Gunnar Andersson, M.D., Retires
He first came to the U.S. on a research fellowship in 1976 and rose to be the president of the Orthopaedic Research Society in 2000. Gunnar Andersson, M.D., Chairman Emeritus of Orthopedic Surgery at Midwest Orthopaedics at Rush, has just retired at the age of 72. We stole a few minutes of his time, however, and asked him to reflect on his years of service to the orthopedic community. As for the most important thing that he has created at Rush, Dr. Andersson told OTW, “It’s the fact that I was able to maintain the private practice model in an academic setting while being successful in education and research. I am strongly supportive of the private practice model in patient care. To be successful in competing with other private groups and academic centers educational and research excellence is critical. While being hugely successful clinically we have been able to attract the best residents and fellows in the country and being one of the best funded and most successful research groups in orthopedics. It’s not my doing, but I am very proud of the accomplishments of my department members.”
“I’m also pleased to have built a premier practice group by careful recruitment and support for all missions in an academic practice. Recruitment is critical and strongly dependent on buy in from the practice partners and their help in finding the right people. Additionally, I have created a destination for orthopaedic patients and a home for the surgeons by building a private office building on Rush campus with availability of ancillary services. This could not have happened without the support of Rush University Medical Center, whose administrators eventually realized that this was beneficial to both parties—the group and the medical center. They leased us land and allowed us to build.”
Asked about one of his fondest memories of his time at Rush, Dr. Andersson noted, “I have a 30/30 memory, meaning I remember everything from 30 years ago and everything from the last 30 seconds. Since I have been at Rush for 30 years I cannot remember the fondest memory. I only remember good things!! The success of surgical interventions is highest on my list, followed by the recruitment of wonderful partners, graduation of well trained residents and fellows, and the success of research and new discoveries. Having a period as president of the medical staff, senior vice president of medical affairs and vice dean all created memorable experiences.”
When we asked Dr. Andersson what gives him the most hope for the future of orthopedics, he reflected, “The strong technology advancement including biologic solutions and minimally invasive surgical procedures have an opportunity to change the profession from the old description ‘big hands and small brains’ to something much more sophisticated and successful. Will we be able to cure the most common orthopedic problems—arthritis, back pain, overuse injuries and traumatic injuries? Probably not…but we will make huge advances.”
As for what gives him pause him about the future of orthopedics, Dr. Andersson added, “I am concerned that the private practice model is disappearing. Hospitals are buying physicians and the graduating residents are increasingly choosing an employed position. There are short term benefits, but long term physician independence will suffer. And developing new technology is increasingly difficult because of cost and regulatory difficulties. Venture capital in orthopedics is drying up because the return on investment is unpredictable. Advancements outside the U.S. cannot easily transfer to our patients. Funding for research is a tremendous problem. NIH [National Institutes of Health] has had no significant increase in its budget for almost a decade and the cost of doing research keeps increasing. I fear we are losing a generation of researchers who are frustrated that their efforts do not result in funding.”
“As for me, I will not retire from many aspects of my professional activities. I will continue to consult, participate in meeting activities, and in research activities. And I will continue to publish. I will however have the luxury of spending more time with my family, travel with my wife, work on my golf game (which needs a lot of work) and spend a lot of time outdoors.”
Technology Pushing NFL Into the Future
What are the latest technological advances helping team doctors do their jobs? Find out from Matthew Matava, M.D., president of the NFL Physicians Society. He tells OTW, “Improved communication and a more rapid response pretty much sums up our most recent progress in the technological realm. The sidelines are so crowded—53 players, 10 coaches, trainers, the media, etc.—we needed someone above it all to assess the field from an enhance perspective. We now have what’s called an ‘eye in the sky’—a certified athletic trainer at the press box level who peruses the entire field. Those of us on the sidelines can’t always see an injury until after the fact, so the trainer calls down to the sidelines and speaks to the head physician. He might say, ‘#42 was staggering as he came out of the tackle.’ Then I can pull the player aside and question him or use the new sideline video monitor to review the event from multiple angles, in slow motion, and even backwards.”
