"Expanding access to evidence-based primary and specialty care is one of the central tenets of enlightened health care," says Thomas Vail, M.D., chair of the UCSF Department of Orthopaedic Surgery. "Innovative collaborations between academic medical centers and their surrounding communities help advance this goal."

That's the thinking behind UCSF orthopaedic outreach services and adult and pediatric satellite clinics that serve patients throughout the Bay Area.

Specialty Services in the Community

The collaborations began a decade ago, when pediatric orthopaedic specialist Mohammad Diab, M.D., set up an outpatient clinic in Greenbrae (Marin County). There, he sees any child with musculoskeletal problems.

Spine specialist Shane Burch, M.D., and sports medicine physician Carlin Senter, M.D., also practice at the Greenbrae clinic. The department provides similar services at clinics in Pleasanton, San Ramon and Santa Rosa. "It's important to support and work cooperatively with local orthopaedic surgeons and primary care physicians in the communities where my patients live," says Diab.

Access for Athletes

Other important community collaborations are the department's sports medicine initiatives. For example, the PlaySafe program offers local high schools expert sports medicine services. "We translate and integrate the protocols we use to treat professional and collegiate athletes to provide the highest standard of care for high school athletes," says Anthony Luke, M.D.

These best practices get integrated in multiple ways.

• On-Site Care and Training: Certified athletic trainers and physicians in sports medicine provide contracted services at high school athletic events and established training rooms at the schools, the Greenbrae clinic and the UCSF Sports Medicine Center. They also collaborate with parents, referees and coaches.
• Concussion Care: "Based on NCAA and CDC recommendations, we provide standardized return-to-play protocols and education about the signs of concussion for athletes, their parents and their coaches," says Luke.
• Heart Care: The program offers free pre-participation cardiac physicals, including EKGs, with immediate consultation and referrals to cardiology when indicated. Recently, one such physical uncovered a rare heart arrhythmia in a 16-year-old athlete. A noninvasive heart procedure at UCSF Benioff Children's Hospital enabled him to return to the sport he loves. Read Ryland Burke's story.
• Public Health Care: The program works with local agencies as well as school nurses and administrators to address public health risks, such as skin infections or infectious disease outbreaks. It has also worked with medical equipment companies to secure donations for families in need.
• Volunteer Coverage: "We work with other professionals in the community, including physician and nurse colleagues, who voluntarily cover our high school events and larger events like the San Francisco Marathon or Golden Gate Rugby," says Luke.

Care for Weekend Athletes

Finally, says Luke, the department's Human Performance Center at Mission Bay offers a health and wellness focus where community athletes can take advantage of interdisciplinary, individualized testing and analysis to prevent injuries and achieve peak performance. "All of this work is driven by a desire to make things better for the communities where we live, work and play," says Luke.

Dr. Mohammad Diab, Dr. Anthony Luke and Dr. Thomas Vail can be contacted at (415) 353-2808.

More Information

• Orthopaedic Institute
• Human Performance Center
• PlaySafe

Orthopaedic Surgery News — Summer 2012 Index