From Pipe Fitter to Physiatrist w/ Dr. Joseph Saveika

Episode Information

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April 11, 2022

Physiatrist Dr. Joseph Saveika talks about his past as a pipe fitter’s apprentice, his current job as a physiatrist, advice he lives by, his daily workout routine, newly emerging medical technologies, and more.

 

Topics Include:

 

• His former career as a pipe fitter’s apprentice
• His current career as a physiatrist and what it entails
• His workout regimen
• Important facets of the doctor-patient relationship
• Exciting new medical innovations
• The value of Doctorpedia to both patients and doctors
• Useful life advice

Highlights

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• “One of the beauties of [physiatry] is that your patients are all extremely motivated and actively want to get better.”
• “I would say physical medicine is probably the ultimate team dynamic.”
• “If you are not happy with the direction your life is heading, you can restart anytime. Hey man, that’s extreme ownership. Just take control of things and change ’em if you don’t like ’em.”
• “The best medicine you can have is prevention, and the best prevention you can have is physical wellbeing.”
• “[Doctorpedia] allows people to obtain credible healthcare information that’s presented in a manner that’s easy to understand and digest. The other thing is, there’s about a million experts on it. So if a patient has a question about something that I don’t deal with, I can direct them there.
• “Technology is certainly changing health and wellness. Things like telehealth have significant advantages, but at the end of the day, medicine also requires physical interactions.”
• “I think the advances in musculoskeletal care are really going to change how a lot of care delivery is supplied in an outpatient setting. The boundaries of what can be handled without an operation are kind of constantly being pushed back. And I think that that is going to dramatically change the field of outpatient rehabilitation.”
• “I would say that humility and a sense of humor will get you just about everywhere in life.”

Episode Transcript

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Daniel Lobell: (00:00)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.

Daniel Lobell: (00:33)
Hello, and welcome to the Doctorpedia podcast. I’m your host, Daniel Lobell, and today I’m honored to be joined on the line by Dr. Joseph Saveika. How are you, doctor?

Joseph Saveika: (00:42)
I’m doing well. How are you doing?

Daniel Lobell: (00:44)
I also am doing well. And I’m excited to talk with you. I’ve read a little bit about you and I usually just ask the doctors to start at the beginning about their childhood, but I’m gonna ask you one little question beforehand. I read that you actually began your career as a pipe fitter’s apprentice. Is that right?

Joseph Saveika: (01:03)
Yes, I did. Many years ago.

Daniel Lobell: (01:06)
What does a pipe fitter’s apprentice do?

Joseph Saveika: (01:09)
They, in very brief terms, they fit pipes, okay. So you… And in this case it was sprinkler systems. So you actually take small pieces of pipe and fit them together into larger pieces of pipe, move them around various geometric obstructions. So obviously in a building, if there’s a corner, the pipe has to go around it, but a pipe is straight. So you apply an elbow and add another piece of pipe when you’ve reached the appropriate angle and continue it on in a straight line.

Daniel Lobell: (01:48)
It sounds kinda like Tinker Toys.

Joseph Saveika: (01:50)
It’s pretty close, actually.

Daniel Lobell: (01:52)
It sounds fun. Did you like it?

Joseph Saveika: (01:55)
It is very physically strenuous, often very uncomfortable work. So I learned a lot, but, and I would never say that I’ve had a bad job, cause you can always learn something. But I have great respect for the people who do it for their entire lives.

Daniel Lobell: (02:15)
What are some of the takeaways that you got from it?

Joseph Saveika: (02:18)
Takeaways from it? Wow. In an industrial environment, please be very, very careful. Because I actually got metal shavings shot into my eye when I was threading a pipe and had to go to the ophthalmologist in an emergent manner.

Daniel Lobell: (02:35)
Wow.

Joseph Saveika: (02:36)
Yeah. And that every job is important. If you go into a building, odds are you’ll never know anything about the sprinkler fitters who put in the fire control system. I was working for a fire control company.

Daniel Lobell: (02:59)
Wow. Yeah.

Joseph Saveika: (03:01)
Your life depends on them.

Daniel Lobell: (03:03)
That’s crazy. I didn’t know my life depended on those people. I’m going into a panic! [Daniel chuckles] Doctor!

Joseph Saveika: (03:10)
What happens if there’s a fire and there’s no sprinkler system?

