1 00:00:00,080 --> 00:00:02,399 This is Carly Beam with the Becker Spine 2 00:00:02,399 --> 00:00:03,699 and Orthopedics podcast, 3 00:00:04,080 --> 00:00:05,839 and I'm thrilled to be joined today by 4 00:00:05,839 --> 00:00:09,039 doctor Matthew Dietz, chair of orthopedics at West 5 00:00:09,039 --> 00:00:11,219 Virginia University School of Medicine. 6 00:00:11,519 --> 00:00:13,359 Doctor Dietz, thank you so much for joining 7 00:00:13,359 --> 00:00:14,099 us today. 8 00:00:14,634 --> 00:00:16,795 Carly, thanks for having me. So before we 9 00:00:16,795 --> 00:00:18,635 dive into our conversation, I'd love if you 10 00:00:18,635 --> 00:00:20,554 could, you know, share a bit about your 11 00:00:20,554 --> 00:00:22,074 background, how you got to where you are 12 00:00:22,074 --> 00:00:22,574 now. 13 00:00:23,195 --> 00:00:25,675 Sure. I'm Matt Dietz. I'm an orthopedic surgeon 14 00:00:25,675 --> 00:00:27,935 and, privileged to be the chair of orthopedics 15 00:00:28,074 --> 00:00:28,975 here at WVU. 16 00:00:29,839 --> 00:00:31,920 My clinical work focuses on hip and knee 17 00:00:31,920 --> 00:00:33,940 replacement in the complex revision 18 00:00:34,399 --> 00:00:35,140 revision surgeries. 19 00:00:35,600 --> 00:00:38,159 You know, I I'm a clinician scientist in 20 00:00:38,159 --> 00:00:38,820 my background. 21 00:00:39,440 --> 00:00:42,340 My research interest focus around prosthetic joint infection, 22 00:00:42,640 --> 00:00:43,140 biofilm, 23 00:00:43,625 --> 00:00:46,664 and how cellular pathways really influence our recovery 24 00:00:46,664 --> 00:00:47,484 after surgery. 25 00:00:48,585 --> 00:00:51,144 Nationally and internationally, I'm working on trying to 26 00:00:51,144 --> 00:00:51,644 improve 27 00:00:52,104 --> 00:00:55,304 translational science around prosthetic joint infection and how 28 00:00:55,304 --> 00:00:57,884 we're taking care of these really challenging patients. 29 00:00:59,000 --> 00:01:00,299 I also work, 30 00:01:00,840 --> 00:01:03,000 with academic medicine to try and, 31 00:01:03,719 --> 00:01:04,219 responsibly, 32 00:01:04,920 --> 00:01:05,420 generate, 33 00:01:05,879 --> 00:01:08,280 industry partnerships that really enhance our ability to 34 00:01:08,280 --> 00:01:09,900 bring technology to our patients. 35 00:01:10,585 --> 00:01:12,745 Excellent. I can't wait to dive in more 36 00:01:12,745 --> 00:01:14,585 into what you're doing in your research work, 37 00:01:14,585 --> 00:01:16,844 but I want to start on you started, 38 00:01:17,865 --> 00:01:21,145 as chair of Orthopedics during a time of 39 00:01:21,145 --> 00:01:23,484 real rapid growth at WVU. 40 00:01:24,079 --> 00:01:25,120 And I'd love to hear just kind of 41 00:01:25,120 --> 00:01:29,040 your first priorities in aligning clinical expansion, but 42 00:01:29,040 --> 00:01:32,079 then also, you know, this research mission that 43 00:01:32,079 --> 00:01:33,299 you've been talking about. 44 00:01:34,079 --> 00:01:36,719 Yeah. I think whenever we're talking about growth, 45 00:01:36,719 --> 00:01:37,515 I think really 46 00:01:38,075 --> 00:01:39,055 meaningful growth 47 00:01:39,435 --> 00:01:42,075 only happens if it helps strengthen your underlying 48 00:01:42,075 --> 00:01:44,155 mission. And even though I've been a part 49 00:01:44,155 --> 00:01:46,334 of the department for greater than twenty years 50 00:01:46,474 --> 00:01:48,795 and seen it grown under steady leadership from 51 00:01:48,795 --> 00:01:51,114 six faculty to the 48 faculty that we 52 00:01:51,114 --> 00:01:51,775 have today, 53 00:01:52,900 --> 