20 Questions: C. David Geier, Jr., MD, Sports Medicine

Dr. C. David Geier, Jr., is director of sports medicine and assistant professor of orthopedic surgery at the Medical University of South Carolina.

Geier attended Wake Forest University, where he earned a bachelor’s degree in economics and graduated magna cum laude (1999). During that time, he also attended Medical University of South Carolina, where he earned his MD (1999). Dr. Geier completed an internship in general surgery at University of Tennessee in Memphis (1999-2000), followed by a residency at University of Tennessee, Campbell Clinic (2000-2004), and a fellowship in sports medicine at Washington University in St. Louis (2004-2005).

Dr. Geier is a member of the American Orthopaedic Society for Sports Medicine, American Academy of Orthopaedic Surgeons, South Carolina Medical Assoc., Southern Orthopaedic Association, Charleston County Medical Society, and American College of Sports Medicine. He is a fellow of the American Academy of Orthopaedic Surgeons and an associate member of the Arthroscopy Association of North America. He has been published in Outpatient Surgery, Applied Radiology, OR Nurse, Operative Techniques In Sports Medicine, Sports Medicine Update, and Oblique Magazine, and he is a principal reviewer of American Journal of Sports Medicine and reviewer of Sports Health.

When did you first decide to become a doctor? Why?

I wanted a career that would challenge me every day. I felt like whatever field I ultimately chose within medicine, I would have new problems to solve, new diagnoses to make, and new opportunities to make people better.

How/why did you choose the medical school you attended?

Even though I did not grow up in South Carolina, my parents moved there when I started college. At the time, the Medical University of South Carolina had a program where South Carolina residents who were attending college out of state could apply for early admission to medical school. Since I was in college at Wake Forest, I had always thought that I would stay there for medical school. The opportunity to go to a medical school in a great city like Charleston and pay in-state tuition was difficult to pass up. Plus I got accepted as a junior, so I could focus on courses that would make me a well-rounded person, such as psychology, sociology, and photography.

What surprised you the most about your medical school studies?

My economics classes in college were very challenging, but they were much different than the classes in medical school. It’s not so much that the classes were more difficult in medical school, but the volume of material was exponentially higher. Just for one test for any medical school course, there could be up to 200 pages of syllabus material covered. The volume of the material was what stood out the most.

Why did you decide to specialize in sports medicine?

I like to solve problems and fix them. In sports medicine, you have a single problem (some sort of injury) where the patient wants to get back to sports or exercise. I have the opportunity to fix that injury, either with surgery, physical therapy, or other treatments, and I can get them back to the activities they like to do. I admire my colleagues in medical specialties, but they often manage a patient’s symptoms instead of actually making his or her underlying illness go away. That’s not my personality. Plus, there is tremendous satisfaction in seeing the excitement on a high school or college athlete’s face or an adult weekend warrior when you clear them to return to the sport or type of exercise that they love.

If you had it to do all over again, would you still specialize in sports medicine? (Why or why not? What would you have done instead?)

Assuming that I would still go into medicine, there’s no question that I would go into sports medicine again.

Has being a specialist in sports medicine met your expectations? Why? What do you like most about it?

Yes, there’s no question that sports medicine, especially as a subspecialty within orthopedic surgery, has met my expectations. Again the satisfaction of getting people back to the activities that they love doing is tremendous.

What do you like least about being a specialist in sports medicine?

There really isn’t too much that I don’t like about sports medicine. It offers a good mix of surgeries, days in clinics with patients, and game coverage.

One of the frustrating aspects when working with young athletes is the pressure to get them back to play. Often these young kids suffer overuse injuries that are completely preventable. Due to pressure from parents, coaches, teammates, and the athletes themselves, they often won’t take breaks needed to heal injuries or to prevent them in the first place.

What was it like finding a job in your chosen career field? What were your options and why did you decide what you did?

There is currently an abundance of orthopedic surgery residents who choose to perform sports medicine fellowships, which has created a more difficult job market than in the past. Jobs are still out there, but there may not be as many openings as in past years and decades. I looked both at private practice opportunities as well as this academic position here at MUSC in Charleston. Since my family was in Charleston, the decision to come back was easy.

Describe a typical day at work.

