Speaker 1:
From the library of the New York Stock Exchange at the corner of Wall and Broad Streets in New York City, you're Inside the ICE House, our podcast from Intercontinental Exchange on markets, leadership, and vision in global business, the dream drivers that have made the NYSC an indispensable institution of global growth for over 225 years. Each week, we feature stories of those who hatch plans, create jobs, and harness the engine of capitalism right here, right now at the NYSC and at ICES exchanges and clearing houses around the world. And now, welcome Inside the ICE House. Here's your host, Josh King of Intercontinental Exchange.
Josh King:
I'm fond of taking what's known as busman's holidays. Perhaps you've heard of the term. I don't know when I first heard it, but its Origins date back to 1893 in the United Kingdom, referring to when a busman or a bus driver or something like that would go off on a vacation in, wait for it, a bus, thereby engaging in a similar recreational activity to his or her actual day job. And that's what's brought me to Vail, Colorado with a small briefcase containing all I need to record an Inside the ICE House episode, usually an activity I undertake weekly from the library of the New York Stock Exchange. I've done it a couple times before across our now 400 plus episodes, in Boca Raton, Florida, in London, in Salt Lake City, at the US Open in Flushing Meadow. And now, in the global epicenter of skiing here in Vail, the flagship of Vail Resorts, NYSE ticker symbol MTN or Mountain.
And yes, I've taken a few turns as well, when I'm out here for a few days of vacation, staying at the home of my friends Douglas and Liz Smith, folks I knew back in the time working in government in Washington. Making the plan to come out here, I mentioned to Doug that, well, if time permitted, I'd like to record a couple of episodes relevant to what we do here at the New York Stock Exchange. Well, Doug got right to work, even while he's serving as my guide through Vail's legendary back bowls and an equally treacherous tour through Vail's vaunted apres ski scene, ending the evening at Scott Rednor's famous Shakedown Bar on Bridge Street in the heart of Vail Village.
So we begin our busman's holiday, thanks to Doug's vast relationships in town, adjacent to the operating theater of the Steadman Clinic, founded by the eminent orthopedic surgeon, Dr. Jay Richard Steadman, who passed away about a year ago in 2023. A renowned innovator in the field of orthopedic sports medicine, Dr. Steadman was internationally known for developing advanced surgical procedures for the favorite of all joints, the knee, including what was known as the healing response and the package, a technique which can restore normal movement to painfully arthritic knees. Dr. Steadman became the go-to surgeon for the world's best athletes, returning many elite players in the NBA, NFL, NBA, Major League Baseball, pro soccer, and of course, skiing.
Now, beyond Vail itself being a New York Stock Exchange listed company, you might wonder how modern day orthopedic surgeons interact with businesses listed on the big board. Well, you'd look no further than Johnson and Johnson, NYC ticker symbol JNJ, the storied pharmaceutical and medical technologies giant that started in 1873, after Robert Wood Johnson began his professional training at age 16 as a pharmacist's apprentice at an apothecary run by his mother's cousin, a Mr. James G. Wood of Poughkeepsie, New York, paving the way then for a novel procedure at the time, something called antiseptic surgery.
Fast-forward 139 years to 2012, that's when J&J completed the $19.7 billion acquisition of Synthes Inc to create the world's leading orthopedics business, now known as DePuy Synthes. Now, you take a look at J&J's DePuy Synthes website today, and you see medical miracles like the ATTUNE Knee System, which replaces the deteriorating joint, the TIGHT-N anchor, the next generation of tendon fixation, and the INHANCE Shoulder System, Johnson and Johnson's latest innovation in shoulder replacement technology. All of these systems and those like them from other manufacturers, whether used on sports stars, wounded warriors, or just aging skiers like me, are being put to the test here at the Steadman Clinic in Vail.
Well, Dr. Richard Steadman's scalpel, embedding those products into the knees and shoulders of the clinic's patients, is now in the steady hands of Dr. Matt Provencher. Along with other surgeons at Steadman, Matt carries on Dr. Steadman's legacy as one of the nation's leading orthopedists, specializing in the treatment and rehabilitation of injuries to the knee and shoulder. And luckily, on this trip, I was not in need of Matt's expert services.
Instead, we talked about Matt's career, which began on the playing fields of Oyster Rivers High School in Durham, New Hampshire, and led to the United States Naval Academy, where he rose to deputy brigade commander among his fellow midshipman and earned the recognition as first team all American as an oarsman for the Navy crew. But alas, like so many aspiring maverick Mitchells, Matt couldn't fly jets like his brother because of corrected vision. So instead, he took his electrical engineering talents to medical school at Dartmouth and then began his residency at the Naval Medical Center in San Diego.
As part of his broad practice, Matt designed studies to help our military members return to duty in a safer and more predictable manner through development of MPOWR, which stands for Mobile Platform for Optimizing Warfare Rehabilitation, a program used to test the military warfighter prior to return to battle. From 2007 to 2013, Matt was appointed director of sports medicine and surgery and then head orthopedic teams physician for Navy SEAL teams 1, 3, 5, and 7, where he was instrumental in setting up the Special Forces Tactical Athlete program, a comprehensive wellness injury prevention and rehabilitation program for Naval special forces.
Now, a lot of a Naval officer's career isn't focused solely on battle. Matt's also led extensive humanitarian and disaster relief work, serving as director for surgical services for five years aboard the USNS ship Mercy, leading the surgical team during Pacific Partnership 2012, the largest humanitarian and civic action in the Asia Pacific region, focused on building stronger relationships and improving disaster response capabilities with partner nations.
