Emphasizing Trust while Providing Comprehensive Care at CHRISTUS Westover Hills Orthopaedics

By: Michael Ferguson
Monday, March 31, 2014

In less than three years, CHRISTUS Westover Hills Orthopaedics has built a robust program founded upon expeditious evaluation and carefully designed treatment protocols.

The charge to build a program from the ground up presented a significant change of pace for Jeffrey Dean, MD, Chief of Orthopaedic Surgery at CHRISTUS Santa Rosa Hospital – Westover Hills and staff orthopedic surgeon at CHRISTUS Westover Hills Orthopaedics.

“Prior to arriving in San Antonio, I served as an orthopedic surgeon in the Army, where I had numerous patients waiting to see me everywhere I went,” he says. “It was a different experience to build a new practice, but we decided that starting from scratch was the best strategy.”

The practice was established to promote the highest standards of care for a wide array of surgical and nonsurgical orthopedic treatments with a focus on sports medicine. As it grew, Brian Kanz, MD, orthopedic surgeon at CHRISTUS Westover Hills Orthopaedics, joined to offer the full breadth of joint replacement procedures.

Establishing a Baseline

Drs. Dean and Kanz follow a foundational philosophy that emphasizes conservative treatment and cultivates a sense of trust with their patients. Before recommending surgery, the surgeons and their patients engage in full-disclosure conversations regarding potential treatment courses.

“Surgery is an option if we think it will help our patients, and we confirm the necessity of that approach with pathology,” Dr. Kanz explains. “We want to ensure that patients’ expectations are realistic, no matter what approach we ultimately use. Patients need to understand everything about their condition and the possible modalities we can deploy to help them.”

Return to Function

Before suggesting surgery, the two surgeons use a number of front-line conservative treatments — including physical therapy regimens, topical and injected medications, and transcutaneous electrical nerve stimulation — to address functional deficits, but sometimes surgery is the best option.

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This was the case for Charlotte Ann Davis, whose shoulder pain had bothered her for several years, but as long as the 74-year-old retiree could dance, swim and bike as usual, she didn’t mind too much. Then the pain began limiting her range of motion. Not only was she sidelined from her favorite activities, but she also couldn’t lift her arm high enough to put her earrings on. After a limited range of motion led to her burning her neck and earlobes with a curling iron, she sought help. A nurse at the assisted living facility where Davis resides recommended Dr. Kanz.

Initially, Davis was apprehensive about surgery, so Dr. Kanz worked with her to construct a physical therapy regimen to improve her condition. After seven months of minimal improvement, Davis opted for surgery.

“When I arrived at the point where it was clear physical therapy wasn’t working, I conceded to shoulder replacement,” Davis says. “I gave Dr. Kanz a list of questions and thoughts about the procedure and hospitalization. I’m on multiple medications, and it was important to me that nothing would change in that regard. He listened to my concerns, told me that nothing would change unless absolutely necessary and reassured me that he would take care of me. It was clear to me that he knew where I was coming from, and because of that, I had absolute confidence in him.”

On Aug. 17, Dr. Kanz replaced Davis’ shoulder joint, and after a one-night hospitalization, Davis was back at home. Although she wasn’t thrilled at the prospect of an overnight stay, Davis remembers the attention she received during her hospitalization as exceptional.

“At one point, I woke up, and Dr. Kanz came in,” Davis says. “He adjusted my pillows himself, and the warmth I felt coming from him in that action was overwhelming.”

For the two weeks following her discharge, Davis received home health visits from nurses and physical therapists. Ten days after the procedure, she returned to Dr. Kanz for stitch removal, and they established a physical therapy regimen at CHRISTUS Santa Rosa Rehabilitation Services – Westover Hills. It’s been eight months since Davis returned home, and she says the combined efforts of Dr. Kanz and the nursing and rehabilitation personnel have returned her range of motion to 95 percent, which means she’s back in the pool, and her social calendar is as active as ever.

Maintaining Lifestyle

Davis’ condition illustrates one of the most important aspects of orthopedic care — helping active people remain active.

“We’re about keeping people doing the things they love for as long as possible,” Dr. Dean says. “If I see 60-year-old patients who have loved running since youth, I have to try to keep them engaged in that activity as long as possible for their emotional and physical well-being. Our objective then becomes activity modification — instead of running seven times per week, we would encourage cross-training or other ways of reducing overuse injuries.”

A number of sports-related injuries can be treated with such activity modification. For example, Dr. Dean saw a 16-year-old who suffered from knee pain originating from performing squats with too much weight. No surgery was necessary, only a simple tweak to the patient’s workout routine — more repetitions with less weight.

“As a medical doctor — and the root word of doctor means teacher — it’s my responsibility to teach my patients about their bodies,” Dr. Dean says. “If they tell me that lifting weights hurts them, I teach them other techniques to reduce the stress on their joints, muscles or tendons so they can continue performing the activities they love.”

But sometimes, expeditious surgical intervention is necessary. Yunhee Rashdi, RN, IMCU, nurse at CHRISTUS Santa Rosa Hospital – Westover Hills, had been struggling with shoulder pain that made it impossible to fulfill her nursing requirements. Having witnessed Dr. Dean’s attentive care firsthand, she turned to him for a consultation about repairing her torn rotator cuff.

“I’d already put my life on hold for three months, and I trusted that Dr. Dean would see me quickly,” Rashdi says. “He saw me within two days of my initial call. We decided on rotator cuff surgery and scheduled it for Christmas Eve. What impressed me most was that he called me on Christmas Day to see how I was doing.”

Collaborative Care

Drs. Dean and Kanz work closely with referring physicians throughout the treatment process, with constant communication between physicians regarding therapeutic strategies and patient progress reports. Mirroring the trust they forge between themselves and their patients, Drs. Dean and Kanz work hard to establish trust with referring physicians.

“With every patient, we demonstrate our dedication to effective management,” Dr. Dean explains. “We understand that we’re stewards of care, representing referring physicians in this area on the continuum of care. We take that responsibility very seriously.”

Meet the Physicians

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Jeffrey Dean, MD, Chief of Orthopaedic Surgery at CHRISTUS Santa Rosa Hospital – Westover Hills, earned his medical degree from Wright State University School of Medicine. A West Point graduate, Dr. Dean trained at Brooke Army Medical Center and is proud to have served 22 years in the United States Army. Dr. Dean is board-certified by the American Board of Orthopaedic Surgery and holds a Certificate of Additional Qualification in Sports Medicine. In addition to his responsibilities at CHRISTUS Santa Rosa, Dr. Dean is the team physician for the San Antonio Warriors, a minor league football team.

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Brian Kanz, MD, orthopedic surgeon at CHRISTUS Westover Hills Orthopaedics, earned his medical degree from the University of Texas Medical Branch in Galveston, where he also served a general surgery internship and completed his orthopedic residency. Dr. Kanz sought to return to the Texas Hill Country and jumped at the chance to practice in San Antonio. His experience in joint replacement complements the robust treatment offerings at CHRISTUS Westover Hills Orthopaedics.

For information regarding the services available from CHRISTUS Westover Hills Orthopaedics, visit www.westoverhillsortho.com. To refer a patient, call 210-703-9758.