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New Treatments and Diagnostics

Medscape: You have seen so many treatment modalities in other countries during your travels. What have you learned about best practices, and what treatments have you been exposed to that you wouldn't have otherwise?

Beim: When I visit other countries, I am always intermixing with other doctors, sharing stories, learning about what they are doing, and teaching them what I am doing. It is a wonderful way to expand your mind about global medicine.

When I was the CMO at the Pan Am Games in 2011, some clinicians from the U.S. Olympic Committee were using diagnostic musculoskeletal ultrasound. I had read about it but had never really seen it used that much. For instance, the radiology department in my local hospital does not routinely do musculoskeletal ultrasound. When I saw it at the Pan Am Games, I was blown away and immediately hooked by what we could do with this approach. The minute I got back I bought a machine and started training very hard. Now I cannot imagine practicing without it. I don't do any injections without my ultrasound. I have reduced my MRI usage probably by 75% for shoulders -- and shoulder surgery is one of my specialties. It is amazing what you can "see with sound." It is great for the patient. For example: You have somebody with a possible rotator cuff tear. Ordinarily you'd order an MRI, get it preauthorized, wait for it to be scheduled, get it done, and get the patient back in the office to read it. How long are you talking about? If you're lucky, a week -- maybe more. Whereas with the diagnostic ultrasound, you are in the office, and within 5 minutes you can see the tear and show it to the patient. And you have spent about one-third of what an MRI would have cost.

Medscape: And you are using this at the Olympics?

Beim: Oh, yes. We will have two ultrasound machines. I have given talks to other orthopedists, trying to get them excited. Very few are using this technology themselves. It just hasn't become mainstream, and every year these machines get better. There is a learning curve, to be sure, and some doctors may be too busy.

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