Insights from Our Rising Star Medical Leaders: Summer 2018

It is no secret that our firm has a huge respect for practitioners working within the medical profession. In fact, many years ago, our very first clients were physicians, surgeons and specialists in ophthalmology. We have great respect for the sacrifices medical professionals make on behalf of their patients, and our community. This is one reason why our firm is proud to sponsor, in conjunction with Venue Magazine, the annual Rising Star Medical Leaders award. As we meet each year’s class of honorees, we are deeply impressed with the commitment of these talented professionals and want to share more of their stories with you. Recently Dean Johns, CPA, CFP and Chris Brennan, CFP, both principals with John D. Dovich & Associates, LLC, met with Jonathon M. Spanyer, MD, Orthopaedic Surgeon of OrthoCincy and Paul Houser, MD, Lindner Center of HOPE, Medical Director of the Harold C. Schott Foundation Eating Disorders Program, both members of the 2017 Class of Rising Star Medical Leaders, to further explore their stories.

Dean Johns: Congratulations, once again, on your recognition as a member of the 2017 Class of Rising Star Medical Leaders. We are very proud of your work and dedication to the people of our community. To begin, tell us a little about what motivated your decision to enter into the health care field.

Paul Houser, MD: My dad is a family practice physician and my mom is a pediatric nurse. I’m the 2nd of 10 kids and my mom did lots of nursing just with us kids. She actually kept chart notes on the kitchen counter when we were sick! My dad would come home talking about how the day went, and even as a kid, I realized how important it was for him to be a part of his patients’ lives in a meaningful way. As I grew up, because I was always interested in biology and science, I wanted to be a vet because I always loved animals. That changed once I started college because I wanted to get to know my patients on a more personal level. Going into psychiatry was a gradual development. And then, fine tuning it even more, I realized I liked working with kids and young adults. I got a chance to get to know them and the stories of their life. It’s a part of medicine where there’s hard science and some art involved. You can ask multiple psychiatrists the same question and get different answers. But in psychiatry, it’s different because it’s all part of the healing process. This is what drew me to psychiatry.

Jonathon Spanyer, MD: I started out as a biomedical engineer and worked for an orthopaedic company designing the actual knee and hip replacement devices. I was working on the devices used to measure patients during surgery. At the end of the design, our team validated it in a lab and then went to California to try out the device with patients and a surgeon. I remember being in the operating room, feeling awkward and out of place as an engineer, and at one point the surgeon turned to me and said, "Come over here. Don’t touch anything. Look in here. Do you see the hip replacement? Here’s your device and this is what I’m trying to do with it. Does that make sense?" "Yes!" I said, "That’s exactly what we designed it to do" and then the doctor looked at me and said, "Good, now get out of the way." I remember flying home on the plane and telling the engineer I was traveling with that I wanted to do that kind of work. "You can’t do that," he responded. "You would have to go to medical school." "I think I will," I responded. The rest is history, and what a journey it has been! I used to design hip and knee replacements and now I perform them!

Chris Brennan: Did you have any mentors who influenced, or helped you, along the way? Or do you have mentoring programs within your current medical practice?

Paul Houser, MD: My mentor, Dr. Sergio Delgado at Cincinnati

Children’s Hospital, is a big believer of a relationship approach in

psychiatry. He taught me to connect with patients on an honest and open level. Watching him and other doctors I admire really helps me as a doctor. Dr. Nelson at Children’s Hospital is another one of my mentors. He gets through to the kids and they are willing to engage with him – I’ve learned a lot from both of these doctors and mentors.

Jonathon Spanyer, MD: We have a great mentoring program for students at OrthoCincy. We work with residents along with physical therapists and nursing students so that they have an opportunity to work along with us. Our practice is large enough that we have the resources to do this. When I was in medical school, I distinctly remember thinking that I wanted to be open to work in any field except Orthopaedics. But as time went on, I realized I was naturally drawn to mechanical problems addressed in Orthopaedics. There are nine sub-specialties within Orthopaedics, and I thought I might do anything other than hip and knee replacement, but with time, I realized just how very rewarding the work could be. There are few things more rewarding than giving someone their ability to walk again.

Chris Brennan: Dr. Houser, as a psychiatrist working with teens, how do you work with patients and make connections with them?

