#46 Don’t Mess with Little Old Ladies with Dr. Colleen Balkam

In this impactful conversation, we dive deep with orthopedic surgeon Dr. Colleen Balkam into the emotional, physical, and cultural terrain of surgical practice—particularly in orthopedics and geriatric care.

What we cover in this episode:

• Coaching, reframing excitement as anxiety, and the importance of pausing when things get hard.
• Facing your first complication as an attending.
• The emotional weight of complications post-training versus during residency.
• Growing up the daughter of an orthopedic surgeon—rounding in soccer cleats and witnessing community impact.
• The torn ACL that inspired her path into orthopedics.
• Giving birth to her first child during residency—and what it took to keep going.
• Trailblazing as one of the first two women in her fellowship program, and how much she loved it.
• Navigating “ortho bro” culture.
• The growing pains of her first year in practice.
• Ergonomics in orthopedic surgery—and how to operate smarter, not harder.
• What enrages her about how the system treats grandma’s hip—and why it matters.
• Going head-to-head with the head of medicine as a resident advocating for patients.
• The sad reality: if healthcare workers don’t advocate for geriatric patients, no one will.
• Understanding hip fracture care as end-of-life care—and reframing what that means.
• Knowing when to go above and beyond for the people who need it most.
• The parallel between breaking barriers as a female surgeon and the women we care for who once broke barriers themselves.
• Seeing herself in her older patients—and why that connection matters.
• Setting boundaries thoughtfully—who are we saying “no” to and why?
• Carving out time for meaningful conversations within a system that rarely makes space for them.
• Her dream to collect patient stories and write a book that honors their lives.
• The privilege of hearing people’s stories at some of the worst moments of their lives.
• Remembering our impact—how a two-hour surgery can define a patient's entire life.
• Why caring deeply is both a gift and a burden for highly empathetic surgeons.
• Sound advice from an ER resident: “Every time a patient is horrible, I remember—they’re having the worst day of their life.”
• And finally: Don’t mess with little old ladies with hip fractures. They are history. They are human. They matter.

Follow Dr. Colleen Balkam Balk on instagram here. Whether you are a medical student, resident, or practicing physician, she’d be honored to serve as a sounding board for you!

Find out more about Empowered Surgeons Group here.