Orthopedic Specialists - Kauai
Catherine Shin, MD
3125 Akahi St. Lihue, HI 96766
Introducing the Orthopedic Specialists Kauai blog
http://blog.orthospecialistskauai.com/
You may have heard about a study published in August in the New England Journal of Medicine about how a procedure that is often done on elderly people with compression fractures of the spine may not be any better than sham or fake surgery.
Could that be true? Get the facts in my first post.
I intend to post mostly about medical news that I find interesting or controversial but I also may throw in a few posts about life on Kauai to lighten things up. Hopefully I have time to put something up once a week or so.
Needle Aponeurotomy is available in Kauai!
Dr. Shin recently visited West Palm Beach, FL where she was trained by Dr. Charles Eaton in the technique of percutaneous Dupuytren's contracture release (needle aponeurotomy). This procedure has been performed in Europe for about 30 years but was first done in the U.S. by Dr. Eaton beginning in 2003. She has often thought that subtotal fasciectomy (open excision of diseased Dupuytren's tissue) was a rather inelegant and ugly surgical procedure, although she has done them for several years.
For the appropriate patient, the minimally invasive needle aponeurotomy (NA) procedure can provide significant correction of Dupuytren's deformities without the need for a big open surgical procedure that might require a skin graft or a recovery time of several months. The procedure is done in the office setting under local anesthesia only. If you would like to find out if you are a candidate for this procedure, please call our office at (808) 245-4800 or 384-1822 for an appointment.
Please visit Dr. Eaton's site at http://www.needledup.com/ for more information on the history of the procedure, multiple before and after photos and other infomation. You may also download his needle aponeurotomy patient information brochure here. More information regarding Dupuytren's contracture and treatment options is available it this very helpful patient site www.dupuytren-online.info Here is also an article from the New York Times regarding the procedure.
The local Blue Cross/Blue Shield insurer, HMSA has been very proactive in the adoption of new technologies. If you have a quick question for a doctor, they have partnered with Microsoft Health Vault and American Well to allow you to consult one online 24 hours a day, 7 days a week.
Virtual Housecalls in Hawaii
Illustration: Mike Austin from Honolulu Magazine May 2009
Do you have a question about your orthopedic problem but live way up on the North Shore?
Dr. Shin has signed up for this service and is one of the physicians that may be available for online or phone consultation. You do not have to be insured by HMSA to take advantage of this service, however there is a significant price break if you are. You do have to be a Hawaii state resident (they will check the billing address on your credit card). It is $10 for a 10 minute visit by phone or teleconference if you are an HMSA member and $45 for a non-member. If you need more time, a 5 minute extension adds $5 or $12.50 respectively.
The link to HMSA Online Care is http://consumersonline.hmsa.com/ and a list of frequently asked questions regarding the service is at http://consumersonline.hmsa.com/faq/. Scroll to the bottom for detailed instructions on how to get set up for a video or telephone visit.
If you want to be sure to reach Dr. Shin, you can schedule an online appointment. This is a service that is best used by those who have a quick question since it is impossible to do much of a physical exam and treatment options are limited. A telelmedicine visit can be helpful to find out if a problem is serious, might need further studies (like an MRI) or is worth a trip to the office for an injection.
Dr. Shin is not new to telemedicine. During her orthopedic surgery residency in Texas, she was a physician in several telemedicine clinics that served the inmates of the large and geographically far-flung Texas prison system. The Texas Department of Corrections (TDC) became one of the forerunners in developing telemedicine due to the distances involved and the costly security necessary to transport prisoners across the state to the UTMB-Galveston hospital which held the contract for their healthcare. For more on this, see http://www.polycom.com/global/documents/company/customer_success_stories/healthcare/transforming_telemedicine_in_texas.pdf.
This is the first time, however, that the internet and cheap broadband access have made this kind of access available to a general population with the blessing and coverage of insurance providers.
Here are some other articles on this innovative service for people in Hawaii. So advanced we stay in da islands!
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Connecting to a Physician with HMSA Online Care (from http://customerservice.hmsa.com/)
There are three ways to connect to a physician with HMSA's Online Care:
- Web-based videoconference
- Secure chat
- Telephone
Web-based Videoconference or Secure Chat
- To connect to a physician using Web-based videoconference or secure chat, access HMSA's Online Care through hmsa.com.
- If you are an HMSA member, access HMSA's Online Care through My Account on hmsa.com to receive your discounted rate for HMSA members.
- Once logged on to your Online Care account, select a physician who supports Video Enabled or Web.
- A webcam is required for a videoconference with a physician.
Telephone
- You need to register online for HMSA's Online Care before you can speak with a physician over the phone.
- Once registered, you can request a phone conversation when connected to a physician online or by contacting HMSA's Online Care at 1 (866) 931-HMSA (4672).