“Often, the player doesn’t know what exactly is causing the pain. He may be holding his shoulder, but in reality it could be an elbow injury. This is why it is so helpful to see the replay…it can be useful in guiding the questioning and examination of the player.”
“In addition, we now have two-way walkie talkies and everyone on the medical team has headsets that allow for immediate communication. If I’m at the 20 yard line and the head athletic trainer is at the other end of the field evaluating a player, then he doesn’t have to send someone to me to give me that information. As of just one year ago we didn’t have these walkie talkies. Also, if the player goes for an X-ray and we are wondering about his status, I can call someone in X-ray on the walkie talkie and say, ‘What does it show?’ Then I can relay that to the head coach and the athletic trainer.”
“Another significant technological advance for the NFL has been the league-wide use of electronic medical records (EMR). We have each player’s records on eClinicalWorks. If a player is traded from a team or gets cut then the original team no longer has access to the records. The players were initially concerned about their information being leaked, but the firewalls have proven to be more secure than paper records.”
“If there is an injury, we also now have electronic hand-held tablets on the sidelines containing all of the players’ prior orthopedic injuries. This involves a real time app where in five minutes we can thoroughly assess a player for a concussion and can compare the current injury to the previous baseline testing scores. Other health information is there as well (medication allergies, etc.) in the event that the player has to be transported to the hospital.”
“In terms of research, investigators are placing sensors in helmets in order to track the forces involved in hits to the head. Unfortunately, we don’t yet know what the threshold is for injury. If we put a monitor on a helmet and after 6 games and 200 head hits there might be 20% rotational hits, 30% direct blows, and 40% to the top of the head…but we don’t have a correlation as to which of the hits are relevant and what is the threshold that will lead to long term injury.
Pronto Ortho From Rush
Why stand around moaning in an ER when you can receive immediate care at a high quality facility? Midwest Orthopaedics at Rush (MOR) is now offering such treatment. MOR, doctors to the Chicago Bulls and the Chicago White Sox, have a new option for patients—OrthoCare Now—available to treat everything from simple injuries, such as sprains, strains and muscle pulls, to more complex ones.
Mary F. Rodts, DNP, CNP, ONC, FAAN is chief operating officer at Midwest Orthopaedics at Rush. She tells OTW, “We saw that our patients were trying to access our services on evenings and weekends, and we wanted to find a way to be more readily available to them. Now, instead of waiting in the ER for several hours or going to multiple doctors before getting to an orthopedic surgeon, they can see one of our providers right away.”
“The clinic is open until 7 p.m. on weekdays and 8 a.m. to noon on Saturdays, and can accommodate everything from sprains, strains and muscle pulls, to fractures and concussions. This is not to replace emergency services for major trauma. Those patients should still seek care at an emergency room.”
“The biggest challenge to organizing this was having the right team available to our patients. We were able to establish our doctor and advanced practitioner coverage as well all other services (X-ray, casting, bracing, MRI, etc.)”
“OrthoCare Now will help us to continue to provide the correct care at the correct time. We are excited that we will be able to offer this new service to orthopedic patients in the Chicago area.”
Dear Dr. Andersson, I am a current Midwest Orthopaedic patient at Rush Medical Center, Drs. Della Valle, Verma are my orthopedic surgeons for hip, knee and shoulder replacement surgeries, and Dr. Jaycox is my pain physician, as I have a spinal cord stimulator because I also have Arachnoiditis and my lumbar spine was fused into my sacrum. I saw you about six years ago, because the pain I have in both my lumbar and thoracic spine has continued to worsen, post-surgically, and after I saw you, I saw Dr Harel Deutsch about possibly having surgery to remove this scar tissue, however Dr. Deutsch declined. But, this pain at both areas continues to get worse, and only Tramadol seems to take a slight edge off this pain. I am still searching for possible surgical procedures that may help alleviate this pain because it really is bad. I am disabled for life, I have not worked since 1999, but it is getting harder and harder to deal with this pain. Can you suggest anything for me, or refer me to a back surgeon at Rush who may be able to help me. Thank you, Doctor. Sincerely, Peter Renardo