Richard Gelberman, MD. I often ask myself how he would handle a certain situation or organize an aspect of the department. He was fair, transparent, and thorough. I apply his principles for faculty in terms of setting fair and realistic expectations, while having the greater good in mind.
What challenges did you face as a woman?
The most difficult time in my career was when my son came along. After he was born, there was this additional person in my life to worry about, and that was really challenging. My husband is a physician, too. We met in medical school and are both surgeons, so we were both balancing busy careers. All of a sudden, there was another person in the world totally dependent on us, and it was really hard balancing everything. For the first time, it mattered when I left the office and how long my operating room day went. This added a lot of stress. I had some great nannies and help from extended family. I really needed those people.
What has been the biggest challenge in this new role of professor and system chair?
I think integrating multiple hospitals into one system is most challenging. I became the first system chair of orthopaedic surgery when Mount Sinai went from one hospital to a seven-hospital system. We acquired hospitals with different personalities. Some departments are very academic, and others never had residents. The patient populations and level of academics varied greatly at the different sites, so integrating them into one system and making them all feel they were part of something bigger required a culture change, which is always hard. I realize that not every department or faculty member is going to be the same, but everyone has a place in our system. It’s important to figure out how to balance that, to allocate efforts and resources among the different sites, and to make sure everyone has what they need to be successful.
What drives you?
I want to feel like I did the right thing for the people I represent. When I had a busy clinical practice, these were my patients. I always wanted to feel like I was doing the very best surgery I possibly could. I wanted to be someone who instilled confidence in my patients. The pursuit of excellence drove me. Now as I concentrate more on administrative work, I pursue excellence in very different settings. I want our department to grow and be financially successful. Looking at an academic department from an administrative standpoint is so different than just practicing medicine. When leading a department in a hospital system, there are competing interests with strategy and politics involved. My job is to do what is best for my faculty and for the hospital system.
How do you deal with conflict?
I have learned that there are always different perspectives in every conflict, so it is very important to communicate. Gathering information before reacting is important to understand the perspectives of those involved. Two people may have two very different perspectives on one issue. Most people mean well, and we are fortunate to work with intelligent people, so I need to understand the different viewpoints and collaborate with all involved to create a solution rather than to react. I communicate information to enable stakeholders to know why certain decisions were made.
Describe an unexpected opportunity, how you handled it, and how it changed your career.
I was asked to interview for different chair positions over the years but did not seriously consider them. I didn’t feel it was a good time in my career. Evan Flatow, MD, who held this position before me, called me at home and, to my surprise, asked if I wanted to interview for his old job. At first, I thought, “Forget that. I am comfortable where I am.” Intelligently, he said, “Don’t answer me now. Think about it, and I will call you in a few days.” I had a conversation with a friend and colleague who said I should absolutely interview for the position and pointed out, “You don’t have to take the job, but you always learn something.” As my discussions at Mount Sinai took place and developed, I realized what a special opportunity it was. It has been a tremendous learning experience in leadership, business of medicine, change management, and now crisis management with the recent COVID-19 pandemic. It definitely changed the course of my life.
What are some of the skills that have enabled you to be successful?
I think my ability to focus. You have to be able to focus on the long-term, keep your eye on the prize, and never waiver. It takes a long time to gather skills to be a surgeon, longer to become a great surgeon, and research takes a long time. In terms of professional career building, you have to focus on what you want and be patient over a long period of time. One of the characteristics of success is grit. By that, I mean being someone who can withstand adversity or hardship and still look at it in a positive way, tolerate it, and work through it. As a leader, one of my strong points is empathy. My department has people from all walks of life and ages, so it is important for me to understand them and their points of view to have everyone work together as a team.
Do you consider yourself an optimist or a pessimist, and why?
I’m definitely an optimist. Even when there were tough times, I always saw the positive. Our work is stressful and challenging, and the world is very critical of what we do, but we are doing a great thing. In spite of it all, people care deeply about their health care, and we are the drivers of that work. Physicians are a collaborative and intelligent group of people, and in spite of distracting issues, we can figure it out.
What are you most and least optimistic about in terms of orthopaedics?
In recent years, there has been a lot of interest in making orthopaedic surgery more diverse, and there are more opportunities than ever for women and minorities to join the field. It is happening in business and other industries as well, and we are benefiting from it in orthopaedics. Also, there are so many basic science advances that I believe we will have improvements in how we manage arthritis and degenerative conditions in our aging population. However, I am very concerned about the economy and how health care is being affected by recent pandemic events. We have several rough years ahead. But orthopaedic surgeons are talented, resilient, and creative, and that will allow us to take an important role as we recover from the pandemic.
Describe the similarities and differences between female orthopaedic leaders and leaders in other fields of medicine.
Orthopaedic leaders are decision-makers. You have to be. We handle emergencies, trauma, and problems that require surgery. There is not a lot of room for vacillating. Orthopaedic surgery by nature singles out people with confidence and decision-making ability. Especially in academic orthopaedics, we work hard balancing all of our other responsibilities. In many other fields of medicine, physicians have service time, and a large portion of their effort is allocated to research. A surgeon is “on service” 12 months of the year. We are people who have a tremendous capacity for managing the things we do. We balance families and practices. We have big tanks. I think women are particularly good at balancing multiple demands and prioritizing urgent issues. That and the ability to be patient and empathize may give women an advantage in leadership positions.
Do you have any advice for young women just getting started in their careers?
Realize this is a great time for women, and hospitals and departments are looking for qualified women. But don’t focus on gender. Just do the best job you can at whatever you are doing. People tell me, “You broke the glass ceiling,” and I say, “No; I ignored it.” At the end of the day, you have to look yourself in the mirror and know you are being the best you can possibly be. I think one thing that is really important is to consider carefully who your support system will be. Our jobs are very challenging, and you need someone in your life who will be supportive, shares your vision for life, and believes in you. I could not have done this without a supportive husband and family.
I would encourage young orthopaedic surgeons to follow their dreams. The only one who limits you is yourself. It takes a lot of hard work, and just because the person next to you is choosing a certain path, that doesn’t mean it is right for you. You need to decide what makes you happy, whether it’s practicing twice a week and spending the rest of your time with your family or a more traditional surgeon schedule. Figure out what motivates you and find the best way for you to contribute to orthopaedic surgery and to your community.
Betsy Nolan, MD, FAAOS, is president and chief executive officer of the Oklahoma Shoulder Center. She is the immediate past president of the Orthopaedic Society of Oklahoma, is an active member of ASES, and serves on the AAOS Board of Councilors. She is a clinical assistant professor of orthopaedic surgery at the University of Oklahoma and holds editorial board positions for multiple journals and leadership roles within the orthopaedic community.