On August 28, 2007 Orthopedics This Week featured a profile on Dr. Robert Pedowitz, Chair of the Department of Orthopaedics and Sports Medicine at USF Health. Orthopedics This Week is published by RRY Publications. This Week is produced 40 times a year, focusing on breaking news in the Global Orthopedics Industry and upcoming technology conferences. This Week also publishes the latest books containing Market Forecasts and Analysis for the Spine Technology and Stem Cell Industries. Below is their profile on Dr. Robert Pedowitz. Click here to view article as it appeared on-line.

Headline: The Picture of Success – Dr. Robert Pedowitz
By: Elizabeth Hofheinz, MEd, MPH
August 28, 2007 / Orthopedics This Week

What patient wouldn’t want to have a physician who once studied altruism? Dr. Robert Pedowitz, now chief of sports medicine and residency director at the University of South Florida, has always had an affinity for delivering aid to those in need. Says Dr. Pedowitz, “There is a family story about how when I was little, I talked about being a doctor for little sores. When asked ‘Why,’ I replied, ‘Because I don’t know how to take care of big sores.”

Born in Long Island, New York, Robert Pedowitz accompanied his family out West at the age of nine. “My father was an engineer who brought us to southern California for a position in aerospace engineering. Through the years, my parents instilled in me an attitude that I could have whatever kind of career I desired. While in college I considered entering the business world. I chose medicine instead because I was fascinated with the sciences and could foresee being intellectually challenged and stimulated my entire life. That was a time when medicine was less complicated. For example, AIDS had not yet appeared, and managed care was nowhere to be seen. These developments are some of the things that tend to make doctors somewhat pessimistic about medicine.”

But Robert Pedowitz knew what he loved and pursued it. “In 1981 I graduated with a B.S. in psychobiology from the University of California, Los Angeles [UCLA]. I didn’t want to just do a basic biology premed curriculum and I was enamored of evolutionary psychology and the origins of altruism. I found it fascinating that there was a biological explanation for cooperation within a society, even when we considered a hive of bees. Psychobiology was the beginning of physiological psychology, a field that has blossomed in the last 25 years.”

Also while at UCLA, Dr. Pedowitz would have a chance to try his hand at something more concrete. “When I entered the School of Medicine at the University of California, San Diego [UCSD], I already had a strong inclination toward orthopedics. During college I had shadowed an orthopedic surgeon and found a real love for the process of treating patients. I am a big guy, 6’ 4’’, enjoy sports, and like taking care of active patients. I could see that orthopedics would allow me to make a profound difference in peoples’ daily lives. What really surprised me during medical school was that when we were required to do a research-based independent study project, I discovered that I really liked it. Academic medicine was definitely in my future.”

Over the next few years, Robert Pedowitz would consider moving a sleeping bag into the lab. “My next career step sent me to the orthopedic residency program at UCSD, an intense, six-year experience. There is typically one year of internship, one year of research, and four years of clinical orthopedic training. One of the most important things in my career development was that during my research year, I was assigned to work with Dr. Bjorn Rydevik, a talented spine surgeon who was on sabbatical from the department of orthopedics at the University of Gothenburg, Sweden. We worked on two projects, one concerning spinal nerve root compression, where we looked at the effect of pressure and time on nerve root function, and another on tourniquet compression. At the end of this year, it was obvious we had developed a couple of great research models that were poised for incredible productivity, with real relevance to clinical practice. Fully engaged in the work, I decided to stay in the lab for a second year, and thus converted to a seven-year residency program. Midway through my second year of research, Dr. Rydevik asked me to come to Sweden, do another year of lab research, and develop this into a Ph.D. program. I went to see the chair, Dr. Wayne Akeson, and told him of Bjorn’s proposal. Dr. Akeson viewed it as a great opportunity and enthusiastically supported the entire process. His mentorship has been absolutely critical for my professional development.”

And so it was off to the land of the midnight sun. “For part of the time, my wife and I took our first child and headed for the small university town of Umea, near the Arctic Circle, so I could work with Jan Friden and his colleagues. As I had hoped, the learning experience was greatly enriching. In Gothenburg, Dr. Rydevik taught me the importance of deep knowledge and critical thinking in order to achieve substantial answers. He also stressed the importance of collaboration in research, noting that pulling in expertise from others is a substantial source of knowledge and creativity for any project.”

Continues Dr. Pedowitz, “While not in the lab, my family and I explored the surrounding areas. We were in Europe when the Berlin wall fell, we walked the streets of Moscow and Leningrad, and in general had an exceptionally rewarding experience. None of this would have been possible without the support of Dr. Wayne Akeson, my mentor and friend to this day. I recently published a textbook on sports medicine and I specifically noted his influence upon my professional development. Among other things, he taught me how to create the right academic environment. Better than anyone, he could look at a problem and understand the most important questions to ask and (hopefully) answer. In the ultimate display of dedication, when I defended my thesis in Sweden, Wayne flew over to show his support.”

