The Living Legend: Steven Kavros, DPM

Transcript

[0:01] You know, the holidays are a very busy time, and as we approach this year’s season, we’d like to hear about your experiences working the holidays as a healthcare professional.

[0:13] So please, share your stories with us, tell us what you’ve learned, and you might just be featured in a very special RX4Success holiday episode.

[0:24] Visit rxforsuccesspodcast.com forward slash contact hyphen us that’s where you can leave us an email or a voice message we’d really like to hear from you so do.

[0:32] Music.

[0:46] Paging Dr. Cook. Paging Dr. Cook. Dr. Cook, you’re wanted in the OR. Dr. Cook, you’re wanted in the OR.

[0:57] Music.

[1:18] Welcome to the Prescription for Success podcast with your host, Dr. Randy Cook. Hello everyone and welcome to Prescription for Success. I’m Dr. Randy Cook, your host for the podcast, which is a production of MD Coaches,
providing leadership and executive coaching for physicians by physicians.
To overcome burnout, transition your career, develop as a leader or whatever your goal might be, visit MD Coaches on the web at mymdcoaches.com because you’re not in this alone.
And don’t forget, CME credit is available when you listen with us, just look for CMFI in the show notes to learn how.
My guest today had a lengthy and distinguished career as a podiatric physician and surgeon, both in private practice and in academia.

[2:06] More recently, he’s pivoted to industry and applied his skills to development of products and devices for wound healing, limb preservation, and orthopedics.

[2:16] So let’s hear my conversation with Dr. Stephen Kavros.

[2:24] One of the things that I really enjoy about doing this podcast is that I get to talk to some really brilliant people and get deeply down into their brain.
And I’m going to do exactly that today. But in addition to that, I’m going to get to talk to an old friend. So that makes this episode especially enjoyable for me.
I hope so. For our guest, Dr. Stephen Kavros, thank you so much for being with us today. It’s great to talk to you again.
Thank you, Randy. It is an absolute honor and a privilege and a pleasure to be discussing our mutual interests that we’ve had in the past.
Well, let’s do exactly that. Let’s have a conversation in which I intend to learn some things about you that I never knew. And I like to start at the beginning, as most of our listeners know and understand you were born in New York, is that right?
Correct. And did you’re growing up there? Early on, I was born in New York City, affectionately known as the Big Apple.
I am a product of a generation called the Baby Boomers. I’m sure you’re aware of them, right?
Yeah, welcome to the club. Welcome to the club.

[3:41] So, yeah, about 10 years after the completion of World War II, I was brought into this world. I started in one of the boroughs of New York City called Queens, five boroughs in New York.
Queens is one of them. And about a year after that, my parents built a home in Long Island in Nassau County, which is not very, very far from the five boroughs in New York.
And I spent my first five years there in New York City. My core family, grandparents, aunts, uncles, cousins, 99.9% of them were in New York City.
So my dad moved out of the city. My grandparents thought he left the world, but only went probably 10 miles away. And again, I spent my first five years on Long Island.

[4:35] And then as a kindergarten transfer, we, our family, picked up and I moved to southern New Jersey just adjacent to Philadelphia.
So that’s really where I grew up. From halfway through kindergarten all the way through high school, I attended that school system in New Jersey, southern New Jersey.
And it was quite an excellent education, excellent time.
I guess you probably know I’m of Greek descent.
I’m second generation. All four of my grandparents are from the island of Crete. All came over on a boat. My wife’s parents, my wife’s side on the other side, they came over on a boat too, but it was the Nina, the Pinta, and the Santa Maria.
So they’re blue bloods. And Mike came over with a little, called a valise, which we know as a suitcase today, and they came to Ellis Island.
So my family, immediate family, is a 15-month-old brother and a sister three years younger.
We are basically second generation and we’re the first ones that really went to college.

[5:47] Prior to us, another set of my cousins went to college that’s a little bit older than us, but we were always instilled that the pathway to success is get an education. We didn’t have one,
You’re going to get one. So that’s how we that’s how we rolled at that time.
And, uh, Well, let’s talk about that a little bit. I’m assuming by what you say that there were.
There were no physicians and surgeon relatives around to influence you. So I’m wondering how you got interested in medicine. Yeah, exactly. So I have no one in my family.

