Thomas Graham, MD, is a clinical professor in the department of orthopedic surgery and associate chief of the division of hand surgery at New York City-based NYU Langone Health.
Here, Dr. Graham discusses what he's learned from treating professional athletes and how surgeons can improve patient engagement.
Note: Responses were lightly edited for length, style and clarity.
Question: How has treating professional athletes enhanced your practice overall?
Dr. Thomas Graham: Professional sports is an unbelievably interesting laboratory. I've built a lot of experience through the tens of thousands of procedures I've done, but I've learned the limits of surgical science by taking care of these athletes. We've then taken some of the techniques that have returned them to the highest level of performance and brought them into the general practice of our specialty. We learn so much because it's a very unique circumstance. We also learn a great deal from the rehabilitation protocols that we've developed for these athletes.
Q: How do you determine the appropriate care for professional athletes who may be in the middle of a season?
TG: I always introduce the concept that there are three different phases we're considering. The short term is the actual competitive season of their sport. Second is the player's career. And then there's playing with your grandkids, meaning life after sports. We need to make decisions that are logical and sound for all three of those phases. Have we given a cortisone shot to play in the World Series or Super Bowl or Stanley Cup? Yes, we have, but we didn't think that was going to be deleterious for something later on. This phase concept is really important. You have to think about that because they have a much shorter window to apply their trade.
Q: Is patient engagement easier with your population of professional athletes?
TG: I think a lot easier [due to] their level of dedication. Not unlike many other people, you're seeing them at a very vulnerable time in their lives. Everything they do is reliant on their body. I'm seeing these individuals who feel like their career is threatened, so they are hypervigilant.
We have a great amount of resources around them — trainers, coaches, etc. I have six or eight cameras trained on an individual who's performing on a field, court or rink, and I can watch them get injured. I literally have injury data that I don't see [for other patients]. I have a very unique information set.
Q: How can orthopedic surgeons improve engagement when working with populations that don't have that level of resource and motivation?
TG: I would say try to become as informed or expert on what other people do. Inquire, question, study. If somebody says, "I work on an assembly line," don't stop there. Ask, "What's your motion? How much strength do you need? What's the range or arch of motion that you utilize? Let me understand that." That may be important in many of the steps you want to provide for them to optimize their outcomes.
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