Latest / UF Health MedEd Cast / Dr. Ryan Roach -- Balancing Health and Performance with UF Gator Basketball

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Dr. Ryan Roach -- Balancing Health and Performance with UF Gator Basketball · UF Health MedEd Cast

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  Melanie Cole, MS (Host): Welcome to UF Health MedEd Cast with
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  UF Health Shands Hospital.
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  I'm Melanie Cole.
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  And today, we're exploring what it's like to be a team physician.
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  I'm pleased to introduce you to Dr.
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  Ryan Roach.
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  He's an orthopedic surgeon and team physician for the University
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  of Florida Gators Basketball.
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  Dr.
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  Roach, it's such a pleasure to have you join us today.
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  When people hear team physician, especially at the collegiate or
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  professional level, what do they fully not appreciate about the role?
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  I'd like you to tell us a little bit about yourself and your journey to being
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  a team physician and what it's really like to work at such a high level.
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  Ryan P. Roach, MD:
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  Melanie, thank you for having me and UF Health for hosting this.
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  So, yeah, probably the most underestimated thing is just the amount
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  of time it takes to actually get into orthopedic surgery sports medicine.
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  And I think we can hit on that a little bit later that there are other
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  ways to become a team physician.
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  I chose the orthopedic surgery route, and that started way back
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  as an undergraduate student.
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  I was a soccer player at Purchase College, and that kind of
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  sparked my interest in sports.
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  I quickly realized that I wasn't going to make a career in soccer.
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  And so, I had to pivot to something that I enjoyed equally.
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  And thankfully, I enjoyed science.
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  And so, the natural bridge for me was to do something that allowed
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  me to enjoy biology and use that science, but also to treat athletes.
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  And so, that led me to orthopedic surgery.
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  So then, I did a master's year to get myself ready for medical school, and
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  that was at Tulane University, and then did medical school down in New Orleans.
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  Then, five years of orthopedic surgery residency, one year of
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  fellowship training, and then that led me to University of Florida.
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  Melanie Cole, MS: Wow, that's quite an exciting story, Dr.
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  Roach.
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  Before we get into the team physicians specifically and what it's like day to
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  day, have you ever had the opportunity to treat upper level athletes?
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  Can you discuss a little bit about that and UF Health's partnership as the
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  medical provider for the United States Olympic and Paralympic Committees?
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  Ryan P. Roach, MD:
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  Yeah.
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  So, I think University of Florida and University of Florida Health, we
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  have an amazing opportunity to treat all different forms of athletes.
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  So, we have a huge outreach program in terms of our high school athletes.
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  We obviously take care of high-level athletes through the University of
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  Florida and the Gator Athletics.
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  But we also have the tremendous opportunity to take care of Team
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  USA, and what an honor that is through our partnership with USOPC.
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  And so, just today, I had an athlete phone in to discuss potential treatment options.
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  So, I think, that's why we do it as a team doctor.
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  It doesn't really matter about a professional or Olympic, but it's
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  such a thrill to meet these people and to talk to them about how they've
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  gotten to their position and how their injuries are affecting them.
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  And then, to be part of the process of getting them back out there, it
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  really is the thrill of why we do this.
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  Melanie Cole, MS: Well, it certainly is exciting.
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  And Dr.
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  Roach, there's a unique pressure when balancing athletic
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  health with team performance.
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  So, how do you navigate that tension?
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  When you think of your ultimate patient, the athlete, the team, the organization,
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  tell us about some of those intense pressures associated with being a
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  team physician at that higher level.
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  Ryan P. Roach, MD:
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  Yeah.
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  Well, I think the thing about sports medicine is that it really is team-based.
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  And so, you have the athlete who's injured, and then you have the bigger
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  picture of how that athlete fits into the team and the sport and the season.
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  And I think the most critical part of that is to appreciate what the athlete wants.
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  They may need surgery.
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  Their injury may dictate that they should do something about it.
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  However, the timing may not be right.
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  And to be successful, I think you have to balance all of the aspirations of the
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  athletes, the goal of the athlete, the timing, the schedule, the specifics of
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  what's going on in that athlete's life with the pathology and what you know as
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  a treating physician to get an outcome.
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  You can't just treat every injury the same.
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  You have to treat every injury according to whatever that athlete requires.
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  And so, I think the goal or the key really to success is just understanding
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  what's important to that athlete, and then melding that into a plan with the
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  background of a treating practitioner.
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  Melanie Cole, MS: Well, that's certainly true.
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  And when we think of a major program like the Florida Gators Men's Basketball,
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  how integrated are you and your medical team with the coaches, the athletic
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  trainers, the strength conditioning staff, the nutritionists, all of the
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  different people that are involved in working with a team like this?
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  How do you integrate with everybody?
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  Ryan P. Roach, MD:
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  Well, I have to give credit to the University of Florida and the UAA,
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  the University Athletic Association.
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  They have such a well-functioning system that prioritizes healthcare of athletes.
