Dorothy: [00:00:00] This month we’re talking to physicians, and today we’re talking to Dr. Shuhatovich, who is a hand doctor, and I met him when my hand was broken after a car accident. I soon discovered that he has a very different approach to treating patients. For one thing, he tells us that he can read a patient’s energy and can see whether or not they are presenting in the same way they’re speaking.
I never thought about this before, but I know that’s exactly what he does. In his own words, he can be brutally honest, but I found him as someone who was really listening to me and really made me feel like everything was absolutely gonna be all right. So from a different perspective, from a different specialty, it all comes down to how a doctor interacts with his or her patients, and believe me. When your doctor says everything’s gonna be all right, it’s so good to hear.
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So Dr. Y, thank you so much for being with us today and, uh, I know your schedule is incredibly busy, but I’m so glad you took this time to be with us today.
Dr. Shuhatovich: Uh, thank you so much for inviting me. This is actually a first podcast I’m ever on.
Dorothy: Oh, well then I hope you have a good experience.
Dr. Shuhatovich: I’m sure I will.
Dorothy: Uh, so for our listeners, doctor was my doctor [00:02:00] when I was in a car accident and had hurt my hand. And I’ll be quite honest, I had never been in accident and I’d never been hurt and I did not respond very well to the whole situation. People were saying to me. What, that’s not like you, you usually just take charge and I didn’t feel very much in charge and so I remember so well meeting you and, and you reassuring me. That I look back now and I think now, was he just saying that to me or is that the way you always are with patients or, you know what, what do you think your style is like?
Dr. Shuhatovich: I think my perception of you initially was the exact opposite.
Dorothy: Oh.
Dr. Shuhatovich: I think you were stoic when you presented, given your situation. Because external variables can affect a patient, and [00:03:00] I know that extremely well from doing it for so long. I generally can see by the way, a patient behaves what they feel versus what they present as. And that delta is something very important for me to recognize as a physician so I know exactly how to guide you so you both feel well and perform well during and after surgery.
Dorothy: So when did you learn that?
Dr. Shuhatovich: I tend to think that a lot of that is genetic. Introspect is genetic, but it can also be taught. Um, some of us have that ability to understand people better than others, and that is not spoken language. That is something you just feel about a person. And then over the years of experience of dealing with every type of permutation of trauma and loss and death and all those things we go through. Uh, you learn to manage that situation for the benefit of your patient.
Dorothy: Hmm. [00:04:00] So now doctor, you’re, you’re, you’re, you came to the United States from Russia, right? And how old were you?
Dr. Shuhatovich: So I was just about to turn 13 years old.
Dorothy: Hmm. That’s a very critical time in a, in a child’s life.
Dr. Shuhatovich: Yeah.
Dorothy: Yeah. And why did you, did your family move here?
Dr. Shuhatovich: Uh, so we were refugees, uh, from the former Soviet Union that just, uh, came apart a few years back. We came straight to Houston. Yeah. So, happy to be here.
Dorothy: Oh, and, and I always picked that up from you. And when we would have our, our visits, of course, at the beginning I had to see you often.
Dr. Shuhatovich: Right.
Dorothy: And, uh, then it, then it was less and less. And, and of course I, I just have to share, you know, you would always say, oh, you’re doing great. You’re making such great progress. And, and later on I wondered, was I really, or you were just telling me that. But I think that was an important part of [00:05:00] me wanting to continue to do the exercises, which hurt like heck.
Dr. Shuhatovich: I tend to be brutally honest with people, probably to some of my own detriment. Sometimes I misread that element of a person. If they want to be coddled or they like information face on, I tend to deliver the information face on. So you were ahead of schedule at every single milestone.
Dorothy: Oh.
Dr. Shuhatovich: Having, having seen thousands of your type of fracture over the last many years I’ve been doing it, I know exactly at which milestone you should be.
Dorothy: You know, it’s just your, your little finger, your little part that connects your finger to your hand. And it seemed that you really had to fill it up with a lot of hardware plates.
Dr. Shuhatovich: Yeah.
Dorothy: Yeah. Because, and of course you never told me till the end that it was more than one fracture.
Dr. Shuhatovich: Sure, sure. [00:06:00]
Dorothy: I mean, you know, I think if I’d known it was that bad.
Dr. Shuhatovich: I think some things are a little bit too academic. So it’s important for me to know, for surgical planning. Versus it’s not that important for me to communicate certain details because I know that those will be managed as part, as part of the overall plan.
Dorothy: Right.
