Best Practices: Howard Luks

The Chief of Sports Medicine and Orthopedic Surgeon on building a strong digital presence as a physician.

As the Chief of Sports Medicine and Arthroscopy at New York Medical College and Advanced Physician Services, Dr. Howard Luks is well versed in treating a wide variety of patients, including tiny athletes-in-training, professional athletes, and weekend warriors. With over twenty years of experience under his belt, Dr. Luks has also built a formidable online presence, using that presence to learn, collaborate, and share evidence-based information in the longevity and orthopedic space.

Read on to learn about how he got started in sports medicine, his do’s and don’ts for building a social media presence as a physician, and what he’s learned from treating patients in the Covid era.

How did you get started in medicine and how did you choose your specialty?

I graduated college as a chemist, but after I landed my first chemist job, I found myself disappointed with the work. I quickly found a new job that mixed chemistry and human biology, and they asked me to get a master’s degree. While at school, I started meeting a number of medical students and soon realized that medical school was the next logical next step for me since I wasn’t happy staying in the physical sciences.

Finding my specialty took a bit more self-discovery. Many physicians say they enter medical school with a passion to help people, I was no different, and could have fed that passion in many specialties. But I think it’s also true that a mentor or attending that you’re assigned to can have a significant influence on whether or not you decide to pursue that specialty in the long run.

Initially, I meandered through a few options. But I always came back to the fact that, growing up, I knew my orthopedist better than my pediatrician. As a kid, I was always playing sports and getting injured, and as a result, developed a great bond with my orthopedist. I also found that every orthopedist I interacted with in my training was very happy, jovial, and outgoing. So I decided to transition into a career in orthopedic surgery with a subspecialty in sports medicine.

How does your digital presence help inform your practice and patient relationships?

When I first created my Twitter account in 2009, there were maybe six doctors or so on the platform. I didn’t really know what to do with Twitter at that point, but I enjoyed communicating with people and getting digitally introduced to physicians that I would physically meet later down the road. At first, it was thrilling to meet someone in person that I had only spoken to online. I was inquisitive and curious about the digital space, and loved seeing what people in my field were working on.

Over the last few years, my blog, which has been around for 12 years, has morphed into a longevity focused space, specifically for people 40 and over. I don’t sell or market any products, but instead use the blog as an opportunity to share evidence-based, physician-created information. There’s so much information out there now, I’ve tried to narrow my focus on longevity so that I can provide targeted and helpful content.

However, I don’t find that leveraging social media as a means to attract patients to my office is particularly useful. In my experience, the best advantage of being online is that it humanizes you. People can get to know you by watching your videos on YouTube, interacting with you on Twitter, or reading your professional Facebook page. To me, that’s the best way to leverage your position in the social space. In some cases, I’ve had patients remark that they felt more comfortable with me in the office after having seen me or read my articles online. In other words, my online presence helped build trust with these patients — which is an invaluable resource.

Recently, you’ve leveraged social media for Covid education. What have been the biggest benefits and pitfalls of using your platform as a means to distribute accurate information?

When Covid first emerged, there were a number of us physicians who were unsatisfied with the information that was being shared with the public. So we collaborated on a post to share the information that we felt was relevant at that point in time. When we started discussing the article, there were just over 88 confirmed cases in the US. By the time we published it, there were over 2,200 cases. Needless to say, we felt the urgency.

Unsurprisingly, my server crashed soon after I published the article. My site, which normally gets around 10,000 visitors a day, suddenly had two million hits. I had to wake up my developer in the middle of the night to get it back up and running. I also forgot to remove the ad software for that post, and inadvertently ended up receiving a lot of earnings. We donated the entirety to a local food bank — I just couldn’t imagine profiting off of something like that.

In the beginning, I felt it was important to share the information I could because it seemed like the experts were holding back. Now, we can all name the top virologists and immunologists in the world, and we can go to them for expert information. So, I haven’t had much to say for quite some time. Once they arrived on the scene, it wasn’t necessary for me to say anything.

What’s the most difficult aspect about working in Sports Medicine?

Sports medicine is a great specialty because I get to work with people of all ages — from tiny athletes to 90-year-olds who are trying to stay fit. I also treat a lot of acute traumatic injuries and chronic overuse injuries. And of course, age-appropriate issues arise.

The number one cause of arthritis is age. So a good deal of my work is helping people come to grips with the natural changes that occur over their lifetime.

I also work to correct misinformation in regard to activity and aging. So many of my patients have been told to stop running for fear of making their knee arthritis worse. These patients are very happy when I tell them that it’s OK to resume running, and that running can help protect their joints in the long term. In fact, there is very little risk to your joints when maintaining an active lifestyle.