And then, moving from battlefield to ballfield, Matt became medical director and head physician for the New England Patriots during the 2014 Super Bowl championship season, pioneering a wellness and injury prevention program for coach Bill Belichick's team. Along the way, adding service as assistant team physician for my Boston Red Sox and Boston Bruins.
If you take a walk through the hallways of the Steadman Clinic to Matt's office, you stare dumbfounded at what is a vast hall of fame gallery of jerseys and uniforms of sports legends that Matt and his colleagues have fixed up and got back into action, just as he continues to do so as a Navy reservist, most recently assigned to Navy SEAL Team 17 in Coronado, California. Our conversation with Matt Provencher on service, surgery, and sports and how they're all interwoven in the application of medical miracles at Vail's renowned Steadman clinic. It's coming up right after this.
Speaker 3:
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Josh King:
Welcome back Inside the ICE House. Remember to subscribe wherever you listen and rate and review us on Apple Podcasts so others know where to find us. Our guest today is Dr. Matt Provencher. Dr. Provencher is a sports medicine specialist in orthopedic knee and shoulder surgeon here at the Steadman Clinic in Vail, Colorado, where I sit and look out of Dr. Provencher's office at this amazing view where I have just completed 32,000 vertical feet over the last or seven hours.
He was previously the chief of sports medicine at the Mass General Hospital in my hometown of Boston, as well as medical director and team physician for the NFL's six-time Super Bowl champion New England Patriots. Dr. Provencher graduated from the United States Naval Academy in 1993, where he was a four-year varsity oarsman and two-time first team all American for the rowing squad. He served as an orthopedic staff surgeon at the Naval Medical Center San Diego from 2004 to '13, and was appointed the director of Sports Medicine and Surgery in 2007. In 2021, Dr. Provencher was named one of the top 28 shoulder surgeons and one of the top 28 knee surgeons in the United States by Orthopedics Today. I am glad that I'm not using his services today. Matt, thanks so much for joining us Inside the ICE House. It's great to talk to you here in Colorado.
Matt Provencher:
Josh, thank you very much, it's a very kind introduction. And dude, I'm impressed. 32K today. It's a legendary day, my friend.
Josh King:
That's good. Where I usually ski, upstate New York, I'll start at maybe 8:15, 8:30, I'll ski hard until 11:30 and then pinot noir takes over and I'll be lucky if I've got 12,000 in, so this was a great day,
Matt Provencher:
But obviously you must had some ski time back in New Hampshire working for Simon, right? You had-
Josh King:
Waterville Valley, Loon, Sunapee, Sunday River in Maine, Sugarbush, Killington, Mount Snow in Vermont. But now I pretty much stick to New York, I don't get to-
Matt Provencher:
That's where I cut my teeth as well. Yeah, super cool spots back there. But it gives you an appreciation for coming out to a place like there.
Josh King:
How many days do you usually get? What's your regimen? I came in, you had a case that you were attending to and you've got people from, judging from the uniforms on your walls, you must be backed up, but how often do you get up there?
Matt Provencher:
It's pretty good, Josh. It's nice being here. There's times when I'm staring at the mountain out my window that I want to be out there taking turns and get some fresh powder, but we get out there and get after it pretty well. It's a really nice work and play environment here in Vail.
Josh King:
I imagine. And I imagine that when the football season ends, as it has now, except for one last game, some of the people will come in here to attend to some of their problems during the season, get ready for camp coming up. But we're recording this episode a couple days before Super Bowl 58 at Allegiant Stadium in Las Vegas, so I'm not going to ask you to prognosticate on what the final score will be in that game, but one of the chief superstars, Isiah Pacheco, had cleanup shoulder surgery in December and has still been dominant during the playoffs. How much has medicine advanced on that particular joint over the past five years, that a guy can have intrusion into his shoulder in December and still be dominant through this tournament?
Matt Provencher:
Yeah, it's amazing. And hats off to Pacheco, the medical staff and everyone else for doing such a great job with him. Look at the playoff performance. He's a huge reason why they're in the playoffs and in the Super Bowl and in the show, and it's really amazing. And over my 25 plus years of being involved with this and doing this and having a great honor to take care of so many of these super high talented individuals has been humbling. But what we're learning is how to make things stronger, more efficient, how to get you back efficiently and at your best without the risk or minimizing the risk of reinjury.
And there's always that tricky balance. And we've got biologics, we've got better anchors, we've got better strong tape sutures, we've got the Rogers internal brace. We've got all these innovations that have come in sports medicine to help, let's face it, not just the pros, but people like you and I to get back to our activities and at a very high level.
Josh King:
Pacheco is a young and resilient 24-year-old out of Rutgers. Aaron Rogers, he has 16 years on Isiah. The future Hall of Famer ruptured his Achilles four snaps into his tenure with the New York Jets and had surgery on September 13th. So Matt, if number 12 walks into the Steadman Clinic, sits on your examination table tomorrow, what are you looking for in terms of his fitness to play? And how would you advise him about preparing for the '24='25 season, if he should be preparing at all?
Matt Provencher:
Yeah, so Aaron, there was all talk about him getting back because of how well he was doing, how his ankle felt. He was taking some slow snaps on the field in the Meadowlands and doing some practice work and everyone was excited and Jets Nation certainly was hoping. But the Jet's had a reasonable season, not terrible. But the problem is, even if that thing heals well, and even if it does well, guess what takes time? And I don't care if it's Rogers or 24-year-old or you and I, we got to get our muscles strong.
And I guarantee you, having felt his calf, if you feel it, you're going to have some muscle atrophy. It just takes time to build that up. And so, there's risk of re-injury if you aren't optimized. And it's the entire kinetic chain, it's the muscles, it's working with our physical therapists, our strength and conditioning, all the people that help put us back together and on the field or back to whatever craft we want to do.