Dr. Shuhatovich: So there is a certain fine line of overwhelming a patient with information that you probably don’t wanna cross versus the fiduciary duty, if you will, to inform the patient. So I think the balance was critical for me to achieve with you, given your presentation, your mental state on presentation. So again, I knew that ahead of time based on how you presented versus what actually happened to you.
Dorothy: Right. And we’d had some time in there.
Dr. Shuhatovich: Yeah.
Dorothy: Because the Beryl hurricane happened.
Dr. Shuhatovich: Yeah. It were delayed.
Dorothy: It was delayed. Yeah. Do you think every physician has to weigh that in their mind, [00:07:00] about how much to tell the patient?
Dr. Shuhatovich: I think they have to, I don’t know that necessarily they do. But I think because at least in my specialty specifically, I generally tend to get a fairly healthy patient that all of a sudden something happened. So their life comes apart, unhinged.
Dorothy: Right.
Dr. Shuhatovich: And then I have to piece them back together. So that delta is very critical to a patient. And you mentioned the word little earlier. It’s only little until it’s yours.
Dorothy: Oh, well, true.
Dr. Shuhatovich: Yeah.
Dorothy: That is so true. Yes. I, uh, I was surprised how much having a hand injury impacted everything that you do. It is, is like you couldn’t forget that you had this injury going on. Everything you reached for. You know, it was just, it was a quite, quite an experience. But now I wanna go back to your background because [00:08:00] what is it that is so different between the, the Russian and the US mentality, do you think?
Dr. Shuhatovich: Gosh, well, my knowledge stops right around the age of 13, but I think we were talking about Dusti KY earlier. Uh, I think there’s, there’s a term both literary and life term called Russian Soul. And, uh, Russian Soul is that aspect of the Russian person that permeates throughout the whole community. It’s very self-sacrificial and fatalistic at both, you know, expense and as well as a tremendous benefit. Um, so it’s just a character trait, if you will.
Dorothy: Well then how did you learn the sympathy?
Dr. Shuhatovich: It’s part of that.
Dorothy: Okay.
Dr. Shuhatovich: Self-sacrifice.
Dorothy: Oh, all right. Tell us a little more about that.
Dr. Shuhatovich: So you sacrifice your own elements for the sake of [00:09:00] the benefit of the other person. Which is uncommon culturally pretty much everywhere. But that is, and I would expand that to actually a lot of Slavs, not just Russians. I think it’s a Slavic trait.
Dorothy: Interesting. Goodness. That seems so, uh, counter. Yes.
Dr. Shuhatovich: Foreign.
Dorothy: So foreign.
Dr. Shuhatovich: We are foreign. Yes, you’re right.
Dorothy: I didn’t wanna say that, but you’re right. Yes.
Dr. Shuhatovich: No, no. You’re not offending me at all.
Dorothy: Yeah. Yeah. So tell me what else you’ve learned. Uh, why, first of all, why’d you wanna be a doctor?
Dr. Shuhatovich: Some things you just know. Um, I could not logically explain it to you fully. I get asked that question all the time. And I always wanted to be a physician. Ever since I remember myself. And I always wanted to be a surgeon specifically.
Dorothy: Really.
Dr. Shuhatovich: And I’ve never once changed my mind.
Dorothy: Oh my goodness.
Dr. Shuhatovich: Since single digits.
Dorothy: Huh?
Dr. Shuhatovich: Yeah.
Dorothy: Nothing. No. [00:10:00]
Dr. Shuhatovich: Nope.
Dorothy: Uh, example, role model, nothing changed. That, that put you on this path.
Dr. Shuhatovich: No, Mo Uh, most, pretty much all of my family members are very academically achieved; accomplished. Um, you know, if you don’t have a master’s degree, you’re sitting at the end of the table.
Dorothy: Oh.
Dr. Shuhatovich: So, um, that part of it was, uh, certainly a driver. So academic achievement and, uh, so you pick out of sort of the most academic fields. And then, you know, my mom is a PhD. My father is a master’s in engineering. I’m a subspecialty surgeon. My uncle is a subspecialty surgeon. I have a bunch of scientists in the family, so it was just that, I think. And I just gravitated towards surgery. Always.
Dorothy: Always. Interesting. And where did you do your residency?
Dr. Shuhatovich: In New York City and Brooklyn.
Dorothy: Oh, a little different than Houston.
Dr. Shuhatovich: Yes. But [00:11:00] uh, my Russian background came in handy. Sometimes I joke that that’s the only reason they hired me over there.
Dorothy: Oh, really?
Dr. Shuhatovich: Yeah. ’cause I can switch to the Russian personality and speak Russian. Ah, and the patients are, are Russian immigrants? Yeah.
