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Published on September 08, 2020

Dr Rocio Fuentes Barrow and patient

Why Orthopedics is a Growing Specialty

With a baby boomer generation that’s aging and popularity of athletics, orthopedics is one of the fastest growing needs in medicine today. These truths made orthopedics a strategic area for Avera – one that has quickly taken shape in less than five years.

“In Sioux Falls, the growth of orthopedics has been phenomenal,” said David Flicek, President and CEO of Avera McKennan Hospital & University Health Center. “Avera had a history of working with orthopedic providers in Sioux Falls who did numerous procedures at Avera McKennan. But we didn’t employ our own orthopedics group until 2016. Now, Avera Orthopedics is the largest integrated orthopedics group in the region.” Across the entire system, Avera Orthopedics has 42 practitioners – 16 of whom are in Sioux Falls.

The Avera Specialty Hospital and attached medical office building at the Avera on Louise Health Campus was planned with a strong emphasis on orthopedics and sports medicine in mind, as well as other growing specialties including gastroenterology, urogynecology, internal medicine and rheumatology.

At the nearby Avera Human Performance Center, the practice of orthopedics integrates with sports medicine, physical therapy and sports training. “It’s been an incredible transformation,” Flicek added.

Framing the Vision

When Avera identified orthopedics as a strategic initiative, leaders wanted to bring physicians on board who could frame that vision. Thomas Ambrose, MD, and Patrick O’Brien, MD, were the first physicians.

“Avera had been discussing starting its own orthopedics group. I was practicing in North Carolina at the time. A big draw for me was to be able to join a practice that I could help mold and develop from the ground floor,” said O’Brien, who is originally from Sioux Falls and returned home to practice. “Each new physician who joined could carve out a niche area for sub-specialized practice based on their specific experience and training,” said O’Brien, who treats patients of all ages and has special interest areas of sports medicine and arthroscopic procedures.

They helped shape a vision in which Avera’s orthopedic practitioners in Sioux Falls would not be generalists, but rather fellowship-trained sub-specialists in a given interest area such as joint replacement, sports medicine, trauma, podiatry or hand surgery. Then they began recruiting other physicians.

"Physicians choosing their own partners was a very strong philosophy. We then recruited specialists who had those defining or differentiating factors. We felt by recruiting specialists we could provide a service that may not have been present in our community previously,” said Ann Heiman, Assistant Vice President for Orthopedics, Therapy and Sports at the Avera McKennan.

Fellowship-Trained Specialists

Jonathan Buchanan, MD, joined the orthopedic practice about 18 months later; his emphasis being in sports medicine and internal medicine. “The model we were going for was that each physician in orthopedics would be fellowship trained to do what they do really well. Among health systems I looked at, Avera was the only one that had a really strong sports connection with physical therapy, training and acceleration, with the doctor there in the middle – that marriage is what I really love about sports medicine.”

Avera was first in the region to have three orthopedic fellowship-trained trauma surgeons who cover call 24/7, specializing in fractures, dislocations and other traumatic injuries. “This allows our physicians with an elective surgery practice to be able to schedule those elective procedures and not be burned out by doing an emergency surgery the night before,” Heiman added.

When this group began forming, Avera McKennan was already pressed for space on its main campus. The idea to build a specialty hospital for orthopedic procedures also became a recruitment tool that helped get physicians excited about the possibilities.

“Physicians were involved at every step of the way. We wanted their input about everything from the number of exam rooms to what diagnostic equipment we needed,” Heiman said.

Buchanan remembers Avera leaders showing him the field in southwest Sioux Falls where they wanted to build the future specialty hospital and human performance center. Even with the disruptions caused by the COVID-19 pandemic, things are on track, and it’s rewarding to see the vision as a new reality.

Benefit to Patients

Patients are the ones who ultimately benefit from this vision.

“People can see a specialist who is focused just on that body part or condition. We hope the expertise and experience we bring, as well as our holistic approach, improve outcomes and help patients do better,” O’Brien said.

“A specialist who has spent years in training and specifically working on joint replacement or wrists and hands or other aspects of orthopedic care has seen it before and knows what the data support in doing this next procedure,” Buchanan said. Physicians in the practice support each other by seeing each other’s patients if need dictates. “Patients can rest assured that whatever it is, our specialists have seen it before and know exactly what to do.”

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