Tucson Orthopaedic Institute Expands Physical Therapy Access

Tucson Orthopaedic Institute opens a third physical therapy location inside fitness gym, FIT at the River. Starting in January 2017, the new clinic will offer patients additional access to physical therapy treatment.

Open Monday – Friday

Monday, Wednesday (8am-5pm); Tuesday, Thursday (7:30am-3:30pm); Friday (7:30am-12:30pm)

2404 E. River Rd., Bldg. #1

Tucson, AZ 85718

At this location is physical therapist Golsa Lotfioff, PT, DPT. Lotfioff received her Doctorate of Physical Therapy in 2014 and now specializes in outpatient orthopedics, sport medicine rehabilitation, manual therapy, aquatic therapy, and pediatric rehabilitation.

Patients can now benefit from receiving physical therapy treatment in a convenient location for rehabilitation from injury or post-surgery recovery. The FIT at the River clinic provides the same quality of care and comprehensive physical therapy services as all Tucson Orthopaedic Institute physical therapy locations.

Tucson Orthopaedic Institute physical therapy locations also include the Northwest office, 6320 N. La Cholla Blvd, #200; and East office, 2424 N. Wyatt Drive, #130. For scheduling information, call (520) 784-6570 or visit www.tucsonortho.com.

Focus on Continuous Improvement

Source: BizTucson published September 2016

Written by: Mary Minor Davis

Photo Credit: Amy Haskell

After three years of living on the road as a national healthcare consultant, Paula Register is ready to plant her roots on firmer ground in Tucson. The new CEO at Tucson Orthopaedic Institute recently got a dog. She’s planted flowers. She cooks at home more.

The North Carolina native first came to Tucson in 2010, working two years at Carondelet Health Network before her consulting job took her back on the road. Now engaged to local cardiac anesthesiologist Michael Hecht, she said she’s ready to settle down.

“Settle” isn’t a word that would normally describe Register. Look at her resume and it is easy to see why she was included in Becker’s 2011 list of Most Influential Women to Know in Healthcare. She’s held senior leadership and executive positions for most of her career. A licensed CPA, she has worked as a senior accountant and CFO for two North Carolina school districts and participated in several mergers throughout her career. In healthcare her roles include CFO and CEO for multi-specialty physician groups and CEO for a Management Services Organization, doubling its size during her tenure. She came to TOI in April of 2015.

“The opportunity at Tucson Orthopaedic came at a perfect time,” Register said. “For most of my career in healthcare I worked with supervising multi-specialty areas. This was an opportunity to focus my time and talent on one area.”

For the previous three years, Register’s consulting career took her to Oahu frequently. “I had the greatest experience working in Hawaii,” she said. “The spirit of the people, the kindness they demonstrate – it’s a good lesson for those of us who work in healthcare. I really learned the true meaning of ‘Aloha.’ ”

She’s incorporated her experience in Hawaii into the TOI philosophy – adopting “kina’ole” – the Hawaiian word for flawlessness.

“It means doing the right thing, in the right way, at the right time, in the right place, to the right person, for the right reason, with the right feeling the first time,” she said. “It embodies the whole patient experience – making them feel welcome, making them feel comfortable, being respectful of their time and hearing everything they have to say. It’s all important.”

This philosophy is what drives Register, who takes her responsibility to run a $50 million business very seriously.

“My job is to provide a good, strong business structure and clinical infrastructure to support the clinical practices, which allow (the physicians) to do what they do best. I call it the triple lane – we’re here to provide better patient experience, better patient outcomes, at a more efficient cost. It’s what we all want.”

To achieve this, Register established a culture focused on continuous improvement. “We want to make sure we get better every day.”

To this end, Register said she asks a lot of questions – especially “why?” – with respect to processes, procedures and programs that serve as patient touch points. “Why do we do it this way?” And the next questions are “How should we be doing it? Can we do it differently and achieve a better outcome?”

“We’re always going to make mistakes – it’s human nature,” she said. “But it’s how we react to that mistake that I think is important. Patients need to know that when things go wrong, we analyze what happened and what we are going to do differently so that it doesn’t happen again.”

