OA Update: Injury Prevention, Athletic Performance and Orthopedic Procedures

OA Centers for Orthopaedics Bolsters Outpatient Orthopedic Practice with New Satellite Office; Plans Major Changes to its Joint Replacement Practice

Evolving Medical Reimbursement Model Forces Tough Choices as Maine’s Largest Orthopedic Group Affirms its Independence

OA Centers for Orthopaedics announced today it has opened a new medical and physical therapy office in Brunswick at Brunswick Station. The new office has a complete orthopedic clinic and physical therapy center and with initial staff of 15. The new Brunswick office marks OA’s third satellite office to open in the past four years. Patients requiring surgery will be referred to Mid-Coast Hospital or to OA’s main office in Portland, which features a state-of-the-art outpatient surgery center in addition to clinical, diagnostic imaging and physical therapy services.

Simultaneously, OA announced that five of its six joint replacement specialists, all of whom provide hospital-based orthopedic procedures, plan to join Maine Medical Partners by the end of the year.

“Rapid changes in the medical reimbursement model, driven by healthcare reform, have forced difficult choices within our practice,” said John Wipfler, CEO of the 230-person Maine orthopedic center. “Our satellite office strategy, in combination with our Portland surgery center, continues to be a successful independent practice model even in the face of declining reimbursements and increasing expenses for procedures. Over the past few years we have had our strongest financial performance ever.  On the other hand, several of our joint replacement colleagues believe they are better served by moving hospital-side to Maine Medical Partners, a division of Maine Medical Center.”

The regional trend towards hospital employment of physicians continues unabated. More than 70% of all medical doctors in Maine are in an employment relationship with a hospital or federally qualified health center (FQHC), according to the Maine Medical Association. Ten years ago that number was less than 15%.

Earlier this year, OA joined with three other specialty medical practices to form Maine’s largest independent practice association or IPA. Members of the Maine Specialty IPA work together to better manage cost issues and improve the delivery of patient care. The IPA enables physician practices to maintain their independence in a challenging healthcare environment that encourages hospital consolidation of physician services.

“OA remains resolutely committed to maintaining an independent physician practice,” said Dr. Douglas Brown, an orthopedic surgeon and co-founder of OA Centers for Orthopedics. “While some of our joint replacement colleagues – who deliver the majority of their services at the hospital anyway – have found it to be more advantageous to move to Maine Medical Partners, the majority of our orthopedic specialists continue to believe patient services are delivered more cost effectively and at a better quality in a focused, independent practice environment.”

Dr. George Babikian plans to join Maine Medical Partners on September 1, 2011, while Drs. Donald Endrizzi, Michael Becker, Brian McGrory and Peter Guay plan to join Maine Medical Partners effective January 1, 2012.

“Despite the departure of a few of our surgeons, OA will continue to provide the complete range of specialty orthopedic care - including joint replacement,” affirmed Wipfler. “We are optimistic about our future, and we feel confident that our strategy is designed to meet the challenges of a difficult era in health care. ”

OA’s Urgent Sports Injury Clinic Provides Fast Access to Orthopedic Sports Specialists

Saturday morning clinic in Portland re-opens on September 3 providing a cost-effective alternative to emergency room visits for sports-related injuries

PORTLAND, ME (September 1) – The high school sports season begins in earnest this week, and with the return of Friday night high school football, soccer and field hockey comes the inevitable sports-related injuries associated with high impact, fast-paced field sports. To provide injured student athletes with an alternative to potentially costly emergency room treatment of bruises, sprains and fractures, OA Centers for Orthopaedics has re-opened its Urgent Sports Injury Clinic for the fall athletic season beginning on Saturday, September 3 at its Portland office.

Staffed by orthopedic sports specialists, the OA urgent sports injury clinic is open every Saturday morning through October 22, 2011 Athletes may walk in at 9:00 a.m. without an appointment to see a sports medicine doctor for their injury.

With high costs, potentially long waits and a likely referral from the emergency room doctor to an orthopedic sports medicine doctor for treatment and observation, a trip to the emergency room is not necessarily the best course of action. The cost of a typical emergency room visit in Maine ranges from $269 to $1,174, according to Harvard Pilgrim Health. The cost of a typical visit to OA’s Urgent Sports Injury Clinic compares favorably at 60% to 90% of the cost of an emergency room visit depending upon diagnostic services required as a result of the visit.