[6:23] In the sciences, not just medicine, but in the sciences. So I actually, as a young, young, young boy, I really didn’t have an academic pathway, probably until high school,
school, sophomore year, high school. Basically, I was much more interested in playing ball, whatever the season was, football, basketball, baseball. But when I was about seven years old and there’s certain sentinel moments in your life that you can remember very clearly.
Growing up in South Jersey, we used to have pretty good effects of hurricanes that used to come up the coast. And one late summer, we had a hurricane come through and on the
area about a block or two behind my house, it was kind of a swampy area anyway. But I was riding my bike after the storm and I came upon this frog that had been killed and kind
of eviscerated in the street. Got off my bike. I just was, I guess, mesmerized to see these internal organs, see viscera, see the muscular system, the osteosystem, the bones.

[7:39] And from that day on, I just fell in love with science, especially biology. Again…
And that is one of the most fascinating path to medicine. Yeah. I mean, it was…
A dead frog brought you… A dead frog. And I brought that frog home, showed it to my mom and explained what some of these…
Oh, she must have been delighted. She was really excited because again, my path in life was athletics. It was not academic at that time, far from it.
In fact, again, I mentioned my brother is 15 months older. We grew up.
Very, very close in a family. Our family is very close, but he from probably, you know, his APGAR score coming out of the womb was in the 150 range of an IQ. And, you know.

[8:30] Picture yourself following him in school every single academic year. You’re Harry’s brother.
Oh, we expect this. I said, no, you know, in second grade, I said, let’s stop that. I am not him. And they quite quickly saw that I was not him. He was again, just that he’s
a brilliant individual. And so is my sister. I’m the middle child. So you know what the middle child syndrome is like, right? Oh, yeah. So in any event, I brought this frog
home and showed it to my mom and I was just enamored. My mom took the cue to go get me a book and I still have this book in my armor now. It’s a science book. It’s probably a,
a little five by seven book on zoology.
And it went through everything from Darwinism all the way up to genetics and into anatomy, physiology, you name it.
And that captured my attention.
And again, it wasn’t until high school when I had my first biology course, my biology teacher who became a very important mentor in my life took me to a different path in life.
She just opened my eyes to the sciences, biology primarily, but also chemistry, and then it went to physics and so on and so forth.
But she was a very, very powerful influence in my life.

[9:52] So at the end of my junior year in high school, my high school was directly adjacent to a hospital in town here.
She said, there’s a program over there and they’re going to take two students. Did typically take a two seniors but they might consider taking you steve if you apply i think she was kind of like when you apply go ahead.
And that’s this program centered around being.
In the department of pathology and working with a technician who did histology preparing slides and the pathologist and i’ll never forget him or when lock he. mentored myself as a junior going from junior to senior and another one of my friends who was senior going into college.
And basically we learned histology and we actually participated in autopsies that summer. Wow.
Yeah, that was my actual first true experience to the medical fields. And he gave me a book, Ham’s, Ham was the author, it’s Human Histology.
And that’s the same book we used in our first year of medical school.
But again, I just couldn’t get enough. I just loved it, loved it and loved it.

[11:12] From high school biology, you know, you go to the chemistry, you go to the physics. And then in my senior year, we had advanced biology, which I took,
which led to some other opportunities with getting more involved with other academic programs in school, which led me to my collegiate opportunities.
At that time, in the mid-70s, There was a little bit of a change in the college curriculum where you could measure in your love of your biology and your chemistry, but they also wanted you to have a little,
bit better balance with humanities.

[11:55] But even at that point, I was so engrossed and enthralled with the sciences, I ended up taking 75% of sciences and only 25% of humanities.
Now, if you were to ask me today, would you do it all over again? I’d say no. I would take 75% humanities and 25% science because in your professional school, it’s nothing but science, as you know.
And I think it makes you a better well-rounded person to understand philosophy, religion, language, history, European, American, whatever it is, literature.
But again, that’s all 2020 is hindsight, right? Well, I’m thinking you probably got a broader experience than a lot of people going to medical school even today, even though they still talk about a broad-based education.
But you got a Bachelor of Arts, not a Bachelor of Science.
So you had some humanities experience. Yeah. Rutgers University did give… I always kind of questioned that during my collegiate years. I said, you know, my buddies are getting a Bachelor of Science. How can you give a Bachelor of Arts?
And I said, you know what? It was King’s College. Now it’s Rutgers University.
Way back when, when it was King’s College, it was one of the Ivy League schools. It’s certainly not now. It’s a great school, but it’s not in that same genre as the Harvard, the Gales, and the Princeton’s.

