Dr. George Douthit on Patient Accountability & Support Systems

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Toree: Howdy, howdy.  I’m Toree McGee, and welcome to The Rapid Recovery Report, sponsored by ROMTech, the modern technology of rehabilitation.  We’re going to be doing these and if you are familiar with our Rapid Recovery Report, then go ahead and fast forward, but we do a regular series here where we talk to different guests.  Sometimes it’s surgeons, sometimes it’s patients, insiders at ROMTech, and we talk about everything, health, wellness.  We also touch on the ROMTech PortableConnect. 

If you are new to the PortableConnect, this little beauty right here that popped up on the screen next to me is our baby.  This is the PortableConnect.  It is a high-tech recovery device that’s geared to get patients moving and on the go to recovering from their injuries and surgeries faster.  If you want to learn a little bit more about us, you can visit us at www.romtech.com and follow our social handles that are in the description below. 

Alabama Expert Orthopedic Surgeon, Dr. George “Butch” Douthit

Toree: Today, we have an awesome guest.  Let’s get right into it.  Dr. Butch Douthit earned his undergrad degree from the University of Alabama Tuscaloosa, and he graduated from the University of Alabama School of Medicine in Birmingham.  He’s a member of some of the most well-known professional organizations in the field, so American Academy of Orthopedic Surgeons, American College of Surgeons is his fellow, Alabama Orthopedic Society, American College of Sports Medicine, a whole mess of stuff.  He is also in the Medical Association of Alabama.  He’s affiliated with practices at Gadsden Regional Medical Center, Riverview Regional Medical Center, and Gadsden Surgery Center, all in Alabama. 

Welcome, Dr. Douthit. 

Dr. Douthit: Thank you assistant.  Great to be here today. 

Toree: Yeah, we’re happy to have you. 

Dr. Douthit: Yes. 

Toree: Let’s get right into our questions.  I understand that you were born and raised in Alabama, and you studied there, and you practiced there too.  How much do you love it in Alabama? 

Dr. Douthit: I just got to say this, it’s roll tide.  Alabama has been my home.  I’m fortunate enough to be able to practice orthopedics in Gadsden, Alabama.  It’s probably about a 30-minute drive where I grew up in Jacksonville, so I really enjoy it.  It’s great.  People are great here.  The weather’s great.  We got the best football in the country. 

Toree: Yeah, well, absolutely.  You knew early on that you wanted to stay in your home state and practice there? 

Dr. Douthit: I did.  I felt like I really enjoy it here.  I have a good relationship with a lot of people in this area.  I felt very comfortable with it.  I was excited to be able to come back to this area and practice orthopedics. 

Toree: I understand that you’re actually opening a new location in your actual hometown, right? 

Dr. Douthit: That’s correct and we’re in the process right now of getting all that arrangement made there, and we’re looking forward to it.  We’re really excited and I know that people over in that area are real excited for us too.

Toree: Well, congratulations.  That is really exciting. 

Dr. Douthit: Thank you.  

Toree: Now, did you have other family members that were in medicine before you that kind of influenced you wanting to get into medicine yourself? 

Dr. Douthit: I did have a great grandfather who was a general practitioner, but other than that, it was just something I really felt like I was called to do. 

Toree: Okay.  What made you pick orthopedics? 

Dr. Douthit: Well, I had a strong background in sports.  I was really involved in sports in high school and in college, and so it just seemed like it was a natural fit for me.  I did have the opportunity to work in the hospital with several surgeons, neurosurgeons, and orthopedic surgeons, but I seem to identify more with the orthopedic surgeons, and just felt like I was a natural fit. 

Toree: Okay.  Clearly, you’re still a big sports fan. 

Dr. Douthit: Absolutely.

Encouraging Patient Responsibility

Toree: Roll tide.  Now, you really believe in holding your patients accountable throughout their entire process, so prep before surgery, during the recovery.  Would you tell us a little bit more about that? 

Dr. Douthit: Yes.  Obviously, it starts way before surgery.  Most of the time, with patients, we see them multiple times probably before we ever get to the point that we discuss having surgery.  Prior to that, we make sure they understand that a big part of the success of this operation is what they go in prepared for. Prepared for surgery.  

If we operate on the knee, oftentimes, their knee may be ready for surgery before they’re actually ready for surgery, so I tell them it’s a big part.  Mentally, you have to go in.  We’re going in here and this is going to be a process.  To be successful, you have to participate in this process.  We try to stress that.  

