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122 | The "Pro Team" Surgeon · The ACL Athlete Podcast

• 0:19
  SPEAKER_00: Welcome everyone to the ACL Athlete Podcast.
• 0:23
  SPEAKER_00: This is the podcast where we talk about everything related to the ACL, whether that's the injury itself, the rehab process, return to sport, and more.
• 0:33
  SPEAKER_00: I'm your host, Dr.
• 0:34
  SPEAKER_00: Ravi Patel, performance physical therapist and coach.
• 0:38
  SPEAKER_00: Between myself and fellow guests and experts, you'll learn through the lens of the patient, the healthcare professional, and the coach.
• 0:46
  SPEAKER_00: The goal of this podcast is to equip you, the athlete, with the education to make the best informed decision about your care and your ACL journey.
• 0:57
  SPEAKER_00: Thanks for joining.
• 0:58
  SPEAKER_00: Now let's dive into today's episode.
• 1:03
  SPEAKER_00: What is up, team, and welcome back to another episode on the ACL Athlete Podcast.
• 1:09
  SPEAKER_00: So today is going to be a unique episode, and we are diving into this topic of the pro team surgeon.
• 1:17
  SPEAKER_00: Or honestly, insert any healthcare professional involved in this space, there's going to be a little bit of an emphasis on the surgeon because this is a conversation that I have.
• 1:27
  SPEAKER_00: I don't want to ruffle any feathers, but I don't really care because this podcast is really important to help you guys be equipped as you're making decisions and making sure that you're building the best ACL team that is going to help support you and not just these, you know, fancy little alkalades that we're going to dive into.
• 1:47
  SPEAKER_00: And so deciding on your surgeon is going to be a very big choice.
• 1:51
  SPEAKER_00: We know this, especially if you're going the operative route.
• 1:54
  SPEAKER_00: So make sure you're doing your due diligence, and that is going to be so vital.
• 1:58
  SPEAKER_00: And before diving in, I do want to say I have great relationships with surgeons and other healthcare professionals in this space, and there are amazing ones out there.
• 2:09
  SPEAKER_00: It's a team effort.
• 2:10
  SPEAKER_00: And the ones who communicate really well, who sit down and educate, and who are a part of this team effort is awesome, and I love it.
• 2:18
  SPEAKER_00: But there is also just like any other single profession out there that exists, you'll get the bell curve.
• 2:24
  SPEAKER_00: And so you'll get the good, the bad, the ugly, PTs included.
• 2:28
  SPEAKER_00: There's tons of us who are not so great at this process, and there's tons of us who are kind of average, and then there's tons that are really awesome.
• 2:37
  SPEAKER_00: And so my goal with this episode is not to, you know, sh throw any shade at any particular profession or anything like this, but is to shed some perspective on basically the hundreds of conversations I've had with ACLers, with physical therapists, with surgeons, and the experiences that people really have with this process.
• 2:58
  SPEAKER_00: Because when you think about it, when you tear your ACL, usually there's a process of going to see a surgeon or an orthopedist, and they're going to help you in making a game plan, hopefully, but they will at least advise, like, okay, yeah, you need to have surgery or MRI or whatever the next steps are.
• 3:17
  SPEAKER_00: And then hopefully talking about physical therapy and what the overall roadmap looks like.
• 3:23
  SPEAKER_00: Now, it's usually a little bit of a rushed process, and so then, therefore, that's where you can start to vet the person and start to decide, okay, what is this gonna look like for me and assembling my team?
• 3:36
  SPEAKER_00: And I think what's important here is that this is also going to have a big domino effect of your expectations and kind of starting to formulate your game plan within your own head and thinking about physical therapy and when you're gonna get back to your goals and things of that nature.
• 3:53
  SPEAKER_00: So there's a massive just domino effect of how this can unfold, which is why the surgeon is usually the first person that is going to kickstart the process and then going from there.
• 4:07
  SPEAKER_00: And so I have a lot of conversations and consultation calls with ACLers who are seeking advice, but a lot of these calls are actually people who are after that surgical process and they are running into road bumps or they're feeling a bit lost or not really taken seriously with some of the issues they're dealing with.