Daniel Lobell: (03:15)
No, I hear you. Yeah, there’s so many things that we take for granted. I once did some work volunteering for the Israeli army and they had me painting the sides of the sidewalk, the curb, when you see the red part where you’re not allowed to park.

Joseph Saveika: (03:38)
Mhm.

Daniel Lobell: (03:38)
So I had to paint red and then white and red and white for miles and miles on the base. And I never took it for granted again when I saw paint on the side of the curb, because I realized how hard that is to do.

Joseph Saveika: (03:50)
Absolutely.

Daniel Lobell: (03:51)
Yeah. So where’d you grow up?

Joseph Saveika: (03:53)
I grew up in Virginia.

Daniel Lobell: (03:54)
Big family?

Joseph Saveika: (03:56)
Not particularly, pretty average

Daniel Lobell: (03:58)
Brothers, sisters?

Joseph Saveika: (04:00)
Oh yeah. Standard two parents, two kids. I have an older sister.

Daniel Lobell: (04:04)
What’d your parents do?

Joseph Saveika: (04:05)
My father was an engineer and my mother was a schoolteacher.

Daniel Lobell: (04:08)
All right. So it seems like you kind of did a little bit of both of those with the pipe fitting, that’s a bit of engineering, and going into psychiatry, that’s a little bit kind of like the schoolteacher type of thing.

Joseph Saveika: (04:20)
Physiatrist. Physical medicine and rehabilitation.

Daniel Lobell: (04:24)
Oh, please forgive me. I don’t even know what a physiatrist is. So let me ask you, what is a physiatrist?

Joseph Saveika: (04:31)
A physiatrist is a physician who works with people with physical disabilities and helps them overcome them.

Daniel Lobell: (04:40)
Hey, that’s still kinda like a schoolteacher.

Joseph Saveika: (04:42)
Well, it depends on what you’re working on, but it can be. Well, there’s a lot to being a doctor that is like a schoolteacher, right? So there’s the classic one: “Hey doc, it hurts every time I do this.” “Well, don’t do that.” [Daniel chuckles] That’s the lesson.

Daniel Lobell: (05:03)
So you said it’s pretty common that people think that, cause I haven’t heard physiatrist, at least I feel like I’m not alone, but still slightly embarrassed, but I didn’t realize that was a thing, a physiatrist. So it’s kind of like, it seems like it has some elements of a physical therapist in it. Is that correct to assume that?

Joseph Saveika: (05:24)
It does indeed. As a matter of fact, one of the things I do is direct physical therapists.

Daniel Lobell: (05:29)
What does that mean?

Joseph Saveika: (05:30)
In very brief terms, I tell them what the patient needs to be worked on.

Daniel Lobell: (05:36)
You kind of oversee the operation, is that a correct way of putting it?

Joseph Saveika: (05:42)
Yes. That’s a very succinct way of putting it.

Daniel Lobell: (05:45)
Like at a construction site. You got the guys laying pipe and you’re overseeing it and you’re like the foreman. You do this, you do that. My…

Joseph Saveika: (05:56)
Yeah, that’s a pretty reasonable layman’s description.

Daniel Lobell: (05:59)
[Daniel chuckles] So what’s the non-layman’s description? Give us the nuts and bolts of it.

Joseph Saveika: (06:04)
The non-layman’s description? All right. Well, depending on your subspecialty in physical medicine, remember, you’re always helping people overcome disabilities, but the disability could be physical. It could be pain. It could be, in some cases, cognitive. Respiratory, pulmonary, any number of things. With COVID-19, we’ve seen a great deal more pulmonary.

Daniel Lobell: (06:35)
How does it actually work? Like, you have different people working under you and you oversee the whole thing. You say, “Look, this is the care that I think needs to happen.” And then “This is how I think you should institute it.”

Joseph Saveika: (06:47)
In my case, yes. Physical medicine’s a multifaceted field. So you can get pretty specialized pretty quickly. In my case, I work in a hospital. So people in a hospital will have various issues necessitating the use of therapy. They may not be able to walk very well or they may be very weak or they may not be able to swallow. So I direct the efforts of the therapists and try to help the patients overcome whatever their deficit is.

Daniel Lobell: (07:29)
What made you choose this specific field of medicine?