“With OA’s Urgent Sports Injury Clinic, injured athletes in Southern Maine have an alternative to costly and time intensive emergency room visits,” says John Wipfler, CEO of the OA Centers for Orthopaedics. “Instead of seeing an ER doc, athletes have access to the same physicians that take care of such teams as the Portland Sea Dogs, the Portland Pirates and many other professional, international, collegiate and high school athletes.”

The urgent sports injury clinic is available at OA’s Portland office, located at 33 Sewall Street in Portland. For more information, call 207-828-2100, or visit http://www.orthoassociates.com/urgent_sports_injury_clinic/.

OA Centers for Orthopaedics Conducts Real-time Surgery Center Disaster Simulation and Patient Evacuation

Collaborative Effort with Public Safety Officials the First Known of its Kind in USA and Model for Private Practices with Ambulatory Surgical Centers

 

OA Centers for Orthopaedics completed a successful real-time surgery disaster simulation and patient evacuation this morning working at their outpatient orthopedic surgery center at Sewall Street in Portland, ME. The emergency drill was conducted in collaboration with local public safety officials including the Portland Fire Department, the South Portland Fire Department, the Regional Emergency Management Information System and Northeast Ambulance. Anesthesiologists from Spectrum Medical Group joined OA's surgery center staff to conduct what was the first simulation of its kind in Maine and perhaps the country. According to the Ambulatory Surgery Center Association, OA is the first and only outpatient surgery center in the country to conduct this type of real-time simulation.

 

A total of 15 patients were evacuated during the drill, which lasted approximately 25 minutes. A simulated mechanical disaster occurred and emergency alarms sounded.  Three patients undergoing surgery prepped and evacuated one-by-one and transported by rescue vehicle to Maine Medical Center. Patients in pre-op, induction and post op were also successfully evacuated. The drill lasted approximately 25 minutes from the point the alarms sounded and the last patient was safely transported.

 

According to Tim Nangle of the Portland Fire Department, in the event of a real emergency, ambulances would have arrived within 5 minutes and the entire evacuation process would have taken significantly less time.

  

The purpose of the training drill was to prepare OA's personnel for a real situation in which patient evacuations were required. OA used a formalized process established by FEMA as part of the National Incident Management System. OA’s incident command center featured clear terminology and an established, unified chain of communication in which life safety, perimeter control, and resource availability were assessed and tested. Months of preparation and collaboration with local safety officials contributed to a successful drill.

For more information, please contact Linda Ruterbories, Director Surgical Services and Program Development, OA Centers for Orthopaedics.

OA Centers for Orthopaedics to Open Orthopedic and Physical Therapy Center in Brunswick, Maine

The Times Record reported on Thursday that OA Centers for Orthopaedics has signed a letter of intent with JHR Development of Maine to occupy 10,000 square feet of office space at Maine Street Station in Brunswick, Maine.  The new office will serve as a satellite location for both OA’s clinical orthopedic practice as well as its physical therapy center. OA presently has satellite offices in Saco and Windham in addition to its main office, which features an orthopedic surgery center, in Portland, Maine.

John Wipfler, CEO of OA Centers for Orthoaedics, is quoted by The Times Record, ‘“OA sees over 70,000 patients a year in our Portland, Maine, center and supporting satellite centers in Saco and Windham. That means OA performs more orthopedic procedures than any other practice in Maine, including some of the most advanced procedures in the nation… With long-term relationships with entities like Bowdoin (College) and many patients coming from the Brunswick area and the north, we thought it was appropriate to be able to offer services in the Brunswick area.”’

The Maine Street Station location is currently being constructed with occupancy planned for late summer or early fall. OA’s space is on the second floor, above space to be occupied by Mid Coast Hospital’s walk-in clinic and adult primary care offices.

Wipfler continued, ‘“Our long-term plan, once we’re up and running, is to have easily 15 to 16 employees, primarily new positions… Those jobs would include physical therapy positions, receptionists, secretaries and medical assistants, with one full-time primary care sports medicine doctor on staff and office space for as many as three physicians.’’ OA’s orthopedic specialists will rotate through the office, seeing patients, just as they do now in Portland, Windham and Saco, Maine.

OA Joins Specialty Groups to Form Maine’s Largest Independent Practice Association

OA recently joined three of the Portland Maine area’s most prestigious specialty medical groups to form a new Independent Practice Association (IPA). The largest of its kind in Maine, the IPA represents over 250 physicians and other medical providers caring for patients in Southern Maine and across the entire state.

Popular in other parts of the country, an IPA consists of a network of physicians who agree to participate in an association to contract with health insurance companies and other payer organizations. Members of the Maine Specialty IPA will maintain their independent physician ownership structures and will seek to achieve cost efficiencies by sharing administrative services.