Josh King:
Before we talk more about your life that you've built here in the Rocky Mountains and this clinic, I want to go back to sea level and start with your time at the Naval Academy, specifically your involvement with rowing. It's a requirement that all midshipmen participate in some form of athletics as they prepare morally, mentally, and physically for a career in the fleet. And like you, my son rose, for Navy, he's a plebe with the men's lights. And like you, he's a walk-on, wrestling daily with trying to get his personal best on the erg, even with all the other commitments on the yard. What inspired you to pursue rowing during your time at the academy?
Matt Provencher:
Josh, first of all, I am psyched your son's doing this. This is amazing. It was probably one of the best things I did in college. And the Naval Academy has so many great things about it, and like you said, morally, mentally, physically, but it's the ultimate leadership laboratory on top of it. And we're able to learn how to lead, what not to do, how to motivate people, how to be a really good person, your situational awareness, everything else.
I got to tell you, the time at the boathouse though was fantastic. And the ability to have an incredible group of brothers that you row with. I was lightweight myself, I was close light and heavyweight. My brother also rode, he was a heavyweight. Much better genetics than myself and 6'4" and a heavyweight guy, and he rode four years. But we both really didn't row. We had a little taste of it in New Hampshire at a program for a couple of weeks in Durham, New Hampshire, but that was about it. We just kind of walked on. They grabbed us and said, "Hey, come try out for the team."
Josh King:
And that's what Toby's experience was in plebe summer too. And he looked at a couple other sports and just ended up with it. And it hasn't been an easy year so far. Do you get a point in your plebe year when you said, "I'm coming from New Hampshire, this is overwhelming to me. I don't have all this time to put all that time in that boathouse"?
Matt Provencher:
No question. There was a lot. I have to tell you, I was very fortunate that our high school, I went to a public high school in Durham, New Hampshire, and we didn't know it at the time, but prepared me and I know many others of my classmates from high school unbelievably well to go on to the next level. And so, Naval Academy was never easy, but at least from the academic side, I was able to hold my own and I was like, "Wow," I was little kid from New Hampshire here. I was worried about all these other things going on.
The academics, you had to work hard. And I was an electrical engineer, of course. I picked a pretty hard major. I don't know, it's just kind my poison along the way. But I liked the problem solving, I liked the engineering, I liked that aspect of it and it taught me so much. But having the boathouse, having a sport, having a group of just really incredible people that you're around all the time, and I know your son Toby is... I'd encourage him to continue that because it's an incredible four years to compliment everything you're learning at the academy.
Josh King:
This area is not known as much for Navy as it is for Army. The 10th Mountain Division was formed in 1941 in Camp Hale, about 30 miles south between Leadville and Redcliffe. And it was then Pete Seibert, New Englander also who served in the 10th, came back from the war and opened this resort with the support from Jack Tweedy. Did that heritage of Pete and this sort of New England tint and military experience give you comfort when you arrived in this place?
Matt Provencher:
Yeah, there's no question. There's a great New England transplant. I went to Dartmouth from med school, New Hampshire kid. There's a lot of people from that area here and it certainly gave a lot of comfort. But there's so much more to it than that. The 10th Mountain and all the training and what went into it in World War II and them all heading off to Europe, it's really an incredible story. And the ski museum here and the-
Josh King:
Checked it out earlier today.
Matt Provencher:
Yeah, it does an amazing job. And I think telling that story, which many of us don't know, but from my military background, post-New Hampshire background, Vail was a natural. I love Boston, don't get me wrong, but this is a great place.
Josh King:
Given the deep military roots in your family, including your grandfather's service in the Army and National Guard, your father's Naval Academy background and your brother's similar path, was the military career always predetermined for you? How did it all work out for you?
Matt Provencher:
Josh, we're always, if you're [inaudible 00:18:04] about your kids going to college, this or that, you're like, "Oh, you probably had the path." And parents are saying, "Go to Navy, go to this." Well, I did apply to the service academies, but I had applied a bunch of other places. The service academy was kind of an afterthought for me at the end of the day and I was like, "Well..." I'm looking at some other places. I'm checking out Brown and Dartmouth and University of New Hampshire and places in upstate New York where you were from.
And at the end of the day, the Naval Academy kind of landed in my lap and my dad had gone there, but it was never pushed on me, which I think was really important. And a really important lesson just now as a parent now, that I have an older son who's not at the Naval Academy, he's at UVA and really thriving there and enjoying the system there. But you have to always support your kids, open their eyes a little bit, but support your kids. I think that's exactly what my parents did, so they did it perfectly. And I think my brother followed in footsteps because of the same way.
Josh King:
Your career path, medicine, not necessarily preordained. When you think about surface warfare officers, special warfare, submarines, aviation, what led you down the medical path?
Matt Provencher:
Josh, it's a super interesting story. Top Gun's coming out when we're heading to college, Tom Cruise, it's cool. That was also part of it. Let's be honest and go there. And I wanted to fly, I wanted to fly jets. Problem is my eyes went to like 20/50 Vision, 20/55, 20/60, and I was like... We couldn't have surgery, couldn't have LASIK, we couldn't have PRK, and so we had to... I wasn't qualified. You had to pick something else. I was not qualified to be a SEAL, which was also on my list. It was not qualified to do Navy diver SEAL, special warfare or fly. I could be a backseat pilot, but I wanted to be a front seat pilot. That's who I am, it's my DNA. My brother got a much better genetics, perfect vision, much better genetics. He was the F18 pilot, so I kind of live vicariously through him and many of my other friends.
