Innovative Clinics Make a Difference
From an online screening process to a one-access-point system, recovery rates are faster
by Barb Livingstone
Calgary firefighter Todd Kusler is passionate about backcountry skiing, so the 43-year-old was not about to let a tangle with a buried log last November — that severely hyper-extended his left leg and ripped up his knee — slow him down.
Thanks to fast intervention at the University of Calgary’s Sport Medicine Centre’s Acute Knee Injury Clinic, Kusler was back on the job, and back on the slopes, less than two months after his accident.
The success of the knee clinic — open six half-days a week to the general public — has led to the development of two more specialized clinics, also located in the university’s Department of Kinesiology.
With the support of private donor funding, the Acute Sports Concussion Clinic launched last fall, and another space that targets rotator cuff injuries opened earlier this year.
Delivering innovative specialist care
Dr. Nick Mohtadi, MD’81, an orthopedic surgeon and director of the Sport Medicine Centre, says the original drive behind the now-six-year-old knee clinic was to deliver innovative, efficient specialist care at one access point and for less money than the regular healthcare process. And the early intervention supplied by the clinic’s sports medicine specialists, says Mohtadi, has meant fewer unnecessary tests and surgeries for patients.
A huge time-saver is the fact a patient does not need a doctor’s referral to be admitted to the knee clinic. Rather, they fill out an online injury assessment/diagnostic form. Knee injuries (the clinic does not treat on-the-job or vehicular-accident-related injuries) must have occurred within the last six weeks.
If a patient meets screening criteria, an initial assessment is made and an appointment is set up at the clinic (within five working days).
Accrued patient data shows an 80-per cent-accurate initial diagnosis through the online screening process for problems like anterior cruciate ligament tears.
Mohtadi says the knee clinic has been overwhelmingly popular since opening to the public in 2010. Despite a budget for 1,800 new patients each year (primarily covered by Alberta Health Care), it saw 2,300 in 2015. That amounts to about 4,500 to 5,000 patient visits (based on two visits per patient) annually.
He estimates there are between 25,000 to 75,000 knee injuries in Alberta each year.
Getting results
Kusler is one of those who was helped in 2015 by the Sports Medicine Centre’s community outreach program. His accident occurred as his ski tip hooked a log buried in a shallow snow pack. His ski binding never released and Kusler was sent lurching forward. In excruciating pain, he was able to grab a tree nearby and push back onto the snow.
He started to head back on one ski, crawled across a barely frozen creek and, with the help of friends, made it home. Despite his apparent injury, Kusler had no intention of going to hospital to, he says, “wait hours to see an emergency doctor.”
A fellow firefighter told him about the Acute Knee Injury Clinic and Kusler went online to fill out the questionnaire. Within a few hours, he received an email asking for more information. The next day — “It was unbelievably fast,” Kusler notes — he had an appointment at the clinic.
“I got really lucky,” says Kusler. “They said I was millimetres away from blowing up my entire leg. [At the clinic,] it was one-stop shopping, between the doctor who was a specialist and the X-rays that were done right there. In under an hour, I had the results, and was able to start physiotherapy immediately.”
The firefighter is now a passionate advocate for the clinic and has resumed backcountry skiing with friends and downhill skiing with his three kids.
“[The injury] was painful, I’m not going to lie. But, I am so grateful to be back in action,” he says.
For more information on the Acute Knee Injury Clinic or the online patient form, visit: sportmed.ucalgary.ca/akic, or call the clinic at 403.220.4687.
Acute Sports Concussion Clinic
After the success of the knee clinic, the new Acute Sports Concussion Clinic, says Mohtadi, was a logical next step given the Sport Medicine Centre’s leadership in research and its focus on sharing its expertise with the community.
Dr. Katie MacGregor is the lead sports medicine physician at the clinic that opened last fall. Partially funded by a private donor, it is the first physician-run clinic of its type in the city that treats injured athletes. A recent university study showed, on average, the concussion risk for youth is about one concussion per every 5,000 practices and games.
How does someone access the clinic?
The concussion clinic is open two half-days a week (Tuesdays and Thursdays). There are two non-physician athletic therapists who do concussion assessment and management, as well as a sports medicine doctor and a researcher. Like the Acute Knee Injury Clinic, there is online screening and assessment. The clinic tries to see patients within 72 hours of being accessed.
Who goes to the clinic?
About 30 new patients per month, mostly between the ages of 13 and 60, with the majority falling somewhere between 13 and 25. Hockey, soccer and football are the top sports that cause concussions in Calgary. Most patients are seen two to five times, which ensures a follow-up.
What does the clinic offer?
Early diagnosis and appropriate management. Typically, that means a short time of rest, and then a managed return to activity. Rather than stalling recovery by spending time with various doctors and referral forms, they can come directly to the clinic.
Clinic results?
For patients, there is less time away from work or school, the diagnosis and treatment is streamlined and health delivery is more efficient, with fewer costs.
Rotator Cuff Clinic
The newest clinic opened earlier this year and is also partially funded by a private donor. It will follow a different model than the knee and concussion clinics (where Calgarians can directly sign up online), as patients must be referred for rotator cuff treatment by a physician.
Mohtadi estimates more than 10,000 Calgarians per year suffer from shoulder pain due to rotator cuff injuries.
The rotator cuff is a group of muscles and tendons covering the top of the upper arm bone that support shoulder and joint function and movement. Injuries may be due to inflammation or a tear in the muscle or tendon.
Part of the clinic’s outreach program includes a physician consultant line for referring doctors.
For more information about the specialty clinics at the Sport Medicine Centre, visit: sportmed.ucalgary.caU