Register said she doesn’t look to adopt change for the mere sake of change, but recognizes that there are some things that don’t need to be handled the way they were in the past because of changes in technology, information systems and other patient interactions.

One of the most noticeable examples of this is the renovated lobby space at the Grant Road location, shared in the central tower with Tucson Medical Center. Previously, check-in for TOI was behind the TMC reception area in a small office. “There were lines out the door,” she said. “When you’re in pain, the last thing you want to see is a waiting line.”

TOI re-engineered the waiting area, moving from the TMC reception area to a more open area at the west end of the tower. In addition, multiple check-in stations were added. “It opened up our availability to patients,” she said. “It’s a much better environment for our staff and our patients.”

Locating services nearer to patients is also part of Register’s strategy. There are currently four TOI clinics in greater Tucson. In the next 18 months, the TOI located on the Oro Valley Hospital campus will complete an expansion, and TOI’s newest satellite office will open next year as part of the new TMC Rincon Health Campus on the southside.

“I have this philosophy that I heard early in my career – people don’t care how much you know, until they know how much you care,” she said. “I think if people know we care, that’s what’s important. I try to show people how much I care – the team, our culture, our patients – and I hope our business owners know how much I care about how I run their business.”

Bisphosphonate Femur Fractures: An Ounce of Prevention is Worth a Pound of Cure

Written by: Ali Dalal, MD

view post on original source – LinkedIn

7/17/2016- Bisphosphonates (BPs) are a revolutionary class of medicines that can preserve bone health and prevent fractures caused by osteoporosis. They go by the trade names of Boniva™, Fosamax™, and Reclast™ among others. They have been shown to decrease spine fractures by 40-70% and hip fractures by 20-50%. They are truly life changing treatments when one considers that 1 in 3 women and 1 in 5 men will experience an osteoporotic fracture after the age of 50.

Like all medicines, BPs have side effects. One especially fearsome side effect of BP treatment is atypical femur fracture (AFF). AFFs are fractures caused by BPs. They are characterized by aching pain in the thigh or groin with weight bearing. They are easily visible on x-rays in their early stages and are much easier to treat before they become complete fractures. To be clear, AFFs are very rare and bisphosphonates most definitely prevent more fractures than they cause. However, the prolonged course of healing and the unpredictable nature of AFFs have caused great concern among patients and the media. A link between the number of years BPs are taken and the risk of AFF has been established. A task force of leading bone doctors and scientists has provided guidelines in 2016 on how to prevent AFFs based on individual patient risk factors. The guidelines are as follows:

Post-menopausal women treated with oral (pill form) bisphosphonates for 5 continuous years or intravenous (IV) bisphosphonates for 3 continuous years should be re-evaluated. If they have not had an osteoporotic fracture during treatment with the medicine (hip, spine, wrist, shoulder fracture), do not have osteoporosis on a DEXA scan (bone mineral density test) and are not considered to be a “high fracture risk” based on age and other factors, they should consider a temporary stoppage of medicine or a “drug holiday” for 2-3 years.  After this time period they should be re-evaluated. The drug holiday allows some of the potential harmful effects of BPs to decrease.

As you can tell, the guidelines are not simple. As a doctor I had to read it a few times before it sank in.  Stopping or continuing the medicine requires significant judgment on the part of the doctor prescribing it. These medicines should not be stopped without a consultation with the prescribing doctor. As a patient, the important thing to take away is that if you have been on these medicines for years and are experiencing the symptoms of AFFs, don’t ignore them. AFFs are much easier to treat in the early stages. Secondly, if you have been taking these medicines for years but haven’t seen the prescribing doctor in a while, it might be time to find out where you stand in terms of your risk. With AFFs, an ounce of prevention is worth a pound of the cure.

  1. Adler et al. Managing Osteoporosis in Patients on Long-Term Bisphosphonate Treatment: Report of a Task Force of the American Society for Bone and Mineral Research. Journal of Bone and Mineral Research. Volume 31, Issue 1, pages 16–35, January 2016

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