Amid the rapid-fire thwacks of a mallet and the gurgle of suction lines, Dr. Brian Cohen works with confidence and purpose. He's not one to hesitate. The scrub and circulating nurses in the operating room tease Cohen at times. His toddler-age daughter needs a puppy, they tell him. Often, nothing needs to be said; his team knows which tool he needs next. He repairs rotator cuffs and replaces knees, hips and shoulders, the joint he most likes to work on. The New York native's skill, drive and almost-robotic discipline have paid dividends for his nonprofit employer, Adena Health System. And by almost any measure, Cohen is compensated well for that workload.