Dorothy: Yeah, of course.
Dr. Shuhatovich: Yeah. So I can relate to them. So when I interviewed in Brooklyn, the chairman like, wait, do you speak Russian and English like this?
Dorothy: Oh.
Dr. Shuhatovich: Yeah.
Dorothy: So, but you’ve also told me that, uh, your whole journey of becoming a surgeon may have been a little harder for you. You said you had to work harder.
Dr. Shuhatovich: Everyone has to work a little harder to be a surgeon because it’s a longer residency. Um, the hours tend to be quite a bit longer than other specialties. And that’s, you know, in any surgical subspecialty, it’s like that. Um. We go for five to seven years for just residency and then fellowship, and [00:12:00] that’s after medical school. Whereas other specialties, you go three to four years most of the time. So it is just a more grueling process.
Dorothy: Mm-hmm.
Dr. Shuhatovich: So, yeah, you work pretty hard on top of that, this is New York City.
Dorothy: That has a different…
Dr. Shuhatovich: That has a different vibe than Texas.
Dorothy: Oh yes. Different mindset.
Dr. Shuhatovich: So I will tell you, there are so many things I did that were you know, just sheer labor. Just to get patients the care they needed, and that was just part of the war that we fought every day.
Dorothy: Mm. Well that’s interesting. I’ve never heard anyone call it a war.
Dr. Shuhatovich: It is, it’s controlled combat.
Dorothy: Is it?
Dr. Shuhatovich: Yeah. You’re fighting for every single person
Dorothy: Really.
Dr. Shuhatovich: Yeah.
Dorothy: Anywhere that you’re doing that, you’re providing medical care?
Dr. Shuhatovich: Uh, me specifically in surgery, that is my experience. You’re pushing patients to CAT scan ’cause they need to go faster than the transport can get them. You’re getting blood work, bringing them to the lab, running to [00:13:00] get blood from the blood bank if they’re exsanguinating, things like that happening all throughout the night, all throughout the day. Every single patient.
Dorothy: Interesting.
Dr. Shuhatovich: Save as many as you can.
Dorothy: So during your residency you had a lot of different kind of experiences.
Dr. Shuhatovich: Absolutely. Yeah.
Dorothy: Yeah. And you even had a, a bit of a touch with breast cancer that you were taking care of women and doing some surgeries then?
Dr. Shuhatovich: Yeah, absolutely. So, uh, my experience in breast cancer was tremendous because my second year residency, um, my chairman, uh, changed and, uh, the new chairman, incoming chairman was a fantastic breast surgeon.
Dorothy: Oh.
Dr. Shuhatovich: So he became our chairman, Dr. Patrick Borgen. And, um, from then on every day we were doing massive breast cases and all the time, and all of us. And then they built this incredible breast cancer center [00:14:00] standalone. I think it was the only one in New York, if I’m not mistaken, at the time. It was a standalone, massive production with every single facility. And we would do the surgery tumor board for it, reconstruction. We would listen to the medical oncologists, radiation oncologists speak. So my residency was very breast heavy.
Dorothy: Ah, and, and what year was this?
Dr. Shuhatovich: This is, uh, somewhere between second and third year residency. So for the next three and a half years.
Dorothy: Take me back. What, what calendar year?
Dr. Shuhatovich: So I guess 2009.
Dorothy: And, you know, even then breasts were new. The whole concept of breast surgery.
Dr. Shuhatovich: Um, I don’t know what changes are now.
Dorothy: Mm-hmm.
Dr. Shuhatovich: But, uh, I felt like at the time we were on the cutting edge.
Dorothy: Oh yeah.
Dr. Shuhatovich: And, uh, my chairman, Dr. Bogen, he brought in a lot of [00:15:00] expertise. He was, uh, coming in from Memorial Sloan Kettering, ah, which always argues for number one spot with our MD Anderson. And, um, he certainly brought the most cutting edge technology surgically and.
Dorothy: But what a gift for you as a, a resident to be able to see that and be around that.
Dr. Shuhatovich: Absolutely.
Dorothy: I know you always wanted to be a surgeon, but why a hand surgeon?
Dr. Shuhatovich: Another question I cannot directly answer, but other than the emotional reasons of just being drawn towards it, um, I think it’s a very elegant specialty because it involves a lot of very intricate structures. I’ve always liked plastic surgery. And that aspect of it plus the reconstructive element. Um, it also combines multiple specialties in one. So I knew I would never get bored.
Dorothy: Oh.
Dr. Shuhatovich: So it combines orthopedic surgery. It combines plastic surgery it com, it combines microsurgery [00:16:00] and I get to do all of that on both adults and children.