Joseph Saveika: (07:35)
I enjoyed working with people on overcoming challenges that prevented them from returning to the community and resuming their regular life activities, basically.

Daniel Lobell: (07:50)
Is there something in your life that made you decide that? Was there a situation or a person or something that inspired you to go that way?

Joseph Saveika: (08:01)
Well, yeah, I worked… In medical school, I did a rotation in physical medicine. And one of the beauties of this field is that your patients are all extremely motivated and actively want to get better. There are some fields where that is not the case.

Daniel Lobell: (08:22)
Right. People who are fighting the care, in other words, or they don’t care at all.

Joseph Saveika: (08:29)
You see that sometimes too.

Daniel Lobell: (08:31)
One of the doctors on here recently told me that they don’t refer to the patient as “the patient” anymore. They just call them a team member. And if you have a team and the other players on the team don’t wanna play, it’s not as great, I suppose, as having a team where everybody’s on board and listening to the coach and trying to get to the ultimate goal. So I think you found a pretty good place to have team members in the field of medicine that you chose.

Joseph Saveika: (09:02)
Absolutely. I would say physical medicine is probably the ultimate team dynamic.

Daniel Lobell: (09:09)
It’s funny because when I was reading about you, I thought it was interesting that you were a psychiatrist and you also did all this physical stuff. And now it makes sense, obviously, that you weren’t also a psychiatrist, but… [Daniel chuckles] I know that you’re the Medical Director of Rehabilitation and Post-Acute Care Service at lines at Norman Regional Health Systems in Norman, Oklahoma?

Joseph Saveika: (09:34)
That is correct.

Daniel Lobell: (09:35)
What brought you out to Oklahoma? Was it the job or something else?

Joseph Saveika: (09:40)
It was a combination of the job and the lack of traffic.

Daniel Lobell: (09:45)
I can’t blame you there. I mean, that’s pretty appealing, the lack of traffic. What’s Oklahoma like? I was only there once for a comedy gig very briefly, but I was in Miami.

Joseph Saveika: (09:56)
Miami. Yeah, that is a town in Oklahoma.

Daniel Lobell: (09:58)
Yeah. That’s where I performed at the University of Miami. But that’s all the Oklahoma I’ve seen. So gimme a little bit about life in Oklahoma, if you don’t mind.

Joseph Saveika: (10:09)
Well, Oklahoma is a big state with a relatively sparse population now. I live in a college town, so it’s obviously largely centered around the University of Oklahoma.

Daniel Lobell: (10:23)
Yeah.

Joseph Saveika: (10:27)
Oklahoma City is 20 miles due north, and that is, like a lot of big cities, they have a couple of professional sports teams. So in a way, it’s really not that different from living anywhere else in the country, maybe with the exception of the tornadoes.

Daniel Lobell: (10:49)
Right. I was gonna ask you, I think there’s a tornado season there that we don’t have, certainly in California. We have earthquake season, but, what’s that like, is that scary? Have you experienced that?

Joseph Saveika: (11:03)
I’ve… Actually, I’ve only been here a little less than five years. I have not seen a tornado or had to go into a tornado shelter.

Daniel Lobell: (11:15)
That’s good.

Joseph Saveika: (11:16)
Yeah. However, there… Certainly in the time I’ve been here, other parts of Oklahoma have been hit pretty badly by tornadoes.

Daniel Lobell: (11:24)
It seems like it would be a bit of a culture shock from Virginia to Oklahoma. Is that a correct assessment?

Joseph Saveika: (11:30)
Absolutely.

Daniel Lobell: (11:31)
Did you grow up in the city in Virginia, or more of a rural area?

Joseph Saveika: (11:36)
I grew up in the coastal metro area. So it’s kinda like a whole bunch of small cities that you really can’t tell much of a difference between. Kinda sprawls on forever.

Daniel Lobell: (11:49)
We talked a little bit about your career as a pipe layer, but when you were doing that, was it already in your mind that you wanted to be a doctor? At what point in your life did that become a goal?

Joseph Saveika: (12:03)
Oh heavens no, not at that time. I actually became an engineer and I was working for a very large multinational corporation as a process control engineer. And that was a good job, I learned a lot, but sitting in a cubicle…

Daniel Lobell: (12:27)
I’m gonna interrupt you cause I’m just sitting here thinking, “Process control engineer. What is that?” There’s so many kinds of engineers, but what does a process control engineer do?

