Q&A With Ryan Sieg, MD

Lieutenant Colonel Ryan N. Sieg, MD is an active duty military orthopaedic surgeon in Fort Hood, Texas.

TOA: Tell us a little about your background.

Ryan Sieg: Growing up, I had always wanted to join the military, but I didn’t know exactly what I wanted to do once I joined.  When I decided that I wanted to be a physician, I heard about military scholarship programs for medical school and voila, the rest is history.  I applied to the military medical school, which is called the Uniformed Services University of Health Sciences.  After medical school, I went to William Beaumont Army Medical Center in El Paso, TX for orthopaedic surgery residency and graduated in 2014.  This was an amazing experience because about 25% of our time in residency was spent working as a civilian at the level 1 trauma center downtown called Texas Tech University Health Sciences Center.  I received top notch training in El Paso and am very appreciative to all my mentors.  After residency, I was sent to Fort Hood, Texas.  This is the second largest base in the United States when it comes to active duty troop population and I have been extremely busy treating our servicemen and women.  The majority of my practice is sports medicine and I perform a lot of shoulder and knee instability surgeries and revisions.  I also have a passion for total joint replacement surgery and with the help of some of my predecessors and current team members, I have helped build a busy total joint practice at our hospital, which has never been done before.

TOA: You’ll be leaving the military in 10 months, what is your plan following that? 

Ryan Sieg: After I leave the military I am looking for an opportunity where I can continue to perform the surgical cases that I have excelled in over the past six years to include joint replacements, arthroscopic sports medicine cases, and general cases.  I enjoy performing many types of cases and I would like to continue that.  I want to work in an environment that is team-oriented and works together to provide quality and efficient patient care.  I also think it is important to balance work and home life so that I will have the ability to work for many more years.

TOA: What has your military experience as an orthopaedic surgeon been like?

Ryan Sieg: My experience as military orthopaedic surgeon has been both the most satisfying thing I have ever done, while at the same time the most challenging thing I have ever done.  Being both an officer and an orthopedic surgeon was challenging because I had to balance the two entities and do both well in order to be successful.  I didn’t get to just focus on being a surgeon.  I had to be a leader and a teacher in an ever changing environment with new command teams, new personnel, new nurses, and new surgical technicians.  I had to stay physically fit in order to pass the Army physical fitness test.  I deployed twice overseas, participated in two medical missions in other countries, traveled to multiple other duty stations for officer training, medical training, and helped other military hospitals when they needed orthopaedic coverage.  I was deployed during part of my board collection window in my first year as a staff surgeon.  Meanwhile, I had to learn how to be a surgeon on my own, pass boards, perfect my craft, and challenge myself in the operating room by taking on the cases I knew I would want to be able to perform when I left the Army.  One of the things I appreciate most about my time in the military is that now I truly feel like I can be successful in any working environment.

Military surgical cases are the same as civilian cases for the most part when we are stationed here at home.  The differences are seen with war trauma.  We have to be able to stabilize and manage large bony and soft tissue extremity wounds from high energy blasts and high velocity weapons.  Once these soldiers return home more definitive care takes place.  Almost all of the war trauma definitive care is performed at Walter Reed Army Medical Center in Bethesda, MD and at Brooke Army Medical Center in San Antonio, TX.  I was involved with some war trauma surgery on deployment as well as definitive care surgery during medical school when I was in Bethesda, but during my time at Fort Hood the surgeries I performed would be similar to a sports medicine surgeon who also does total joint replacements and general cases.

Some of my most memorable experiences in the military were on deployment.  My team and I treated patients to stabilize them long enough to get them to the next echelon of care.  Surgical management depended on the amount of resources available.  Once the patients left our facility we wondered if we did the right thing at the right time.  Something is different when you see one of your own military servicemen or women injured, dying or dead.  There’s a sensation that envelopes your heart when tragedy strikes like that.  Of course, you don’t feel it until the situation is over when you see the flags over the coffins, but it is always there.  It’s the reason I did what I did, but it’s a blunt reminder of the evils of war.  I’ve made good friends and worked with some of the best people in the world and I’m proud to have served our country.  Now it is time to move forward and serve the civilian sector as an orthopaedic surgeon.

TOA: What clinical developments have you witnessed during your time as an orthopaedic surgeon?  

Ryan Sieg: In my previous 6 years since graduating residency, I have witnessed the improvement in all aspects of orthopedic surgery, but most notably I have really seen and experienced the continued development of minimally invasive surgery and the rise of robotic total joint replacement surgery.  All inside acl reconstruction, arthroscopic rotator cuff reconstruction as well as hip arthroscopic surgery are all examples of procedures that are now commonly performed that I did not perform much or at all as a resident.  Robotic total joint replacement surgery has been a part of my practice in the last year.  It has been amazing to see the intra-operative estimations of joint balancing and component positioning turned into real numbers in live time in the operating room.

TOA: Where do you see orthopaedics in 10 years?  

Ryan Sieg: In 10 years from now, I think there will be even more of a demand for orthopedic surgeons than there is today.  We will be unable to provide all of the orthopedic care that is needed.  We will have to help lead the development of musculoskeletal education to primary care providers as well as to the general public, especially in the arena of injury prevention.  Most patients with musculoskeletal complaints improve with nonsurgical treatment measures to include proper diet and exercise, activity modifications, bracing and NSAIDs.  It takes time to counsel, educate and motivate our patients and we will need to work as a team on this.  Research in the realm of mental, emotional and spiritual health through mindful meditation as well as other modalities has also been promising and I think this will have to be continually encouraged so patients will be able to have a successful surgical outcome.

I also believe that the operating room environment will be quite different in 10 years.  I think robotic surgery will be the norm rather than the exception for many surgeries.  In addition, artificial intelligence will start to be incorporated during surgery.  Robotic surgery is already being used today, most commonly during joint replacement surgery, but it will be used even more for different types of surgeries in the future.  For example, it could be used to help position tunnels for ACL reconstruction, ensure cam and pincer bone is removed properly, reduce long bone fractures with proper rotational alignment as well as reduce and fix intra-articular fractures.  I think artificial intelligence will help the surgeons perform surgery by giving live advice during difficult cases.  It will be like having a second surgeon who is really experienced in the OR with us.