Dorothy: Oh, interesting.
Dr. Shuhatovich: And nerve surgery of course. Which is part of microsurgery.
Dorothy: Right, right.
Dr. Shuhatovich: So variety of cases that I do is, I think it’s second to none.
Dorothy: It just amazes me that there is that much difference in, in what you’re doing. It’s it, it’s hard for us to comprehend. I mean, but when you lose control of your hand or you know, you just don’t have that function anymore, how, how important is that to people? Do they ever really recover when your hand is, is been hurt really bad?
Dr. Shuhatovich: Absolutely. Yeah. There are so many things we can do as surgeons to reconstruct loss function. It’s really, there’s a massive kitchen sink of technology and techniques and uh, just expertise and therapy and other modalities. I can get you back to function a lot. [00:17:00] Sometimes perfectly.
Dorothy: Sometimes perfectly. Yeah. Well, you kept telling me I was gonna be back.
Dr. Shuhatovich: Yeah, yeah. You’re back.
Dorothy: And I am.
Dr. Shuhatovich: Yeah.
Dorothy: And you never once mentioned my age. Which was a gift I told you that I kept expecting at your age, but you never said that.
Dr. Shuhatovich: Indirectly, and I’ll tell you how.
Dorothy: Okay.
Dr. Shuhatovich: So when I quote somebody, a time of each milestone, I calculate that into my answer. So I don’t necessarily tell you’re old or young. I generally just in my mind, measure the time and I know exactly at what age, what happens. Just from seeing so many patients over the years.
Dorothy: Right.
Dr. Shuhatovich: I consider quality of skin, quality of bone, quality of the fracture itself, in your case, the presentations. So I calculate that into the whole equation of you asking me and my answering, when am I gonna be, et cetera, [00:18:00] and then I give you the answer with the time and that gets calculated into that time.
Dorothy: Oh, interesting. Mm-hmm. And you had a very, and I’m sharing this just because I, I’ve not had this kind of experience with physicians and of course not having an accident ever, it was, it was a whole new thing, but you always made me feel like, wow, I get to see you today. Now, is that just part of your style?
Dr. Shuhatovich: Yes. That was a loaded, yes, you’re right. So yes, I want to make sure my patients feel empowered to do the next steps, because even if we try not to be, we still tend to be a little bit of a Negative Nancy. Because when you present to me, even if you’re ahead of schedule, I will tell you, yes, you’re ahead of schedule, but this is [00:19:00] what you also need to do. So that seems to a lot of people as a negative.
Dorothy: Mm.
Dr. Shuhatovich: Because they’re, they, that’s how they perceive me saying, okay, but you still need this much angle of motion.
Dorothy: Right.
Dr. Shuhatovich: So that sounds to a patient. Sometimes, like I’m saying something negative, it’s not. It’s just the next step. So I have to be as positive as I can on presentation so the patients feel overall empowered to do the next step.
Dorothy: Well, and whether you know it or not, we felt, I felt like you weren’t rushed. You weren’t, even though I know how many patients you’re seeing a day, I didn’t feel like you were rushed and I felt like the time you were with me, you were with me.
Dr. Shuhatovich: Yeah.
Dorothy: And really paying attention to my case. And that’s, that’s a true gift. Uh, you don’t always feel that way when you’re in the medical world and seeing physicians, something you’ve always had or, you had to learn that?
Dr. Shuhatovich: Um, it is something that we try to do as [00:20:00] much as we can, but given the current sort of medical climate that we have in this country, sometimes we fail at that. We try as best as we can, but there are a lot of external pressures on us that we sometimes cave in.
Dorothy: And that is to move more patients through as fast as you can?
Dr. Shuhatovich: Yes, in some ways, yeah. Yeah. There are a lot of people that are in these settings where there’s a certain number of patients quota, if you will, that must be met in order for them to achieve certain economic milestones for the management of the practice. So I don’t have that, so I’m never rushed for that reason.
But also if I have 36 patients scheduled in one day. And they’re surgical patients with dressing stitches, things like that. There’s the simple convenience of the patient. I don’t want [00:21:00] them sitting in the waiting room for two hours for me.
Dorothy: Right, right.
Dr. Shuhatovich: So that pressure is more important to me currently.
Dorothy: Hmm. And so one of the things that you, you mentioned had to do with, uh, and again, we’re talking in general, we’re talking the way the environment is, but it, you had a real, I don’t wanna say beef, but a real disagreement on how physicians should be addressed. Do you remember telling me that?
Dr. Shuhatovich: Yeah, of course.
Dorothy: Yeah. So tell us about that.