Joseph Saveika: (12:41)
Well, in my case, I was a civil engineer who worked in the environmental control areas. A process control engineer is someone who oversees statistical quality control with regard to whatever it is that you’re monitoring.

Daniel Lobell: (13:02)
So you still are overseeing quality control, only now in medicine.

Joseph Saveika: (13:06)
That is… Yes, technically correct.

Daniel Lobell: (13:11)
So, you were sitting in a cubicle, you said you weren’t a big fan of the cubicle. People never say, “You know what I loved? The cubicle. That was my favorite thing that I missed when I left that career.”

Joseph Saveika: (13:21)
Yeah. That was not so fun.

Daniel Lobell: (13:25)
[Daniel laughs] Was that the biggest motivating factor for you to find a new career? Were you like “I hate the cubicle?”

Joseph Saveika: (13:30)
Well, that was part of it. I just really did not take well to having a desk job, generally speaking.

Daniel Lobell: (13:40)
Yeah.

Joseph Saveika: (13:40)
So I started volunteering at an emergency room that was local to where I was working, and one of the doctors there said “For the amount of time you spend here, you could go to medical school and you could do this as a profession.”

Daniel Lobell: (14:03)
Isn’t that great? The guy said it and you actually went ahead and did it. That’s amazing. You know how many people give you advice and you just go, “Yeah, yeah, you’re right.” That’s it. [Both chuckle] But you actually took action and changed your entire course of your life, which is amazing.

Joseph Saveika: (14:20)
Yeah.

Daniel Lobell: (14:22)
And how great is it that that doctor had the foresight or the insight to tell you that, and that you actually listened. The whole thing is pretty remarkable. So you had this passion for medicine because you were doing it on a voluntary basis and then you wind up pursuing it. What age were you when you went back to medical school?

Joseph Saveika: (14:48)
Oh gosh… My mid twenties.

Daniel Lobell: (14:52)
So that’s not typical, is it?

Joseph Saveika: (14:54)
It is not uncommon, but not the average.

Daniel Lobell: (14:59)
Were you one of the older people in the class?

Joseph Saveika: (15:02)
I was definitely in the upper half. I was not nearly as high in that area as I was when I went to graduate school.

Daniel Lobell: (15:20)
I think your story’s inspiring for a few reasons. But one of them that’s really coming to mind is this idea that you can completely change your life if you’re unhappy in a career, you can pick up and start again. And I think a lot of people would be afraid to do that. A lot of people would not want to give up the security of what they were already doing for something they’d rather be doing. But that’s not the case with you. What do you think about you is it that helped you to achieve that?

Joseph Saveika: (15:53)
Well, if you’re having a bad day, you can restart your day as many times as you think you need to.

Daniel Lobell: (16:04)
[Daniel chuckles] That’s good advice. I think I’m gonna start having 10 cups of coffee a day with that advice. [Both chuckle]

Joseph Saveika: (16:10)
I don’t know if I’d do that.

Daniel Lobell: (16:12)
No, I’m kidding. My days aren’t that bad. Go on, sorry.

Joseph Saveika: (16:15)
If you are not happy with the direction your life is heading, you can restart anytime. Hey man, that’s extreme ownership. Just take control of things and change ’em if you don’t like ’em.

Daniel Lobell: (16:31)
I love that piece of advice. I think that’ll speak to a lot of people who tune into the show as well. I think it’s something we all kind of think or hope is true, but to hear from somebody who actually did do that, and not only did it, but has excelled in doing so, it’s fairly motivating, I think, and inspiring. So what do you do for fun?

Joseph Saveika: (16:56)
I enjoy working out and spending time with my family and friends.

Daniel Lobell: (17:01)
It’d be funny if you said, “I volunteer at a civil engineering job.” [Daniel laughs]

Joseph Saveika: (17:07)
Absolutely.

Daniel Lobell: (17:08)
You just totally reversed it. So you say you enjoy working out and spending time with family and friends. Well, that’s great. Any specific kind of workouts that you particularly recommend or enjoy?

Joseph Saveika: (17:23)
Well, actually I’m a fan of total body fitness. So I wake up fairly early in the morning. I do a great deal of… Actual and appendicular, it would be in my terminology, a whole lot of floor and core. And then I actually go run.

