Has Obamacare Led to Increased Reliance on Emergency Medicine?

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lots of people waiting for care at er

A new poll of the American College of Emergency Physicians shows that patient volumes have increased since January 1st, 2014, when the ACA requirement to have health insurance went into effect.

According to Dr. Michael Gerardi, president of the American College of Emergency Physicians,”The reliance on emergency care remains stronger than ever. It’s the only place that’s open 24/7, and we never turn anyone away.

More people getting access to necessary medical care is a good thing, but seventy percent of physicians surveyed are concerned that their emergency departments are ill-equipped to handle this increased patient volume. Over a third of those surveyed even reported that they’d considered leaving the profession.

Dr. Christian Balldin, board certified orthopedic surgeon and sports medicine specialist with The San Antonio Orthopaedic Group, was interviewed by 1200 WOAI Radio on why an increased reliance on emergency medicine isn’t necessarily a good thing.

According to Dr. Balldin, part of the problem is “lack of information on the patient’s part that they shouldn’t go to the emergency room for routine medical care.” People who have never had medical insurance before may not realize that the ER is by far the most expensive place to seek care and 24/7 availability should not be the reason to choose to be seen there. WebMD explains how to tell when to go to the ER.

Another issue is timely access to care. Patients on Medicaid or exchange health plans may have difficulty finding physicians and specialists who will accept their insurance. With very limited networks, even if an in-network doctor is found, there may be a long wait to get an appointment.

If you need to seek medical care, consider the best place to seek that care. True emergencies should be handled by the ER, but other issues could wait for a doctor’s appointment or be treated after hours by an urgent care center, minor emergency clinic, or a specialty walk-in clinic like the OrthoNow Injury Clinic. If in-network coverage is an issue, consider asking facilities about cash rates for out-of-network patients, which sometimes can be less expensive than in-network rates, especially if you have a high deductible health insurance plan.

TSAOG Celebrates National Athletic Training Month 2015

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It’s National Athletic Training Month and a perfect time to acknowledge the contributions of athletic trainers as an important part of the sports medicine healthcare team.

TSAOG would like to give a special shout out to our fantastic athletic trainers, Bryan Meyenberg, MA, ATC, LAT and Dallas Rainer, BS, ATC, LAT. These talented ATs work in conjunction with our sports medicine specialty trained orthopedic surgeons to provide coverage and support for athletic organizations in and around San Antonio, from middle school sports to community events up to the San Antonio Scorpions.

According to Dr. Brad Tolin, one of TSAOG’s sports medicine specialists, “Athletic trainers are an essential part of a Sports Medicine team. They are typically the first to evaluate an injured athlete on the field. Their skill, knowledge, and close working relationship with an Orthopaedic surgeon are integral elements to successfully caring for the athlete.  At TSAOG, we are fortunate to work closely with outstanding athletic trainers at the professional, collegiate, and high school levels.”

Athletic trainers are healthcare professionals who specialize in the prevention, evaluation, treatment, and rehabilitation of athletic injuries. To learn more about athletic trainers and what they do, visit the National Athletic Trainer’s Association webpage.

Do you need Athletic Trainer coverage for your team or sporting event? Learn more here:

Preventing Common Soccer Injuries (VIDEO)

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Sports medicine specialist and team physician for the San Antonio Scorpions Dr. Christian Balldin appeared on Great Day SA yesterday to discuss soccer safety and things players and parents can do to prevent common injuries. Watch the full interview below:

Video Courtesy Great Day SA~

Interest in soccer has been growing in the US in recent years. It’s a sport where you don’t need a lot of equipment to play, just a ball and some shin guards to protect your shin bones (tibias) from injury.

However, one of the most common injuries in soccer is not a contact injury at all, but an injury that occurs to the knee when pivoting or changing direction. These are called Anterior Cruciate Ligament (ACL) tears. Learn more about ACL injuries and how to prevent them.

In the video above, Stephanie Nino, lead physical therapist at TSAOG’s Medical Center office and team physical therapist for the San Antonio Scorpions, demonstrates exercises that you can perform to give your body better motion control for knee movements, which can reduce your risk of ACL tears and other knee injuries. 

Educating our community on how to prevent common injuries (as well as treating them when they occur) is one more way TSAOG makes your health our mission.

Could Your Team’s Super Bowl Loss Affect Your Knees?

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Root for your team in the Super Bowl this Sunday. Make sure you cheer hard because a loss could cause increased binge eating this weekend.  