Dr. Shuhatovich: I don’t like the word provider.
Dorothy: Why?
Dr. Shuhatovich: Because I’m a physician. I’m not a provider. Um, I took a Hippocratic Oath. As a physician, my title is a physician. I earned it. Physician is a very honorary degree to me. Physicians have been called physicians since the times of [00:22:00] Pharaoh, so I feel like it denigrates us a little bit.
Dorothy: That’s so interesting. I mean, in this healthcare world, we use that term a lot. You know, healthcare provider.
Dr. Shuhatovich: Yeah.
Dorothy: But you pointed out that could be the person who transports you to ct.
Dr. Shuhatovich: We all provide care. That is correct. That’s an umbrella term.
Dorothy: Right.
Dr. Shuhatovich: That is true.
Dorothy: But still, it ruffles your feathers.
Dr. Shuhatovich: It does.
Dorothy: And how? How do you respond to that? When someone.
Dr. Shuhatovich: I correct them.
Dorothy: Oh, really?
Dr. Shuhatovich: Yeah.
Dorothy: Administrators and anyone else who might say that?
Dr. Shuhatovich: Anyone.
Dorothy: Oh, and how do you do that?
Dr. Shuhatovich: I let them know that I’m a physician.
Dorothy: Do they get it?
Dr. Shuhatovich: Or a doctor? Sometimes they get it, sometimes they don’t.
Dorothy: Hmm. [00:23:00] And we can be a little dense sometimes.
Dr. Shuhatovich: Yeah. So can doctors.
Dorothy: Yeah. Yeah. I, I just, I found, found that so fascinating. I thought, I’ve never even thought about that. Of course, now I’m in the old school physician is a physician, but certainly never, ever put it in that context of how does a p physician feel when they’re called a provider.
Dr. Shuhatovich: Um, I think what you’re starting to allude to is the little bit of dehumanization that happens, um, in our medical system with regard to the physicians. Um, I think it’s been a trend for some time. It’s an unfortunate negative trend in our medical community and, um, I hope someday that reverses, but I don’t see that happening anytime soon.
Dorothy: What else don’t you like in our medical world?
Dr. Shuhatovich: Um, I guess we all don’t like a lot about insurance [00:24:00] companies.
Dorothy: Mm-hmm.
Dr. Shuhatovich: Um. Give you an example. If you go to Best Buy and you decide to buy a television, you have to pay every time. That does not happen to you with an insurance company.
Dorothy: Explain.
Dr. Shuhatovich: You do the work, half the time you don’t get paid.
Dorothy: Hmm. That is so true. Even in my world.
Dr. Shuhatovich: Sure.
Dorothy: Yeah.
Dr. Shuhatovich: In your world, especially.
Dorothy: We, we fight it all the time.
Dr. Shuhatovich: Yep. Why do I need to have a team of billing and collections in general? Why?
Dorothy: Why?
Dr. Shuhatovich: It makes no sense for me to fight for what I’ve already done.
Dorothy: Oh, good point. And we do, we do the same thing. It’s uh, always galls me when you hear stories of insurance plans that may have a policy of, we just deny everything going in, you know.
Dr. Shuhatovich: Better yet, artificial intelligence doing that.
Dorothy: Oh yes.
Dr. Shuhatovich: Yeah.
Dorothy: So have you had to fight for, uh, your [00:25:00] patients having certain kind of surgeries or.
Dr. Shuhatovich: All the time. Of course, I’ve written thousands of letters of medical necessity spoken to thousands of peer reviewing physicians who are not even my peers.
Dorothy: What do you mean?
Dr. Shuhatovich: For example, a peer reviewer that does, let’s say, allergy and immunology, cannot discuss a hand surgical case with me because they just, they, they don’t have the same training I do. And vice versa. So they don’t have the credentials to deny or accept my claim.
Dorothy: That’s true.
Dr. Shuhatovich: So that’s an extreme example, but, that kind of, but that thing happens to us all the time.
Dorothy: Right. Once you get to that peer review.
Dr. Shuhatovich: Yeah.
Dorothy: You know, many times where we’re at, it’s just denied.
Dr. Shuhatovich: It’s just denied.
Dorothy: Yeah. And then we’re calling someone who has been hired and you’re not saying the right words. That are on their list.
Dr. Shuhatovich: Correct.
Dorothy: And then you’re [00:26:00] denied. And it’s, it’s, it’s so frustrating, but it cost us more to have to deal with all that when we’re trying to provide care.
Dr. Shuhatovich: Yeah.
Dorothy: And remember we’re dealing with a whole uninsured population also.
Dr. Shuhatovich: Sure.