“This association will be a source of improved performance for our practices,” said Dr. Thomas Murray, OA surgeon and sports medicine specialist. “Additionally, the IPA becomes a potential vehicle for other independent medical groups wishing to collaborate and gain the benefits associated with further alignment of clinical and business best practices.”

In forming Maine Specialty IPA, the physician association is countering a trend towards hospital-based employment and away from independent practice. Economic pressures in the form of rising costs and lower payments for procedures have forced many private practice medical groups in Maine to give up their independence and to become employed by ever larger regional health organizations.

In the primary care area alone, approximately 2,000 Maine physicians are now employed in practices that are owned by hospitals or federally qualified health centers (FQHC), according to Gordon Smith, Executive Vice President of the Maine Medical Association. This means that approximately 70% of all medical doctors in Maine are in an employment relationship with a hospital, health center or FQHCs, whereas 10 years ago that number was less than 15%. On the specialty side, about half of the specialists now have such an employment arrangement, whereas only a small number of specialty physicians were employed by hospitals ten years ago.

Members of the newly formed IPA believe that by combining their resources, they can be effective in providing physician-led solutions to the challenges facing Maine and the nation as it relates to the delivery and financing of healthcare services.

“This collaboration will enable our physicians to work more closely together to improve the coordination of patient care, address cost issues in healthcare, and promote strong, independent physician practices,” said Dr. Daniel Landry, President of Spectrum Medical Group.

Other medical practices have approached the association, which is limited initially to the founding members, which include Chest Medicine Associates, Portland Gastroenterology Associates, Spectrum Medical Group and OA Centers for Orthopaedics.

UMaine Female Player, Rachel Burns, Fights Through Multiple ACL Injuries

The January 16, 2011 edition of the Maine Sunday Telegram featured an article by staff writer Jenn Menendez about UMaine player, Rachel Burns. After three surgeries to her right ACL, Burns tore her left ACL after only 5 games back into her season. Dr. Thomas Murray, OA orthopedic surgeon and sports medicine specialist, assisted with the story by providing the reporter with information about the nature of the injury and the growing epidemic among female athletes.

Explaining the difference between boys and girls, Murray is quoted as saying, '"What happens for girls in general, it's not how they jump, but how they land," said Murray. "Their knee tends to turn in or buckle. Boys land with a wider base of support."'

"Hurt Girls, Revisited: ACL Injury and Surgery Epidemic" originally published in this blog in 2008 provides much greater detail about the nature and extent of ACL injuries among female athletes.

Proper training, conditioning and learning the proper mechanics of starting, stopping and jumping can help mitigate ACL injuries among female athletes. Referring to the OA Performance Center in Saco, reporter Mendendez notes, '"OA runs a training center in Saco designed to strengthen the joint for athletes looking to return from surgery or prevent the injury."'

The article goes on to say, "Athletes can focus on preseason conditioning for muscles, endurance and agility drills… but returning to the court or field comes with risk."

'"There is always concern for repeat injury. I'm sure her doctors will talk to her about the risks associated, should you keep going back," said Murray. "That conversation will happen. But every patient has their own set of values."'

OA wishes Rachel Burns a speedy recovery and healthy return to the court.

 

OA Performance Center Hosts Joe Friel Workshop: Winter Base Training for the Endurance Athlete

Internationally Recognized Coach and Author to Focus on Successful Winter Training Techniques for Endurance Athletes Seeking Summer Peak

OA Performance today announced that Joe Friel, an internationally recognized endurance athlete coach and author, is to present a daylong workshop, “Winter Base Training for the Endurance Athlete.” Oriented specifically to triathletes, cyclists, runners and duathletes, Friel’s workshop provides an in-depth look at successful winter training techniques for athletes seeking peak performance in the summer months. The workshop is to be held on Sunday, December 12, 2010 from 8:30a to 4:00p at the OA Performance Center at 15 Lund Road in Saco, ME.

“Endurance athletes are always looking for quality information and advice that will give them an edge,” said Stan Skolfield, the OA Performance Center Manager. “Joe offers a tremendous amount of knowledge and insight about what it takes to improve endurance performance.”

Coach Joe Friel has trained endurance athletes since 1980. His clients are elite amateur and professional road cyclists, mountain bikers, triathletes, and duathletes. He is the author of ten books on training for endurance athletes including the popular and best-selling Training Bible book series. Friel conducts seminars around the world on training and racing for cyclists, multisport athletes and coaches, and he provides consulting services for corporations in the fitness industry.