But medicine sort of landed in my lap. No one in my family was in medicine. I'm like the family doctor. I take care of all the ailments and not even orthopedic. And it's a blessing to do what I do now and I'm very honored and humbled. But you look along the way and there's so many mentors that I think all of us that are listening have to be thankful for and mentors that I certainly have to be thankful for. And it's maybe a 10 or 20-second conversation that probably shifted my life to go into medicine. And it's amazing.
I called my dad and I was devastated. I got my physical for my eyes, they were bad. I can't be a pilot, I was devastated. "What do I do?" He's like, "Go see Dean John Kelly, he's the dean, he was my chemistry professor, he's the dean now. Just go talk to him." And I went into his office, classic, he was old dean of students. And dust off my dad's record from the sixties there, he's like, "I tried to get your dad to go to medicine. Would you ever consider medicine?" And it was literally a two-minute conversation and he kind of set me on the path.
Josh King:
You go from Annapolis to Dartmouth, as you said, for medical school. You've got four years of incredible discipline scheduling and you end up on the kind of Ivy League campus that you might've looked at as an undergraduate, saying that you looked at Brown as well. What was the sort of cultural shock for you to go from the yard up to New Hampshire?
Matt Provencher:
And Josh, I'm sure you've seen it with your son and all the stuff, incredible stuff you've done, which I'm super impressed with by the way. But you talk about the discipline of time of life, which you had at the Naval Academy and it sort of just... We all went through it and everyone had it.
And in fact, I had a pretty significant leadership position there. I was the second in command, the deputy brigade commander. So when I picked medicine, the commandant and midshipman, the superintendent, he was always mingling with all the time because we had all these dignitaries, having dinner with Margaret Thatcher and all these dignitaries, they were always coming to the Naval Academy and hanging out. We were always, the brigade commander, I was a deputy brigade commander myself and a few others would always go to these events. It was always crushing my studies. It was always on a Tuesday night, a Thursday night or whatever, and you're like, "Oh," rowing practice, everything else going on.
But it was amazing, when you look back, but the superintendent and the commandant like, "Really? You're going medicine? You're going the other way? You're not a line officer. You need to go to a submarine. You're an electrical engineer, you need to go be on a ship, you need to go lead, you need to go command."
And I got that, but it really... I had a great another mentor and guy was general Terry Murray, and he was the deputy commandant, was a football player at the Naval Academy, said, "Listen, you're doing a great job here. We need great leaders in medicine. We need great leaders to take care of me, my knee, my shoulder." And so, that's why I continued on the path.
But to summarize, when I got to Dartmouth, it was awesome. I loved it. I was like, "This is sort of a college experience in medical school." And there were just a million less rules. If I didn't want to go to class, I didn't really have to. I did because it was how I learned. But having a little bit less structure for me after four years in Naval Academy was really good. And I also, I loved it there. Dartmouth was fantastic. I'd go do it again.
Josh King:
I'd have to ask, because it's so current and you have such a unique perspective of having four years at a service academy and then back to Dartmouth for med school. We're watching what's happening on Ivy League and college campuses around the country today. Ken Griffin has suspended his... He's given 500 million to Harvard already, but he's halted donations because he sort of dismisses what's happening on these campuses as a bunch of whiny snowflakes. You saw what kind of student and patriot the service academy turns out, and yet you also are an alma mater of the Ivy League, so what's your take?
Matt Provencher:
Yeah, it's really interesting to watch it unfold because I think the Naval Academy, the military's cross section of America. We dealt with very similar issues and problems and situations and we have all walks of life, men, women, different cultures, different skin colors. And I got interviewed all the time about our treatment of women at the Naval Academy or treatment of different races or treatment of African Americans or treatment of Jews at the Naval Academy, whatever it was, whatever group it was. And I said, "Listen, we got our wake up call a long time ago." We're the military and we treat everyone with fairness, transparency, with the utmost of integrity and the utmost of respect.
And so, that's the environment I grew up in. That's the environment my parents raised me in. And if I see less of that, it doesn't sit well with me because that's what I've been raised to do and be about and it's how we take care of our patients. Everyone, you might have a little bit busier schedule, you might be a super busy pro player or an admiral in the Navy or the chief of Naval operations. Yeah, I got to respect your schedule a little bit, but you're getting the same treatment as anyone else out there.
And for me, growing up in New Hampshire, that's how we did it. We never had that, for me, there really wasn't that caste difference or difference in people. Everyone you had to treat with respect. And if you didn't, my mom would kill me. That's [inaudible 00:25:00].
Josh King:
That's a mom and a good dad, Matt. Up in Hanover, you found your calling in orthopedics and brought that calling to your orthopedic residency at the Naval Medical Center in San Diego in 2004. And it was there, until 2013, that you gave medical care for Navy SEAL teams 1, 3, 5, and 7. As the head of orthopedic team physician for these SEALs, what strategies and processes did you implement to make sure that they performed at peak levels?
Matt Provencher:
Yeah, Josh, this was another great journey that, being a rower, your son's going to go through this, you went through this during your sports days as well, is how do you take care of our most important commodity, which is the human body? The trained human soldier, the warrior, the Navy SEAL, the female marine, you name it, that's our most important commodity. And taking care of your body, taking care of yourself, you got to do that first before everything else.
We weren't doing a great job at it, and so we learned we had to get better. And with that, we had to, guess what? In the military, you got to use data, you have to use information, you have to use analytics because you have to show what this means, what the return on investment's going to be, what we save the government, and how we do a better job with our people and having them ready for the government's needs, the president's wishes. That's what we had to do. And when we were able to do that and sit down, we literally sat down at a bar in Coronado and sketched out on an napkin of what this human performance program would look like, at least for Navy Special Warfare. But now I'm very proud that many other smart people beyond me-
Josh King:
What'd the napkin have on it?