Dorothy: So it, it just seems, it’s so frustrating.
Dr. Shuhatovich: Yeah. And half of that time, I’ve already done what the patient needs because a lot of my patients have trauma and I cannot wait.
Dorothy: Right, right.
Dr. Shuhatovich: And then I did it anyways because that was for the benefit of the patient.
Dorothy: So how do you, how do you emotionally deal with that?
Dr. Shuhatovich: Drink a lot of wine.
Dorothy: Oh no, seriously. Do you ever feel like it just gets to you and you’d get outta it?
Dr. Shuhatovich: It gets to me. It gets to me, but um, you know, somehow we keep going. Um, it’s really hard to, um, really, I would love to be Mother Theresa and say it’s the human being that [00:27:00] gets me out of that rut. The person that helped me. Which is my patient helps me emotionally. But it’s not all of that.
Dorothy: So is it a rut? Is that what doctors feel sometimes?
Dr. Shuhatovich: Uh, our suicide rates, uh, speak for themselves.
Dorothy: Tell me more about that.
Dr. Shuhatovich: There’s a much higher suicide rate among surgeons, anesthesiologists, a lot of different physicians than that of a general population. You hear about that all the time. Your friends. Friends of friends. It happens a lot.
Dorothy: Hmm.
Dr. Shuhatovich: That part of dehumanization that happens systemically. Commoditization of medicine too. Yeah. Where people think that I fixed your broken bone, you paid me $400. Those are equivalent. No, I gave you your life back.
Dorothy: So true.
Dr. Shuhatovich: Mm-hmm. Same with breast cancer. You give them their life back.
Dorothy: Mm-hmm. [00:28:00] I never really thought about it like that.
Dr. Shuhatovich: We should switch to happier topics.
Dorothy: Okay. Tell me a happier topic.
Dr. Shuhatovich: You’re the questions.
Dorothy: Um, but see that’s what I found so fascinating about you’re letting us have an insight into what happens with physicians and we don’t always see that. General public doesn’t see it. The patient doesn’t see it. In fact, I remember saying to you, why do you not have a smile on your face with, there were five pictures of all the physicians in your office and you were the only one that didn’t have a smile, and, and do you remember your response to that?
Dr. Shuhatovich: Uh. Not specifically, but it may have been with the whole Russian mentality of self-sacrifice. Yeah. That tends to be my reasoning for coming out in pictures. So seriously. Yeah. I’m not actually that serious until I need to be.
Dorothy: Yeah, but I mean, you look.
Dr. Shuhatovich: But the [00:29:00] face is different. Yeah.
Dorothy: Yeah, yeah. You were very, very, uh, professional, like, ooh.
Dr. Shuhatovich: Inherent Slavic stoicism.
Dorothy: I see. Yeah.
Dr. Shuhatovich: Yeah.
Dorothy: Yeah. Uh.
Dr. Shuhatovich: Can get rid of it 31 years later.
Dorothy: Well, but we all have our, our backgrounds that we, that we deal with. Yeah. So what is the most exciting thing to you about being in medicine?
Dr. Shuhatovich: Um, most exciting thing is I really love what I actually do. Uh, surgery to me is amazing. Every aspect of it, not just my own, I’m just as curious about neurosurgery or anything really. Surgical, oncology, breast, whatever. Surgery to me is, it’s almost a diagnosis.
Dorothy: So you spoke earlier about how you, you teach empathy. How do, how do you teach that?
Dr. Shuhatovich: Usually you want to do that to someone before entering [00:30:00] formal medical training.
Dorothy: Well, then you’d have to get ’em in high school or college.
Dr. Shuhatovich: Okay, college. College. The applicants that I get as rotators, and I’ve had quite a few of those, you show them how you handle a patient and then you come outside the room and see what did you notice about them when you entered the room? Read their body language. Because, because I can tell you that within a few seconds of walking in, I can already tell you two thirds of the story before talking to them. Just simply based on how they’re sitting holding their extremity, what they’re doing to it, their mental state, how much pain they have, what burdens they brought in with them. I can tell that ahead of time.
Dorothy: Besides your act, besides your injury.
Dr. Shuhatovich: Besides their injury.
Dorothy: How do you, how do you tell that?
Dr. Shuhatovich: Some of it is innate? Some of it is watching people over and over again, present to your office, sitting in that chair right before you start examining them. It’s very [00:31:00] important to know how to approach each type of patient, and I teach that after each encounter.
I’ll take the medical student out of the room after I’m done examining them. What did you notice before we walked in? What did you notice right as we walked in? What did you think of how we came up with a diagnosis and how did I go through the differential diagnosis with the patient and what did I specifically say and not say, and for what reason?