[13:19] But they went with a Bachelor of Arts, even if you had a science degree.
Background, because they wanted you to have the humanities and come out as a quote-unquote well-rounded person.
So your baccalaureate degree was in biology and the sciences, and it sounds like even from back in high school you were thinking about a medical career, but you focused it fairly quickly.
You decided to go into podiatry. Can you tell us how that happened? Certainly, but in college, just as a little precursor, in college I had quite a bit of
sciences, but one of my mentors in college was, his name was Dr. Sin Lee, L-E-E. He was from Taiwan. He was from Michael Reese. He was educated in University of Chicago at Michael
Reese, and he was kind of a world leader in developmental biology. And during my time in college, I was very heavily involved in the research aspect. So I thought I was going
to go down this path of a PhD and doing research in developmental biology. And developmental biology and especially cell biology at that time in the mid-70s was kind of a virgining.

[14:38] Field. We knew mitochondria, we knew DNA, RNA, we knew Golgi complex, all those things, But it wasn’t really that deep yet.
And I ended up doing research with him and did research.

[14:53] His animal model was a chick embryo. So we ate a lot of eggs after the experiment. But the chick embryo model was a really great one for developmental biology.
And my senior year when I did my thesis on this cytotulation being the effect of nautochord development in chick embryos, it was this formula, this chemical that would affect how,
cells divide and how cells act against one another.
I had to give a presentation at the New Jersey Academy of Natural Science. At that time, I was scared to death because I never was up in front of an audience, especially
New Jersey Academy of Natural Science and give a senior thesis, but I practiced in front of a mirror ad nauseum.
My wife or my girlfriend at that time, that became my wife much later on, she said, boy, you can’t really practice this much more. You’re just beating yourself to death. I gave that…

[15:59] I graduated thinking I was going to be going into a research field and doing that. I actually took a year off between college and when I matriculated at Temple University
for Podiatric Medicine because I was really kind of torn between veterinary medicine and,
something on the human side.
Coming from New Jersey, New Jersey was a state that had no affiliation with a veterinary school.
Getting into a veterinary school from New Jersey was almost very, very difficult because all the other schools were accepted on a regional basis. If you were in the Midwest, if you were in the South, whatever.
I could apply to University of Pennsylvania and Ohio State. They’re the only two people that would accept my application.
I did that as a senior in college.
Rejected from Penn and I got on the waiting list at Ohio State, but not enough people left or didn’t matriculate.
So anyway, I spent that year between post-college as a biology and a chemistry teacher at where I actually went to high school.

[17:10] And during that year, one of my classmates who was one year ahead of me at Rutgers came back and saw me and he said, Steve, I’m a freshman at this College of Podiatric Medicine at Temple University in Philadelphia.
It’s really exciting. It’s really novel. It’s got a lot of growth in surgery, in diabetic fluid, in podopediatrics, and research.
He said, you know, to mix your research interest and your clinical interest, why don’t you take a look at it? So I did.
I went over. I applied. I got in. And that’s, as I say, that’s all she wrote.
In the College of Podiatric Medicine in Temple, I engrossed myself in research from almost the get-go.
But also, I quickly gravitated to the clinical aspect of patient.

[18:02] Interaction patient care and i call myself even to this day a grunt a worker be because my heart and soul is really patient care even with the other things that i’ve been fortunate enough to do and lucky enough to do,
it’s the patient care that really gave me the satisfaction and let’s just talk so much i want to talk to you about but once you got into,
podiatry school, did you immediately feel like you were in exactly the right place?
And man, I really hit a home run.
I did. I did. Again, going back to that 70-year-old kid finding a frog, inviscid in the street, all the way through my middle, end of high school, in college.

[18:54] I really focused on the anatomical sciences. I loved gross anatomy, histology, and biology, development of biology. So my first year, it was a traditional academic process. I mean,
as opposed to the much more integrated process that they have today, where you’re in clinic as a first year student, right? Now, when we went to school, I assume we’re pretty close in age.

[19:20] The first two years was basic science, the second two years was clinical science, your clinical rotations. So in my first two years, I just ate up. I spent more time in gross anatomy than.

[19:33] I don’t think any of any other of my classmates. I just loved the dissection. I loved the.

[19:40] Process of learning as much as I could on the anatomical sciences, which helped me immensely later in the surgical field or the diagnostic field because when you look at something.

[19:56] You remember the old x-rays on an x-ray view box, you’re looking at a two-dimensional item. When now, you know, you and I are in practice and all of a sudden CTs and MRs come out.
Well, you’re looking at something still on a plain film, a two-dimensional on a computer, but really you have to envision this 3D. And that’s where I think I really was blessed.

[20:21] With the ability to look at something and be able to look at it from the front, the side, the back, the middle, the top, the bottom, and get a very good impression of what’s happening,
in a three-dimensional aspect. So for surgery or for a diagnostic procedure, I was really,
very, very comfortable understanding what I’m looking at. Or more importantly, when something goes wrong and something always goes wrong, usually in a surgery, how do you remedy that?
And how do you go from a cookbook process to an innovative way of repairing something without thinking that, well, that’s not what the book said.
You’ve got to think on your feet and you have to have the vision to do that.
Do you think your early experience in the autopsy room sort of informed you in a way that most young medical students are just not able to process?
Do you think that really helped you in that regard in that three-dimensional imaging and then those sorts of things?