Daniel Lobell: (17:45)
I’m a fan of partial body fitness. I only work out one muscle. No, I’m kidding. [Daniel chuckles] That’s great. So every day you do that? Every day you work out and go run?

Joseph Saveika: (17:58)
Yes. Every day before work.

Daniel Lobell: (18:00)
That seems like a very healthy way to start the day.

Joseph Saveika: (18:04)
It is.

Daniel Lobell: (18:04)
Does it give you energy for the whole day? Is that the idea?

Joseph Saveika: (18:10)
Yes. And it’s also very peaceful because at the time I wake up, that is the only point in time that nobody’s looking for me.

Daniel Lobell: (18:18)
Ah, also good advice, to find time that’s just yours. What do you wish your —

Joseph Saveika: (18:24)
4:00 AM is wide open on most people’s schedules.

Daniel Lobell: (18:28)
Yeah. [Daniel chuckles] The secret hours of the day. What do you wish your patients knew, coming into you?

Joseph Saveika: (18:36)
The best medicine you can have is prevention, and the best prevention you can have is physical wellbeing. And I will throw in a shameless plug for immunization.

Daniel Lobell: (18:51)
Why is it shameless? I don’t know, I mean, it seems like a fair point. If we’re talking about preventative medicine.

Joseph Saveika: (19:00)
Because there are plenty of people who either don’t have access to or don’t get for whatever reason, preventative medicine.

Daniel Lobell: (19:13)
What do you think are the most important facets of the doctor-patient relationship?

Joseph Saveika: (19:20)
Straightforward communication. Once you’ve done this long enough, you tend to notice that patients will tell you what they think you want to hear as opposed to what you actually need to hear. And that is really not the best way. And that is actually part of the patient rights and responsibilities, under responsibilities, is to be straightforward and truthful.

Daniel Lobell: (19:59)
So when you say that, for example, what patients tell you they think you want to hear, what would be an example of that?

Joseph Saveika: (20:07)
“Do you smoke?” “No, doc, I don’t.” And they have a pack of cigarettes and a lighter in their shirt front pocket. So…

Daniel Lobell: (20:15)
So basically they’re looking at you like a parent and they’re hiding what’s going on, instead of like a team member.

Joseph Saveika: (20:21)
Yeah, exactly. And for whatever reason, they don’t want to tell you.

Daniel Lobell: (20:26)
Mhm. Because they think they’ll be in trouble or something. So you have to suss it out, in other words, when you’re in these situations as a doctor. You have to be… You don’t know if you have a credible witness, basically.

Joseph Saveika: (20:41)
That is correct.

Daniel Lobell: (20:43)
So as you’ve done this, would you say you’ve become very good at detecting when people are being dishonest with you?

Joseph Saveika: (20:53)
Well, very good is a judgment that I would defer to other people. I’ve certainly learned a lot. “Do you smoke?” “No.” “There’s nicotine stains on the second and third fingers of your right hand.”

Daniel Lobell: (21:15)
[Daniel chuckles] So that kind of answers my next question, of what do you do once you figure it out. You gotta call ’em on it, I guess.

Joseph Saveika: (21:25)
You just ask ’em again. And of course at the end of the day, if they still deny it, you have to note that they denied it, but still allow for the possibility that they do in your treatment.

Daniel Lobell: (21:41)
Mhm. So straightforward communication from patient to doctor, but I suppose that also goes from doctor to patient.

Joseph Saveika: (21:48)
Absolutely.

Daniel Lobell: (21:50)
What’s the biggest compliment that a patient can give you?

Joseph Saveika: (21:54)
“He helped me.” That’s why I’m here.

Daniel Lobell: (21:58)
Well, that’s straightforward. [Daniel chuckles] That’s straightforward.

Joseph Saveika: (22:03)
There are some aspects of being an engineer I can’t get away from.

Daniel Lobell: (22:08)
Right. Right. [Daniel chuckles] Quickest way from point A to point B.

Joseph Saveika: (22:13)
Absolutely.

Daniel Lobell: (22:14)
How has COVID changed the way you interact with patients?

Joseph Saveika: (22:20)
Well, I work exclusively in a hospital now, so I actually see all patients in an N95 respirator and goggles. A fair portion of my patients have communication deficits. So it actually makes it harder for them.