Workshop Agenda:

The workshop agenda includes volunteer metabolic performance testing by OA Performance Center athletic performance specialists:

 

8:30a            Registration

9:00a            Welcome

9:10a              Building a Better Winter Base

• Fundamentals of periodized training (What is periodization? What should we train in the winter months to assure summer success?)
• Muscular endurance, aerobic training and strength training for the endurance athlete
• Testing: Establishing a base with Lactate Threshold Test and V02 Max Test (an audience volunteer is asked to take each test with results shared later in the day)
• What do test results mean? How do I improve?
• Tools: Training Peaks, periodization examples, training stress, fatigue, fitness and form

 

10:30a            Break

 

10:45a            Race Weight and Metabolic Efficiency

• What is optimal body composition?
• How do I achieve race weight?
• Paleo diet for athletes
• What is metabolic efficiency?
• Why is fat burning important for longer endurance events?
• Metabolic Efficiency Test: Establishing a base and improving (an audience volunteer is asked to take a Metabolic Efficiency Test, results shared later in the day)
• Body Fat Test: Establishing a base (audience volunteers are asked to be tested, results shared later in the day)

 

12:00p            Lunch Break

 

1:00p            Physiology of the Successful Endurance Athlete - What Are My Limits?

• Share results of V02 Max Test – meaning interpreted
• Share results of Lactate Threshold Test – meaning interpreted
• Basics of athlete physiology 
• What are my limiters? How do I improve as a cyclist? As a runner? As a swimmer?
• Training tools (power meters, GPS units, etc)

 

2:15p             Break

 

2:30p            Going Long - Special Requirements for Half and Full Ironman Distances

• Metabolic Efficiency Test results shared and interpreted
• Implications for Ironman competitors
• Training protocols: how much is enough?
• Balancing overload, super compensation and recovery
• Overtraining - signs and symptoms - striking the right balance
• Race day nutrition
• Race day trouble shooting (It's a long day – what adjustments can be made along the way? How do I avoid trouble to begin?)

 

3:30p            Q&A

 

4:00p            Adjourn

 

 

Registration:

Registration for “Winter Base Training for the Endurance Athlete” is open to all interested participants by calling 207-710-5509. OA Performance Center is charging a nominal price of $25. The workshop is limited to the first 200 registrations.

Off Season Training for Triathletes, Endurance Athletes and Cyclists

by OA Performance Center on Thursday, November 4, 2010 at 4:13am

Build Strength, Power, Speed and Fitness with the OA Endurance Training Package!

New Winter Training Program for Endurance Athletes Runs from November 15 - April 2

The OA Performance Center is pleased to introduce a new Off Season Training Package for the endurance athlete. Designed by sports medicine specialists for triathletes, cyclists, runners and multisport endurance athletes, the OA Off Season Training Package provides a winter training venue and training program to build strength, power, speed and fitness.

 OA's Off Season Training Package includes the following:

• Unlimited spin classes
• Monthly performance evaluations and lab testing
• Unlimited adult fitness classes
• Monthly coaching consultation
• Bi-monthly nutrition workshops
• Free admission to seminars and workshops

OA's Off Season Training package in incredible in that it allows the endurance athlete unlimited access to spin classes, adult fitness classes and their choice of monthly performance evaluations and lab testing. Lab tests allow the athlete to make an accurate assessment of their current levels of fitness and to measure improvements throughout the winter.

 Lab tests offered at the OA Performance Center include:

• V02 Max
• Lactate Threshold
• Metabolic Efficiency
• Resting Metabolic Rate
• Running Assessment
• Bike fit evaluation
• Body fat testing
• And more!

Unlimited Adults Fitness Classes include:

• Spin classes (lead by Stephanie Chase and Mike McDonald)
• Strength training
• Speed training
• "Metabolic Blast"

Monthly coaching evaluations are provided by Bob Turner. Bob will evaluate your test results and make recommendations about how you might organize your training to improve results.

For more details, pricing and/or to register, call 207-710-5509.

Portland Pirates Choose Maine Orthopedic Sports Medicine Practice as Team Physicians

Focus is on concussion management, illness and injury prevention, treatment, rehabilitation and a quick return to function

OA Centers for Orthopaedics today announced that the Portland Pirates has selected OA as their Team Physicians for the 2010-11 season.

Professional hockey players risk injury every time they step foot on the ice. Throughout the course of the season, players suffer from knee, shoulder, hip, groin and back injuries as well as concussions and lacerations to the head, scalp and face. Among younger athletes, hockey-related injuries have risen by more than 85% since 1990.¹ More is at stake for professional athletes who making a living on the ice.

