Issue link: http://digital.copcomm.com/i/883365
3 8 | PULSE Fa l l 2 0 1 7 Memorial does a great job of supporting physicians and giving them the tools and resources they need. "For instance," Dr. Zickuhr adds, "I had a patient recently with an ankle fracture who saw a doctor she just didn't click with. She came to me to do her surgery, but needed medical clearance quickly. Our physician network liaison was able to get her in to see a primary care doctor within 24 hours and we did the surgery right away. Torrance Memorial focuses on the patient." Dr. Zickhur says she became a surgeon because she likes to build things. "Orthopedic surgery is one of those specialties that can take someone who is unable to perform because of an injury and improve their situation. It's very satisfying to me. I like getting my patients back to what they like doing the most." Excited also about working within the Torrance Memorial Physician Network, Dr. Zickuhr says, "Our office had a discussion a few years ago, when we realized it was just a matter of time before we joined a hospital affiliated physician network or a big 300-person medical group. Torrance Memorial has always been such a great hospital and close ally, it was a natural move to work with them. "What's important is that patients find doctors who listen to them and who they trust. Our orthopedic surgeons, spine surgeons, sports surgeons, are all at the cutting edge of technolog y," Dr. Zickuhr continues. "For example the technolog y for ankle replacements is getting better every year, and we aren't sitting on our laurels just watching. We are doing everything we can to stay ahead and keep our patients happy." FOCUS ON CARE Stephen Nuccion, MD, has been practicing orthopedic surgery—with a focus on sports medicine and shoulder and knee surgery—in the South Bay since 2003. He definitely has noticed an increase in knee replacements, arthritis and other overuse conditions and injuries as the population ages. "People are living longer and staying active over the course of their lives, which means they develop issues earlier than the previous generation," says Dr. Nuccion. "Knee replacements are very common, especially in our active South Bay population, and patients are getting them earlier. With shoulders it happens later in life." Like other Torrance Memorial orthopedic surgeons, Dr. Nuccion is a big believer in physical therapy and other exercise modalities to preserve or protect a joint. "e trend I see is certainly toward prevention of surgery and to maintain good outcomes aer surgery." Indeed, in addition to the systematic pain management protocol, the Torrance Memorial orthopedic department has also adopted a pre- and post-operative program. "Many surgical outcomes can be improved if a patient restores motion and maintains strength before the procedure," Dr. Nuccion says. "So a pre-op routine that doesn't aggravate but supports the joint is oen prescribed. Usually a physical therapist will guide the program and demonstrate the exercises so the patient can do them on their own. e idea is to be preemptive," he adds. "e stronger you are going in, the stronger you are coming out." Surgical procedures have evolved as well, Dr. Nuccion says. "Probably the biggest change has been the minimally invasive surgeries for joint and tissue replacements." Also he adds that the department doctors are starting to use growth factors such as platelet-rich plasma (PRP) injections, which are prepared using patient's own blood. e platelets are filtered, then injected, releasing growth factors that increase repair and speed healing. "PRP can be appropriate for certain types of surgeries when we need to stimulate the healing response—such as for a ligament gra—and can even be used to avoid surgery. I've seen [the procedure] be successful for rotator cuff tears and arthritic knees. If we can stimulate healing, restore function and minimize intervention, it's a win-win for everyone." "Torrance Memorial is so far-reaching in its plan for the future," Dr. Nuccion adds. "It's committed to providing a stable base of health care for the community. I'm grateful to be a part of this vibrant network." THE NOT-CUTTING EDGE Ironically while most of the doctors who make up the Torrance Memorial orthopedic team are surgeons, they don't consider surgery their main mission. "e vast majority of people I see do not need surgery," says Tiffany Rogers, MD, "Just about 1 in 100. e other 99 need the right diagnosis and management of their condition, which means physical therapy, activity modification, core strengthening, sometimes weight loss and tips on how to avoid making it flare up again." Much of what Dr. Rogers counsels stems from her master's degree in physical therapy and also from her life. While she was an all-American basketball player at the University of Utah, she herniated a disc. "My doctor didn't send me to physical therapy. I suffered off and on for years, and every time I tried to play, my back would go out. I ended up going to PT school and learned how to treat it with certain exercises and habits. My experience really gave me the insight to understand from the patient's perspective. Accepting limitations is no fun." Dr. Rogers' physician assistant ("my sidekick") Jeff Satterfield, PA-C, shares her background in PT, and has worked in PT and rehab for 10 years. Stephen Nuccion, MD "TORRANCE MEMORIAL IS SO FAR-REACHING IN ITS PLAN FOR THE FUTURE. IT'S COMMITTED TO PROVIDING A STABLE BASE OF HEALTH CARE FOR THE COMMUNITY. I'M GRATEFUL TO BE PART OF THIS VIBRANT NETWORK."