[21:29] Immensely. Again, I was 16 years old when I was doing that assisting in autopsies. It was just an incredible experience to visualize the anatomy that is actually a fresh anatomy
compared to a preserved cadaver that we’re dealing with in our education.
But when you’re dealing with something that was beating a couple hours ago, totally different perspective.

[22:04] It sounds like the educational process up to that point was possibly in excess of your expectations. I’m wondering how it felt to get into private practice, which you started there in Philadelphia, I believe.

[22:19] Yes. Private practice, after my residency, I had a really phenomenal residency. I couldn’t have asked for a better one.
I had a combination of an in-depth view of foot and ankle surgery, but I think more importantly, I had an orthopedic group that ran the hospital there, the surgical part of the hospital,
that was probably an easy 75% of my education too, and also some plastics.
The orthopedic team there.

[22:55] Saw right away how interested and how engaged I was to participate in anything that they did, whether it was a hip, a wrist, an arm, a knee, foot, an ankle, it didn’t matter.
I grew very close to those gentlemen. They were five guys in the group, as well as my podiatric mentors too.
What it taught me was a lot of the podiatrists that were lucky enough to get residencies at the time that we were coming out, I was coming out, they really just focused on, you,
know, let me understand how to do a forefoot surgery real well or a midfoot or hindfoot surgery, but it didn’t give them the entire view of the entire patient.
And the entire patient is so much more important than just a hammer toe, for example. And the reason I say not to diminish a hammer toe, because that hurts somebody.
And you have to fix it if all conservative efforts fail. But what I’m trying to say is that hammer toe is attached to a person.

[24:03] That bone that you’re treating is no different than the way you would treat a fracture or another surgical entity in a tibia, an ulna, a radius, a hand, a metacarpal, and learning
the principles of bone physiology, of bone surgery, of compression, of fracture care,
would only enhance the ability for you to be a better practitioner of what you are eventually going to do.
Again, I was very fortunate to have a dynamic, one of the best programs in the country at the time. But when I came out, I had done a ton of different procedures, even in the
foot and ankle, many, many more procedures in depth, complicated procedures that most of my colleagues. But when I came into practice, I said to myself, okay, I’ve got this great training. However, ever.

[24:56] If somebody comes to me and they need a really complex thing done, and if I’m not doing that every day or every other day or multiple times a week, my skill set is not going to be as good.
I refer that patient out because I’m just not doing it. And that’s whether it’s my foot and ankle work that I did initially, or if someone were to come to me and say, hey, Steve, I need my,
knee scoped or I need my hip replaced, who do you suggest I go to? My reply is go to somebody who does it all the time because you’re going to get a better result. And when I went to Mayo later in my.

[25:37] Practice time, I became involved with physicians, especially in the orthopedic department, for for example, where I was part of that team right there,
that they were doing 150 hips a year,
instead of the average orthopedist that might’ve done 10 total hips a year.
Who would you rather go to? I viewed myself the same way. If I can’t do that ankle fusion that I was trained to do, but if I’m only doing two a year, I’m not gonna be any good at it as compared to someone that’s doing 100 a year.
And that’s how I feel medicine should be practiced, by who’s doing.

[26:14] Who’s got the best skill set? I don’t think there’s any arguing with the data on that. The better results always go to the people with the most experience.
And what I want to do at this point is talk about that move to Rochester, the Mayo Clinic. Now there is a prestigious place where you can be surrounded with really smart people,
And I can imagine you must have been delighted to have the opportunity.
You want to fill us in on that?

[26:47] Yeah. Again, you know what I said about a curve ball? You never know when it’s coming.
So here I am. I’m in private practice for nine, almost 10 years in Philadelphia, South Jersey. And one of my mentors, orthopedic mentors, Gad Gutman, he just took a great interest
in my academic interest and my surgical skills, my manual skills and so on.
And he said, Steve, when I left the program, he said, you’re going to be bored out of your head in private practice. You’ll just be despondent. I said, why?
Because he said, you just have a different path in life, a different path in life than I know what you’re doing.
You’re going out to private practice and you’re going out to solo private practice.
And I said, yes, I know, I’m one of the dinosaurs, even in the early 80s, not too many people were going into solo practice anymore.
They were joining groups because they couldn’t compete with the, they had to compete rather with the HMOs and the managed care.