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  And I'll just tell you, that isn't the case everywhere.
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  And so, the system just functions very well.
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  And I also got to credit Coach Golden.
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  I mean, he just runs an incredibly tight ship.
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  And so, I think, you know, just like you have the athletes on the court and that
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  team, you also have the healthcare team.
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  That includes an amazing athletic trainer, John Michelini, who I tell people to
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  think of as the quarterback of healthcare.
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  He's the day-to-day person, really kind of in tune with how the athletes are feeling.
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  Then, you have the amazing strength and conditioning coach, the nutritionist,
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  that keep the athletes—hopefully keep them from getting injured,
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  and they do a great job of that.
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  And then, you have the team doctor.
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  We are all in communication basically weekly, just making sure we understand
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  the athletics, the team's schedule.
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  If there are any injuries, we see them basically on the day of injury.
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  And if we're not around, we'll see them the next day.
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  But the key to success there is really the communication.
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  Melanie Cole, MS: Well, it certainly is.
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  And Dr.
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  Roach, basketball is such an explosive, high-demand sport.
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  When we think of the most common injuries that you see over the course of a season,
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  are there certain injuries that are becoming more prevalent as the game gets
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  faster, more positions, more year-round?
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  Tell us what you see with these teams on a day-to-day basis.
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  Ryan P. Roach, MD:
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  Well, I think the things that I see are not exactly what everyone else sees.
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  So, the more common injuries are going to be kind of the small
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  finger injury, ankle sprain, things like that, or muscle strain, things
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  that don't necessarily require surgery or time away from athletics,
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  but certainly require treatment.
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  The more kind of public-facing injuries are the ones that require time away.
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  And certainly, we've seen an increase in Achilles tendon injuries and
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  other tendon injuries such as patella or extensor mechanism injuries.
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  And we don't exactly have an answer in terms of why that's happening,
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  but I think you hit on it.
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  The game is changing.
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  It's becoming more explosive.
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  The amount of time in terms of training has changed, and how these
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  athletes are training has changed.
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  And certainly that plays a role in this increase, but it isn't the
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  whole thing, and we really haven't figured out why that's happening.
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  Melanie Cole, MS: Yeah, that's such an interesting point that you're making.
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  And when you're talking about these injuries, soft tissue injuries can
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  certainly be tricky because imaging doesn't always tell the whole story.
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  So, how much of your decision-making comes from your clinical experience?
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  You're an orthopedic surgeon.
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  Understanding and getting to know the athlete themselves.
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  And Dr.
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  Roach, I mean, it's such an exciting time in the world of sports medicine
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  and orthopedic surgery with the imaging technology and biologics
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  and rehab science and things that we've learned over the years.
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  So, how did all that tie together for you when looking at this athlete's
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  injuries and deciding what's next?
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  Ryan P. Roach, MD:
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  Well, yeah, I think have to consider everything.
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  We have a saying that you don't treat the X-ray or the image, you treat the patient.
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  And so, certainly, you have one MRI finding that may
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  affect one athlete one way.
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  And then, you know, it doesn't affect another athlete the same way.
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  And so, I think you take every element of the patient and of their presentation.
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  And you kind of combine that with what you know of the injury, and
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  you try to come up with a plan.
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  You know, a great example would be an ankle sprain.
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  Some people can bounce back from an ankle sprain much faster than another.
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  And that takes a lot about knowing the athlete and what their
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  tolerance level is and what their commitment to the rehabilitation is.
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  And so, again, it's kind of like you just take every piece of
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  information and help formulate a plan that's best for that athlete.
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  Melanie Cole, MS: One of the things, Dr.
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  Roach, that I've seen in sports over the years is the challenge, and this is
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  a challenge in sports medicine for the coaches, for the trainers, for the team
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  physicians, is balancing that rapid return to play with long-term athlete health.
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  So when we think of navigating that tension and those return-to-play decisions
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  can be so incredibly high pressure, especially during conference play,
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  March, that sort of thing, who ultimately has the final say when determining if
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  an athlete's ready to return to play?
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  And what are you thinking when you're deciding this?
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  Ryan P. Roach, MD:
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  Again, I got to give a shout-out to the organization and to the coach.
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  Here there is zero pressure.
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  We all want the athlete to be back out there.
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  And certainly, I just won a national championship.
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  The expectations this year are high.
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  And obviously, an injury can change and derail all of that.
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  So, there's always the motivation to get an athlete out there.
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  However, there's never a pressure from coaches or administration
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  at the University of Florida.
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  And so, that decision ultimately is always on myself as the
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  team doctor, my partner, Dr.
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  Cluxton, who's also one of the team physicians, again, the athletic
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  trainer, John Michelini, who's the captain of the ship and the athlete.
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  And we sit down.
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  Often we include parents, sometimes now agents in the world of the NIL.
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  And really, it's a decision between the provider and the patient, what's
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  the safest and balancing their motivation with what we know in terms
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  of protecting them as an athlete.