00:01:54,739 And I thought it was really important to 54 00:01:54,739 --> 00:01:56,200 to sit down and listen, 55 00:01:56,659 --> 00:01:58,739 to our team members. And so, you know, 56 00:01:58,739 --> 00:02:00,439 in those first few weeks, 57 00:02:00,899 --> 00:02:02,979 as I took over as chair, I held 58 00:02:02,979 --> 00:02:04,180 over a 125 59 00:02:04,180 --> 00:02:06,765 interviews with everyone from our frontline staff at 60 00:02:06,765 --> 00:02:09,104 the front desk to our most senior faculty, 61 00:02:09,564 --> 00:02:11,805 trying to really identify what we should keep 62 00:02:11,805 --> 00:02:14,044 doing and protect, you know, what we could 63 00:02:14,044 --> 00:02:16,444 grow or scale at the system level. And 64 00:02:16,444 --> 00:02:18,125 then maybe what we could stop doing, what 65 00:02:18,125 --> 00:02:19,745 was getting in the way. And I think 66 00:02:19,884 --> 00:02:22,629 when we focused on that, you know, one 67 00:02:22,629 --> 00:02:24,229 of the things I I I realized and 68 00:02:24,229 --> 00:02:25,769 I think I've known all along 69 00:02:26,069 --> 00:02:28,469 is that really our best asset isn't our, 70 00:02:28,469 --> 00:02:31,110 you know, newest technologies or the newest AI. 71 00:02:31,110 --> 00:02:33,189 It's it's the people who show up every 72 00:02:33,189 --> 00:02:35,669 day to provide this great care, for our 73 00:02:35,669 --> 00:02:37,289 patients in the state of West Virginia. 74 00:02:37,895 --> 00:02:39,655 Yeah. Absolutely. And, I mean, in a lot 75 00:02:39,655 --> 00:02:41,574 of my other conversations I've had with spine 76 00:02:41,574 --> 00:02:43,655 and orthopedic surgeons, especially when it does come 77 00:02:43,655 --> 00:02:46,694 to technology and AI, so is that human 78 00:02:46,694 --> 00:02:50,055 aspect that really comes forefront that really matters 79 00:02:50,055 --> 00:02:52,134 the most in terms of how effective some 80 00:02:52,215 --> 00:02:52,794 a tool 81 00:02:53,439 --> 00:02:54,259 really is. 82 00:02:54,719 --> 00:02:56,579 And I was wondering, you know, were there 83 00:02:56,799 --> 00:02:57,699 were there any, 84 00:02:58,719 --> 00:03:02,019 interesting takeaways, any interesting shifts that you've 85 00:03:02,400 --> 00:03:02,900 made, 86 00:03:03,519 --> 00:03:05,359 from these conversations, these, 87 00:03:05,759 --> 00:03:07,139 more than 100 some 88 00:03:07,485 --> 00:03:09,884 conversations you had when you started? Well, it's 89 00:03:09,884 --> 00:03:13,245 amazing the recurring themes that you see where 90 00:03:13,245 --> 00:03:15,965 people aren't always overburned by the amount of 91 00:03:15,965 --> 00:03:18,044 work. They just wanna take away those roadblocks 92 00:03:18,044 --> 00:03:20,250 so they can continue to provide great care. 93 00:03:20,250 --> 00:03:22,349 And so however we can enable that, 94 00:03:22,650 --> 00:03:24,590 and a lot of times, that's just identifying 95 00:03:24,650 --> 00:03:26,889 a system that makes things routine for people 96 00:03:26,889 --> 00:03:28,750 so they can continue to do the work 97 00:03:28,889 --> 00:03:30,669 to prevent things like burnout. 98 00:03:31,210 --> 00:03:32,590 And I think those were 99 00:03:32,985 --> 00:03:35,405 how we can address that and streamline processes 100 00:03:35,465 --> 00:03:37,625 for people, make it easier for them to 101 00:03:37,625 --> 00:03:38,525 do their job. 102 00:03:39,224 --> 00:03:41,305 Yeah. And, you know, when you're thinking about 103 00:03:41,305 --> 00:03:43,625 the or the orthopedic department, can you talk 104 00:03:43,625 --> 00:03:46,584 about these ideas and how you're striking that 105 00:03:46,584 --> 00:03:47,569 balance between 106 00:03:47,949 --> 00:03:51,090 protecting your own time for research and education, 107 00:03:51,310 --> 00:03:52,129 but then also 108 00:03:52,509 --> 00:03:54,990 meeting all the different demands of your day 109 00:03:54,990 --> 00:03:57,569 to day practice and clinical work all around? 