Paul L. Linsky1, Jin Ye Yeo2
1Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA; 2ASJ Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. ASJ Editorial Office, AME Publishing Company. Email: asj@amegroups.com
This interview can be cited as: Linsky PL, Yeo JY. Meeting the Editorial Board Member of ASJ: Dr. Paul L. Linsky. AME Surg J. 2025. Available from: https://asj.amegroups.org/post/view/meeting-the-editorial-board-member-of-asj-dr-paul-l-linsky.
Expert introduction
Dr. Paul L. Linsky (Figure 1) was born and raised in Birmingham, AL. He attended college at the University of Alabama at Birmingham where he received his bachelor's degree in chemistry. He also attended medical school at UAB. He then trained in general surgery at the University of Louisville. While there, he spent one year in a translational lab focusing on heart failure, organ perfusion, and ex vivo lung perfusion in large animal models. After residency, he returned to UAB for his fellowship in cardiothoracic surgery, where he received exceptional training in robotic general thoracic surgery. He then joined the faculty of the Medical College of Wisconsin in Milwaukee, WI in 2018. Dr. Linsky specializes in robotic approaches to thoracic pathologies, both malignant and benign. He has busy clinical practices at both Froedtert Hospital and the Clement J. Zablocki VA Medical Center. He conducts clinical outcomes research but focuses on medical education at all levels, being the Associate Clerkship Director for Surgery and the Program Director of the Independent Cardiothoracic Fellowship at MCW. He is also the Vice Chair for the Thoracic Oncology DOT.
Dr. Linsky’s clinical interests include minimally invasive, particularly robotic, management of thoracic disease, both malignant and benign. He particularly focuses on thoracic outlet syndrome, thymectomy for myasthenia gravis, and pectus repairs in his benign practice and all forms of thoracic malignancies. His clinical research focuses on esophagectomy outcomes and robotic outcomes in the VA system. He is a member of the General Thoracic Surgical Club, the Association of Academic Surgeons, the Society of Thoracic Surgeons, and a fellow of the American College of Surgeons.
Figure 1 Dr. Paul L. Linsky
Interview
ASJ: How did your background in chemistry influence your transition to medicine and surgery, and what led you to pursue cardiothoracic surgery?
Dr. Linsky: Chemistry was my favorite subject in high school. This was due to the nature of chemistry and having one of the greatest teachers in my entire life teach it to me. Chemistry has so many facets and different subspecialties, but they are all linked with procedural logic and diagnostic testing. I feel it prepared me for a career in medicine more than most of the biology classes I took.
Cardiothoracic surgery has always been fascinating to me. My initial interest started in 6th grade when I was fortunate enough to do a pig heart lab. Through medical school, I was always drawn more to cardiopulmonary physiology and pathology. Then, during my third year of medical school, I just loved operating and the operating room. I also had the privilege of learning under some of the most outstanding cardiothoracic surgeons. The combined experience made it undeniable to me that cardiothoracic surgery was the field for me.
ASJ: What motivated you to specialize in robotic approaches to thoracic surgery, and how do you think robotic techniques have changed the field?
Dr. Linsky: The advantage of robotic surgery in thoracic surgery was obvious. The morbidity of a thoracotomy being removed from the patient was a large driving force, but we did have thoracoscopy prior to robotics. The inherent advantages of what could be done with the robot over straight thoracoscopy were undeniable. The vision is incredibly better and the articulating instruments with the ability to do microsurgical moves are clearly superior to thoracoscopy. It only took me seeing one case to know it was the right direction for the field.
The robot has not only allowed thoracic surgeons to perform more complex surgeries minimally invasively but also get patients back to a high quality of life much faster than open surgery, complex or straightforward cases included. My M.O. is “Robot First”. I will almost always start a case robotically even if I think we will have to convert. I have always been surprised by how far I get in the case and, most of the time, I complete the case totally robotically.
ASJ: As a surgeon who practices at both Froedtert Hospital and the Clement J. Zablocki VA Medical Center, how do you approach working in different healthcare settings, and what unique challenges and rewards come from treating patients in these environments?