[27:54] But the economic decisions were there even in the early 80s, in mid 80s. But I said, no, in my education, my training, I visited a whole bunch of different podiatric offices and I saw the same recurring theme.

[28:10] They take somebody young as a junior associate and they say, we’ll give you a partnership in five years, three and a half, four years, four and a half years comes by. Hey, you know what? It’s not working out. See ya.

[28:22] And I’ve saw that over and over and over. And I said to my wife at that time, I am not going down that rabbit hole. I’ll start from scratch and we’re going to be eating hot dogs and macaroni and cheese.
Because if I build something, it’s for me. It’s not for me to waste five years of my life after this and then start over again in your own practice.
So that’s what we did. We bit the bullet and we gave up a ton of stuff. We had a family started at that time. Priority was taking care of her and children, but nine years it worked out.
And then through our other processes, I got this call from the head of orthopedics at Mayo Clinic.

[29:09] And he said, you know, I talked to Dr. Gutman, Gad Gutman at one of our national meetings. And he said, I know this guy who really would benefit from this type of environment.
And he said, by the way, I, you know, at that time, I had really gravitated more from, you know, I did the general, what I call elective foot surgeries, the hammer toes, the bunions, the metatarsal things, all the simple clean surgery.
But I was also gathering a very good referral base from a lot of my family physicians that would trust me to take care of their patients that had foot ulcers, leg ulcers.
And I developed a really good interest in that.

[29:54] And in my residency, I got some of that also because one of the hospitals that I did work at was a police and firemen hospital and we had a lot of diabetics in there even at that time and I would see a lot of people with ulcers, venous and diabetic, ulcers from diabetes,
etiology.
And one of the plastic surgeons that I used to try to pick his brain all the time, I said, you know, what do you do for this? What do you do for that?
He says, I don’t know, I just wing it.
You know, this is how I was taught in my residency. I do wet to dry and I put some betadine ointment in there and that’s it. See you later.” I said, well, I’ve been looking around and I think there’s some other opportunities here. He said, well, go to it then.
So I found this book, Biology and Surgery of Wound Healing, and it was by a gentleman, Earl Peacock.

[30:43] And Earl Peacock was the head of plastic surgery and hand surgery at University of North Carolina, a World War II vet who came out, went to medical school, became a plastic surgeon, and actually I.

[30:55] I devoured his book because it was on the science of healing what what are the phases what do these faces mean not just how you what what does it look like and how do you fix it. That’s what really turn me on to a lot of the wound healing biology that’s when i started digging deeper and getting a little bit more inquisitive in the late eighties.
About wound healing. There were no societies, wound healing societies at that time. It was all kind of learned by the seat of your pants. So that’s how I basically, when I spoke with
Dr. Mori, I said, look, you know, I would love to come here, but I’m really interested in wound healing, not just general foot science and medicine. And he says, well, we’re starting this new integrated multidisciplinary vascular center here, which will include vascular surgery,
vascular medicine, interventional radiology, PM&R. I think you’d be a great fit to go in there and do,
wound care, wound healing for them. We’ll get back to our conversation in just a moment.

[32:05] But first I want to let you know about a great gift idea from MD Coaches. You can actually give the gift of coaching with an MD Coaches gift certificate. All you have to do is let us know,
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[32:32] And this was truly at the true genesis of the discipline that is fairly well recognized and.

[32:45] Available in a lot of places, and that is the discipline of wound management, which prior to that was you just didn’t see anybody that was going to, well I wouldn’t say anybody, but you
But you didn’t see a lot of people that were going to develop a great interest in an altar that had been present for months, if not years.
And it truly was the beginning of an entirely new scientific and clinical discipline. And you were certainly part of that.
And clearly it opened some new avenues for you in terms of other interests that you might follow. You want to talk about that a little bit?
Oh, sure. During my, again, I called myself to work in Grunt, seeing patients all day long. But I would come in early in the morning and then stay later in the evening and do my research.
Because early on, I didn’t have funded research. It wasn’t until later that I had some NIH and I had some industry-sponsored stuff. But that industry-sponsored stuff research enabled me to really dig deep in the weeds and develop some interesting products and technologies.
And fortunately, some of those are available now for…

[34:08] National and international use for our colleagues. And that process, for example, one of the xenografts that I did a lot of work with, which is for the listeners that aren’t
familiar with that term, it’s an animal product that is processed FDA clear to be placed into a human. So an allograft and an autographed comes, you know, is skin that comes from you and is put on you. An autograft is a human product that goes to a human product and a xenograft is,
an animal product that goes to a human person. So I worked on this one xenograft and I did about four years of work, got it through so many processes and then it was well commercialized
by a company. And then at the latter stage of my time at Mayo, I had the privilege of,
developing a couple other medical devices. And I got very, very interested in that aspect of.