110 00:03:58,270 --> 00:04:00,465 Yeah. I mean, it it's tough. And I'll 111 00:04:00,465 --> 00:04:02,305 tell you that I'm always trying to find 112 00:04:02,305 --> 00:04:03,205 a better answer. 113 00:04:03,824 --> 00:04:06,064 I think whenever I talk to our students 114 00:04:06,064 --> 00:04:08,064 and our residents, I think this idea of 115 00:04:08,064 --> 00:04:09,125 work life balance, 116 00:04:09,745 --> 00:04:11,205 can become a real challenge. 117 00:04:11,985 --> 00:04:13,664 And then when you're trying to protect time 118 00:04:13,664 --> 00:04:16,000 for research and education, I think that if 119 00:04:16,000 --> 00:04:17,600 you if you have the idea of balance, 120 00:04:17,600 --> 00:04:19,600 you're always failing someone. And so I think 121 00:04:19,600 --> 00:04:20,100 it's, 122 00:04:20,480 --> 00:04:23,220 more practical to think of sort of, intentional 123 00:04:23,279 --> 00:04:25,360 priority management in terms of what are you 124 00:04:25,360 --> 00:04:27,520 focusing on right now. And I think that's 125 00:04:27,520 --> 00:04:29,855 really important so that just like I protect 126 00:04:29,855 --> 00:04:31,855 my OR time, I also have to protect 127 00:04:31,855 --> 00:04:34,254 that research time, that the meetings start on 128 00:04:34,254 --> 00:04:35,955 time and that and that they're focused, 129 00:04:36,334 --> 00:04:38,435 and that they provide meaningful results. 130 00:04:39,055 --> 00:04:40,814 I think the other piece is that making 131 00:04:40,814 --> 00:04:43,199 sure that you have depth in leadership. I 132 00:04:43,199 --> 00:04:45,279 think that if if I'm the bottleneck, if 133 00:04:45,279 --> 00:04:47,699 I'm the only one able to make decisions, 134 00:04:48,160 --> 00:04:50,400 then I think that, I become a real 135 00:04:50,400 --> 00:04:52,580 limiting factor for the growth of the department. 136 00:04:52,800 --> 00:04:54,524 And so I think that's how you protect. 137 00:04:54,604 --> 00:04:56,125 You know, we have great leaders on the 138 00:04:56,125 --> 00:04:58,524 educational side in terms of, you know, managing 139 00:04:58,524 --> 00:05:00,524 the day to day with our residency program. 140 00:05:00,524 --> 00:05:02,925 And I think that's critically important as we're 141 00:05:02,925 --> 00:05:04,625 looking to try and grow as a program. 142 00:05:05,404 --> 00:05:07,024 Yeah. And then you're kind of focusing 143 00:05:07,459 --> 00:05:09,379 specifically on your research. What have been some 144 00:05:09,379 --> 00:05:11,560 most interesting findings that you've 145 00:05:11,939 --> 00:05:13,000 been looking into? 146 00:05:13,459 --> 00:05:15,300 Well, I think one of the things is 147 00:05:15,300 --> 00:05:18,339 looking at how pervasive infection is across. So 148 00:05:18,339 --> 00:05:19,959 while we're looking at the impact 149 00:05:20,259 --> 00:05:22,580 that infection has from a mortality rate, it 150 00:05:22,580 --> 00:05:25,024 has mortality rates very similar to some of 151 00:05:25,024 --> 00:05:26,084 our common cancers, 152 00:05:26,464 --> 00:05:29,024 but our treatment options are so limited. And 153 00:05:29,024 --> 00:05:31,504 so from an