John W. Jaureguito, MD, is an orthopaedic surgeon in private practice in Fremont, Calif. since 1995, where he owns Fremont Orthopaedic & Rehabilitative Medicine (FORM, www.formortho.com) with two other physicians. Jaureguito earned his bachelor’s degree at University of Notre Dame, where he studied science (preprofessional) and graduated Cum Laude in 1985. He earned his medical degree from St. Louis University School of Medicine in 1989. Dr. Jaureguito completed his residency in orthopaedic surgery at University of New Mexico Medical Center (1989-91) and University of Chicago Medical Center (1991-94). Lastly, he completed a fellowship in orthopaedic sports medicine under Lonnie Paulos, MD, at Orthopaedic Specialty Hospital in Salt Lake City (1994-95).
Dr. Jaureguito is a member of the American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, California Orthopaedic Association, Alameda Contra Costa Medical Association, and Bay Area Knee Society. His alumni association involvement includes University of Chicago Department of Orthopaedics, University of New Mexico Department of Orthopaedics, St. Louis University School of Medicine, and University of Notre Dame. In addition to serving as director of FORM Sports Medicine Program, his clinical activities include consulting at The Pitching Center in Pleasanton and at Mitek Products, a Johnson & Johnson Company. He is also an athletic team physician at University of California East Bay in Hayward, Ohlone College in Fremont, and Mission Valley Athletic Conference in Fremont. Dr. Jaureguito has been published in Operative Techniques in Sports Medicine, Arthroscopy, American Journal of Sports Medicine, and The Journal of Bone & Joint Surgery.
When did you first decide to become a doctor and why?
My reasoning for becoming a doctor dates back to childhood. There was always a driving desire for me to be a physician. I believe this was both instilled in me by my parents and became part of who I was growing up to be. By the time I was in high school, I decided I wanted to be an orthopedic surgeon and that I was going to be going to medical school and I really did not consider other avenues. ,
How did you choose the medical school you attended?
When I applied to medical schools from college. I was accepted at about five or six different schools. I chose the medical school I went to based on both the reputation of the school as a strong clinical school as well as for personal reasons, as at the time I was engaged and my fiancé and I wanted to attend the same medical school.
What would surprise you the most about your medical school studies?
The biggest surprise about the first two years of medical school studies was the volume of the workload and the difficulty of the workload. The first two years were extremely time consuming from a studying perspective, and the difficulty level was higher than anything I had been exposed to in the past.
Why did you decide to specialize in orthopedics?
I was exposed to orthopedics as a junior in high school and then subsequently as a senior in high school. I had a severe knee injury requiring surgery. I have always been a sports oriented person and orthopedics allowed me to stay involved with athletes through my practice.
If you had to do it over again, would you still become an orthopedist? Why or why not? What would you have done instead?
If I had to do it over again, I may not have become a physician. If I had become a physician, I would absolutely be an orthopedic surgeon. I believe that orthopedics is by far and away the best suited specialty to my personality, my work habits and talents. If I had not gone to medical school, other areas that I would have been interested in would have included sports broadcasting, the business of sports, or some type of horse related job as horses are one of my passions.
Has being an orthopedist met your expectations and why?
Being an orthopedic surgeon has absolutely met my expectations. It is an excellent specialty. It allows for both uses of your cognitive abilities as well as your physical abilities. The combination of interaction with patients, both in the office as well as being able to treat them in the operating room, is very gratifying. Indeed, there is immediate gratification with surgery that you can see both at the time of the surgery as well as radiographically in postop visits. From a standpoint of the patient’s perspective, a great deal of what we do changes the patient’s life significantly for the better and they are very grateful for this, and this is satisfying as an orthopedic surgeon.
What do you like most about being an orthopedist?
My favorite part of being an orthopedic surgeon is definitely the surgical procedures that I get to perform and the benefit that my patients get from these surgical procedures.
Why do you like least about being an orthopedist?
Probably the one thing that is very specific to orthopedic surgery is that it is a surgical subspecialty and therefore produces a great deal of pain for patients. Unfortunately, therefore, I have to interact with a number of patients who are drug seeking and this is something that I greatly dislike. Something that I dislike that is more general towards medicine is the struggle fighting insurance carriers every step of the way in the treatment of patients.
What was it like finding a job in your chosen career field? What were your options and why did you decide what you did?
When I came out of my fellowship training in 1995, HMOs were becoming popular and there was more or less of a hiring freeze at the time and it was very difficult to find a position. I was, fortunately, able to find a position through a family contact and this job was in a location that was attractive to me. I was interested in academics, but only if I could find the right academic job. An academic job in a location that was to my liking was not available at the time, and therefore I elected to go forward with private practice. At no time was I really interested in working for an employer such as Kaiser and this was not something I looked into.
Describe a typical day at work.
