Prof. Dr. Thorsten Gehrke
Prof. Dr. Thorsten Gehrke: „I will implant more than 500 prostheses this year.“ ©Helios Endo Klinik Hamburg

The Helios Endo Clinic in Hamburg is the biggest endoprosthetic center in Germany. No other clinic implants more artificial hip and knee joints. In this interview, hospital director Thorsten Gehrke explains how the specialist clinic is doing during the pandemic.

Prof. Dr. Gehrke, how has your daily work routine changed since the “shutdown light” in November?

Prof. Dr. Thorsten Gehrke: Nothing has really changed in the Endo-Clinic. There is no reduction of case numbers. We rarely have patients who cancel selective surgical interventions because they are scared to become infected. We work on a normal level. That is mainly due to the fact that we are an orthopedic specialist clinic where no Corona cases are being treated. In addition, we didn’t have any COVID transmission this year. Almost 7,000 patients were operated since the beginning of the pandemic and there hasn’t been any Corona case.

What about big revision surgery which might necessitate a stay in the intensive care unit and occupy beds? Can these take place?

Prof. Dr. Thorsten Gehrke: At the moment, we don’t operate high-risk patients which will most probably have to stay in the intensive care unit. High-risk patients who need surgery due to an emergency will of course still be operated. We developed a system in spring which protected us from transmissions until now. Before their stay, we go through a questionnaire with the patients. If the questionnaire is okay and the patient doesn’t show any risk of Corona, he can come to the clinic on the next day and will be tested. On the evening of the admission day, we will have the test result and in the case of a negative result, the patient can be operated the next day.

The most frequent orthopedic surgery in Germany is the implantation of an artificial hip joint. In the Helios Endo-Clinic in Hamburg, this operation is performed over 2,500 times per year, more than in any other clinic in Germany. You are the medical director here. Does the often cited flat hierarchy work in a big team?

Prof. Dr. Thorsten Gehrke: It’s true that it doesn’t work without hierarchy in a clinic of this size. There has to be someone who indicates a direction. From my experience, it leads to chaos if everybody has a say. This is even more the case for a highly specialized hospital with clearly defined standardized processes which must be complied with. The high number of cases you mentioned can only be achieved with a certain compelling nature. I’m not a fan of flat hierarchy, but I like cooperativeness and team spirit.

You came to the Endo-Clinic Hamburg during your further training and were promoted very quickly. You are leading the clinic as medical director for 16 years already. After so many years as director, do you still find the time to operate?

Prof. Dr. Thorsten Gehrke: I am one of the medical directors who still operate a lot and I will implant way more than 500 prostheses this year. I perform as many surgeries here as all the other assistant medical directors. From my point of view, it’s like handcraft: the craftsman has to be at least slightly ahead of the journeyman. Only like this, you can receive the necessary respect and professional recognition in an operative area.

The heart surgeon Dr. Dilek Gürsoy recently unsuccessfully applied for the position of a chief physician although she is renowned for her professional expertise. Can you image a woman leading the Endo-Clinic after you?

Prof. Dr. Thorsten Gehrke: I find that hard to imagine, because endoprosthetics is a very physical area. You have to lift heavy tools and sometimes move extremely heavy extremities. Concerning the skills, women are often really good and significantly better than men, but they are often pushed to their physical limits in endoprosthetics. If you for example have to get help when treating an obese patient, they could lose their authority as head physician. When it comes to hand, foot or shoulder surgery, sure, why shouldn’t a woman be able to lead such a specialist clinic? These physical limitations don’t exist in heart surgery as far as I know, which is why I don’t understand why Dr. Dilek Gürsoy shouldn’t be able to become chief physician.

Before the pandemic, you traveled around the world a lot, you took up a guest professorship in Shanghai, today you are a visiting professor at the universities of Buenos Aires and Santiago de Chile. Do you think that you will be able to give guest lectures again next year?

Prof. Dr. Thorsten Gehrke: I don’t think so. I think it’s realistic to say that we will be able to travel to South America, Asia and South Africa only at the end of next year. Maybe it will even be in 2022.

After his medical studies in Hamburg, Prof. Dr. med. Thorsten Gehrke completed his further training in orthopedics and trauma surgery in the Johanniter Hospital Geesthacht, the Christian Albrechts University in Kiel and the Helios Endo-Clinic in Hamburg. He has been medical director and chief physician of the Helios Endo-Clinic in Hamburg since 2005.

This interview was first published in a longer version in the Deutsches Ärzteblatt/Ärztestellen.