orthopedic standpoint, we really have 154 00:05:31,504 --> 00:05:32,164 an opportunity 155 00:05:32,544 --> 00:05:34,464 to advance the care that we're trying to 156 00:05:34,464 --> 00:05:37,319 provide to our patients, whether through through our 157 00:05:37,480 --> 00:05:37,980 multidisciplinary 158 00:05:38,360 --> 00:05:41,399 clinics with our infectious disease colleagues or exploring 159 00:05:41,399 --> 00:05:43,660 new technologies in terms of how to disrupt 160 00:05:43,960 --> 00:05:46,199 biofilm or this slime layer that coats some 161 00:05:46,199 --> 00:05:47,020 of these implants, 162 00:05:47,480 --> 00:05:50,839 providing in or, cures to infections that have 163 00:05:50,839 --> 00:05:52,839 been so challenging to treat for for so 164 00:05:52,839 --> 00:05:55,055 long. Whether you're a spine surgeon or a 165 00:05:55,055 --> 00:05:56,115 total joint surgeon, 166 00:05:56,495 --> 00:05:58,735 infection continues to be a a problem that 167 00:05:58,735 --> 00:06:00,035 we remains unsolved. 168 00:06:00,895 --> 00:06:02,175 Yeah. What do you think will be some 169 00:06:02,175 --> 00:06:02,675 other 170 00:06:03,055 --> 00:06:03,955 big disruptors 171 00:06:04,335 --> 00:06:05,475 in orthopedics 172 00:06:05,855 --> 00:06:08,379 and total joint care that you expect, in 173 00:06:08,379 --> 00:06:09,439 2026? 174 00:06:10,220 --> 00:06:12,860 I think access and and rapid recovery. I 175 00:06:12,860 --> 00:06:14,000 think looking at 176 00:06:14,300 --> 00:06:17,180 not only speeding up the surgery, but decreasing 177 00:06:17,180 --> 00:06:17,920 the challenges 178 00:06:18,300 --> 00:06:20,954 after the surgery. And we've done that in 179 00:06:20,954 --> 00:06:23,214 identifying and we take care of a really 180 00:06:23,354 --> 00:06:26,254 unhealthy patient population in in rural West Virginia. 181 00:06:26,875 --> 00:06:28,555 One of the things that we identified is 182 00:06:28,555 --> 00:06:30,954 we have to get these patients ready for 183 00:06:30,954 --> 00:06:33,540 surgery to decrease the readmissions, to decrease their 184 00:06:33,540 --> 00:06:35,699 length of stay. And so we developed an 185 00:06:35,699 --> 00:06:39,300 orthopedic medical optimization program where the patients get 186 00:06:39,300 --> 00:06:42,100 involved with the care prior to even setting 187 00:06:42,100 --> 00:06:44,420 foot in the OR, and that's really improved 188 00:06:44,420 --> 00:06:45,160 our results, 189 00:06:45,540 --> 00:06:46,040 thereafter. 190 00:06:46,944 --> 00:06:49,105 And can you speak more to, you know, 191 00:06:49,105 --> 00:06:51,745 your refs referencing, you know, working with this 192 00:06:51,745 --> 00:06:54,064 complex patient population? I know you I know 193 00:06:54,064 --> 00:06:56,644 I'm out there. You're serving a largely rural, 194 00:06:57,665 --> 00:06:58,165 landscape. 195 00:06:58,705 --> 00:07:01,129 And I guess, can you talk more about 196 00:07:01,589 --> 00:07:04,229 how that reality is shaping, how you think 197 00:07:04,229 --> 00:07:07,829 about scaling services like spine, joint replacement, and 198 00:07:07,829 --> 00:07:08,329 trauma? 199 00:07:08,870 --> 00:07:10,789 Yeah. I I think, you know, in terms 200 00:07:10,789 --> 00:07:13,704 of scaling it, I think rural care really 201 00:07:13,704 --> 00:07:15,004 develops through reliability, 202 00:07:15,384 --> 00:07:18,105 through delivery of care, not through just promises. 203 00:07:18,105 --> 00:07:20,665 And I think that's an important aspect of 204 00:07:20,665 --> 00:07:21,805 what we can deliver, 205 00:07:22,425 --> 00:07:25,004 from an orthopedic standpoint, from a system standpoint. 