I have two typical days at work; those that are surgical and those that are nonsurgical. My nonsurgical days begin usually around 5 a.m., getting up and getting ready for work. I will see patients typically starting at 7 a.m. and see patients until around 4 to 4:30 p.m. I do not take a lunch. I eat in between patients and therefore I’m seeing patients for roughly nine to 10 hours straight. This makes for a relatively difficult day. My other days are surgical days. These days typically are similar in length beginning at 7 a.m. routinely and finishing usually around 4 to 5 p.m. On occasion, there are emergent surgeries that need to be done in the evening, but this is less common. There are days where I will work half day in the office and half day in the operating room, but these are less common.
On average, how many hours a week do you work? How many hours do you sleep per night? How many weeks of vacation do you take?
On average, I work approximately 50 hours a week, sometimes up to 60 hours a week. I rarely work less than 40 hours a week. I sleep seven to eight hours a night. I particularly make an effort to get at least eight hours of sleep on evenings before big surgery days. As far as vacation is concerned, I typically take about two to three weeks of vacation a year.
Are you satisfied with your income?
Yes, I am very satisfied with my income. If you look at the rankings of physicians from an income basis, orthopedics ranks probably in the top three and so income has never been a complaint. It has provided very well for my family.
If you took out educational loans, was paying them back a financial strain?
I did have educational loans, but I did not have a great deal of educational loans. I had $30,000 of loans when I completed my training. I had an additional $30,000 of loans of my wife’s to pay back as well. She, too, is a physician, but does not practice, so that totals $60,000 of student loans. One of the very first things that we did before even buying a home was paying back our loans so that they would not be a financial strain.
In your position now, knowing what you do, what would you say to yourself when you started your medical career?
I would say stop, take a look around, consider other options and be sure that this is something you want to do. I personally had blinders on at that time and did not really consider any other career option, and although medicine has been very good to me, it is a profession that requires huge sacrifice.
What information/advice do you wish you had known when you were beginning your medical studies?
Even though this may sound funny and obvious, it did not really occur to me that being a physician would mean that I would be constantly surrounded by people who are sick and injured. When people are sick and injured, they are not themselves and they are not at their best, and always interacting with people that are sick and injured on a daily basis can be difficult and energy draining.
From your perspective, what is the biggest problem in health care today?
The biggest problem in health care today, in my opinion, is the unrealistic expectations of our society. We want the very best health care and in the U.S., we have it. However, to have the very best health care, it is going to cost money and unfortunately our society does not want to pay for their health care. There is, in my opinion, a belief that health care is a right and that it should be provided inexpensively. These two do not add up. The technology necessary to provide the type of health care that we have in the U.S. is very costly and we are on a crash course in terms of these two divergent paths. I believe there are big changes in store for health care and that we are heading towards a two-tiered system.
Where do you see orthopedics in 10 years?
Orthopedics remains a very technology dependent profession and orthopedics will stagnate if the technology slows. Should major cuts in health care funding be undertaken by the current administration or future administrations, then I believe orthopedics will suffer to a certain extent. On the other hand, in the next decade, the baby boomer population will continue to age and this is going to result in a great deal of volume of patients for orthopedic surgeons to care for.
What type of outreach volunteer work do you do, if any?
My primary volunteer work is through my sports medicine program. We care for two colleges and five high schools. I provide an afternoon every other week at one of the local colleges where I see student health clinic patients as well as athletes. I also take care of local junior college athletes. A number of these athletes do not have insurance. I also see a number of athletes through our office from the high schools and often some of these are uninsured as well. In addition, I support a great number of local sports teams through donations and sponsorships.
Do you have a family? If so, do you have enough time to spend with them? How do you balance work and life outside of work?
I do have a family. I have two children. My son is 18 years old and my daughter is 14 years old. I have been very active in their lives and I have not let my profession take away from my interaction with them. My son has always been active in baseball and for a number of years, I was the coach or manager of his teams. This required me to take a great deal of time off of work and cost countless dollars, but this was not a concern of mine as spending time with my children was the priority. I now do the same with my daughter through her horse riding activities. Balancing work and life outside of work is relatively easy once you commit to it and are not concerned with money lost.
Do you have any final piece of advice for students interested in pursuing orthopedics as a career?
I think that orthopedic surgery is an excellent career choice, but any career choice in medicine is daunting and a huge sacrifice. I always speak about the “lost decade,” which is the time following college until you get out of your training. For an orthopedic surgeon, there are four years of medical school, five years of residency and typically one year of fellowship training. This is a total of 10 years, hence the “lost decade.” During this time, you are working huge numbers of hours and you put your life on hold. During this time, other people outside of medicine are finding out who they really are, enjoying life, meeting their spouse, getting married, buying their first home, starting a family, and a lot of these are things that you put off in medicine. I think that someone who is interested in going into medicine and orthopedics should think long and hard whether this sacrifice is worth it because when you get out, it does not get any easier, particularly in the early parts of a career. To be a good physician and a good orthopedic surgeon, one has to be very dedicated to their practice and to their patients.