• 4:28
  SPEAKER_00: And so this is where we have a conversation of like their experience and the process itself and what that looks like.
• 4:36
  SPEAKER_00: And I'll ask about the surgeon and what was their interpretation of all this, what did they do?
• 4:42
  SPEAKER_00: How was your experience specifically with them?
• 4:45
  SPEAKER_00: And oftentimes they will get touted, especially if it's a a big well-known surgeon, that they'll be touted as their ex-surgeon of this pro team or the college team, or insert whatever cool alkaloid you want.
• 4:58
  SPEAKER_00: And I find this super interesting because I get it, it's humans.
• 5:04
  SPEAKER_00: We want to kind of tout these things that are really important that shows, you know, vetting this person or the credentials, if you will.
• 5:12
  SPEAKER_00: And it's important, you know, even for people who are seeking out our care, I hope that they are asking us about these things and making sure that our credentials are in place, our experiences are in place, that we've actually worked with hundreds of ACLers, which we have, and there's proof to show that.
• 5:28
  SPEAKER_00: And so I think the thing that's important here is when we are looking at the surgical process, sometimes whenever I'm having these conversations, the ACLer will be like, Yeah, well, you know, they just kind of told me this is what I'm gonna get, this is the next steps, or maybe they'll just see them.
• 5:48
  SPEAKER_00: Here's the graft, here's the surgery date, move on to the next assistant handles most of the other stuff, and then there might be a check-in at three months, six months, etc.
• 5:58
  SPEAKER_00: And I'm not saying the surgeon needs to be overly involved.
• 6:01
  SPEAKER_00: Of course, like you know, they play their role in this process, but I think the experience and the education and understanding what your options are are key here.
• 6:12
  SPEAKER_00: And it's not uncommon that I'll see these athletes who are having these problems and they will say, you know, well, they were supposed to be the best ex-surgeon of this team and they work for this team.
• 6:25
  SPEAKER_00: And I almost like have to back up a second and kind of like let that not be a thing that influences my decision because that doesn't necessarily tell me that they are the best of the best, just because they got in line with this pro team or college team.
• 6:39
  SPEAKER_00: While I do think there can be value there, I think we have to go a little bit deeper into this to really understand okay, is this person the right fit?
• 6:48
  SPEAKER_00: And they have the credentials and making sure that these alkales don't kind of get in the way of what it is that needs to be done, or to figure out if this is the right person.
• 6:58
  SPEAKER_00: And when we dive a little bit deeper, a lot of times what I'll hear is that they didn't really get much attention or the problems are getting overlooked as like, ah, like it's it's fine, no, it'll get better.
• 7:09
  SPEAKER_00: And while there are times where sure the conversations around that can happen, but if something continues to persist and nothing's being done, well, that's not going to help you to get back to what you want to do, right?
• 7:22
  SPEAKER_00: Which is why I don't think that these alkalades really carry as much weight as we think.
• 7:28
  SPEAKER_00: And let me expand on this a little bit because I don't want this to come off as a podcast episode where I'm just knocking these surgeons because there's so many of them that are really awesome, and these alkalades do line up.
• 7:40
  SPEAKER_00: But then I think sometimes what happens is when I get on these phone calls, and then people are like, Yeah, they were this surgeon, and then I talk about the experience with them, and then they're just like, Yeah, this doesn't line up really well of like it being this best of the best surgeon, and you just kind of being this number in this process, or maybe things getting overlooked.
• 8:01
  SPEAKER_00: So let's dive a little bit deeper here because I do want to expand on this.
• 8:05
  SPEAKER_00: And when having these conversations, I realized that having this type of background, these alkalades, or maybe this status, if you will, there are two things that can happen.
• 8:15
  SPEAKER_00: The ACLer takes what they say and assume this is the best without questioning it.
• 8:20
  SPEAKER_00: And this is kind of like the shiny object syndrome.
• 8:22
  SPEAKER_00: You're also entering a space that you probably don't really know, right?
• 8:26
  SPEAKER_00: Like most of people who tear their ACL are just like hit with the fire hose in the face.