206 00:07:25,785 --> 00:07:27,884 It's how do we reduce that friction, 207 00:07:28,360 --> 00:07:30,680 whether it's through our medical optimization program or 208 00:07:30,680 --> 00:07:32,139 whether it's trying to prevent, 209 00:07:32,839 --> 00:07:35,500 osteoporotic fractures through our metabolic bone, 210 00:07:35,879 --> 00:07:37,099 optimization pathways. 211 00:07:37,720 --> 00:07:39,579 And I think it's taking those best 212 00:07:40,455 --> 00:07:42,134 You know, when we're working in this sort 213 00:07:42,134 --> 00:07:44,134 of hub and spoke model, you know, the 214 00:07:44,134 --> 00:07:46,535 complex cases are coming to the tertiary center, 215 00:07:46,535 --> 00:07:49,115 but we as that academic hub can also 216 00:07:49,495 --> 00:07:51,415 send some of our best practices, some of 217 00:07:51,415 --> 00:07:52,154 those pathways 218 00:07:52,455 --> 00:07:54,455 out to our system hospitals to improve the 219 00:07:54,455 --> 00:07:55,595 care that they're receiving. 220 00:07:56,270 --> 00:07:58,350 Mhmm. And how are you thinking about I 221 00:07:58,350 --> 00:07:59,090 know CMSA, 222 00:07:59,870 --> 00:08:00,430 they have, 223 00:08:00,830 --> 00:08:01,790 going on their, 224 00:08:02,430 --> 00:08:04,129 rural health, transformation 225 00:08:04,910 --> 00:08:06,770 model. Can you speak to that? 226 00:08:07,629 --> 00:08:10,064 I think that's one that's a tough, 227 00:08:10,464 --> 00:08:11,685 aspect to navigate, 228 00:08:12,225 --> 00:08:14,704 from a funding perspective. I think that's where 229 00:08:14,704 --> 00:08:17,044 we had to have good value based care 230 00:08:17,104 --> 00:08:19,024 in terms of what we're putting out there, 231 00:08:19,264 --> 00:08:20,625 for our patients and being, 232 00:08:21,425 --> 00:08:23,044 responsible along that pathway. 233 00:08:23,860 --> 00:08:26,019 Got it. And then doctor Deeds, one last 234 00:08:26,019 --> 00:08:28,419 question for you is, you know, besides everything 235 00:08:28,419 --> 00:08:30,660 that we have spoken about, what are three 236 00:08:30,660 --> 00:08:31,160 other 237 00:08:31,779 --> 00:08:35,080 big health care trends that you've been following? 238 00:08:36,115 --> 00:08:36,855 I think, 239 00:08:37,394 --> 00:08:40,514 our workforce is extremely important. I think it's 240 00:08:40,514 --> 00:08:42,674 maintaining that great team doing the things that 241 00:08:42,674 --> 00:08:45,235 they wanna do. I think looking at AI 242 00:08:45,235 --> 00:08:46,294 enabling technology 243 00:08:46,754 --> 00:08:48,615 is one of the methods that we can, 244 00:08:49,309 --> 00:08:51,870 see the the burdens decreased on our workforce, 245 00:08:51,870 --> 00:08:54,669 but doing it in a responsible fashion. And 246 00:08:54,669 --> 00:08:57,549 then I think working on these collaboration, these 247 00:08:57,549 --> 00:09:00,990 relationships between academic medicine and industry where we 248 00:09:00,990 --> 00:09:03,490 can form partnerships that really develop 249 00:09:03,804 --> 00:09:06,365 the and, lead to translatable care that we 250 00:09:06,365 --> 00:09:07,665 can provide to our patients. 251 00:09:08,764 --> 00:09:10,925 Great. Well, doctor Dietz, thank you so much 252 00:09:10,925 --> 00:09:13,245 again for taking the time to chat. It's 253 00:09:13,245 --> 00:09:15,325 been a great conversation, and I hope to 254 00:09:15,325 --> 00:09:17,485 connect again. Thanks so much, Carly. I really 255 00:09:17,485 --> 00:09:18,239 appreciate it.