An Interview with Dr. Philippa Pavia, DVM, DACVS

The vetcareerservices’s Podcast

In this podcast, Laura interviews Dr. Philippa Pavia, a surgeon and the Medical Director at Blue Pearl Downtown in Manhattan. Dr. Pavia describes her path to becoming a veterinary surgeon and she also shares her insights and advice to those who are just starting their career as a veterinary specialist.

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Episode Transcription

Laura: Dr. Pavia, hi, welcome.

Dr. Pavia: Hi. Thanks so much for having me.

Laura: Sure. Thank you for speaking with me today and for being so generous with your time. I'm so excited about this podcast series and learning more about how accomplished specialists such as yourself get to where you are today. So presently, not only are you the medical director at the BluePearl Pet Hospital in downtown New York City, you are also the intern coordinator for the New York region. That's right. So how much time do you spend managing vs. practicing?

Dr. Pavia: I have my full time job as a surgeon. That's four days a week plus one night on-call. And then I have Mondays are my admin day and I probably spend several hours spread throughout the weekend, Mondays as well. On the medical directorship as well as the intern program. And then really anytime I have any downtime during my regular workweek, I'm checking my different emails and, you know, going through my text messages. And in these days, everything is constant connectivity all the time. So I'm getting a lot of texts and lots and lots of emails throughout the week and the weekend. So it can be a lot it can be kind of a nonstop onslaught if I let it. And I do try not to let it at all times. So I am working on that work life balance as well.

Laura: Do you have any secrets on time management?

Dr. Pavia: Oh, secrets, I think surgery residency, quite frankly, does a really good job of teaching you time management. If you don't have great time management during your surgery residency, during all that time of studying and trying to have a little bit of a life at the same time, then you're probably not going to make it or you're not going to be a functional person by the end of it. So yeah you just learn to be very efficient I think, working really well on deadlines. So I have a slightly nontraditional way of getting here where where I am. I was a humanities major as an undergrad. And so I worked a lot on deadlines for things that maybe I shouldn't have left until the deadline. So I know from that as well as from actually from being a surgeon, working under pressure and working with short timelines is something I'm not just comfortable with, I kind of enjoy. So, you know, by virtue of that, what I've learned to do is, and I'm not saying that I'm particularly good at it, but I've gotten a lot better over the years, is carving that time out and say this is the time when I'm not going to do the work things. And then however much time I have left over for the work, it's going to have to be enough time. So what I'm not good at is compartmentalizing. I do think a lot about my work when I'm not there. One thing that's wonderful about veterinary medicine but certainly can be a challenge in terms of having a little bit more of that separation, is that we do tend to be very close with our colleagues and a lot of my closest friends are my colleagues. So by definition then work bleeds into your social life as well. But I don't see that as a negative. I actually see that as one of the best things about veterinary medicine.

Laura: So you did your internship and your residency at AMC?

Dr. Pavia: I did. I did. And I worked there when I was 17 as a volunteer in the radiology department actually, right between high school and college. I'm a native New Yorker and I've had some fun jobs in the veterinary industry on my way.

Laura: So you probably, did you always know you wanted to be a veterinary surgeon?

Dr. Pavia: Apparently I did. My mother loves to tell a story of me as an extremely hyperactive child. The only way she could get any peace would be is if she set me up with all of my stuffed animals and they were only stuffed animals. Dolls were not acceptable in my childhood, it was only stuffed animals. And she would give me a box of Kleenex and a roll of scotch tape. And an hour later all of my stuffed animals would be bandaged. So, they'd have elaborate orthopedic injuries I guess. So I suppose even before I knew, I knew. But I actually thought I wanted to be an equine surgeon. Yeah. So there was a period of time in veterinary school when I really thought I was going to go into equine medicine.

Laura: And so you spent some time at New Bolton I believe.

Dr. Pavia: I did, I actually worked there for a summer before applying to veterinary school. And I had a really great experience there, a really wonderful mentorship. So, yeah, I really enjoyed my time there.

Laura: Stepping back over your career, what has been the most challenging aspect?

Dr. Pavia: Oh, I think one of the most challenging things was back when I was an undergrad. I was trying to do a double major in all the pre-med requirements and get an English lit degree from Yale, and I realized and I also wanted to be riding horses and I was on two teams and I also wanted to be a person and have some friends. And I realized I could not do it all. And I had to make a decision that I was gonna take a post back and finish up my science requirements after college. And there was a period of time when I was sure I wasn't going to get into veterinary school. And this was before the time when they when they really appreciated having multiple perspectives and second degrees and things like that. And I was really terrified that I wasn't a bio chem major. I wasn't a physics major or something like that. And no veterinary school is going to look twice at my application. So that was a really, really hard time that I had to sort of prioritize. You know, I knew I was, I knew veterinary medicine was gonna be my life for the rest of my life. And I only had four years to study architecture and art of the ancient near east and the Victorian novel. But although that was one of the hardest decisions I made in a really hard year, coming out of out of university, you know, my friends and colleagues were going on to grad school and their first jobs and I was living at home with my parents and taking organic chemistry that turned into one of the smartest things I ever did.

