council award
We recently spoke to Dr . Bhandari about his life and work .
Where did you grow up ? My parents moved to Hamilton from India in 1969 when I was nine months old . In India , Mum was a teacher and Dad was a textile engineer , but of course they weren ’ t able to do those jobs in Canada , so they took whatever jobs they could to support their family . Mum and Dad worked very hard , and I never felt anything but their desire to support me wholeheartedly in making a life in Canada .
What influenced your decision to choose orthopedics ? During an elective block in my first year of medical school , one of my teachers was Dr . Robin Richards , an orthopedic surgeon at St . Michael ’ s Hospital . One day I was observing Dr . Richards doing fracture surgery . I was the only medical student in the room and it was quite intimidating being surrounded by senior residents and fellows . All of a sudden , Dr . Richards said , “ Mohit , where ’ s Mohit ? I ’ d like him to come and take out this screw .” Next thing I knew I was removing a surgical pin . Now , for Dr . Richards , it was probably nothing , but to me it meant the world – so much so that I went home and made a commitment to pursue orthopedics . I wanted to be just like him .
What led you to a focus on research over surgery ? During my orthopedic residency in the early 90s , people started to talk about a new concept called ‘ evidence-based medicine ’. I was intrigued and decided to complete the new Masters of Design , Measurement and Evaluation at McMaster University . It was there that I met Professor Gordon Guyatt who transformed my vision of what an academic researcher could be and , from that point on , I was hooked . Research for me was a bit of a self-fulfilling prophesy – the more I learned , the more I learned what I didn ’ t know and the more I wanted to search for answers . And those answers can mean that instead of helping one patient at a time , you can be helping hundreds at a time , even though your personal impact on them is not direct .
What does ‘ evidence-based ’ medicine mean to you ? In the past , surgeons worked hard , developed their skills and then could rightly see themselves as “ experts ”. But in the last few decades , our profession has come to recognize that what really separates a “ great ” surgeon from a “ good ” surgeon or the “ exceptional ” from the “ great ,” is not skill alone , but good decisionmaking . And in order to make good decisions , doctors need the best evidence to better guide them .
Why is it important for orthopedic surgeons to know when their fracture patients are victims of intimate partner violence ? Isn ’ t it more important for emergency department physicians to identify ? The fact is , the majority of domestic assault victims don ’ t disclose the true cause of their injuries to ER physicians ; and they usually only see that physician once . But in the course of repairing fractures , an orthopedic surgeon builds a relationship with the patient over a longer period of time , making them perfectly placed to help . Our research showed that one in ten women attending fracture clinics had a history of abuse and by the time the fracture has occurred they are dealing with serious , escalating violence .
You are leading a number of research trials in underdeveloped nations regarding road traffic accidents . Tell us about this . Broadly speaking , the majority of trauma cases occur in developing countries . In contrast , most of the gains made in orthopedic research have little impact in those countries because the research recommends treatments and utilizes resources not readily available in poorer countries . By lending a local focus to research , surgeons can more easily find ways to help patients by taking into account the available local resources .
What keeps you grounded and moving forward ? Nothing has been gifted to me . I ’ ve had to work hard and I ’ ve had to fail a lot . I think I ’ ve learned so much because I failed so much , and those failures continually push me forward . I also try to never lose sight of my parents ’ good example . They worked hard to create a good life in Canada for me and my sister . I think that much of what I do is my way of honouring their sacrifices and giving back to the country that welcomed us . MD
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Dialogue Issue 4 , 2016