Assessing non-surgical treatment options for patients

Michael Milligan, M.D., CAQSM
Non-Surgical Sports Medicine
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 Q: How do you as a non-surgical sports medicine physician help a patient decide whether to get surgery or to try a different treatment option?
Michael Milligan, M.D., CAQSM: It's important for us to make sure that the patient who needs surgery gets the appropriate treatment. At the same time, we know that a lot of the patients who come in to see us – they don't need surgery, they need some other treatment. That might be physical therapy, it might be some home rehabilitation or changing their running shoes or their position on their bike, changing how they practice or how they warm up. Being able to help patients with all those pieces and guide them through that process is really a part of what we do. Guiding patients towards surgery when they need it and away from surgery when that's not the appropriate treatment is the cornerstone of what we do. To be that expert who can help that patient through that decision process and guide them through those options and try to make sure they're fully educated on all the available resources that are there – even newer technologies like orthopaedic biologics, you know, we have a lot of different tools in our belt and we want to make sure that patients are getting the right care whatever that is.
 Q: What are some of the things non-surgical sports medicine providers can provide as alternatives to surgery?
Michael Milligan, M.D., CAQSM: Each patient problem is a unique problem and we have to approach each one individually based on that patient’s needs and that patient's condition or problems. There are problems that come in where the only really viable option is surgery, and when that patient comes in we educate them on that, we get them to the right provider, we make sure they get the best care that the Andrews Institute can provide. At the same time, we know that many of our patients are seeking alternatives to surgery. They're not candidates for surgery. They may have things going on at home or work that make it not a good time to do surgery. And so for those patients we’re looking at all the other options that can help them get better. Physical therapy is obviously a cornerstone; physical therapy is very effective for many problems. We're fortunate to have excellent physical therapy resources at the Andrews Institute throughout our area provided by the Andrews Institute. At the same time, there are other opportunities – that might be braces or splints to help a patient with a condition. It may be giving them a program of things they do on their own at home. It may be treatments such as injection medications, and those come in a variety of forms. We also have the opportunity here at the Andrews Institute the offer some cutting-edge experimental treatments like stem cells and platelet rich plasma (PRP) and we refer to those as orthobiologic treatments, so we have a lot of options on the table depending on the patient and their particular condition.


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