“Concussions, illness and injury prevention are major concerns for professional athletes today,” said Tom Murray, M.D. of OA Centers for Orthopaedics and Head Team Physician for the Portland Pirates. “So as we begin working with the Pirates, we are bringing their concussion management practices up to NHL standards, making recommendations – including flu shots this week – to reduce the prevalence of illness during the season and providing expedited evaluation and diagnostic services when athletes are injured.”

OA was an early adopter and a longtime proponent of the ImPACT test for concussion management. ImPACT, or Immediate Post-Concussion Assessment and Cognitive Testing, evaluates concussions through computer-based neuropsychological testing. It measures multiple aspects of cognitive functioning in athletes, and provides tools to assist physicians in determining an athlete's fitness to return to play after suffering a concussion. The test provides immediate results for evaluating physicians and indicates whether additional diagnostic action, including a written test and physical evaluation, are required.

As Team Physicians for the Pirates, OA’s sports medicine specialists will be at every home game the Pirates play this year. OA will follow-up with all injuries and recommend treatment and rehabilitation plans to the injured athlete, trainers and coaches.

“We chose OA because they are the best sports medicine practice in Northern New England, offering the most comprehensive, innovative care and solutions for all of our team’s medical needs,” said Brian Petrovek, Managing Owner/CEO of the Portland Pirates. “When our guys get hurt, we want them to have immediate medical attention. OA provides that support for the Pirates, and we are excited about this new relationship moving forward.”

The OA medical team is lead by Head Team Physician, Thomas F. Murray, Jr., M.D., with Assistant Team Physician, Lucien R. Ouellette, M.D., with orthopedic consulting support from OA’s Sports Medicine Center team of medical professionals.

 

OA physicians also serve as the Team Physicians and/or sports medicine consultants for the Portland Sea Dogs, Portland Phoenix Soccer, Bowdoin College, St. Joseph’s College, USM and dozens of area high school sports teams.

¹ Bloomberg Business Week, September 26, 2010: http://www.businessweek.com/lifestyle/content/healthday/643435.html

Dr. Scott Marr Selected as U.S. Team Doc for the ITU Long Distance Duathlon World Championship in Geel, Belgium

OA Centers for Orthopaedics today announced that U.S.A. Triathlon has selected Dr. Scott Marr to accompany the U.S.  Men’s and Women’s Duathlon Teams at the ITU Long Distance World Championship in Geel, Belgium on August 10, 2008. More than 300 duathletes from around the globe will compete in this sanctioned world championship event. While in Belgium, Dr. Marr will be responsible for the medical care and treatment of elite and age group athletes participating from the United States.

Dr. Marr is the current medical director for the Tri-Maine Series of triathlons and duathlons. This year Dr. Marr became an official team physician with U.S.A. Triathlon. U.S.A. Triathlon is a member of the International Triathlon Union (ITU), the world governing body for both triathlon and duathlon. In 2004, Dr. Marr worked with U.S.A. Triathlon as a physician at the Lake Placid Ironman competition in July, and this year he was selected to accompany U.S. athletes in Geel, Belgium for the prestigious world championship event.

“Long distance duathlon is a grueling test of endurance,” says OA’s Marr. “The Long Distance World Championship consists of an 18-kilometer run, a 74-kilometer bike race and a 9-kilometer foot race before crossing the finish line.” Top athletes will complete the course in just over three hours.

While in Belgium, Dr. Marr will run a medical clinic for U.S. athletes before, during and after the event. Dr. Marr brings a full medical kit to treat athletes with gastrointestinal problems, sinus infections, muscle and joint problems, among other potential ailments and injuries afflicting endurance athletes.

On race day Dr. Marr will be on the lookout for both dehydration and hyponatremia, a condition characterized by low blood sodium. “I encountered such a situation in Lake Placid,” relates Dr. Marr. “Athletes suffering from hyponatremia often present with symptoms similar to dehydration, but are treated differently as they are essentially fluid overloaded as opposed to dehydrated.”

At OA, one of the top orthopedic centers in the country, Dr. Marr is an orthopedic sports medicine specialist with a special interest in endurance athletics including performance physiology and injury prevention. He is a Fellow in the American College of Sports Medicine and currently serves as the Team Physician for the University of New England and Windham High School, as well as U.S.A. Triathlon. An avid cyclist and triathlete himself, Dr. Marr will compete in the USA Triathlon National Age Group Championship in Portland Oregon on September 20, 2008, having qualified with 2nd in his age group and 6th overall at the Mooseman Triathlon at Newfound Lake, New Hampshire this past June.