Matt Provencher:
It was literally a bunch of columns and circles of like, this is what we've got. We need better resilience training, we need better mental capacity and mental health and mental wellness training. We need psychology, we need strength conditioning and we need performance analysis. We need to assess your hips and shoulders and knees, your musculoskeletal condition. We need to see how your back's doing.
We don't want you to get injured before deployment, we don't want you to get injured during deployment. Devastating to a unit, devastating to the morale, devastating to the function is you get injured while you're trying to go out and do your job. It's just like a pro football player. Same in the military and anyone in the military, it could be a sub driver, it could be a female marine, it could be a Navy SEAL.
So that's what we wanted to do was add the... I wanted to know more about you and your body and your performance and you knew yourself. And that's the culture we really tried to show big government, big joint special operations command, big Marine, big Navy, to be able to bring these programs to enhance and protect our most important commodity, which is the human.
Josh King:
Sometimes the dock is not always around when the SEAL team is deployed, there's medics who have training. But we lost two Navy SEALs, Christopher Chambers and Nathan Ingram in the Arabian Sea off Somalia a couple of weeks ago. Their situation seemed perilous. But how are SEALs trained now to protect themselves on dire missions, and when injured, administer emergency medical aid?
Matt Provencher:
Yeah, I'm definitely not a SEAL, so I don't want to speak to training. I haven't gone through it or anything. But having taken care of the folks, what I can speak to is how we optimize them to do their job. And we learned how to work with the operator to optimize their human performance. Developed injury prevention programs, developed mental wellness programs, take care of potential post-traumatic stress, post-traumatic issues, sleep hygiene, huge. If you don't sleep, your body doesn't heal. So we started very simple and the impact we were able to have on not just this community, I think, and this is a collective, I'm just one very small pawn on this very big team that we had, that was able to do this and put this together, and I think execute something in which we were able to make a significant difference in their training, their readiness and their ability to perform.
Do we have more work to do? Of course. However, that's something we learned and we know we had to take care of the human performance. And me, from the orthopedic and sports medicine side was a great learning environment because I learned more from the physical therapists, our mental health professionals, our internal medicine docs, people like Kirk Parsley and Jason Jagju and Mark Rogo and strength conditioning, and the whole slew of people it takes to take care of our military at the highest level was something that I'm very proud to be involved with because we made a difference.
Josh King:
3,000 miles away from San Diego, during your tenure at the Naval Medical Center, you witnessed the aftermath of September 11th and the Iraq war. Describe, if you can, Matt, the challenges and experiences you encountered while treating and caring for the injured servicemen and women returning home from these conflicts, what we've learned medically from the forever wars. It was one thing to be, before 9/11 and then these 20 years after and everything that we've learned from Iraq and Afghanistan.
Matt Provencher:
Yeah, Josh, this is something that I know resonates with a lot of my partners, a lot of residents we had in training when I was in training, even as a resident, this was actually starting and it quickly became staff. But our people that were in the trauma world and orthopedic trauma, general surgery trauma, we knew that we had to do better as a team. And so, we had a great team that was very committed to taking care of the wounded warriors at the highest level. And what we learned there is we needed a better program, we needed a better system, we needed processes, we needed efficiencies, and we had to make sure that they were cared for as close as possible to where their family was so that they could recover and be mentally sound so that they could rehabilitate and do a great job.
And so, the C5 program launched military-wide, especially out of San Diego, Walter Reed and San Antonio is the three major facilities. But I have to tell you, not just myself, but certainly many others and my partners that do this day in, day out, way more than I did and my hat's off to them, but we were sitting around a conference room table all the time in Balboa, as we called it, Naval Medical Center San Diego. And we got more weary, in a way. It was hard. It was hard seeing the limbs that had been amputated, the new amputation we had to do, the limb reconstructions, the salvage, the burning flesh, the IED blast and the stuff we would find in skin and buttocks and these things that were put in these IEDs by the enemy, by the terrorists was terrible. The stuff we would see in there, coat hangers bent up and shrapnel and glass and things. It was really devastating injuries.
But the coalition of the medical team to help our wounded warriors get back was really amazing. I learned a lot. And my boss, Dana Covey, John Webster, Captain John Webster, Captain Dana Covey were always like, "Provencher, I know you want to do this sports medicine, this and that. You're an orthopedic surgeon first and you're going to care for these wounded warriors." And that was the mantra. They didn't have to tell me. We're all over it and we're going to take care of the mission, take care of what the government asked us to do and we learned a lot.
Josh King:
Let's pivot from the military medicine to the sports medicine through the unique character of Bill Belichick. His ties to the Navy are well chronicled. Coaches born in Annapolis, his dad, Steve, joined the Navy and the forties served in both the Europe and the Pacific. In 1956, he joined Eddie Erdelatz's Navy football staff where he'd spend in the next 33 years, until 1989, as an assistant coach and a scout. And when I was back at the yard, I walked by his headstone at Hospital Point. Were you aware of the connection you had when you first got the opportunity with the Patriots?
Matt Provencher:
I did. And again, my hat's off to my dad, my family, everyone else, Josh, [inaudible 00:33:23]. So I got called by the Krafts to go interview for the head team physician job, medical director for the Patriots. And knew Belichick had been at the Naval Academy, my dad had known Bill's cousin very well. They were classmates there. And my dad actually played football and was coached by Steve, Bill's dad.