[35:06] Delivering that type of service. And I thought, well, if I could help 100 people, maybe with this process on the medical device side, I could affect thousands of people. So long story short,
I ended up going into this one company out of Boston for this new Zinnigraf product that,
actually did quite well. And it filled a void for very, very deep wounds, for burns, and limb preservation, which again was one of my main goals in life, was how to save somebody’s limb
that was in jeopardy of losing it, whether it was from diabetes or vascular or some other neuropathic,
process and it just allowed me to develop a different skill set.
Even before that, I developed a little bit more of a business skill set after private practice with some work at Pfizer and some other private companies.
And it gave me a business background and then the medical background. And I made that leap of faith into the medical device world.

[36:19] It was a jump into a cold bucket of water. because how my values looked at taking care of a patient wasn’t exactly parallel to the business
world, I guess. So there was a little bit more pressure to do things in a revenue path instead of just a pure clinical path. And my goal is to marry both of them, have a great clinical story and a great clinical outcome and a great evidence-based reason why you should use it,
it, and then go to the payer and say, this can affect your number of patients that you cover. If you use this, it can decrease the recidivism of another episode or whatever.
It’s basically trying to marry those both together. And that’s where I landed for a few years. Then I did some more clinical work on the private side. And then I just returned again,
to more of a industry position. I’m currently Chief Medical Officer for a medical device company,
that basically started as an R&D company in the oral and the dental arena. And you say, well, Why would a guy doing wound and limb preservation go to oral and dentistry?
Well, it’s because the foundational technology that they have.

[37:49] Can go into the wound world, into the burn world, into a drug world, into a tumor world to mitigate a tumor.
And it’s all tissue. And you have to be able to understand where some of these things can go and how do you get them there through the regulatory process.
I am not a regulatory person. But I’ll tell you by the seat of my pants.
Yeah. I mean, you learn a lot by having to take something that, it’s termed de novo, which means there’s not a predicate out there to give you a smooth path into the FDA clearance.

[38:29] It’s an eye-opening process, but it can be accomplished with the right people. Surround yourself with good people, have faith, have the people that you work with, make sure that they’re on the same page as you,
and then you can have a successful process.
And that is really exciting. So I still love seeing patients. I still see patients a day a week for specifically advanced wound issues.
But I have at this stage of my life, most of my efforts being directed towards medical device and very shortly drug development.
You know, Steve, you’ve clearly made quite a number of really pivotal moves in your life, life, both personally and professionally.
And I’m just curious to sort of get into the, the more philosophical area here, um, uh, particularly with this, with this last change, did you, did you ever have
any reservations about leaving a situation that was as scientifically and,
personally satisfying as the Mayo Clinic environment, and then moving on to do something in a completely different environment.

[39:49] Was that a struggle for you at all, or did you wake up one day and say, you know what, it’s time to move along? How did that work out? Well, Brandy, to be succinct, every day I think about that, every single day.
Why am I doing this? Why did I, I had such a good opportunity, why? But diversity is a part of me. For example, I couldn’t in private practice.

[40:15] It just bored it. It didn’t hold my attention to do the same thing every day It became very mundane. I needed more diversity.

[40:25] Going to Mayo gave me that diversity. I mean my other two colleagues in podiatry at Mayo.

[40:33] Were very happy doing what they were doing. I was not I I took that and I I Expanded the breath and the scope of the foot and ankle medical delivery at Mayo, and then I went over very shortly to the vascular wound center and expanded the capabilities of what I knew I was capable of doing.
The same thing with being there for 20 years.
I knew I had something else in me that I was meant to do and to accomplish. accomplish and Yes, giving up those patients. You know, I still in my desk have a folder full of,
probably 200 letters that are handwritten from patients that when I.

[41:18] When they found that I was leaving the clinic they wrote to me and you know wished me, you know Good success and good luck and you know, who am I gonna go to now?
I said there’s plenty of other good people out there. You’ll find them and they’re right here, you know But I knew I just needed that leap.

[41:34] And I’ve never been one to say, well, I’m just going and I’m going to go do it. I do it with trepidation. I do it with butterflies in my stomach.
And typically it takes a couple of months to say, hey, did I do the right thing?
And then sooner or later you get comfortable and you see that you’re making an impression. You see you’re making forward movement and you say, yes, this is why I did it because I am making an impact somewhere.
And I’m not saying a huge impact, but it can be incremental. It can be tiny, but it’s still an impact.
And it gives me the professional satisfaction that I’ve accomplished something else.