A recent study showed that the populations of NFL cities whose team lost the Super Bowl consumed more calories and fat the day after a Super Bowl loss. The amount of calories consumed by Americans while watching the game is also staggering. Over 30 million pounds of snacks, including over 11 million pounds of potato chips and 90 million chicken wings, are estimated to be consumed on Super Bowl Sunday annually.  
The Super Bowl party is a great event and a celebration of the American passion of football.  However, there is a potential price to be paid in joint health if the effects of the party are not addressed.

Increasing body weight can lead to increased pain in the joints (especially lower extremity joints like the knee and ankle).  Studies have shown that overweight patients with knee pain experience a measurable decrease in pain as they lose weight in 10 pound increments.  The causes of knee pain include arthritis and injuries (such as tears of the cartilage, meniscus, and ligaments).  The pain associated with these conditions can be increased if your weight is significantly above your ideal body weight.

What can you do about knee pain?

  • Maintain your fitness and optimize your body weight.
  • Avoid stressful situations for your knee, such as heavy lifting and repetitive stress, if it is in pain.
  • Work on increasing the strength and flexibility of the knee joint.  A strong and flexible joint has a much better chance to resist abnormal forces and control pain.
  • Seek medical advice about your condition if it fails to improve.
  • Have your team win the Super Bowl?  Sure, it makes it more fun, but it may also lead to less binge eating the day after the game.

If your knee pain persists after a trial of reasonable measures to improve it, you should consider seeking professional evaluation of your knee.  There are many treatments that can assist in recovery and improve the outcome of your knee.  Advances such as minimally invasive arthroscopic surgery, injections targeted for treatment, and even stem cell therapy can improve knee pain and increase function.

S. Josh Bell, M.D.Dr. Josh Bell is a board certified orthopedic surgeon and sports medicine specialist with The San Antonio Orthopaedic Group. He treats all sports-related injuries and conditions of the shoulder, hip, knee, and ankle for patients aged 11 years and older. His special interests include sports injuries, total hip replacement, and arthroscopic surgery. To schedule an appointment with Dr. Bell, please call 210.281.9595 or request an appointment online.

Happy Retirement, Dr. Gonzalez!

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Dr. David M. Gonzalez will be retiring from private practice, effective February 28th, 2015. 

According to Dr. Stephen S. Burkhart, “Dr. Gonzalez served more than 21 years in the United States Army, retiring as a Colonel before he joined our group in 2001. He served as Chief of Orthopaedics in various assignments during his Army career from Ft. Hood to Seoul, Korea, as well as the 93rd Evacuation Hospital in Saudi Arabia during Operation Desert Storm. Since joining, Dr. Gonzalez has been a strong supportive member of our group and was instrumental in paving the way for our group on the implementation of electronic medical records and the development of our ancillary services. On behalf of the group, we send him best wishes in his well-deserved second retirement and hope you will do the same.

As of March 1st, 2015, Dr. Ronald W. Connor will be taking over Dr. Gonzalez’s practice. Current patients of Dr. Gonzalez will have the option of transferring their care to Dr. Connor, another TSAOG physician, or any other physician of their choice. If you are a current patient with Dr. Gonzalez and have any questions about your medical records or continued care, please call our main office at (210) 804-5400.

Dr. Gonzalez has been a part of the TSAOG family for the past 14 years and he will be missed. Happy retirement, Dr. Gonzalez!

TSAOG Congratulates Our Texas Super Doctors® 2014

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The following five TSAOG physicians were recently featured in Texas Super Doctors® 2014, which appeared in the December 2014 issue of TexasMonthly magazine:

The Super Doctors® list identifies top physicians in over 40 specialty areas, as selected by their peers and independent research conducted by Key Professional Media.

Dr. Brad S. Tolin received additional recognition this year as part of the Texas Super Doctors® Hall of Fame since he has been listed as in Texas Super Doctors® for 10 consecutive years!   

Congratulations to all our TSAOG Texas Super Doctors® 2014!

TSAOG Customer Survey Highlights – December 2014

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When our patients have something nice to say about us, we like to brag about it! Please enjoy some of the highlights from TSAOG’s December 2014 Customer Survey:

  • “Well organized and on time. I was very pleased with Dr. Balldin’s assessment and treatment plan and his answers to my questions”
  • Dr Bell and his staff always addressed each patient by name and treated individuals with warmth and compassion. Over the last year I never waited more than 10 minutes to see Dr Bell and for most of my appointments he was right on time.”
  • “[I liked] that there are multiple docs under one roof whose specialties overlap and they can collaborate.”
  • “[Dr. Brenman] and his nursing staff are always super efficient and even though I know they see a huge amount of patients they offer me really personalized care.”
  • Dr. Brown is extremely knowledgeable and explains procedures and options well, and PA Rice has been very helpful and thorough.”
  • “I never feel like I am in an assembly line like I have when I am a patient in other practices.”
  • Dr. Burkhart gave me my life back by successfully operating on my rotator cuff injury. No more pain and can do anything I did before the surgery. Great Man Dr. Burkhart!”
  • “I don’t like coming to the SAOG only because it means I am injured or starting to fall apart due to age, BUT I like coming to SAOG because I’m cared for very well and am very satisfied with my care and the customer service. Thanks to all of the staff, keep up the great work!” (Dr. Connor)
  • “I was very impressed with how well the office was run overall. There was a calm atmosphere and everyone I encountered was very pleasant.”
  • Dr. Drukker was already my physician, but also a lady in Houston recommended him. He is great!”
  • “Very happy with Dr. Garcia. Also with his regular follow-ups”
  • “I like Dr. Gonzalez and think he is an excellent surgeon and physician.”
  • “Although Dr. Hartzler is listed as a shoulder/ elbow specialist, he agreed to see me regarding my foot/ankle problem. He was very kind and I felt well taken care of.”
  • Radiologist and Leticia (Technician) were awesome. I was nervous and scared and they made me feel at ease and explained everything.”
  • “I was actually surprised at the speed with which I was able to get a new patient appointment.”
  • “Doctors are friendly and listen carefully” (Dr. Hibberd)
  • “Keep up the great work — both the office and the practice seem to run like well-oiled machines, with great resources and availability.”
  • Dr. Hughes listens well, takes my lifestyle into consideration when making recommendations on treatment.”
  • “I have always been able to be seen promptly by my doctor and the staff has always been courteous and professional.” (Dr. Jacobs)
  • “I would like to thank Dr. Kaiser for the wonderful job he did on my knee.”
  • Dr. Kirk was very gentle, patient & explained in great detail everything I needed to know.”
  • “I loved the care I received from Dr. Marx and would highly recommend him to anyone needing surgery.”
  • “Able to get seen quickly, Dr Ochoa is a good guy. I would recommend him to anyone.”
  • “With a complete state of the art facility each and every detail was handled perfectly. An amazing staff and an equally amazing set of doctors. I was completely impressed and 100% pleased!”
  • Dr. Paul Pace and his staff are amazing and I am so thankful to each and every member of his team that were involved in any aspect of my surgery and continued treatment. Thank you thank you thank you”
  • “The doctor shows an interest in my overall well being.” (Dr. Rowland)
  • “The doctors are fully informed in the field of orthopaedics. They offer a storage of information to help me understand my condition and the plan of treatment. They are friendly and make you feel very comfortable.”
  • “It was my first visit with Dr. Rutstein and I was very impressed. She is well informed in her field and had answers to all of my concerns. She took a lot of time to explain and offer suggestions. It was a beautiful experience. Her treatment plan is making a big difference in my condition. “
  • “…chiropractic services help me a lot.” (Dr. Seidel)
  • Dr Taber has a great bedside manner, very professional. I completely trust him with my care”
  • “From the first visit, my care has been exceptional, personalized, and caring. This is the best orthopedic organization I have ever had the honor of using. You have extensively improved my daily functioning and reduced my pain significantly, improving my overall lifestyle.”
  • Dr. Tolin exhibits exceptional patient relations. He is PROFESSIONAL, focused on the patient, and educational. I have never had the superior attention he provides to me.”
  • “Very pleased with all aspects of the hip replacement process. I would and have recommended Dr. Ursone to anyone considering hip or knee replacement. Extremely pleased with the care provided by North Central Baptist Hospital.”
  • “Excellent customer service!” (Dr. Valdez)
  • “Excellent experience. Some of my favorite docs in the past have had poor staff. Not SA Orthopedic! Everyone is top notch!” (Dr. Viroslav)
  • “I know that the good Lord sent me to Dr Woodbury and his staff.”

We encourage you to review and rate your experience with TSAOG.  The next time you visit us, please take the time to fill out our patient survey and you may see one of your comments online the next month! You can also choose to submit a testimonial online anytime

Please note: Spelling and punctuation errors may have been corrected for readability.

Should Your Child Specialize in One Sport?

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Orthopedic surgeon and sports medicine specialist Dr. Robert Hartzler was interviewed this morning by WOAI Radio on safety guidelines for youth sports. Check out the full interview here:

A recent study found strong evidence to support the idea that young athletes should diversify – playing more than one sport, rather than specializing in only one sport. The study determined that young athletes (between the ages of 7 and 18 years) who specialized in only one sport were 1.5 times more likely to sustain an injury and 2.3 times more likely to sustain a serious overuse injury than their more diversified counterparts.