• 8:31
  SPEAKER_00: You're just trying to figure out uh what is a graft, you know, I have to have surgery, all these things.
• 8:36
  SPEAKER_00: So you're just trying to survive.
• 8:38
  SPEAKER_00: But with that said, you're also trying to make sure that you have the best surgeon.
• 8:43
  SPEAKER_00: And if someone comes in with this status or these alkalades, you're less likely to question things.
• 8:48
  SPEAKER_00: And especially if you're not sure even what options exist, you're just gonna take what they say and be like, all right, well, sure, yeah, let's do that.
• 8:56
  SPEAKER_00: And then the second thing that happens is surgeons of this type of status sometimes can come in and say this is the only way and the best way to do it.
• 9:04
  SPEAKER_00: And while that can be the case, I don't want to say that, like, oh, like every time you go to do this, you should have 10 different options given.
• 9:13
  SPEAKER_00: Of course, we need to make sure that the most important thing here is that this can get people into trouble for if you walk in and you're just told this is what's gonna be done, and then it's almost like this transactional meeting, it's almost too much blind trust for such a major surgery.
• 9:31
  SPEAKER_00: And I think that's the main point I want to get across here is that you need to make sure you vet this person, and even with your PT or whoever else you're working with, there needs to be some vetting.
• 9:42
  SPEAKER_00: Like figure out who you're working with because this is gonna be such an important player in this process.
• 9:47
  SPEAKER_00: So, now let me talk about an ideal scenario.
• 9:50
  SPEAKER_00: Surgeon walks in, you're there trying to figure out what's going on, what are the next steps.
• 9:55
  SPEAKER_00: They're educating you on what's happened and what are going to be those next steps.
• 10:00
  SPEAKER_00: So, discussing of if surgery is an option or not from that big picture point of view.
• 10:06
  SPEAKER_00: And then if surgery is an option, then we're looking at different graph types and we're considering your goals within that.
• 10:14
  SPEAKER_00: And there are plenty of conversations I've had with surgeons and with ACLers where they've, you know, been consulting different surgeons, and the surgeon will be like, Well, hey, like, you know, in this case, I would typically do a patellar tendon, but since you are a BJJ athlete, a jiu-jitsu athlete, you might be on the ground more.
• 10:32
  SPEAKER_00: Kneeling pain can happen.
• 10:33
  SPEAKER_00: So let's see if we could do maybe a quad tendon or consider some other options.
• 10:38
  SPEAKER_00: But if it's the surgeon that's just kind of coming in and it's like, hey, you've torn your ACL, here's the graft, see ya.
• 10:46
  SPEAKER_00: Like, that's something that I'm just like, ah, I don't think, no matter what the transaction is, that's not going to work for people because of this being such an important surgery.
• 10:56
  SPEAKER_00: And your graph type can make a big difference in terms of your recovery.
• 11:00
  SPEAKER_00: So hopefully there's a conversation around what that whole process looks like, and then also the rehab game plan.
• 11:07
  SPEAKER_00: And when you walk away from your visit with your surgeon, you understand those options, you understand what those potential next steps are, versus just this like transactional, this is what's being done to you.
• 11:19
  SPEAKER_00: Goodbye.
• 11:20
  SPEAKER_00: And I think that's what happens a lot in healthcare because we have built it up to be this kind of transactional volume-based.
• 11:27
  SPEAKER_00: All right, here's this number, I gotta see this many patients.
• 11:30
  SPEAKER_00: Like, let's just kind of get them in, get them out.
• 11:32
  SPEAKER_00: And of course, there is revenue tied to those things.
• 11:35
  SPEAKER_00: And while that can exist, sure, it's the thing that gets us in trouble and allows people to fall through the cracks.
• 11:43
  SPEAKER_00: And I see this being this way more than I don't, unfortunately.
• 11:49
  SPEAKER_00: And that's what I want to shed light on here with you guys is depending on the credential, sometimes this can get overlooked.
• 11:56
  SPEAKER_00: And so no matter the background, no matter those alkalades, you should always ask questions and get those answered.
• 12:04
  SPEAKER_00: If you feel like you're being rushed, or if you feel like the surgeon doesn't have time to entertain those, then you know it might be time to find another surgeon, you know, and it might be kind of going out of your geographic location a little bit further to do that because this is not a surgery to be overlooked.