[42:14] Sounds to me like that wherever you go you come with a sense of determination to to make it right for absolutely again diversity and.

[42:26] I Guess I would just say thoughtful decisions,
You know think my dad was an aviation mechanic And he started a Campbell Soup aviation department, and he was a great mechanic He taught me why I think I’m good at mechanics, but I can’t hold a candle to him.
In fact, way back when, when I was a resident and I was doing rheumatoid foot repairs, these poor people have such bad knuckle joints where their toes meet the long bones, they’re overlapped and so on.
I said to my dad, I said, I need to make a device. I need to take this bone screw and put it on a handle of like a hemostat because I want to screw it into the distal medullary canal, pull up and cut with my other hand because I’m doing it ineffectively.
My dad took the cancela screw and the hemostat, cut it, silver soldered it. I sterilized it and I used it.
I still have those to today. Zimmer, the big company Zimmer wanted to take that, but they already had their own. That was probably the beginning of my love for medical device.
But you’re right.

[43:51] It’s thinking, how do you think to make a situation better? And I think I’m a really good carpenter.

[44:01] Which made me good manually dexterity to be handling surgery. But where the weight peels from the shaft is when you have a problem. When that cuff goes down, when that oscillating
saw breaks, when that screw breaks in deep and you can’t get it, how do you rectify that?
That’s to me separates somebody really good versus somebody who’s just good.
You know, how do you handle the adversity? And you know, life is adversity.
I mean, I don’t know too many people who go through life and say, hey, I’ve never had a hiccup.
You know, I’ve never had a problem.
How do you handle it? It’s the people who are successful are the ones that know how to handle it and can resurface. You know, I was just thinking how fascinating it is that it sounds like everywhere you’ve
been, you have really made your life as good as it can be and you’ve been very effective with it.
And I’ve really enjoyed hearing you talk about the success in your professional life, but I’m wondering if you’d like to talk a little bit about what you like to do for fun. for fun. Do you ever have any fun?

[45:20] Oh my gosh. My wife says when you retire, you’re going to be busier than when you’ve worked. And you know, I’ve been working 70 hour weeks most of my life. My love, I love
fishing. I love hunting. Photography is a great passion. I love the creativity of those things. I’m still an avid sports enthusiast. Although, you know, my rotator cuff is gone.
I can’t pitch like I did in college and high school.
But even in my busiest of busiest times, I coached baseball for 16 years with one of my sons or both my sons, really. I just involve myself in community activities.
I’m a strong believer in giving back.
We didn’t touch on this, but I was the last year of the Vietnam draft.
I was 17 and by the time I turned 18, I went and signed up. Luckily, unfortunately, my number was high enough, and I was in college at the time.
But I always wanted to do some type of military service.

[46:28] Even in podiatry school, I tried to get in to the Army, the Air Force, or the Navy. But the guys and the girls that were in there as podiatric surgeons and podiatrists, they.

[46:40] They weren’t coming out because they had it too damn good.
It wasn’t until I developed low frequency ultrasound, another medical device that I did at Mayo starting in 99 to 2000, got it through the FDA.
The biggest satisfaction professionally in my life is when this technology, I finally got this technology to go over to Iraq and Iran to take care of blast injuries.
These poor soldiers and Marines and seamen, their abdomen and thorax were well protected, but their limbs were getting blown off.
This technology, the slow frequency ultrasound was able to… It wasn’t specifically for wound healing, but it was for the antimicrobial action.
There was a bacteria that’s in the sand, a synobacter bogmani, it’s a gram negative of rod that we didn’t have an antibiotic to treat it.
And these poor people were getting infected and they were losing limbs, not just from the blast injury, but from the secondary infection.
And it was in 2008, the technology finally went in there to the Navy SEALs and some of the Marines. And I can’t tell you how satisfying that was.
But during that process of developing this, I again.

[47:59] Fought hard to go into the Army or the Navy as a reservist at Mayo while I was at Mayo and I was over 40 at the time and there’s a hard cutoff for Benoitri as 40 years old and I had letters from.

[48:12] As high as the White House to let this this this this this working grunt get in there and do some service and again,
Even a congressional act couldn’t get me in there. So anyway, I found this path with the US Coast Guard Coast Guard Auxiliary, we support the Coast Guard, Active Coast Guard and Department of Homeland Security.
And this goes back to what do you do for fun? I’m a member of the Coast Guard Auxiliary and I serve the Coast Guard and Department of Homeland Security on my spare time.
And you’d say, what the hell are you going to do? What are you doing in Minnesota?
Well, there’s a big river here called the Mississippi and there’s a lot of contrabandic.
Yeah, contraband comes up and down and there’s also a lot of other things that we do, but that gives me satisfaction to give back. And you know, the busier the person, typically the more they can accomplish.
And again, as I said, when I retire, if I retire, when I retire, I probably have more things to keep me busy than I’d ever want.
But right now, I’m just living the life. Well, Steve, I have really had a lot of fun picking your brain for the last hour or so.
I’ve learned a lot of things about you that I didn’t know and have learned a lot more about things that I’ve been curious about since I first met you. And I appreciate you so much being here to share the story with us.

