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Dr. Sebastian Rodriguez-Elizalde built a same-day anterior hip program inside a Canadian public hospital — not a private surgical center. This conversation covers what it actually takes to change your approach, your team culture, and your system all at once.

Sebastian trained in posterior approach at HSS and transitioned to anterior approach early in his independent career. In this episode, he talks honestly about the ego hit of relearning something you were already good at, the anxiety of operating without a safety net, and the decision to go all-in without giving himself the option to retreat. He describes surgery as choreography — a measured cadence where every team member understands the beats of the day.

What makes this conversation different is the emphasis on system change. Sebastian didn't just get faster in the OR. He brought his entire team to observe high-efficiency programs run by surgeons like Charlie DeCook and Kristoff Corten, then built a hybrid Canadian model from what everyone learned. He explains how overcoming institutional inertia in a public healthcare system requires patience, proof of concept, and the ability to speak the language of administrators, nurses, and anesthesiologists — not just surgeons. Whether you are early in your career or rethinking how your OR runs, this episode offers a practical blueprint for building something better without burning out.

⏱️ Chapters:
00:00 Introduction and guest background
01:39 Why surgery is like choreography
05:58 Why team rhythm matters more than surgeon speed
08:03 Real constraints of a Canadian public hospital system
10:37 Overcoming institutional inertia to drive change
14:11 Post-fellowship growth and learning to lead system change
16:27 How measuring every surgical step changes your practice
18:41 Switching from posterior to anterior approach mid-career
23:19 Going all-in and what it teaches you about ego
26:00 Why the whole team needs to see high-efficiency surgery
30:09 Mistakes surgeons make building rapid discharge programs
32:04 Three non-negotiables for a high-efficiency OR
36:50 Evaluating new technology when every dollar matters
43:18 Career advice and the five percent growth rule

Listen to the AHF Podcast on your preferred platform:

Buzzsprout: https://ahfpodcast.buzzsprout.com
Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487
Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc
LinkedIn: https://www.linkedin.com/showcase/ahf-podcast
YouTube: https://www.youtube.com/@anteriorhipfoundation
Homepage: https://anteriorhipfoundation.com

This podcast is intended for educational and informational purposes only.

The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.

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