Dorothy: And do they get it?
Dr. Shuhatovich: Some, do we have hope? The new, hope, the new generation coming up. They’re really, really smart. Oh, yeah.
Dorothy: Oh, and they’re more in tune to that.
Dr. Shuhatovich: Um, I wouldn’t say more. I just think that there’s, there’s still a lot of good people entering medicine.
Dorothy: Mm-hmm. So, but that’s not a normal, uh, curriculum.
Dr. Shuhatovich: No.
Dorothy: Not every doctor’s gonna take that student out and talk that way, right?
Everyone can read a [00:32:00] book.
That’s good advice.
Dr. Shuhatovich: I teach them what they cannot read in a book a lot.
Dorothy: Ah, yeah. And should. Not should, I hate shoulds. But is that something you would encourage anybody who’s working with a, a potential doctor or a potential?
Dr. Shuhatovich: Uh, if, if they feel like they can.
Dorothy: Okay.
Dr. Shuhatovich: Yeah. Some physicians, because of, like we said earlier, external pressures and internal pressures too, they don’t have the emotional strength to do that or, mm. They simply lack the ability to do so, and that’s no detriment. That’s just how different people are. Um, those that have the ability should.
Dorothy: So what would you say to a patient or to someone who’s feeling very uncomfortable with their doctor? How if it’s their only choice, they don’t have another [00:33:00] choice?
Dr. Shuhatovich: Depends on the reasons. If you think that you don’t have any other choice, but it’s simply the attitude of the physician, but not the reported outcomes and historical performance, I would say you should probably bite the bullet and go with them unless you have another choice, especially in subspecialty. Um, because there’s so few of us. But if you have another choice, go ahead and get a second opinion.
Dorothy: Mm-hmm.
Dr. Shuhatovich: You should feel very comfortable with your physician, on all levels, not just intellectual. Also interpersonal. And it’s also important for us too, to connect to you because if we don’t, you’re unlikely to do what I ask.
Dorothy: Well, that’s so true. What we say, so often, your recovery is gonna depend on that relationship you have with your physician.
Dr. Shuhatovich: Absolutely.
Dorothy: Doesn’t matter if it’s breast cancer or a hand injury. [00:34:00] It’s gonna be, it’s really, really, uh, predicated by what you came out of that room feeling. Yeah.
Dr. Shuhatovich: Yeah.
Dorothy: We cannot discount emotions.
Dr. Shuhatovich: Absolutely. I usually tell people that what I do in surgery is about 25% of the whole picture.
Dorothy: Oh.
Dr. Shuhatovich: Yeah.
Dorothy: That little? Man.
Dr. Shuhatovich: I think it’s a lot. 75% is that interpersonal relationship. And rehabilitation and compliance and really precis, precision with which each patient approaches what you say. And, um, a lot of times people take it as a suggestion. It isn’t, it’s an absolute statement when I ask you to do something, it’s not a could you please do it? No. You have to do it in order to achieve your best possible outcome.
That’s the reason I say it that way.
Dorothy: Well, you left no doubt in my mind that I needed to do certain things. Yeah, yeah. There wasn’t. [00:35:00] It wasn’t even a question.
Dr. Shuhatovich: Yeah. It was very mathematical on your part as well, and I could tell you were that way.
Dorothy: Hmm. Not sure I get that part, but that’s okay.
Dr. Shuhatovich: Exactly.
Dorothy: Oh, exact yes. Yeah. Yeah. True. Yeah. I kind of expect that.
Dr. Shuhatovich: Yeah. Yeah, yeah. You have to be exact with people that are exact in nature.
Dorothy: Hmm. So what else would you tell a patient to do as they’re meeting a physician for the first time or, what? What should they listen for or look for?
Dr. Shuhatovich: Well before they see a physician.
Dorothy: Okay.
Dr. Shuhatovich: They should research the physician. The physician must be board certified if what they need requires fellowship training. And sometimes people don’t know that it does. But they should be fellowship trained. Yeah. In this age of medical subspecialization, you should go to the person that knows the most about your problem. For example, breast surgeon.
Dorothy: All of our radiologists are fellowship trained, our trained [00:36:00] radiologists.
Dr. Shuhatovich: Correct. Right.
Dorothy: And that’s all they do.
Dr. Shuhatovich: Yeah.
Dorothy: Makes a difference.
Dr. Shuhatovich: That’s exactly it.
Dorothy: Right. So interesting. So research and then I’m in, I’m in the room with a physician. Now what am I looking for?
Dr. Shuhatovich: Connection.