Daniel Lobell: (22:35)
You think that will go on indefinitely at this point? Or will it go back to no goggles and and mask?

Joseph Saveika: (22:50)
Yeah, that is largely dependent on the behavior of COVID-19, which nobody really knows.

Daniel Lobell: (22:59)
Mhm. But there could also —

Joseph Saveika: (23:00)
It certainly will for the short term.

Daniel Lobell: (23:03)
There could be other bugs going around as well, right? I mean, I wonder if this has been something that may have been long overdue in the medical industry because doctors probably pick up bugs all the time before COVID-19, right?

Joseph Saveika: (23:22)
That I don’t know, I’m neither an infectious disease specialist nor an epidemiologist.

Daniel Lobell: (23:28)
Well, I’ll tell you the truth, neither am I. [Both laugh] So we’re conducting this interview obviously on behalf of Doctorpedia, the great Doctorpedia.com. And so I’m inclined to ask you a little bit about the online health space. What are your views on the online health space? How has it affected you, in terms of what you do? And do you encourage or discourage patients to go and look online for information before they come and see you?

Joseph Saveika: (24:03)
I actually neither encourage nor discourage, and I do this to avoid hurting the feelings that people who are maybe not literate with technology or do not have access to it. If they do ask me, I direct them to a valid evidence-based source of information, like Doctorpedia.

Daniel Lobell: (24:29)
So I guess that kind of begins to answer my next question, which is what attracted you to Doctorpedia, but I’ll let you answer it a little more fully than that.

Joseph Saveika: (24:39)
Well, it allows people to obtain credible healthcare information that’s presented in a manner that’s easy to understand and digest. The other thing is, there’s about a million experts on it. So if a patient has a question about something that I don’t deal with, I can direct them there.

Daniel Lobell: (24:59)
Right.

Joseph Saveika: (25:01)
Yeah. Theoretically, I could also direct them to the National Library of Medicine, but the likelihood of somebody being able to find a scientific article addressing their question, read it and understand it is not very likely, or they wouldn’t be asking the doctor in the first place.

Daniel Lobell: (25:23)
So that’s an important point for people tuning in who aren’t so familiar with Doctorpedia, that it is such a great resource. And if you don’t want to go to, what did you say, it was the library of medicine, the national library?

Joseph Saveika: (25:36)
The National Library of Medicine. That’s just an example. They could go to the Cochran Health Database too.

Daniel Lobell: (25:48)
So how are you involved in Doctorpedia aside from just directing people there for information?

Joseph Saveika: (25:55)
I am a strategic advisor to Doctorpedia.

Daniel Lobell: (25:59)
Laying down those pipes.

Joseph Saveika: (26:01)
Yeah. Something like that, yeah.

Daniel Lobell: (26:02)
Figuring out the direction to go in. So what does that mean in layman’s terms? Being a strategic advisor. What are you actually doing, and what are some of these strategies that you can talk about that are being implemented right now?

Joseph Saveika: (26:20)
Well, let’s say I’m helping make their content more useful to medical providing organizations. So the value of Doctorpedia to the consumer is pretty obvious. But there is a second part that says that Doctorpedia has to have a value proposition to the organizations that are interacting with it. And that’s where I come in.

Daniel Lobell: (27:07)
So I’m an organization, let’s say, I’m a medical organization. So how is Doctorpedia useful or beneficial to me?

Joseph Saveika: (27:19)
Any number of phone calls to a doctor’s office are relating to a question. And the way that works is that probably the receptionist will write it down and forward it to the doctor, because the doctor’s seeing patients right now. What happens is that the doctor then at the end of the day looks at the message, comes up with an answer, and calls it to the patient. Now, this is two things that aren’t terribly great. It’s a delay in the response to the patient, because what if the question is, “I’m having crushing sub-sternal chest pain radiating to my left arm and jaw.” Now hopefully if someone picked up the phone, they’d figure that out, but what if they left it on a voicemail? This is not good.

Daniel Lobell: (28:22)
Right.

Joseph Saveika: (28:24)
And the other thing that happens is that either the physician is going to have to see less patients in order to respond to all the messages or the physician is gonna have to stay later to respond to all the messages. You don’t wanna restrict access to healthcare because the physician’s doing something else, and neither do you want the physician to work forever or the provider to work forever, because that just leads to burnout.

Daniel Lobell: (28:54)
Right.