Laura: How long did it take you to finish up those prerequisites?

Dr. Pavia: It took me one year. Although I ended up being the least qualified member of my incoming class in veterinary medicine. I had taken the fewest prerequisites of anyone in my incoming class, so I could only go to Penn because they had the lowest requirements. I had never taken stats. I had never taken bio chem and I only ever taken one semester of organic chemistry. So yeah.

Laura: Well it turned out okay.

Dr. Pavia: It turned out ok. I just had to work really hard that first year in veterinary school. But yeah, it was worth it. And I'm really happy, I think it gave me a lot of perspective. I think it's made me more efficient as a communicator, both to clients as well as in my medical record keeping. Just writing, I don't think anyone tells doctors how much they write and how much that's a part of your job. And also being a little bit more well-rounded in terms of my background and my interests. Those interactions with clients, I think are a little bit easier as well

Laura: What has been the most rewarding aspect of your career?

Dr. Pavia: Well, I mean, I'm a surgeon, so I have a very much a Fix-It mentality. I love task driven, performance driven, outcome based tasks. And that is the most rewarding thing is when I see an end. It's also the client experience and the human-animal bond. They come in and there's a dog or cat with a problem or in my residency, a chinchilla affair, a dribble, whatever it was. And there is something wrong. And by the time they leave the hospital. That's not wrong anymore. I've actually been able to make a measurable difference in the quality of life for both the pet and the owner. And that is incredibly gratifying. I mean, just as an example last week also that there is a lot of teamwork involved in it, too. So those are the cases that really kind of warmed my heart. So as an example, just last week I did bilateral femoral fracture repairs on a dog who had actually fallen off of a roof. And he had a pneumothorax and a hemoabdomen and he even got air in his brain. And he was on the ventilator. He had severe neurological abnormalities. So this is a dog who, you know, critical care, neurology, internal medicine, everyone was involved in saving this dog's life. And then I went in and fixed both of his femoral fractures and we all got to watch him go home. Those are the things that I think, you know, bringing everything together, everything you've learned, those are the cases that really make the impact and make you keep going to work when maybe not every case has a happy ending and maybe not every owner is, you know, sunshine and rainbows to deal with. But those are the ones that really you remind yourself why you do this every day.

Laura: You're touching a little bit on compassion, and compassion fatigue and mental well-being. Do you have any secrets that you could share with us as to how you stay at the top of your game?

Dr. Pavia: One thing that my colleagues do joke with me about is that I don't have that, surgeon mentality, I think honestly, the surgeons who probably have the easiest time of it are the ones who are able to compartmentalize and sort of can think of their cases as pure physics. And I can't do that. I actually do find myself getting emotionally involved and and getting attached to my patients in ways that I have to watch myself with that. Because if I do get attached and I do empathize with owners completely to that extent with every case, I can't keep going that way. So do I have the answer to that? Absolutely not. But I do find ways of kind of managing it. So and this is something where I'm very grateful to my excellent staff. You know, let's say I've a patient who I've seen on an appointment the day before and comes in for surgery the next day. I may you know, I've done a full physical exam the day before. What I'll do is I'll listen to them. I'll check their labs and look over with my stethoscope, make sure nothing major has changed. But I literally wont look my patient in the face that day sometimes. Right. Like, if it's a really critical surgery, I'll have to just divorce myself from the reality of them as a living being and to say this is a technical problem. You know, it's like a rock climber facing a difficult wall. I just break it down into its integral steps. And then when I'm done with the challenge, it's like, don't look down. Right. So you can't look down.If you're in the middle of the surgery and you look down, you're going to have second thoughts and you're not going to be able to do your job. So, yeah. I mean, you do go into that zone at a certain point and you stop thinking about them as they're full beings. And then when you're done with the surgery, you can go right back to it. But you do have to create a little bit of emotional distance for sure.

Laura: Do you listen to music when you are in the surgery suite?

Dr. Pavia: I do. Yeah.

Laura: I've heard a lot of surgeons do. And they have their specific artists that they like to listen to. But I've never really asked. But I would imagine it helps get you in the zone a little bit, just like an athlete.

Dr. Pavia: It does, it absolutely does. And I mean, I have a lot of music going on in my head all the time. I played the violin for 17 years growing up. So music is something that is very emotionally powerful for me and it gets me in different spaces. And I have very different music that I listen to when I'm at home by myself versus when I'm at the gym versus when I'm in the O.R.. So for me, like being in the O.R. is a very team based experience. So I'll often ask people, hey, what do you like to listen to? What do you want to listen to?Something that, you know, brings people together and everyone can, you know, enjoy the music and kind of get into it from that perspective. Music is definitely important. I play a lot of music of the 70's and 80's and 90's. And depending on the age of my intern, sometimes I'll have like a Britney Spears, Nsync surgery day. So, and then now that they're getting younger and younger and I'm like, oh, one direction, no, I'm not playing that one. Yeah. No, it's fun. It lightens the mood, but it also is focusing as well.