Dorothy: Okay.
Dr. Shuhatovich: Do I understand what I’m being told? And also is the physician using. Medical language that is confusing or is a physician explaining to me so I can understand that’s very important.
Dorothy: So if I don’t understand, what do I say to that physician?
Dr. Shuhatovich: Uh, could you explain it to me? I don’t understand this. And it’s not a, it’s not a knock on anybody. It’s just sometimes we don’t exactly know if we’re speaking medical language. And some people are not medical in backgrounds, so they should be able to understand what you’re saying. Communication. Absolutely. So yes, I would just ask that question. And if they can’t [00:37:00] explain it to you simply in a few seconds, they probably don’t understand that at all themselves.
Dorothy: Oh!
Dr. Shuhatovich: That’s another trick.
Dorothy: Wait a minute. Say that again.
Dr. Shuhatovich: If a physician cannot explain to you what’s going on, in a few seconds, succinctly, they probably don’t understand it themselves.
Dorothy: That’s huge.
Dr. Shuhatovich: Yeah. It’s a life hack.
Dorothy: A life hack.
Dr. Shuhatovich: Yeah. Bonus points.
Dorothy: Ah, ah, I got it. Ah, you know, sometimes my communications with you is a little difficult.
Dr. Shuhatovich: I wasn’t gonna say anything.
Dorothy: Thank you.
Dr. Shuhatovich: You’re welcome.
Dorothy: Alright, so I’ve established communications.
Dr. Shuhatovich: Yeah.
Dorothy: Anything else that, that I should be watching?
Dr. Shuhatovich: Yeah. Simple, simple language. You understand the person, um, you come out feeling like you understand your problem to the best of your ability. You have no questions unanswered. [00:38:00] If you do have questions, you have a way of coming back and asking them.
Dorothy: Most people don’t.
Dr. Shuhatovich: Most people don’t.
Dorothy: They, they get home and go, oh, I wish I’d asked this or that. But they don’t wanna bother the doctor.
Dr. Shuhatovich: So I don’t know if you remember, but a lot of times I’ll end the appointment by saying, if you don’t have any more questions, I’m gonna keep moving. But if you have any, I’m just around the corner. Right. That’s one of my lines.
Dorothy: Right. It is one of your lines.
Dr. Shuhatovich: And and that’s a door that I open to the patient to say, look, if whatever, just wait for me for a second, I’ll be back and answer your questions.
Dorothy: Right.
Dr. Shuhatovich: Yeah.
Dorothy: That, that’s very encouraging.
Dr. Shuhatovich: So they feel like they’re burdening me.
Dorothy: Yeah. And we do, you know, we think you’re busy.
Dr. Shuhatovich: Yeah. Yeah. And that’s kind, that’s very southern of us. It is.
Dorothy: Yes.
Dr. Shuhatovich: I love that. I love that. Couldn’t wait to come back to Texas.
Dorothy: Ah. There is a difference.
Dr. Shuhatovich: Huge.
Dorothy: Any last encouraging words or recommendations for that patient?
Dr. Shuhatovich: I think we kind of covered most of it.
Dorothy: That’s good.
Dr. Shuhatovich: Communication is key. Understand everything [00:39:00] right and the future’s bright, everything positive. I have to. Otherwise, what’s the point. Yeah. Life is wonderful.
Dorothy: It is.
Dr. Shuhatovich: And we both make each other’s lives better.
Dorothy: People really need people.
Dr. Shuhatovich: Yes.
Dorothy: They do.
Dr. Shuhatovich: Yeah. I continue because of my patients.
Dorothy: Yeah, we all do that. Well, I appreciate you making the time for us today. Thank you so much for being with us and I have a feeling we’re gonna get you back because you are so full of information.
Dr. Shuhatovich: Well, I’m very happy to be here. Didn’t think a hand surgeon would be on a breast cancer podcast.
Dorothy: Hey, I, I think you showed, told us a lot. Shared a lot. Yeah. I think our listeners are gonna love this.
Dr. Shuhatovich: No, I really enjoyed this. This is my first one, like I said, and, uh, thank you for having me.
Dorothy: Oh, of course.
Post-Credits: Thank you for joining us today on Let’s Talk About Your Breasts. This podcast is produced by Speke Podcasting and brought to you by The Rose. Visit TheRose.Org to learn more about our organization. [00:40:00] Subscribe to our podcast. Share episodes with friends, and join the conversation on social media using #LetsTalkAboutYourBreasts. We welcome your feedback and suggestions. Consider supporting The Rose. Your gift can make the difference to a person in need. And remember, self care is not selfish, it’s essential.