[49:41] But at this point, I want to do what we came for, and that is I’ll get out of your way and close my mic and the audience. Dr. Steven Kavros is going to give us his personal prescriptions for success.

[49:54] Thank you very much randy again this is what pleasure to participate in your podcast i have three that i kind of focus on the first one is basically surround yourself with people. Have the same mission and culture that you have because if you do that you’re.

[50:18] Eventually going to be successful in whatever you do and I’m not talking about monetary. I’m talking about Anything that you value as successful.

[50:29] In my decades and Mayo I’ve taken care of hundreds of CF CEOs of small cap companies mid cap and large companies and there was an underlying
message from each one of them and they’re basically this I became as I became a lawyer I got educated and got a law degree not because I wanted to
practice law but because I wanted to reason and and understand the world in a different way which it taught me number two I surrounded myself with good people,
who knew their specific domain much better than I did.

[51:12] And number three, I’ve made mistakes, but I never make that same mistake twice.
So again, surround yourself with people that you trust and that you value and you’ll be successful.
Number two, I alluded to this, listening skills. Listening skills for a clinician, Doesn’t matter what domain you’re in, what specialty you’re in.
God gave you two ears and one mouth.

[51:41] Listen. Even if you’re constrained with a 12 minute visit today for your patient, like a lot of family practitioners, 12 minutes, that’s all I get.
Listen, listen, listen. They know their bodies better than I know their bodies.
And then you can help them out better. That is absolutely imperative. Take the time to listen.

[52:05] If I had that benefited home, in my home situation, my wife would be much happier. But I guess you can’t do it on both sides of the fence.

[52:16] The third is rely on people that are very special to you in your life to keep you centered, to keep you focused, and to keep you from straying off of your mission. It sounds simple,
but family to me is the most important thing.
Without a strong family from my grandparents to my parents to my spouse and to my kids and all extended family, I probably wouldn’t have had that drive as vehemently as I did.
My wife has been the strongest proponent of who I am and what I’ve done. And there are many times that I said, I just don’t know if I’m going to continue.
And she said, get a grip.
You can do it. You’ve always done it. You’re different. You can navigate through this.
Listen to people who believe in you because if you just listen to yourself, you might be pushed in a different direction.
So listen to people who really have your best interest involved also. And that can be, again, a partner, a spouse, a mentor, an old colleague, it doesn’t matter.
But when you think the world is closing in on you, take a breath and go ask for help. Go ask for somebody else’s advice.

[53:45] And I think it’ll be the best for it. So those are the three things that I kind of still value today and how I kind of go day by day.

[53:55] I again appreciate the opportunity to spend some time with you.
Dr. Stephen Cavarose, I want to thank you so much for sharing your wisdom with us today. It has been very insightful and I have really, really enjoyed the conversation and learning some things about you that I have been unable to acquire over the years that we’ve known each other.
Before we go, I want to give you an opportunity to tell the audience where they can find you, whatever you would like to share, whether it be email addresses or Facebook pages or or whatever you got, we’d like to know where you can be found.

[54:36] Oh, well, thank you. Well, the simplest is my personal email. It’s my last name, K-A-V-R-O-S, another S and a J, at gmail.com. You can also find me on LinkedIn. Those are probably the two,
that would be the easiest. I do have an email at work also, which is just scavros at epien.com.
So those are the three. Well, thank you again, Steve. Dr. Steven Cavros, it has been a real pleasure having a conversation with you this afternoon. And thank you again for being here.

[55:21] Thank you so much for joining us today. You know, you can really help us with a five-star rating. That’ll give our podcast much more visibility, and that helps us reach many more
listeners. Exclusive content is available for you on our Patreon page, including membership-only material, like personal rapid-fire Q&A sessions with our guests. To be sure you never miss an episode, visit our website at rxforsuccesspodcast.com to subscribe. And while you’re there, learn,
how to get CME credit from CMFI just by listening. Special thanks to Ryan Jones, who created and performs our theme music, also Craig Claussen of Claussen Solutions Group, who edits the show. And remember, be sure to fill your prescription for success with my next,
episode.