Laura: Right. Right. Is there anything that you would have done differently?

Dr. Pavia: I would have worried less.

Laura: That's very insightful.

Dr. Pavia: Every single step of the way I would have worried less. I would have realized that there's so many ways to do things right. And there's so many ways to do things wrong and agonizing over making every decision perfectly is not worth your energy and your time. And that, just to have more perspective, I think the whole way through.

Laura: That's terrific. And I'm sure that will help a lot of people. What advice would you give residents who are just finishing their residencies and starting their first jobs?

Dr. Pavia: That's a tough one. But don't expect that your residency has taught you everything you need to know. That was one of the hardest things I came out of my residency and I kept on seeing cases that I'd never seen before. And I said, oh, my goodness, am I supposed to already know how to do all these things? Absolutely not. Your residency is there to teach you the skills with which you then figure out how to tackle the problems you've never seen before. And one of those skills that your residency teaches you is knowing who to ask and when. That you have resources. That's why you were in a training program. And despite the fact that you're no longer in a training program, by no means does it mean that you have to have all the answers. One of the most gratifying parts of my job right now is having been out, what is it now, five years, I'm kind of right in the middle. I have my colleagues who have been practicing for 20, 30 years, and they are great resources for me, my co-surgeon who I'm working with in my hospital now, was my intern when I was a third year resident. So I get to be that resource for her. And then I'll have, you know, a senior surgeon who's been practicing 30 years when a new plate technology comes out. He'll give me a call and ask me how to use the new plate technology. So I think coming out of residency, that is one of the really most difficult things is when do you ask for help? And when do you realize, like, you got this, you can figure this out. And that's yeah, I think that's hard. But also, once again, worry less. Don't feel bad about asking for help. Don't feel like it makes you any less of a surgeon. Just. Yeah, just just feel comfortable realizing that everyone else has been in your shoes and no one is judging you.

Laura: So it sounds like most of your colleagues, when you started out after you finished your residency, were receptive to being there for you.

Dr. Pavia: Absolutely. And that's another thing is when you're selecting a job, your first job out of residency. And it sounds really trite and it sounds like one of those things of like lists of questions to ask in an interview, but really figuring out what the mentorship is going to be like. I applied for a couple of jobs out of residency where I was going to be the only surgeon or sometimes the only specialist. And I'm so happy I didn't take those jobs because I think that is where you lead to a lot of anxiety and a lot of stress when you're by yourself. So looking for a job in which even if you don't have another surgeon on site making sure there's someone where you can always pick up the phone and ask if you need to.

Laura: Terrific. I'm just so thrilled that you sat down and spoke with me today. Is there anything? Do you see any big changes in veterinary surgery on the horizon?

Dr. Pavia: Good question. One of the big questions that I have is, are we going to go the way of human medicine? Are we going to become further and further sub specialized, is soft tissue, going to break off from orthopedics at some point? You know, are we going to have more fellowships? Like right now, there is a surgical oncology fellowship. There are some interventional radiology fellowships, things like that. I'm really curious to see which direction it goes, because as our body of knowledge grows and as the complexity of the techniques that we're able to perform grows, I do think that greater levels of training are going to be required and desired with that sort of larger amount that we could know. So I'd be interested to see if outside of teaching hospitals if more people would divide up their specialties going forward. Very interesting to see.

Laura: Is that something that's being discussed, I mean, commonly now among your colleagues?

Dr. Pavia: You know, less in private practice. Because it's just a matter of availability and scheduling and numbers. You know, if there's only two surgeons in a practice, it's very difficult to divide up soft tissue in orthopedics. And it's also one of the big issues as well. You know, working in private practice from a financial perspective, orthopedics is just more profitable. It tends to be healthier patients, lower overhead, lower nursing costs, things like that. So that is another issue, is that probably that will take longer to split out in a private practice than it would in an academic salary based model. So I'm not sure that really there's a lot of push towards that. I think there are a lot of people who might want to do just one or the other. I certainly have colleagues who, you know, only want to do orthopedics. And if they never saw another spleen again, they would be very happy. But yeah, no, I don't know. I think it will take a while. I think like everything else in veterinary medicine, there's gonna be a delay in between human medicine and veterinary medicine. But I'm interested to see which way that goes. Also really interested to see where our future veterinary nursing goes, like with the veterinary nurse initiative and the push for changing the nomenclature from technician to nurse. And, you know as we've talked about, out of context of this conversation, just the future of veterinary nursing, I think is a really really interesting place for us to monitor going forward.

Laura: I agree. Terrific. Thank you again for speaking with me today. And it's been interesting to learn about your path. You've had such a nontraditional path, so it's fun to hear about it.

Dr. Pavia: Yeah, well, it's been it's been fun. It's been a lot of fun.

Laura: Okay, terrific. Thank you so much Dr. Fabia.

Dr. Pavia: My absolute pleasure.