Joseph Saveika: (28:57)
Everybody’s gotta go home at some point.

Daniel Lobell: (28:59)
Just to tie a knot on this, you’re saying Doctorpedia would eliminate a lot of those questions and a lot of that time that a doctor would have to spend, because people would be able to find the answers to their questions online?

Joseph Saveika: (29:13)
Well, I hope they wouldn’t. I hope it wouldn’t eliminate the questions because…

Daniel Lobell: (29:19)
No, not eliminate the questions, but —

Joseph Saveika: (29:21)
That would imply that people weren’t paying attention to their health.

Daniel Lobell: (29:25)
Right, right.

Joseph Saveika: (29:26)
But certainly supply the answers.

Daniel Lobell: (29:29)
Right.

Joseph Saveika: (29:30)
So…

Daniel Lobell: (29:31)
So that seems like… I see what you’re saying. So it’s beneficial to the patient but it’s also beneficial to the medical establishment. So…

Joseph Saveika: (29:42)
Absolutely.

Daniel Lobell: (29:42)
In terms of… That seems like a very big umbrella to just say, okay, so you’re all covered. But in terms of like getting in touch with a specific organization, how do you individualize that?

Joseph Saveika: (29:59)
Well, that’s marketing.

Daniel Lobell: (30:00)
So what are some of your favorite features of the site, aside from the fact that you can direct people there for information?

Joseph Saveika: (30:09)
Well, besides the curated and reviewed medical content, which is wonderful, I actually like the video presentation.

Daniel Lobell: (30:27)
Yeah.

Joseph Saveika: (30:27)
Because you could make a giant blog with all the answers on it, but what happens if the patient can’t read? What if they’re long and wordy?

Daniel Lobell: (30:49)
Absolutely. Or if they do read, but they confuse psychiatrist for, how do you say it again? Physiatrist?

Joseph Saveika: (30:58)
Physiatrist.

Daniel Lobell: (30:59)
Yeah. It can happen. So…

Joseph Saveika: (31:04)
It happens routinely. [Daniel chuckles]

Daniel Lobell: (31:07)
How do you feel technology is changing health and wellness? And do you think it’s all for the better?

Joseph Saveika: (31:13)
Well, technology is certainly changing health and wellness. Things like telehealth have significant advantages, but at the end of the day, medicine also requires physical interactions. So that’s kind of a limited entity by definition. There are wearable technologies now.

Daniel Lobell: (31:37)
Such as?

Joseph Saveika: (31:37)
That lead to the concept of remote monitoring, which are gonna have significant promise in the healthcare of tomorrow.

Daniel Lobell: (31:47)
For example?

Joseph Saveika: (31:48)
There are garments that will actually track temperature. There are garments that will record cardiac activity.

Daniel Lobell: (32:01)
Wow.

Joseph Saveika: (32:03)
That can be relayed for a lifetime, or it can be kind of stored and accessed at a later date. Pretty cool.

Daniel Lobell: (32:20)
Do you have any of these? Have you tried any of them or recommend any of them?

Joseph Saveika: (32:26)
No, actually I’ve never tried ’em. They, by and large, are not yet covered by insurance, so it becomes a significant issue.

Daniel Lobell: (32:36)
Right. But we’re getting there, hopefully, I think so. Because think of all the money the insurance companies would save if people practiced, as you said, preventative medicine.

Joseph Saveika: (32:47)
Oh yeah. I mean, until COVID-19, telehealth largely wasn’t covered by insurance.

Daniel Lobell: (32:54)
I remember over a decade ago I was touring in South Africa and they had a program where the more you go to the gym, if you swipe in with a card, the lower your health insurance cost is every month, to incentivize people to be healthy, to save money for the companies. And I thought, I couldn’t believe that they didn’t do that here.

Joseph Saveika: (33:19)
They do, sometimes. Some companies do.

Daniel Lobell: (33:22)
Yeah? Well, it makes sense. I mean, and these wearable technologies would go along in that line of thinking.

Joseph Saveika: (33:31)
Absolutely.

Daniel Lobell: (33:33)
So you don’t have any wearable technology for health that you mentioned, but do you have any apps that you use to monitor your health?

Joseph Saveika: (33:41)
No, I don’t engage with any apps to monitor my health. I engage with my doctor.

