Leadership Beyond the Operating Room: What Formal Training Really Does for Orthopaedic Surgeons

A Conversation with Dr. Mary O’Connor

Dr. Mary O’Connor is co-founder and Chief Medical Officer of Vori Health, chair of Movement is Life, and Professor Emerita of Orthopedics at the Mayo Clinic. Over more than two decades in academic medicine at Mayo and Yale, she built a career defined by both surgical excellence and a long list of firsts for women in orthopaedic surgery. In 2021 she left academia to help build a company aimed at rethinking how musculoskeletal care is delivered. The conversation below has been lightly edited for clarity from the recorded interview.

You spent more than two decades in academic medicine at Mayo Clinic and Yale before co-founding Vori Health in 2021. What ultimately convinced you to leave academia and pursue entrepreneurship to transform musculoskeletal care?

Dr. O’Connor It came from the realization that changing the way we deliver care within the traditional healthcare system is incredibly difficult. Hospitals and health systems build their financial margin on elective surgeries, imaging, and procedures. So if you point out that there is over-utilization of surgery for low back pain, which has been well documented, or over-utilization of MRI, which often triggers a cascade of inappropriate care, you run into a wall. We know that many findings on an MRI don’t actually correlate with clinical symptoms. The leaders in those systems are caught in Clayton Christensen’s classic innovator’s dilemma. They can’t innovate, because their financial viability is tied to the very over-utilization you’re trying to reduce. If they do the right thing, they risk financial failure.

And you do have to make a margin to keep your doors open and serve your community. To paraphrase Sister Generose at Mayo Clinic: “No margin, no mission.” But the second half of that quote is “no mission, no need for margin.” Unlike a business that sells a product, our mission isn’t to make money. Our mission is to serve communities and help people. To do that, we still have to make a margin. I always say it’s not a bad thing to make a profit in healthcare; you have to make a profit. But you have to keep the mission of why you’re doing it at the forefront. Deciding to leave academic medicine wasn’t difficult in terms of what I wanted to do with my professional time and the legacy I hoped to leave. What you have to be ready for is not making money. In the startup world, you don’t get paid like a surgeon. So I advise the young surgeons I mentor to get out of debt and put themselves in a financial position where, if they wanted to pivot, they could.

You’ve built Movement is Life around the idea that better health can spread through a community. Can you describe how that happens? [Editor’s note: the original question was lost to a transcript artifact — Kamil to confirm exact wording.]

Dr. O’Connor One woman decides to eat healthier. Then her children start eating what she’s making for herself, and then her husband does too. That’s the ripple in the pond. One woman makes a decision that improves her own health, and now she’s influencing her whole family. That’s how we move wellness and better health into communities.

I’m very proud of that program, and I’m proud of our annual summit. This year we’ll hold it in Detroit on September 24th and 25th. You can go to our website, movementislifecommunity.org, for information, or reach out to me directly after you see this video. It’s an outstanding summit, with excellent speakers addressing the health disparity issues we continue to face. This remains an ongoing, nonpartisan issue. These disparities affect all of us, and we need to keep working to lessen them.

When you think about it at a 30,000-foot level, we don’t really have a healthcare system. We have a sick care system. My philosophy is that we need to move wellness into the community and keep sick care within the healthcare system.

You have broken remarkable barriers as the first female member of the Musculoskeletal Tumor Society, the International Society of Limb Salvage, the AAHKS, and the Knee Society. What has that journey been like, and how has the field changed for women in orthopedics?

Dr. O’Connor It’s been a wonderful journey. I’ve been blessed with many mentors and sponsors, because none of us get there alone. It was two Mayo surgeons, Arlen Hanssen and David Lewallen, who put me up for membership in the American Association of Hip and Knee Surgeons. I later became the first female program director for our annual meeting and the first woman president, and now I’m delighted there’s another woman in the presidential line.

These are questions of whether we, as an orthopaedic surgery profession, truly want to say we are welcoming to the best and the brightest. The point is that we want to attract talent, and talent comes in all shapes and sizes. We want to support the diversity of people in our profession, and that does not mean negating quality or excellence. I have never bought into the idea that to promote diversity you have to compromise on the quality of your candidates. I don’t believe that’s true at all. But we all have bias. Part of creating that cultural space is being able to say: a woman can be an excellent orthopedic surgeon. An African-American can be an excellent orthopedic surgeon. That change is what opens the door to diversity with excellence.