So it was great to connect my dad even with Bill after I got the job and everything. Supposed to be a 45-minute interview turned into about four hours of talking about exactly what we're talking about, human performance, what we had done with the Navy special warfare, what we had done with the Marines, what we had done with everyone else to optimize human performance in the military.
And I got to tell you, Bill's a great guy. He's brilliant. He has a photographic memory. He's super driven, supercharged. I can tell you after one of the Super Bowls, he's like, "All right Matt." And we, literally at the party, he's like, "All right, that was great, [inaudible 00:34:17] a job. I need to meet with you on Sunday night." I don't don't know what, 2:00 AM or something at the Super Bowl. He's like, "I need to meet with you on Tuesday so that we don't have the Jets bypassing what you call," because he loved what I called the competitive medical advantage and that's what we tried to bring to the team.
Josh King:
Were you surprised that of the six, seven open head coaching slots, coach didn't get one of those or didn't want one of those or the chemistry wouldn't be right the way it was with the Krafts?
Matt Provencher:
Yeah, I think that's potentially it. This is not the last we see of Bill Belichick though.
Josh King:
Much has been made of Tom Brady's fitness regimen and his work with Alex Guerrero. He wasn't that limber during his famous combine video. What was the secret to Tom's long-term success?
Matt Provencher:
He quit eating pizza and junk food. And he had people like Alex, who's... Alex is amazing in many ways. And many pro athletes have gurus or helpers and Alex is certainly one of those, which Tom really took an affinity to, obviously. And we worked closely with Tom and Alex and our medical staff to optimize not just Tom, but everyone.
And the concepts that Tommy has, is staying active and in the game, guess what? It was the same things were sort of doing with our Navy SEALs. Their hips were tight, their legs were tight, their hamstrings were tight, they would get all these overuse injuries, their sleep cycles were off, their adrenal axis was off. Tom was into all of that, pliability, stretching, range of motion, and Alex was a big part.
But my hats off to Tommy's, whatever... Tommy's like reverse aging. It's unbelievable. And he's great and I love what he's doing. I love what he's doing for his body and keeping at the top of his game. He's a great leader, he's great inspiration. And for me, it was very special to have him around because he was just an amazing human and a big part of the success of that team because of what he did for preparation. And that was a big part of it, taking care of his body.
Josh King:
When I was showing up here, Ryan walked me through the hallway and showed me the framed set of Julian Edelman's gloves. He spent 12 seasons with the team, didn't play in 2017 due to an ACL tear. How has treatment for that common injury changed over the years? And more broadly, given the type of player that number 11 was, how has the NFL and all sports in general evolved to manage concussions better?
Matt Provencher:
Yeah, JE 11's a special player. That guy, he's unbelievable. Love the guy. He's great leader, super driven, there's no harder worker. And he just keeps taking a lick and keeps going and he's amazing.
So had kind of the same principles. And I'm not sure what path he was on before I got there, but Tommy certainly got with him and said, "Listen, you got to get your muscles, you got to get pliability, you got to get those hamstrings stretched. We don't want these overuse injuries."
Now, being a little bit shorter slot receiver, he's playing a tough position, a position that can get injured quite a bit in the NFL, one we took care of quite a bit. And it was a great pleasure to have the opportunity to take care of him. And for his ACL or just any ACL in general, the technology has come so far since what we had 20 years ago. We're better at biologics, we're better at graft, we're better at anatomically putting this back together of where your ligament used to be and how we... All of that, guess what it adds up to? More efficiencies, rehabilitation, more predictable return to play and getting your muscles back much better, Josh.
So there's a lot to be said about that guy's work ethic and who he is. And that was a special group around him, Gronk, it's a very special group of players that Bill had assembled at that time.
Josh King:
We had Gronk at the New York Stock Exchange last week for the IPO of Flutter, NYSC ticker symbol FLUT. It was great to see Gronk there. We also had Marshawn Lynch come through doing one of his in your city Thursday Night Football packages. And Marshawn was an incredible character.
But bring us back to that 2014 Super Bowl. They could have just handed the ball Marshawn one yard over that goal line, and instead, they throw, and Malcolm Butler does that interception. You're on the sidelines and this team physician. What was that moment like for you?
Matt Provencher:
Well, being on the sidelines as team physician is... I didn't play one snap or run one yard, but for me, it's kind of exhausting. I know the medical team [inaudible 00:38:54]-
Josh King:
I saw some of the stress in your visage when I looked at some of these pictures outside.
Matt Provencher:
Totally. Josh, I'd be exhausted because it's stressful. You're trying to take care of the team, you get them back, you're looking for injuries, you're trying to manage a lot of stuff and a lot of players and other things and external things. So it's a lot, being the head team physician, I didn't really realize it. My hat's off to so many people that done a much better job than myself at it.
But what I can tell you is that Super Bowl was really special. I'm sitting there and I'm like, "Okay, yeah, great, we're going to... Well, we get the runner up ring, that's okay. We did pretty well." And all of a sudden, he picks it off.
Now, what's interesting is Lombardi, Mike Lombardi on the sideline near me and one of Belichick's helpers at the time, he's like, "That's the exact play that they practiced." And I saw it and we were there, we were at the practice facility at Arizona State, we were at before. And we're at the practice facility and it was one of the last two plays that they had practiced and run because of film, because of tape, because of preparation. It was that exact goal line play with Malcolm Butler picking it off. And I was like, I go back and I'm like, "I remember that."
You're right, it's amazing. So practice and preparation, practice and preparation. That was destined to happen. And the call was for a pass and they were ready.