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  Melanie Cole, MS: Dr.
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  Roach, for listeners that are looking to go into this field, but they want to
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  know about that pressure, they want to know about what's going on, let's talk
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  about your game-day responsibilities.
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  What does it look like from start to finish?
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  How do you prepare mentally, physically for the unpredictability
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  of acute injuries, for helping these motivated athletes?
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  What does your game day look like?
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  Ryan P. Roach, MD:
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  So yeah, I think, you know, the one thing I always counsel people that are thinking
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  about this is all the other stuff.
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  So, I have my own practice, I have my own family, I have all these
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  other things going on in my life.
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  And then, I have athletic coverage.
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  And so, that is a big commitment.
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  And if you don't love it, that can be incredibly taxing to do a full
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  day of clinic or a full day of operating, and then have to go to a
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  basketball game or a football game and spend that time on the sideline.
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  But if you love it, there's no bigger thrill.
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  And so, on a game day of basketball, generally, I'll
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  show up a half an hour early.
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  I'll meet with the athletic trainer and my partner, Dr.
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  Claxton.
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  We'll kind of just talk about what's going on.
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  Sometimes there's injuries that require treatment, preoperative medication,
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  sometimes preoperative injections.
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  And then, ultimately, we get the team out there, and we hold our breath, and
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  we just hope that nothing bad happens.
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  I know, in basketball, we've been pretty fortunate in terms of injuries.
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  I'm knocking on wood right now.
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  But historically, we've had some pretty scary things.
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  We've had cardiac arrests, we've had open fractures, all the way
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  to, again, just like dislocated fingers and things like that.
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  And so, I think as a team physician, you kind of have to be ready for
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  everything, which I think is exciting.
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  But that if you don't have that personality, it can be a little stressful
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  too, because you really don't know what the game's going to throw at you.
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  It could be an eye injury, which for an orthopedic surgeon, obviously, you know,
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  we don't have extensive training in that, to, you know, a skin rash to everything.
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  So, you got to be comfortable with being uncomfortable a
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  little bit, if that makes sense.
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  Melanie Cole, MS: It does make sense, and I'm so glad that you spoke a little
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  bit about some of the aspects and personality traits that you find most
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  advantageous if someone wants to break into the sports world as a team physician.
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  Before I ask you for your last bit of advice, I'd like to ask you a really fun
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  question about what do you do for fun?
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  I mean, here you are, this busy orthopedic surgeon.
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  You mentioned your family.
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  You've got your team during season.
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  What do you do for fun, Dr.
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  Roach?
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  What is something your colleagues and your patients and even, you know,
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  your friends might not know about you?
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  Ryan P. Roach, MD:
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  Well, my family is a big part of my life.
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  So, I have three young kids and a wonderful wife who's also a physician.
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  So, a lot of my fun is just hanging out with them.
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  Outside of that though, I do a tremendous amount of other stuff I like to do.
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  I played sports.
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  I still dabble.
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  I like to consider myself a soccer player, although last time I played,
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  I limped off the field with so many aches and pains that I don't
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  know that I'll ever play again.
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  But I love sports.
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  I'm playing golf and tennis at least weekly.
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  I love to cook.
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  I love to garden, actually.
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  My kids and I have a nice garden that we keep up and eat from.
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  I bake.
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  That's kind of a weird one, but people that know me know that I bake because
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  I'm always eating baked goods or bringing in some of my test stuff.
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  But, yeah, I kind of like to dabble in a bunch of things.
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  Melanie Cole, MS: Very cool.
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  Thank you so much for sharing that.
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  Now, best advice for clinicians interested in entering this field.
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  What keeps you passionate about the work despite the pressures, and
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  what would you like them to know about how exciting this field is?
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  Ryan P. Roach, MD:
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  Well, I think the best advice I can give is test it out.
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  Try to shadow, try to get involved.
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  Because if you can experience it firsthand, you can get an idea of whether
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  or not it's something you'll enjoy.
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  If you enjoy it, there's no better job in the world.
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  And I think that could be said for anything.
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  But if you don't enjoy it, then all these extra stresses and all these extra time
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  commitments will really weigh on you.
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  So, I think if you can somehow experience it firsthand, either through shadowing
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  or whatever your access may be, I think that'll give you a glimpse into it,
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  which will give you some perspective and help you make a really good decision.
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  Melanie Cole, MS: That was a great discussion.
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  Dr.
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  Roach, thank you so much for joining us today and sharing what it's like
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  to be a team physician at that high level, at that collegiate level.
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  Thank you again.
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  And to learn more about this and other healthcare topics at UF
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  Health Shands Hospital, please visit innovation.ufhealth.org.
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  And to listen to more podcasts from our experts, please
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  visit ufhealth.org/medmatters.
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  That concludes today's episode of UF Health MedEd Cast.
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  I'm Melanie Cole.
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  Thanks so much for joining us today.