Dr. Linsky: I am privileged to work at two outstanding medical facilities where I have the ability to do robotic surgery, so my management of patients is identical at both sites. That being said, each patient population has some distinct differences, as anyone who has worked at a VA and non-VA facility can tell you.
I love taking care of all my patients, but the Veterans are just special. They are always grateful and have great stories. Ultimately, the honor of serving those who have sacrificed so that my family, friends and I can live freely. Veterans have unique issues that the VA system does an outstanding job of managing to ensure they get the best care. With all the political changes happening currently, I hope that those in power realize how well the VA takes care of veterans and tries to preserve the VA system.
My practice at Froedtert is much broader with all types of patients from all walks of life. The variety and mix make it interesting. Being a specialist, I see a lot of people who have gotten no answers for what ails them, and I may be the first physician that can offer insight or help. That is really gratifying.
ASJ: Your clinical research focuses on esophagectomy outcomes and robotic outcomes in the VA system. What are some of the key findings from your research, and how do they impact the treatment and management of thoracic diseases?
Dr. Linsky: I am excited about both lines of study. What we are seeing in our esophagectomy work is that a lot of assumptions have become dogma in the treatment of these patients. We have done a lot of work using the National Cancer Database to look at questions about the extent of lymphadenectomy at the time of esophagectomy and whether induction treatment for patients with T2N0 adenocarcinoma of the esophagus is better. Our work shows that a more extensive lymphadenectomy does help with survival in stage III patients and that patients do just as well or better with adjuvant therapy after esophagectomy. These are important questions that the field is still trying to figure out and I am hoping our work can push the outcomes of esophageal cancer patients further.
In regard to the VA robotics, we have shown in our first project that not only is robotic surgery in the VA increasing, but it is also decreasing open surgery and conversions to open surgery. This all helps patients. We are just moving into more granular specific study into robotic thoracic surgery in the VA system.
ASJ: What do you see as the future of robotic surgery in thoracic surgery, and what further innovations or improvements do you anticipate in this area?
Dr. Linsky: As technology and artificial intelligence (AI) advance, so will our abilities with the robot. I know that the total integration of radiology and intraoperative planning is coming soon. As more competition enters the market, more innovation will soon follow. Ultimately, and, in my opinion, rather sadly, the robot will do the surgery. We as surgeons will just supervise. When that will happen, I am unsure, but I feel it is inevitable.
ASJ: In addition to clinical research, you also focus on medical education. What changes have you seen in the landscape of medical education in cardiothoracic surgery over the years, and how should educators best equip the next generation of surgeons?
Dr. Linsky: This is an interesting time for both graduate and undergraduate medical education. There are a lot of people with great ideas to further the advancement of education. Technology and AI are also advancing the fields. With that comes gains and losses, especially in medical education.
I think the biggest change is the forward acknowledgment of physicians as people with real problems with their own personal problems and limits. I think past generations were expected to be superhuman, and that has led to some bad patterns in physician well-being. However, I am afraid that the pendulum is swinging too far in that direction too.
I honestly hope that we can make medical education more based on the reality of where we are currently. Medical schools need to have classes in medical finance, personal finance, and the state and dynamics of our healthcare system. Residencies need to explain billing and administrative leadership to their trainees. Also, we need to have real discussions about the fact that being a surgeon is hard and nothing is going to change that. In fact, as many fields are still in workforce deficits, that is very unlikely to change. I firmly believe that preparing our trainees for these difficulties is more important than trying to hide them from them.
ASJ: As an Editorial Board Member, what are your expectations and aspirations for ASJ?
Dr. Linsky: To continue to make an impact on the academic field of surgery. I want to find outstanding research that deserves to be shared with the surgical community and do it. I expect to spread ASJ’s influence further than it has ever been.
ASJ: Finally, what legacy do you hope to leave in the field of thoracic surgery, particularly in robotic surgery and medical education?
Dr. Linsky: I hope that my legacy is that I was a great surgeon who pushed the boundaries and expectations of what thoracic surgery could do and taught many others to be great surgeons, even better than me.