Josh King:
Call was for a pass and they were ready. Talking about being ready, you also worked with the NHL's Boston Bruins and MLB's Boston Red Sox as well. Saw that picture of number five, Dustin Pedroia out in your hallway. Are there different methods of treatment or practices you need to follow when you're helping athletes at different sports? What's it like, for example, helping former Red Sox outfielder Mookie Betts or Bruins forward Brad Marchand recovery compared to Brady or Gronk?
Matt Provencher:
Yeah, I know, Josh, that's a really good question. It's sports specific, but it's also, I think even more important, athlete specific. Where they are in their game, where they are in their career, where they are in their contract, pre-season, if it's not or everything else. There's so many things that come into play in terms of how you go about managing athlete.
I had several NFL players here just this past week in Vail and a couple were thinking about surgery sort of on the edge, but they're in a contract year. And we talked to their agent and we talked to, there's an attorney and another agent who's an attorney. And they're great and the agents are amazing, we work very closely with them, but it's kind of a team decision to figure out what is best for the player.
But each sport, each position of the sport has very unique requirements. We write about that, we research it, we publish it. We have different return to play guidelines for football versus hockey versus baseball versus skiing versus whatever. There are many different requirements based on the unique aspects of your sport. And that's, I think, another one of the very interesting advances in our field is how we're going about testing for that and using almost machine learning and, again, data analytics to make informed decisions about return to play.
Josh King:
Matt, since 2016, you've been practicing as a complex shoulder, knee, and sports surgeon here at the Steadman Clinic in Colorado. Moving your focus from Navy SEALs, professional athletes, although they're still coming through your door, to now weekend warriors like me who use sport as a hobby instead of a profession, how do you adjust and personalize the process for everyday individuals compared to whether you're working with a SEAL or a professional athlete in a contract year?
Matt Provencher:
My approach has always been about patient-centered care. And the patient could be an athlete, could be chief of Naval operations, could be brand new Marine just enlisting and leaving from Kansas to go to San Diego. For me, it's all about a patient-centered approach and having a discussion with the patient about options, outcomes, what we think, using the best data, using the best medical evidence, using collecting data, with the imaging, their exam, their history, and really trying to take that personalized approach. It hasn't really been different for me from day one in medicine and that's what was drilled into us at Dartmouth, is really making that patient-centered approach.
And with that, it really helps because there's tough decisions. You can live with this or there's three different surgeries you can do and here's this one, this one, this one. I'm going to leave you with what I think is a good option for you, but these other two are very viable. That being said, you're going to make this decision, not me. I'm going to give you the information and you're going to make a best informed decision. And that's how I like to practice and that's why Vail is such a great fit because that's what Steadman did to the Steadman Clinic, is really make it a patient centered, about the patient, and that's what's really important.
Josh King:
You mentioned Richard Steadman, he passed away about a year ago, at the age of 85, a member of the US National Ski Hall of Fame. He treated athletes like Ronaldo, Martina Navratilova, Montana, Bode Miller. What has he meant to the practice of orthopedics?
Matt Provencher:
He's amazing. We miss him dearly here. He taught us all that, Josh, and reinforced those principles of just take great care of your patients. Listen to the patient, take great care of your patients, let them decide. We get tough cases here and we like it. But we want to let the patient really weigh into their goals, their desires. And spend time with them and that's what we're about.
And every time you get caught up in every day and this and that and you're running around and running around, you always have to take a deep breath and think about what Dick Steadman was about and what he taught us and what his principles were. And it's like any other mentor in any of our fields out there. Think about that great, when you're having a tough day, when you're having this, think about that great person. Take a deep breath, looking from a 30,000-foot view and hit the reset button. And you know what? Everything's going to be okay.
Josh King:
It's going to be okay. As we begin to wrap up, Matt, there's a story I read in the Summit Daily from 2009, before I came out here, that Dr. Steadman got a call from the Vail Ski Patrol shortly after he took up practice. They reported they had a patient with a knee injury. It was a guy who'd been prone to falls and mishaps over his career, name was Gerry Ford. President and Mrs. Ford were longtime beloved fixtures in Vail. What do they mean to this place? And how have you seen it change over the years since they were skiing down the slopes?
Matt Provencher:
Yeah, I wish I had the opportunity to hang out and just have dinner with them. One of those icons in our government, in our world, as a leader. They've been incredible people to have here in Vail. Incredible philanthropists and incredible for the community because of who they are and who they were. And I can see why Steadman got along so well with them because they're very similar mindset, great leaders, calm in the storm, always doing the best they can, always putting their best foot forward all the time for their job and for their people.
Josh King:
Lastly, just want to get from you your philosophy around your website, the predictors which analyzes injuries to the top NFL players. The site also features the Health Matters Podcast where you and your colleagues give further insights. I see all your rig here. You are ready to go, sir. How do you believe these platforms contribute to enhancing public understanding and awareness of injuries and pro sports, especially at a time when sports gambling is so prevalent and the need for injury information is at an all time high?
Matt Provencher:
Yeah, Josh, I have to credit people like Jonathan Kraft and others and people that are very into the data analytics of what we do and who we are. And I started my journey with this, again, way back in with the Navy SEALs, with the military, of optimizing performance and preventing injury. If you had injury, to try to optimize their return and using that data to get them back and stay healthy and creating a safer environment as best you can in the military, creating a safer environment as best you can in the NFL, NBA, NHL.
And that's really the goal, is using data analytics to help the NFL Players Association, to help the players, to help understand the true differences between grass and artificial and hybrid now we're talking about, to understand why World Cup uses it in soccer, but we don't always use it in NFL. And there's logistical challenges there at stadiums and things like that, but the data and the analytics tell a great story in terms of how we can make a better game, how we can make it safer, how we can prolong the longevity of the 3.6, 3.8 years average longevity of an NFL player, which-
Josh King:
What's your perfect surface?