• 12:20
  SPEAKER_00: As someone who's done this twice, as someone who has worked with so many people with this, this surgeon is going to be a key player.
• 12:28
  SPEAKER_00: Your physical therapist is going to be such a key player, and I want to make sure that you guys feel equipped to be able to ask those questions.
• 12:36
  SPEAKER_00: So if you need those, you can download a resource that we have on our website.
• 12:42
  SPEAKER_00: It's free.
• 12:42
  SPEAKER_00: You can go to theaclathlete.com.
• 12:45
  SPEAKER_00: You also have podcast episodes seven and eight for eight questions to help ask your surgeon about ACL surgery.
• 12:52
  SPEAKER_00: It's just to help vet them, see how many surgeries they've done, the graph types, the rehab process, the testing.
• 12:59
  SPEAKER_00: And the other big thing here is the gut test.
• 13:01
  SPEAKER_00: Make sure your gut is giving you that feeling that this is the person I want to go with.
• 13:06
  SPEAKER_00: I always advise people to consult multiple surgeons just to get some good options.
• 13:12
  SPEAKER_00: I told a story recently of evaluating a recent athlete who tore her ACL, and her knee was pretty blown up, swollen, couldn't move it very much, a lot of pain.
• 13:23
  SPEAKER_00: She said she saw a surgeon pretty quickly after, and he wanted to get her in the next week for surgery.
• 13:28
  SPEAKER_00: I was like, well, red flag.
• 13:30
  SPEAKER_00: Well, we need to we need to pause here because your knee is freaking out from the ACL injury, and we don't need to rush in there and just have surgery because that's just going to complicate things further.
• 13:41
  SPEAKER_00: So this is where it's going to be really important to have the surgeon that is dialed in and gives you a really gut feeling and to get multiple opinions and then make a very good informed decision.
• 13:53
  SPEAKER_00: And so find that surgeon that is going to educate you, provide the options, communicate well, answer your questions, and knows this process.
• 14:02
  SPEAKER_00: Not the one who's done a few ACL surgeries or who is the big shot who has done this surgery for this athlete.
• 14:12
  SPEAKER_00: Because, you know, the other thing that can get overlooked is that if they are so focused on these high-level athletes, then are they going to give you the same amount of attention compared to, you know, someone who's, you know, Sally who wants to play Ultimate Frisbee again?
• 14:27
  SPEAKER_00: And I find this that happens in the space a lot because there can be this thing where there's favoritism, whether you believe it or not, it happens.
• 14:36
  SPEAKER_00: Every one of us does it.
• 14:38
  SPEAKER_00: And so this is the other thing to think about with this space and with choosing your surgeon, choosing your healthcare team in all honesty, because every single player in this is going to be so valuable and is going to help move the needle for you.
• 14:53
  SPEAKER_00: And as I wrap up this episode, the goal here wasn't to bash any particular profession or particular surgeon.
• 15:00
  SPEAKER_00: It's just to shed some light on some of the conversations that I have around these types of uh figures or people who are influenced a lot by these certain alkalades.
• 15:12
  SPEAKER_00: And I just want to make sure that you guys are able to make good decisions about your care and not letting the shiny object syndrome get in the way of what could be a very good experience and your ultimate outcome to getting back to what you want to do.
• 15:26
  SPEAKER_00: And this applies from the surgeon to the physical therapist to the strength coach to anyone else involved.
• 15:33
  SPEAKER_00: And I think it's important to make sure that we have the person in our corner who's going to be on our team and who's going to hear us out to educate us, to make sure we have our questions answered, and to support us even if something doesn't go the right way.
• 15:49
  SPEAKER_00: And so that's what's really key here, and I don't want that to get overlooked.
• 15:54
  SPEAKER_00: Capiche, that sound good?
• 15:56
  SPEAKER_00: Alright, guys, that's gonna do it for today.
• 15:59
  SPEAKER_00: Thank you all so much for listening.
• 16:00
  SPEAKER_00: This is your host, Robbie Patel, signing off.