Dec 13, 2016

Interview Transcript

Dr. Miller: You have a sports injury or a musculoskeletal injury, should you go to the ED or not? We're going to talk about that next on Scope Radio.

Announcer: Access to our experts with in-depth information about the biggest health issues facing you today. "The Specialists" with Dr. Tom Miller is on The Scope.

Dr. Miller: Hi, I'm Dr. Tom Miller and I'm here with Dr. Joy English. She is a sports medicine physician here at the Department of Orthopedics, and she's going to tell us a little bit about the new Orthopedic Injury Clinic. You don't really need to go to the ED, do you, if you have a sports injury?

Dr. English: You definitely don't. And I would recommend that for most injuries, it's actually best to come on into our Orthopedic Injury Clinic rather than waiting in the emergency department with long wait times and high copays as well as high cost from the emergency department.

Dr. Miller: Not only that. But if you go to our Orthopedic Center, you're going to see a specialist that is trained in and treats musculoskeletal injuries, correct?

Dr. English: That is correct. So everybody that works in our Orthopedic Injury Clinic is a staff member in the Department of Orthopedics at the University of Utah.

Dr. Miller: When did this clinic open? It's relatively new and it's kind of a new idea across the country, I believe. Isn't it?

Dr. English: Yeah, I think it's definitely a new concept, especially within the Department of Orthopedics or specialty care. So we opened in the middle of September and it looks like, so far, we've actually had a lot of patients and a lot of patients with good experiences.

Dr. Miller: Well, Dr. English, this isn't your first rodeo. Tell us a little bit about the first injury clinic that you set up.

Dr. English: Yes. So after my fellowship here at the University of Utah, I began work at Washington University in St. Louis. There, we started an orthopedic injury clinic that grew pretty quickly, initially seeing something like 100 patients a month and now seeing something like 600 patients a month.

Dr. Miller: Oh, that's massive growth. Over what period of time?

Dr. English: Within about a three-year period of time.

Dr. Miller: Wow. So that took a lot of people out of EDs and having to wait and actually coming to a place that was designated for that type of injury. That's really interesting.

Dr. English: Yeah, it's wonderful because patients can see you in the Orthopedic Injury Clinic but then they can also follow up with you afterward. It also helps streamline care so it's very easy for me to get a hold of one of my colleagues if you have a fracture or an injury that needs to be seen by another orthopedic physician. It's very easy for me to get you into them and get you referred to them. And if it's something that's non-operative, then you can follow up with the same provider that saw you originally, which is really nice for continuity of care.

Dr. Miller: Talk a little bit about the types of injury, then, that you're going to see in this type of a clinic.

Dr. English: The majority of injuries that we see are fracture care or breaks of the bone. We see sprains of ligaments. We see muscular strains. We see a lot of just kind of bumps and bruises, making sure that it's not anything more significant.

Dr. Miller: Now, it's not just strictly related only to sports injuries, correct? You do other types of injuries or do you just take care of sports-related injuries?

Dr. English: Yeah, we definitely take care of other types of injuries as well. I would say, for the most part, we see musculoskeletal injuries. So with regard to things like concussion, we don't see much of that in the Orthopedic Injury Clinic and that's because it may be staffed by an orthopedic physician that may not see concussion all too often.

Dr. Miller: That's a good point. What about falls, like an elderly fall?

Dr. English: We definitely see falls. I've actually seen quite a lot of those recently because I think some of the guys and ladies in our Internal Medicine Department and specifically, in our Geriatrics Department, have used us pretty frequently, and I think it's a really good place for some of these folks.

Dr. Miller: Now, are there certain orthopedic injuries that you do defer to the ED because of a higher level of care?

Dr. English: Yeah. So if you are wondering if you should be seen in the Orthopedic Injury Clinic, I think a good rule of thumb is if the bone is sticking out of the skin, it's probably not the correct place to go. And also, if you see a pretty significant deformity, we may not be the right place for you either. But other than that, we can take care of most things.

Dr. Miller: Well, I would think that maybe motor-vehicle trauma might go to the ED rather than to the Injury Clinic. Many times, these people are transported, or patients are transported by ambulance. So how does the ambulance know to come either to your clinic or to the ED?

Dr. English: So usually, if you're in an ambulance, you're headed to the ED. I don't know that you necessarily have a say in that. But I would say, one thing that we do actually see are some motor-vehicle collision injuries that are a week or two out that aren't getting any better.

Dr. Miller: That makes sense. That makes sense.

Dr. English: So those are usually much more stable injuries and can be seen at an outpatient clinic rather than the emergency department. You know, so if you think you need a higher level of care, it's not a bad idea to err on the side of caution and go to the emergency department. But if you feel that your injury can be taken cared of in an outpatient setting, I think it's reasonable to come on in.

Dr. Miller: Now, is there an age limit to the patients in your clinic? Or do you, for instance, do you see pediatric patients there?

Dr. English: We do see pediatric patients that are ages five and older. And no age limit for the higher end.

Dr. Miller: And do you repair fractures on site?

Dr. English: It depends. So some fractures that require reduction or putting the fracture back into place can be easily done in our clinic. Others are a little bit more complex. So again, if you see that there is a significant angle to the bone when you experience an injury, it's not a bad idea to go to the emergency department, or you can always come and see us. And if we feel that it's something above our level of care that we can provide there, we'll get you over to the ER at Utah.

Dr. Miller: How about the hours of care?

Dr. English: So we operate currently Monday through Thursday from 4:00 to 8:00 p.m. And on Friday, from noon to 6:00 p.m. We don't have any weekend hours as of yet, but that's a direction we think we're headed in.

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