Sports medicine is a very satisfying specialty and more so now as my focus has turned to the longevity space. I try to put everything into perspective by sharing with my patients that everything is interconnected, and if your goal is to remain active throughout your life, then you need to start taking care of your body early on.

I’m so happy when patients tell me that the exercise I prescribed worked so well that a previous issue is no longer bothering them and they don’t need an operation. Or that they’ve lost 20 pounds and no longer need to take my metformin. Helping these patients will small adjustments are just as satisfying as the bigger surgical interventions I perform.

In what ways has Covid-19 changed your practice for the better?

When we shut down in late March, there was a lot of hesitancy toward adopting telemedicine amongst my colleagues, but I jumped on and quickly found that it was a great way to stay in touch with my patients.

After using it more regularly, I also discovered that what we’re taught in medical school was right all along: After speaking with a patient, you should have a good idea of what the diagnosis or top possibilities are. You then confirm your diagnosis with a physical exam. In other words, you should have a pretty good idea of what’s wrong before you even touch the person. In August, when we opened back up, I started seeing the patients I had consulted virtually in person, and I learned that the diagnoses I gave over telemedicine were, in fact, very accurate.

Finally, I think the number one problem with in-person visits these days is we don’t give the patient enough time to talk with us. As a result, a lot of physicians don’t develop good listening skills until pretty late in their careers. I hope this telehealth revolution will offer us more time to speak with — and more importantly — listen to our patients.

What advice would you give to a physician just starting to build out their social media presence?

Have a good set of goals in mind. Use social media to build professional relationships and increase your knowledge base. You’re likely going to meet a number of very talented people in various fields. Some might be completely unrelated to health care and medicine. But if you’re open to it, you’ll learn a lot more than you originally anticipated.

That being said, be aware of the digital echo chambers that exist and how dangerous they can be. Following voices that mimic yours will limit your growth and only narrow your intellectual and professional horizon.

For those who are entering the social space with the intention of driving patients in the door, know that no marketing specialist can 100% deliver on that promise. For the most part, take their advice with a grain of salt, and be prepared to work hard. Developing a presence that will send patients back to you is far more of a marathon than a sprint. And it will take a very long time to develop that kind of presence on multiple channels.

Lastly, be aware that having a presence in social media can also become a huge time suck. It’s incredibly easy to get lost on Twitter. My advice: Give yourself a dedicated social media time slot. And don’t let it spill over into your other responsibilities and time constraints. This will be enormously helpful when it comes to giving your spouse, your children, and yourself the time you deserve.

Vital Signs

Where’s your favorite place to go for a run? I’m a trail runner — I hate running on roads. I love running on a mountainous single track trail, where every step is technically unique. I can run the same trail three times a week and make new discoveries each time. It’s a phenomenal feeling and the absolute best de-stressor.

Are there any foods that you typically recommend to support injury recovery? PROTEIN. Protein intake is so important, especially as you age or if you’re recovering from an injury or surgery.

Maintaining muscle mass as you get older is important as it correlates with longevity. Losing muscle mass is normal as we age, and happens in a process called sarcopenia. But for some, losing muscle or muscle atrophy can be unrelenting and a serious determinant to recovery.

In order to keep the process of muscle protein synthesis a net positive, you need to make sure you have an adequate protein intake. If you’re recovering from a major injury or surgery, that might look like including 26 to 30g of protein per meal. Also, you need to make sure that you have a little bit of protein before you go to bed. Otherwise, you may become catabolic at night.

Do you have any go-to vitamins or supplements?

Personally, I use creatine to support age-related muscle loss. I also recommend it to those who are recovering from surgery, to help maintain muscle mass and strength. Otherwise, I’m not a big vitamin or supplement person. I believe in eating three whole meals a day and getting my nutrients from those meals. I’m also not afraid of whole, non-processed carbs. If you’re a performance athlete, you need carbs to sustain what you’re doing, just as you need protein.

What’s one healthful habit you’d love to see patients adopt?

It’s said too often but not adopted often enough: exercise. If exercise were a pill, everyone would take it. It’s truly the best medicine that we have available for disease prevention and treatment.

Many people shy away from it because they don’t want to go out and get sweaty, but you don’t have to participate in intense exercise to reap big benefits. In fact, if you look at the studies, walking as little as 6,000 steps a day is enough to dramatically decrease your all-cause mortality. You don’t need to run 20 miles a week.

You can learn more about Dr. Howard Luks here.

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