Daniel Lobell: (33:47)
Well, it seems like a good app as well. Your doctor. [Daniel chuckles]

Joseph Saveika: (33:51)
Yeah. Probably the best one, honestly.

Daniel Lobell: (33:54)
Yeah. Yeah. So are there any advances in physiatry that you’re excited about, or things that you feel are gonna change the way you work?

Joseph Saveika: (34:07)
I think the advances in musculoskeletal care are really going to change how a lot of care delivery is supplied in an outpatient setting. The boundaries of what can be handled without an operation are kind of constantly being pushed back. And I think that that is going to dramatically change the field of outpatient rehabilitation. People are living longer and being healthier. They’ll continue to be more active. So you’re going to see a larger volume of kind of musculoskeletal injuries that can now be treated with less surgery. May still involve a procedure, but not an operation in the classical sense.

Daniel Lobell: (35:24)
For example?

Joseph Saveika: (35:25)
Upon the time, there’s a condition called calcific tendonitis which is basically when the tendon gets overused and starts to turn to calcium, bone. They are pushing back the frontiers on that, on what can be managed percutaneously, which means through the skin, as opposed to operatively, which means you cut the person open.

Daniel Lobell: (35:59)
So through the skin, is that like acupuncture?

Joseph Saveika: (36:03)
Well, it’s a bigger needle than acupuncture, but yeah, same concept.

Daniel Lobell: (36:07)
Right. So you think that’s where it’s headed?

Joseph Saveika: (36:11)
I certainly think so. A lot of things that used to be handled by open operations are done laparoscopically now.

Daniel Lobell: (36:20)
Yeah.

Joseph Saveika: (36:22)
Now they put stents in people’s coronary arteries rather than bypassing them and what they can and can’t stent seems to get more open every few years. I’m not a heart specialist, but.

Daniel Lobell: (36:45)
Right. But I think, by mitigating how much we have to cut people open, we’re able to probably prevent a lot of infection and a lot of complications that arise through surgery that don’t need to.

Joseph Saveika: (37:03)
You are absolutely correct. Can’t have a complication if you don’t have an operation, right?

Daniel Lobell: (37:08)
Right. [Daniel chuckles] I love it. So we covered, what I usually round these interviews off with is, I’ll talk to the doctor a little bit about what they do to stay healthy, but we did cover that. So instead, I’m going to change it up a little bit and ask you if you have some life advice for the listeners that you’d like to share.

Joseph Saveika: (37:36)
Oh my goodness. I probably gave that at the beginning. You can start your day over any number of times. If you do not like the direction you are headed, you are free to change it at any time.

Daniel Lobell: (37:52)
What are some of the other big lessons that you’ve learned along the way, from your own life?

Joseph Saveika: (37:59)
Oh goodness. There’s been so many. I would say that humility and a sense of humor will get you just about everywhere in life.

Daniel Lobell: (38:19)
I like that. Well, I certainly have the sense of humor and hopefully I have humility, but it’s something you always have to work on. Then if you’re too humble, then that’s not great either because you gotta let people…

Joseph Saveika: (38:34)
No, no, that does not mean you should be a doormat.

Daniel Lobell: (38:38)
Right.

Joseph Saveika: (38:39)
Nobody should.

Daniel Lobell: (38:41)
You know, I wonder if doormats ever get upset when they hear that. What’s wrong with me?

Joseph Saveika: (38:45)
They may, they may. [Daniel chuckles] They’re used as a terrible reference. People walk all over ’em.

Daniel Lobell: (38:53)
Yeah. Well, doctor, thank you so much. It’s been an absolute pleasure speaking with you, and thanks for informing me about an entirely new field, to me, of medicine that I didn’t know anything about, and your advice in life and in medicine is invaluable. Thank you so much for your time today.

Joseph Saveika: (39:13)
Well, thank you for having me.

Daniel Lobell: (39:15)
My pleasure, and I’ll look forward to seeing all the progress on Doctorpedia, and seeing what you’re doing there and building and developing.

Joseph Saveika: (39:27)
Absolutely. Come check this out.

Daniel Lobell: (39:41)
This podcast or any written material derived from its transcripts represents the opinions of the medical professional being interviewed. The content here is for informational purposes only, and should not be taken as medical advice. Since every person is unique, please consult your healthcare professional for any personal or specific needs.