Your story at Yale is well known, including your involvement in the Title IX protest with the women’s crew. How have you kept expanding your horizons and pushing forward throughout your career? And what’s one piece of advice you’d give to someone younger — in residency or trying to become an orthopedic surgeon — to keep them moving forward?

Dr. O’Connor I would say: don’t let people tell you that you can’t do it. There will always be people who say you can’t, or tell you to give up or stop trying. Most people, though not every single individual, can get there with hard work, determination, and perseverance. But you still can’t get there alone. I could never have had the career I’ve been blessed with if it hadn’t been for my mentors and sponsors.

Early in my career, Frank Sim, one of my mentors and a world-famous orthopedic oncologist, was supposed to travel to Sweden to give a presentation. He said, “I can’t go, but Mary O’Connor can. I want you to invite her.” So I went to Sweden, gave a strong talk, and began making connections. The same thing happened in the hip and knee world. Jim Rand, a wonderful arthroplasty surgeon at Mayo Rochester, was asked to run a hip and knee course in the Florida Keys, and he said, “You should ask Mary O’Connor — she’s at Mayo Clinic in Florida.” They did, and that became the first of many courses I ran in the arthroplasty world. It’s about people who have already made it looking for ways to elevate and raise up those coming behind them. That’s how I got here.

You’ve spoken powerfully about mentorship and sponsorship in your own career. What advice would you give to senior surgeons about lifting up the next generation, especially women and those from underrepresented backgrounds?

Dr. O’Connor Be open to looking at the talent that’s there, because there’s a great deal of it. Recognize the value that diverse people bring to our profession — not only in decision-making, but in perspective and culture, and in helping us understand how to take better care of our patients. There are cultural humility lessons each of us could learn.

I think back to one of my patients, a brilliant young woman from South America with a PhD. She had an orthopedic oncology problem and needed surgery. She came to see me, and her brother came with her. Her father had passed, and her brother was now the patriarch of the family. Fortunately, I knew enough to understand that he was —

[Editor’s note: the recording appears to cut off here. Kamil to supply the remainder of this final answer from the full recording.]

Key Takeaways

Formal leadership training appears to deliver real value to orthopaedic surgeons, with most participants advancing into leadership roles afterward and reporting that the skills were useful in their current work.

Men and women drew different benefits from the same programs — women more often in networking and mentorship, men more often in team, vision, and organizational skills — while both reported similar gains in emotional intelligence and mentorship. Surgeons want more nonclinical content, particularly in healthcare administration and business, reflecting how leadership responsibilities grow across a career.

Dr. O’Connor’s conversation reinforces the paper’s quieter theme: careers are built through sponsorship. The programs a society offers matter, but so do the individual acts of naming someone for an opportunity they haven’t yet been given.

Future Directions

The clearest opportunity is evaluation itself. Survey-based perception data is a starting point, and future work using structured interviews, longitudinal tracking, or institutional records could establish whether these programs cause the career outcomes they’re associated with.

Curriculum is the second frontier. Participants asked for training in administration, business, and team management, suggesting programs should evolve alongside the expanding nonclinical role of senior surgeons. The gender findings also invite a more tailored approach, one that meets participants where they are rather than assuming a shared starting point.

Closing Perspective

Read together, the paper and the conversation make a coherent point. Leadership in orthopaedics is learnable, and formal programs help, but the human layer beneath them — a mentor’s recommendation, a sponsor’s willingness to name you for a room you haven’t entered — remains decisive. The best leadership curricula will be the ones that teach the nonclinical skills surgeons increasingly need while preserving space for that quieter work of lifting others up.

Reference

Irani CR, Vutukuri R, Rumps MV, Saraf SM, Mulcahey MK. The Impact of Formal Leadership Training Programs Offered by the American Orthopaedic Association. JBJS Open Access. 2025;10(3):e25.00100. doi:10.2106/JBJS.OA.25.00100