Dr. Mark Seeley from Geisinger Health System joins the show for a stimulating discussion on a wide range of topics including his practice as an employed surgeon in a healthcare system with its own health plan and some of the unique opportunities this provides. We discuss the role of surgeons in the stewardship of healthcare spending. Dr. Seeley elaborates on his work in education and his recent study evaluating a novel femur osteotomy simulation tool. Articles selected for the lightning round include MRI predictors of residual hip dysplasia 10 years after hip reduction, risks of refracture after operatively treated both bone forearm fractures, and complications of operative treatment for lateral condyle humeral fractures with associated elbow dislocation.