According to Dr. Hartzler, “For most kids it is now recommended to avoid specializing before late adolescence. Most kids in most sports are well served by being a diversified athlete and playing more than one sport.” The reason for this is that younger athletes are still growing their bones and developing their muscles. Putting too much repetitive strain on certain areas of the body without developing others can lead to overuse injuries. “Baseball pitchers, for example, put a very high level of stress on the medial collateral ligaments of the elbow and the shoulder, and over time, those structures will become damaged.

In addition to diversification, it is important to remember that young bodies need a recovery period. A good rule of thumb is that a young athlete should participate in sports no more hours per week than their age in years (i.e. an 8 year old athlete should participate in sports no more than 8 hours per week).

Some other tips to reduce your young athlete’s risk of injury include:

  • Avoid specialization in a particular sport until after puberty. 
  • Take 1-2 days off from sports per week to allow the body and mind to recover.
  • Take at least 1-2 weeks off between seasons.
  • Take at least 2-3 months off from a specific sport during the year.
  • Encourage free play to develop other areas of the body.

HartzlerDr. Robert Hartzler is an orthopedic surgeon, fellowship trained in sports medicine and shoulder and elbow surgery, with The San Antonio Orthopaedic Group. He treats patients aged 6 years and up for any sports-related injury with a special focus on conditions of the shoulder and elbow. To schedule an appointment with Dr. Hartzler, please call 210.281.9595.

Avoid Ladder Falls This Holiday Season

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Orthopaedic surgeon and sports medicine specialist Dr. Christian Balldin was interviewed last week by WOAI Radio about safety precautions for an injury-free holiday season. Check out the full interview:

A new report released by University Health System shows a significant increase in injuries related to falls over the past 5 years and the holidays are a common time for people to fall off ladders while attempting to hang Christmas lights.

According to Dr. Balldin, “We see a number of injuries all the way from significant injuries of the foot to hip fractures and lower back fractures.

When using a ladder for holiday decorations, the National Safety Council recommends you:

  • Always keep 3 points of contact with the ladder (i.e. two feet and one hand).
  • Use a ladder with grips on the feet to avoid slipping.
  • Wear shoes that give you good traction.

If you are uncomfortable on a ladder, the holidays are probably not the best time to push that comfort level and there are other options. There are companies you can hire to hang your Christmas lights for you and the cost is nominal compared to a trip to the emergency room.

Also, if you’re thinking about operating a power tool on a ladder, STOP NOW. Earlier this year, Greg Norman illustrated the dangers of this particular activity when he was injured when his chainsaw slipped while trimming branches.

Dr. Balldin recommends using common sense and caution to stay safe this holiday season. “If you have to think about whether you should do it or not, you probably shouldn’t do it.”

broken bone doctor san antonioDr. Christian Balldin is a board certified orthopaedic surgeon, fellowship trained in sports medicine. He treats patients aged 3 years and up for any sports-related injury as well as conditions of the shoulder, hip, and knee. His special interests include complex knee reconstruction and shoulder arthroscopy. To schedule an appointment with Dr. Balldin, please call 210.281.9595.

Warmer Weather = Higher Risk for Tommy John Surgery?

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Back in May, we looked at the worrisome spike in MLB pitchers undergoing “Tommy John” elbow ligament reconstruction surgery.  There are several risk factors that place pitchers at risk for shoulder and elbow injuries, but one of the most common is throwing too many pitches with too little rest (overuse).   

A new study, published last month in the Orthopaedic Journal of Sports Medicine, investigated whether MLB pitchers from warm weather areas (like Texas) had higher rates of Tommy John surgery than those from cold weather areas.  The results showed that the risk of undergoing Tommy John surgery was 2.3 times higher for pitchers who played high school in warm areas versus cold.  The warm weather pitchers also had surgery at a younger age and after fewer MLB seasons than the cold weather pitchers.

Could this be because kids from warmer climates tend to play more year-around baseball than those from colder climates?  Are our kids at risk of “throwing out” their arms earlier because warm weather leads to more pitches, increasing their chances of overuse injuries?  Since the study did not present specific details on seasons played or innings pitched for these players, we won’t know the answers to these questions until further research is done.

However, this study lends further support to those who advocate for careful monitoring of our young throwers.  Players and parents should know the recommended pitch counts and rest intervals published by the American Sports Medicine Institute and Little League Baseball to help reduce the risk of injury.

HartzlerDr. Robert U. Hartzler is an orthopedic surgeon, fellowship trained in shoulder and elbow surgery. He treats patients aged 6 years and older for any sports-related injury with a focus on conditions of the shoulder and elbow. His special interests include elbow arthroscopy, arthroscopic shoulder reconstruction, and total shoulder replacement. To schedule an appointment with Dr. Hartzler, please call 210.281.9595.


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