Surgeons can make patients active participants in their treatment plans to bolster the patient experience, which is exceedingly important as healthcare transitions to value-based care. New York-based orthopedic surgeon Kevin Plancher, MD, aims to do just that.
"Medicine is about listening to people and it's a lot of work. I have the good fortune of being able to take time with my patients so that I can really listen — a luxury that not every physician is afforded," Dr. Plancher says. "I find that by taking my time, and digging deeper, I can spot red flags that may take me away from orthopedics for a bit, but it all comes full circle. The body is a whole, and orthopedics is simply a part of that interactive whole."
In September 2016, Dr. Plancher performed rotator cuff surgery with a right bicep attachment on Lena Cavanna, as she was experiencing pain in her bicep following exercise. Dr. Plancher walked her through every detail of the treatment plan. Prior to a procedure, Dr. Plancher notes it is crucial to manage a patient's expectations and educate them about the ins and outs of their procedure and recovery process.
"When he takes care of you, he takes care of everything. He is not only looking at the area that needs surgery, but the entire patient," Ms. Cavanna says. "When he came into the pre-op room and looked at my chart, he went through each section of the chart to make sure that everything was in order and to guarantee my safety and understanding of the protocol leading up to my surgery. He further inquired whether the anesthesiologist had been in to see me and if I was comfortable with him. His main concern was my welfare and to relieve any apprehensions because he knew I was nervous and apprehensive about having surgery. He wanted me to go into surgery as relaxed, comfortable and feeling as secure as possible. His attention to detail and to me gave me tremendous confidence."
Dr. Plancher has found success through looking at the whole patient to assess other factors that may impede the healing process. By doing this, he can learn whether a patient seeking an orthopedic procedure has diabetes or another underlying condition and make the necessary adjustments to the treatment plan before the patient has surgery.
"If I have an 18-year-old rower that comes to my office with continued lower back pain and lower extremity numbness and tingling, well that's just not normal — he's too young," Dr. Plancher says. "I must think out of the box if an MRI is normal. I'm not just going to order physical therapy and an anti-inflammatory, I need to dig deeper — why is this happening? I will order blood tests and I look for other things like autoimmune and rheumatoid disorders. It's more common than you think, unfortunately sub-specialization has made us look at people with blinders on every day, but we need to resist this and trust our patients and what they say to us."
Following surgery, Ms. Cavanna received a protocol regarding treatment, rehabilitation and a list of dos and don'ts. A successful recovery entails three key components, which Dr. Plancher refers to as the "Orthopedic Trifecta." The components include:
A surgeon well versed in a patient's pathology and anatomy. Dr. Plancher notes this surgeon should also be updated on the latest literature and techniques. "This surgeon should care for the patient more than the person cares for himself or herself," he adds.
A patient who will adhere to the surgeon's post-op protocol. "You can be set up with the perfect architecture but if you don't have equal participation by the patient all can be lost," Dr. Plancher says.
A physical therapist that is both well studied and capable. Dr. Plancher said he has worked nearly 28 years with physical therapists who understand both his and his patients' expectations.
"A bonus is to have an orthopedist that has had surgery on him or herself so they have the empathy to understand what the patient is feeling," Dr. Plancher adds.
Dr. Plancher provided the name of a physical therapist who Ms. Cavanna noted did not deviate from Dr. Plancher's treatment plan, which she said highly contributed to her successful recovery.
"If you follow Dr. Plancher's protocol to the letter, you will heal quickly," Ms. Cavanna says. "I don't have any pain and I have full range of motion."
Dr. Kevin Plancher also passes along his expertise professionally; he was the chair of the Orthopaedic Summit 2016: Evolving Techniques, which was held in Las Vegas. More than 550 orthopedic and sports medicine physicians attended the event. He is a founding member of the American Academy of Orthopaedic Surgeons' Educational Enhancement Fund.
After earning his medical degree from Georgetown University School of Medicine in Washington, D.C., he completed his residency at Harvard University's combined orthopedic program. He underwent a fellowship at Indianapolis-based Indiana Hand Center and Vail, Colo.-based Steadman-Hawkins Clinic.