Says Dr. Pedowitz, “After my year in Sweden, I returned to UCSD and completed my last two years of residency, all the while putting the finishing touches on my Ph.D. thesis. Upon graduation, I stayed at UCSD for one year as an attending physician, then went to Duke University for a sports medicine fellowship. Particularly instructive and fun was taking care of the school’s teams—especially during the National Collegiate Athletic Association tournament. Having gleaned much, I returned to UCSD and started up an orthopedic sports medicine program. In addition to directing this program for 10 years, I also ran the residency program. I organized the recruitment of residents and managed the structure of education. This was a time of transition in the field, including increased regulatory issues in residency education. My goal, which I believe was fulfilled, was to instill in residents a respect for orthopedic history. In this field we tend to have a cowboy mentality, i.e., ‘We can do better than anyone.’ When you have such an attitude you run the risk of repeating the same mistakes—and patients suffer in the process. We should strive to appreciate what’s already been done and tried. At the same time, we should not assume that what’s been done historically is automatically correct.”

The positions Dr. Pedowitz held at UCSD served as a building block for the ultimate leadership challenge. “Approximately one year ago I was recruited by the University of South Florida [USF] to chair the newly-formed Department of Orthopaedics and Sports Medicine,” says Dr. Pedowitz. “It was an extraordinary opportunity that I couldn’t pass up. USF’s residency training program had closed 15 years ago and was never reinvigorated. To add to that problem, the orthopedic surgery department was fairly disorganized. I was brought on to rebuild the department as well as the orthopedic surgery training program. After a significant amount of work and changes in programmatic structure, we got accreditation one month ago. This has been an exercise in taking some seriously dysfunctional elements and repairing them. Most times when someone accepts a chair position, the best you can hope for is to nudge the ship in a different direction. Here I have had the opportunity to build a new ship.”

Aside from the shipbuilding opportunity, Dr. Pedowitz was drawn by the rare prospect of having state funding for his field of interest. “Two years ago USF received a grant from the state of Florida that provided for the initiation of the Sports Medicine and Athletic Related Trauma [SMART] Institute. Developed as a marquis program in sports medicine, the program is slated to receive several million dollars per year. These funds will be directed at regional outreach and education efforts whereby coaches, parents, and athletes receive a high level of training in sports medicine. Some of these monies will go towards positioning athletic trainers in schools to give student athletes a higher level of care. Another portion of the funds will be put toward the development of an academic orthopedic surgery program. The athletic training and education program, which has been at USF for many years, was last week moved into the department of orthopedics. The first such effort in the country, it is an undergraduate training program housed in the orthopedics department. This is truly exciting because it connects what we’re doing in SMART with the training of the athletic trainers themselves. As a result, the program has now been renamed the Department of Orthopaedics and Sports Medicine.”

When given a chance to use the part of his brain that doesn’t involve internal politics, Dr. Pedowitz jumps at the chance. “My research career has come in phases. Originally, I conducted research on nerve and muscle compression physiology. Following that I went through a period of imaging research, during which time I worked with Dr. Don Resnick, a world-renowned radiologist, on a variety of projects. Our most recent effort is a book that will be published in 2008, which is designed to gather orthopedists and radiologists who are experts in magnetic resonance imaging in sports medicine. This unusual collaboration results in chapters where a radiologist writes about what orthopedic surgeons need to know about imaging, with corresponding chapters by orthopedic surgeons regarding what a radiologist needs to know about the clinical care of the patient.”

Continues Dr. Pedowitz, “Also stimulating was my time researching topics related to sports medicine and the shoulder. When I first started out, rotator cuff repair was all done open, but is now frequently done arthroscopically. It was obvious that we had challenges, particularly with the fixation devices for the rotator cuff. I set out to develop an area of research on rotator cuff fixation biomechanics. I worked with Andrew Mahar, M.S., head of the UCSD orthopedic biomechanics lab, and published about 10 papers on this topic. Some of this research has been focused on the strength of sutures. When surgeons work arthroscopically with anchors, we tend to break the suture. So, manufacturers developed stronger sutures so that surgeons wouldn’t break them. Our lab studied the effects of these strong sutures on mechanics, i.e., how the sutures hold the knots. Most surgeons assumed that they would automatically hold better, but some of these sutures are slippery and you could tie something you’d never break by hand. But if the suture is slippery (imagine a Teflon suture), we know it will loosen. In the end, you see, the surgeon still has to tie a good knot. My related work has focused on anchors and bone. Anchors are typically screwed into the soft bone of the humeral head—bone that is especially soft in the elderly. If the surgeon puts an anchor in deep, a natural instinct, the consequences of this are that the anchor can shift in the bone and the suture can cut through the bone. The implication of this work was that we should put the anchor into the hardest bone, which is near the surface, and use strong sutures.”

Dr. Pedowitz has got his patients and his family life all sewn up. “My wife is an attorney who has practiced for 22 years. She is now taking a short break to determine what she wants to do with her career. Our oldest child, Rachel, will be a student at Cal Berkeley next year. As a dad focused on leadership, I am proud to say that not only was she president of her high school student body, but she was elected president of the Council of Presidents for the entire San Diego Unified School District. My son Jason is in high school and spends his free time playing water polo and golf. His dad is a lousy golfer, but I try to keep up. Our family enjoys traveling and we have a wonderful Caribbean cruise planned for the entire extended family: grandparents, parents, and kids. It should be a ton of fun.”

“Passion is an overused word,” says Dr. Pedowitz, “but there’s probably a reason for that. My message is to do what invigorates you and you can’t go wrong.”

Dr. Robert Pedowitz … eschewing the cowboy mentality and putting forth professionalism.

Reproduced from: Orthopedics This Week