Paul Houser, MD: Well, no psychiatrist will tell you they’ve mastered that art, and it is an art. It’s also a lifelong process to learn. I’ve learned that honesty and transparency are the key to making connections with teenage patients. What I’ve found is I get to know the teens and try to learn about them, in terms of what they want to do for fun, what their hobbies are, etc. I try to get to know them and create some common ground with them, but above all, being honest with them. Teens and young people know when adults are "feeding them a line" and are trying to give them a stock answer to move on to another question. This turns them off faster than anything else. I tell my patients I want them to be honest rather than polite and they respond to that. Kids know when I’m being fake and really, why would they trust me, if I’m being fake, but I’m asking them to be honest?

Dean Johns: Dr. Spanyer, with your specialty of ortho replacement, what’s the basic age of your patients?

Jonathon Spanyer, MD: Most of my patients needing hip and knee replacements are in their 60s-80s, but the most rapidly growing population needing total joint replacement are people in their 40s and 50s – mainly because people are more active, playing sports and lots of other physical activities. When you combine that with the fact that replacement surgery is much easier, as is the recovery, and for the most part, patients are healthier, it makes the procedures much easier. Often, these surgeries can be safely performed as outpatient procedures. Those are best case scenarios. I have patients in their 80s and 90s who needed replacements, but they think they are too old and don’t want to have surgery. We always try conservative care first. One 89 year-old patient failed conservative care and had a hip replacement. She was so thrilled with the result, that a year later, when her knee really started acting up she chose to proceed with a partial knee replacement at age 90, getting home the same day of surgery. Her recovery was predictable, rapid, and the treatment was effective. She asked me to tell others not to delay if they needed surgery done.

Chris Brennan: From our perspectives as financial planners and advisors, and with regards to the massive student loan debt that some medical students carry we’re curious as to what is the best financial advice you’ve ever been given?

Jonathon Spanyer, MD: When I was a student, I didn’t receive much financial advice along the way with the exception of meeting with a financial counselor who showed me all the numbers in terms of what I would owe in debt and student loans by the end of my education. I remember asking him "Are you sure this was a good idea?" He looked over his glasses and said "Yes. As long as you finish school and plan to practice medicine for many years." Not exactly the most encouraging talk, as this was part of his standard discussion with students.

Paul Houser, MD: Yes, I definitely received financial advice in medical school. I remember the instructors sitting us down during the week of orientation in med school where they gave us one talk about student loan debt. I wish we’d had more classes than just the one. In looking back, some of the debt was inevitable, but I wish I knew more about it then. Those financial factors do impact your later life, but at the time, the focus is, just get through anatomy and physiology. However, one thing I did learn after college is the value of disability insurance. We all spend a lot of time training our brains and hands and these are assets we need to protect. This isn’t something I realized as a student, but once I began practicing medicine, I realized this is a critical decision to consider and make that will impact my future and

that of my family.

Dean Johns: What career advice would you give a high school senior thinking about entering medicine?

Jonathon Spanyer, MD: I would advise someone to decide early on what kind of medicine they want to practice, especially if it’s a primary care physician or a sub-specialty. The cost of education is so much higher than even ten years ago. There are many resources available for doctors going into primary care roles and I would say to definitely decide early if primary care is right for you. Then you can utilize those resources and find the community that’s right for you, giving back in a way that no one else can. I didn’t know all of this at the time, and I ended up incurring huge student loans. A lot of my colleagues knew what they wanted to study and were able to get a portion of their courses paid for.

Dean Johns: I’m always hesitant to ask medical practitioners what they do in their free time, but I’m going to go ahead and ask the question here…what do you like to do in your free time?

Paul Houser, MD: I really enjoy creative writing. In fact, if I wasn’t a doctor, I think I’d like to write full-time.

Jonathon Spanyer, MD: My wife and I have a large family, and I love spending every spare moment with them at home.

Dean Johns: Thank you for your service to our community. While on the surface, it’s easy for people to question why anyone would want to work in such a challenging career field, listening to your inspirations and motivations for working as medical practitioners and specialists is truly heart-warming. 

John D. Dovich & Associates, LLC is located at 625 Eden Park Drive, Suite 310, Cincinnati, OH 45202. For more information, call 513.579.9400 or visit www.jdovich.com. John D. Dovich & Associates is a Federally Registered Investment Adviser. Registration as an investment adviser does not imply a certain level of skill or training. The oral and written communications of an adviser provide you with information about which you determine to hire or retain an adviser.

For more information on Lindner Center of Hope, please visit www.lindnercenterofhope.org.

For more information on OrthoCincy, please visit www.orthocincy.com.