Matt Provencher:
I want to do it. Well, it's hard to argue with grass. Maybe it's hybrid, but grass, again, in our data, The Predictors shows that grass, for all injuries and all comers, is safer. Now, it's getting better, the game's getting safer, it's getting better, but injuries are part of every sport we play. It's a part of your skiing today, potential. It's part of NHL, it's part of baseball, it's part of high school sports. Our goal is to try to minimize it as best we can and we use data in the analytics.
And so, at The Predictors, that's the journey we've been on is helping to try to optimize player health, player safety, and then understand what an injury means to a team, to a game, and giving information to the public, through Fox Sports, which I've worked with extensively, on what that injury means and really just informing the public about what's a calf strain, what's a hammy, what's an ACL, what's a shoulder [inaudible 00:48:32] versus a separation, what's a neck strain, what's a stinger? And really informing the public about things we take care of all the time. And so, I got a great team with a hundred years of NFL [inaudible 00:48:41] experience, among everything else, that puts us all together and try to help understand the game and health better.
Josh King:
Where do our listeners go to find the site and the podcast and follow more about you and your work?
Matt Provencher:
Yeah, Justin, check out thepredictors.com. I also have some information at the Steadman Clinic and Provencher MD as well.
Josh King:
As you consider the advancements in technology that we've been talking about today that are expediting the recovery process, here we are in 2024, Matt, where are we in 2028, 2034, in terms of the practice of orthopedics and advancing this technology and focus?
Matt Provencher:
Josh, what we're seeing is more minimally invasive techniques, more minimally invasive approaches, more use of your own biologics, taking advantage of your own genetics, your own DNA, type matching, everything to help us heal injuries better and getting you back more efficiently, more predictably, and stronger than you were. That's where we're going.
It's super exciting time to be involved in orthopedics, orthopedic sports medicine, or just medicine in general. The data and analytics are going to help us a ton on that. And the ability to three-dimensionally understand our world. Keep in mind, we started with X-rays. It's two-dimensional. And we got MRI, still two-dimensional, then we got 3D CT, then we're working on 3D imaging and other 3D MRIs. And we're going to be able to really understand, in an augmented reality environment, how to treat you better.
Josh King:
Steady Steadman loved skiing, he loved sports, he loved calamari, according to research.
Matt Provencher:
[inaudible 00:50:19]. Every time we went out to dinner with him, it was great.
Josh King:
George Gillette, in one of his eulogies, said, "We all discovered that this was a very fully rounded man." So beyond the military, medicine, and sports, what are the things that make Matt Provencher here in Vail a fully rounded man, the kind of things that just turn you on?
Matt Provencher:
Well, many, many thanks out to my wife and my family and my parents and brother and everyone else around me. You need a great support group, and so I definitely want to thank all of them. And it's great watching my kids grow up and be a part of so many different fun activities and just growing up into young adults at this point. It's really, truly amazing.
I try to take time for myself. And it's hard at times, but I really try to get up in the morning. I try to have time for myself in the gym or get up for an early Nordic session or an early skin up the mountain in the winter. In the summer, it's biking, it's mountain biking, it's road biking. Between my wife and I, I think we have seven or eight bikes now. I don't know why, just kind of acquired them, and gravel and road and mountain and all hybrid and whatever. But that's great.
We also, we spend a lot of time in San Diego, in Coronado. And we were very blessed that the Navy kept us there almost about 17, 18 years. I was deployed a bunch, but [inaudible 00:51:32] also stationed in Japan and Africa and many other places. But we love San Diego and they love getting back there as well. And that's a very special place for us where our kids were raised on early. So we're very blessed, very honored to be where we are in life.
Josh King:
Well, I'm blessed and honored to be able to walk into the Steadman Clinic today, to look at the annals of all your patients and what you've done for them, and then to be able to sit down with you for this hour. Thanks so much for joining us Inside the ICE House.
Matt Provencher:
Josh, an absolute pleasure and congratulations on your incredible story. It's a great honor to be here with you today at my desk in Vail, watching the mountain and seeing your suntanned cheeks there and goggle tan. I love it. After a great legendary 32,000 day.
Josh King:
Thanks, buddy.
Matt Provencher:
It's awesome.
Josh King:
Great day. Thanks very much for joining us.
Matt Provencher:
Yes, appreciate it.
Josh King:
And that's our conversation for this week. Our guest was Dr. Matt Provencher, one of the nation's leading orthopedic surgeons, Naval doctor, and former team physician for the New England Patriots. If you like what you heard, please rate us on Apple Podcasts, so other folks know where to find us. And if you've got a comment or question you'd like one of our experts to tackle on a future show, or to hear a guest like Matt Provencher, make sure to leave a review. Email us at [email protected] or tweet at us at ICE House Podcast.
Our show is produced by Lance Glynn, with production assistance, editing, and engineering from Ken Abel. Pete Ash is the director of programming and Production at ICE. And I'm Josh King, your host, signing off. Thanks for listening. Talk to you next week.
Speaker 1:
Information contained in this podcast was obtained in part from publicly available sources and not independently verified. Neither ICE nor its affiliates make any representations or warranties express or implied as to the accuracy or completeness of the information, and do not sponsor, approve, or endorse any of the content herein, all of which is presented solely for informational and educational purposes. Nothing herein constitutes an offer to sell, a solicitation of an offer to buy any security or a recommendation of any security or trading practice. Some portions of the proceeding conversation may have been edited for the purpose of length or clarity.