The typical day really depends on where I am that day. If it is a surgery day, I get to the operating room about 6:45 a.m. and operate until 3 p.m. or 5 p.m., depending on the number of surgeries. If it is a clinic day, I start at 7:30 a.m. and see patients until the last appointment at 6 p.m. I then answer emails and call patients with MRI reports until about 7 p.m. Also, since I work at an academic medical center, I have a number of meetings, conferences, and courses where I teach residents and medical students. Also spread throughout the year, I serve as team physician for a tennis tournament and a professional soccer team. I have nights where I serve as a team physician for those teams and events.

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?

It’s difficult to say with any regularity the number of hours I work because it often depends on how many patients I have in any particular clinic or what number of surgeries I have on any particular day. I would estimate that I work at my orthopedic surgery job between 40 and 60 hours per week. That doesn’t include the time that I spend writing articles for my blog and many newspapers, magazines, websites, or other social media work. As much as I can, I try to sleep six to seven hours per night and I take one to three weeks of vacation a year. Occasionally I use conferences in mountain or beach destinations where I’m speaking as part conference/part vacation opportunities.

Are you satisfied with your income? Explain.

Yes, I am satisfied with my income. I never went into medicine solely to make money. You have to love helping patients. If you don’t, no amount of money will make the job worth it, in my opinion.
I would strongly discourage anyone from choosing medicine as a career specifically because of potential income. Reimbursements from providing health care services to patients are declining quickly, and the amount of work required for each patient in terms of documentation and a number of other issues make earning the same amount of money doctors made in the past more and more difficult.

If you took out educational loans, is/was paying them back a financial strain?

Fortunately, I did not have to take out educational loans as I was an in-state resident for medical school.

In your position now, knowing what you do – what would you say to yourself when you started your medical career?

I think that I made the right choice by going into orthopedic surgery and then specializing in sports medicine. But I do see a number of people that don’t seem to be all that happy in their jobs. I do wonder if many people choose residencies and specialties based on the residents they worked with while rotating in medical school rather than the nature of the specialty itself.

What information/advice do you wish you had known when you were beginning your medical studies?

I have been very lucky and have worked really hard through medical school and then residency to get where I am now. I would tell medical students that all of the standardized tests and all of the grades actually do matter. Sure there are specialties where you can be in the middle to lower part of your class. But I would encourage everybody to work as hard as they can to leave all possible options on the table. Poor grades early in medical school put some specialties out of reach.

From your perspective, what is the biggest problem in health care today?

I think physician burnout seems to be increasing quickly, and I expect it will get worse. Declining reimbursements coupled with increasing regulation and requirements for documentation and a number of other legal and insurance issues threaten physician incomes, and more importantly, job satisfaction.

Where do you see sports medicine in five to 10 years?

I think that sports medicine will continue to advance with new technology and equipment to treat athletes’ injuries better surgically. The rehabilitation and medical treatments available will improve as well. I expect that we will be able to get athletes and people who like to exercise to have longer careers and be able to play sports and exercise longer and more successfully than ever before.

What types of outreach/volunteer work do you do, if any?

I volunteer at my children’s school frequently.

Do you have a family? If so, do you have enough time to spend with them?

I have two young children, and I do try to spend time with them. When I do have time with them, I make every effort to separate work and devote my full attention to them rather than deal with work issues.

How do you balance work and life outside of work?

I don’t know that there’s an easy answer to a work–life balance. Due to phones, email, and the internet, doctors are expected to always be accessible. That’s true in many types of work, but the line seems to be blurrier in health care. You have to set boundaries. Nights and weekends when you aren’t on call, you often have to turn off your phone and make a point to not check email constantly.

Do you have any final piece of advice for students interested in pursuing sports medicine as a career?

There are so many different ways to get involved in sports medicine – orthopedic surgeon, physical therapist, athletic trainer, strength and conditioning trainer, etc. First, I would encourage them to decide if they want to go to medical school. If so, then they have to decide whether not they want to go into orthopedic surgery and then sports medicine as a subspecialty. On the other hand, they can do a primary care residency, such as family medicine or pediatrics, and then do a primary care sports medicine fellowship. If they don’t want to go to medical school, they could go to physical therapy school or study to be an athletic trainer.