120. What Aviation Taught Me About Surgery

What can surgery learn from aviation, team dynamics, and building systems that actually function under pressure?In this episode, Dr. Kristofer M. Charlton-Ouw, MD, talks about building a vascular program inside a smaller hospital system, creating specialized OR teams, and why consistency, culture, and workflow matter so much in complex surgical care. The conversation also explores the realities of balancing patient care with administrative systems, how different incentives shape hospital operations, and why communication across teams can completely change outcomes for both patients and physicians.The second half of the episode shifts into aviation, where Dr. Kristofer M. Charlton-Ouw explains how studying aviation safety and crew resource management changed the way he thinks about surgery, complications, leadership, and high-performance teams.02:38 Building a physician-centered vascular program08:17 Creating specialized vascular OR teams14:36 Why consistency matters in vascular care19:46 The vision behind building a new system24:46 Understanding how hospital systems operate30:33 The billing code story that changed staffing34:54 Balancing physician priorities and administration42:16 How large organizations change over time49:58 What aviation taught him about surgery53:09 Crew resource management in medicineWho Should ListenThis episode is for vascular surgeons, physicians working inside large health systems, healthcare administrators, and anyone trying to build better systems of care without losing autonomy or quality of life. It is especially relevant for earlytheAbout Kristofer M. Charlton-Ouw, MDKristofer Charlton-Ouw graduated from Vassar College with a B.A. in History before earning his M.D. from Harvard Medical School. He completed his general surgery residency at NewYork-Presbyterian Hospital. He later completed his vascular surgery fellowship at Memorial Hermann Hospital and the University of Texas Health Science Center at Houston.Dr. Charlton Ouw served as Program Director for the UT Vascular Surgery Fellowship and Integrated Residency and was Director of the Memorial Hermann Heart and Vascular Institute’s Vascular Ultrasound Laboratory. His clinical and research interests include aortic aneurysm and dissection, prosthetic graft infection, hemodialysis access, peripheral arterial disease, and postoperative pain control. In 2020, he joined HCA Houston Healthcare and helped found Gulf Coast Vascular.Connect with Kristofer M. Charlton-Ouw, MD💼 LinkedIn: Kristofer Charlton-OuwAbout LocumstoryLocumstory is a free, unbiased educational resource about locum tenens to answer your questions about the how-tos of locums on their website, podcast, webinars, videos, and a locums 101 crash course.Visit locumstory.com to find out if locum tenens makes sense for you and your career goals. Follow Life of Flow📲 Instagram: ⁠⁠⁠⁠@LifeofFlowPodcast⁠⁠⁠⁠👍 Facebook: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠💼 LinkedIn: ⁠⁠⁠⁠Life of Flow Podcast⁠⁠⁠⁠🐦 X: ⁠⁠⁠⁠@VascularPodcastIf this episode changed how you think about hospital systems, physician autonomy, and the incentives shaping modern medicine, share it with a colleague who’s navigating the same realities. And if you’re enjoying Life of Flow, a quick review helps more physicians and healthcare professionals find conversations like this.