James Chen, MD, is an orthopedic surgeon and sports medicine specialist with Orthopaedic Sportsmed Group in San Francisco. Dr. Chen earned his medical degree from the University of California Davis. He interned and completed his residency at the University of Hawaii Queen's Medical Center in Honolulu. He completed his sports medicine, arthroscopy and shoulder fellowship at the University of California San Francisco. Dr. Chen has expertise in minimally invasive arthroscopy. Here he discusses his interest in multiple ligamentous knee injuries and ACL revision surgery, the way his practice utilizes online services to streamline patient care and the move towards minimally invasive procedures.
Q: Why did you choose to become an orthopedic surgeon?
Dr. James Chen: I grew up in Sacramento and back then playing sports was about the only thing available to do. Soccer was my sport. I played on a competitive traveling team as a youth and that led me to play in high school and in college. My friends and I were frequent fliers in the local orthopedic surgeon's office. Sports were such a large part of my life that even as an adult working with athletes made the most sense.
Q: What areas of sports medicine and orthopedic surgery research are you currently interested in?
JC: Ever since I was a resident I always had an interest in multiple ligamentous injuries of the knee. These are challenging cases because people need stability in their joints to function at high levels. It always surprised me that if you had an ACL tear or a single ligament tear in the knee you could have an excellent outcome. But if you had a two or three ligament injury or a knee dislocation you wouldn't have as good of an outcome. I think one of the reasons for this is that multi-ligamentous injuries blend trauma surgery with sports medicine, so you need to have a unique skill set to take care of them. I get excited about the prospects of being able to return someone with this injury back to high function.
I'm also very interested in multiple revision ACL reconstructions. There are many patients out there who have had an ACL reconstruction more than once and this number will continue to grow. These cases are also challenging because the choices of graft and tunnel trajectories are more limited the more surgeries the patient has already had. I hope at some point that the outcomes between single and multiple revision ACL reconstructions become negligible.
Q: How do you balance providing quality patient care with the challenges of the rapidly changing world of healthcare?
JC: I think providing customer service and high quality patient care is the most important thing you can do as a doctor. Doctors must understand that healthcare is a consumer-driven industry and you must make your patients happy by providing them excellent care and excellent outcomes. To meet the needs of active and high demand patients my offices utilizes an online booking system through ZocDoc. This service allows the patient to book as well as fill out patient registration forms online. We communicate with our patients electronically via email. We also use an online patient dashboard called Health Loop when a patient has surgery or has an injury. This software sends the patient questions about their symptoms and status updates and alerts us if there are any red flag responses. It also allows the patient to send a message to the office so they feel like there is an open chat with their provider.
I think having a team of like-minded partners is key to staying ahead of the curve. We have partnered with imaging centers that are responsive and will scan our patients the same or next day if needed. We have aligned ourselves with other physicians and ancillary providers who embrace technology and understand the needs of the modern patient.
Q: What is the most difficult sports medicine case you have encountered during your career?
JC: The most challenging case I have encountered is a multiple ligamentous knee injury in an athlete with professional prospects. The patient had a traumatic knee dislocation with an atypical combination of ligaments torn that required both open and arthroscopic techniques. Because of this we had multiple orthopedic surgeons in the case each doing a separate technique.
Q: How do you think orthopedic surgeons and sports medicine physicians will change the way they treat athletes in the next five to 10 years?
JC: I think we will continue to be very aggressive in the treatment of athletes. As our minimally invasive treatments and surgeries continue to become even less invasive, the lines will blur between conservative and minimally invasive treatment. Not too long ago PRP injections were the new thing in sports medicine and some notable professional athletes had successful results with it. Now we are at the point where mainstream patients come to the office inquiring or requesting this procedure that is not covered by insurance. I suspect that we are only at the beginning of new less invasive discoveries that will change the way we treat athletes.
A series of articles featuring orthopedic surgeons on issues ranging from personal background to current research developments is published weekly. We invite all orthopedic surgeons and sports medicine specialists to participate.
If you are interested please email cpallardy@beckershealthcare.com.
More Articles on Sports Medicine:
Team Effort in Orthopedics: Q&A With Dr. Thomas Lardner of Somerset Medical Center
Building a Strong Sports Medicine Program & Online Presence From Scratch: Q&A With Dr. David Geier of MUSC Sports Medicine Program
Achieving Goals With Orthopedic Care: Q&A With Dr. Jeffrey Carlson of Orthopaedic & Spine Center