Rotation Block 4: Sports Medicine/Orthopedic Surgery

This last rotation was spent with Dr. Gary Waslewski, MD at the Arizona Sports Medicine Center. Dr. Waslewski serves as the orthopedic surgeon for the Phoenix Coyotes and also works with the Chicago Cubs and San Francisco Giants, whose rehab programs are stationed in Arizona. He also is the team physician for Chaparral High School, which was a nemesis of my high school, Tempe High. Having a true interest in sports medicine, I wanted to see both aspects of the field- the primary care side and the orthopedic surgery side. Although I had strong leanings already for the primary care route, I wanted to see firsthand what life as an ortho doc would be like. To start with, Dr. Waslewski is easily the nicest and must humble surgeon I've ever met. His patients love him because he is actually willing to listen to them. After examining a patient, he'll usually say something like, "Hmm. So what are we going to do about this?", before going into a number of different options for the patient to decide upon. This was very gratifying to the patients, as they were able to weigh the pros and cons of each option. Then, another cool aspect was that they didn't feel like they had to decide right then, as he would tell them that he would write up the note, and then when his medical assistant goes through them the following day or two, see would call the patients to schedule either a surgical procedure or conservative followup. He also reassured the patients by offering a number of conservative approaches, instead of pushing them into surgery right away. Of interest, he was very interested in Osteopathic Medicine as a valuable alternative approach. During my first week working with him, we saw a mid 30s lady with chronic Right hip pain. Imaging showed some arthritic changes, but not really enough to mandate surgical intervention. Injections had proved unsuccessful. Out of the blue, he said, "How's you hip and pelvis OMT skills?" I said they were pretty good, and began a quick eval. Her seated flexion test was prominently positive on the right side, revealing a locked out SI joint on the right side. I made sure to show Dr. Waz the huge difference there as she bent forward for the test. I also quickly evaluated her innominates by rocking her ilia anterior to posterior, which showed major restriction on the right side, as it was stuck anteriorly. At this point, I had Dr. Waz come over and rock her ilia and put my hands over his to ensure that he could appreciate the difference. So I did a few techniques to balance things out, explaining to the patient, Dr. Waz, and his medical assistant, all of whom seemed mesmerized, what my treatments were accomplishing. When the patient got up from the table, she stated she hardly felt any pain! It was such a thrill! Sharing my enthusiasm for osteopathic medicine to the medical community is almost the same rush as sharing my testimony of the gospel of Jesus Christ (although of course not as eternally fulfilling)! I got major props from Dr. Waz and his assistant, which opened up a lot of opportunities for me to incorporate OMT into this allopathic rotation!

I also had the chance to follow and work with some of the other docs in the practice, which is always nice to see how each physician conducts his/her practice differently. One doctor, Erik Dean, is a primary care physician who specializes in sports medicine. I was able to spend a week with him, which was completely awesome! I really enjoyed the diagnostician role of the primary care sports doc, which was more acutely injured patients. To me, it is more exciting seeing a presentation and trying to figure out the injury based on history, mechanism of injury, and clinical exam, than to have all the imaging and saying what it is and decide the plan of care. I also was able to do a lot more procedures with Dr. Dean, as the primary care schedule is more spread out than the clinic time for a surgeon. Overall, it was a great rotation!