We try to do a good job in the office prior to that talking explaining surgery.  We offer pre-operative classes at the hospital that go over everything and not only a big part of just what’s going to happen in the operating room but what surrounds the operating room.  Even down to what clothes they need to wear.  We often encourage family participation.  We explain how we use the PortableConnect.  I think that’s a big part of it, yes. 

Toree: Okay, absolutely.  I imagine with it being such a common surgery, oftentimes, people don’t think it’s as big of a deal as it is but it’s still a major surgery. 

Dr. Douthit: It’s a very big, major surgery and we want them to understand this. But in order for this operation to be successful, they have to buy into it, and they have to do their part, and that’s what we try to emphasize. 

Toree: Absolutely.  I mean, you believe that patients and people do better when they’re pushed a little bit before and after surgery, versus a less aggressive approach to rehab.  Is that right? 

Dr. Douthit: Yes.  We try to focus some on the pre-rehab and trying to get them to understand that this is a full participation operation that they need to participate in it, yes. 

Toree: Yeah.  Do people heal faster usually if there’s higher expectations placed on them by their surgeon? 

Dr. Douthit: I think they do, yes.  We try to lay out the expectations of the surgery and I think that we try to tell them.  I often use the phrase and I try to tell them how important this is because it’s always nicer if you’re walking down the road or out walking down the trail, you know where the snakes are, you know what they need to look for and what to be prepared for.  I think that we see that.  The ones that come back for a second operation, having known what to expect the first one, just seemed to do better.  It just makes sense that the more you understand about what we’re doing in the operating room, what we’re trying to accomplish outside the operating room, I just think the better they buy into it and the better outcome we all get. 

Toree: Yeah, that makes sense to me. 

Dr. Douthit: Yes.

Toree: I assume a lot of it’s on a case-to-case basis because if you have somebody who’s having a knee surgery that’s maybe 80 years old and not super active versus somebody who is an athlete, then it’s going to be a little bit different recovery. 

Dr. Douthit: It is, but again, when we’re talking about the patients, we try to involve their families.  Most of them that are 80 years old, we dig into their home situation, who’s going to be there with them.  We encourage them to bring along a coach, someone who there is going to be able to participate in their care to make sure, yes.  

Obviously, some of the younger patients that are motivated back, whether it’s sports, work, or whatever, they have a lot of motivation. But we try to involve as many people, support personnel.  We just think that’s important. 

Dr. Douthit’s Patients on the PortableConnect

Toree: Yeah, it makes sense.  I mean, accountability is important and having that support system is really important too.  We’re really proud and really honored to have you working with us in the PortableConnect.  Can you tell us a little bit about the results for your patients and how that’s been? 

Dr. Douthit: I’ve been using the PortableConnect probably for about 18 months now.  It’s been a great hit from the first.  I can’t tell you the number of patients that just come to me, and said, “This is great.”  They love the PortableConnect.  They said, “Gosh, I wish I would have thought of this.”  A lot of times, we talk to the patient about them, and we just said, “Now, you do realize now that you need to get on this PortableConnect several times a day, and not only that, I’m going to be able to follow you.”  They said, “What?”  I said, “Yes, I have access to my telephone.”  I’ll show them.  I said, “I can pull this up, I can see.” That really gets them involved knowing that they’re going to be accountable for it.  Like I said, I just can’t tell you the number of patients that have come to me and says, “Look, if you ever need me as a testimonial, I’ll be more than happy to talk about this, this is fantastic.”  

A lot of them go back and compare the fact they’ve had previous surgeries and all, and how much they felt like this was really an important part of their surgery. 

Toree: Absolutely.  Well, I’ll get those names and numbers of those patients after this. 

Dr. Douthit: I will do it.  I’ve got a long list of them, yes. 

Toree: Okay, perfect.  Now, you also combine physical therapy with the PortableConnect in your patient’s rehab plan, right? 

Dr. Douthit: I do, yes.  Yes, we do. 

Toree: What’s the best balance that you think you found between the two? 

Dr. Douthit: Depending on the situation here in our practices and depending on the support at home.  A lot of these patients say, “I’ll start out with a PortableConnect,” but sometimes we incorporate home health from the beginning just the first week or two to get the patient, make sure they’re safe at home, and then quickly, we’ll get them to an outpatient setting. We usually substitute this have about two visits a week with outpatients.  

Obviously, a big part of their rehab is from the PortableConnect. We encourage them to use this several days and get on, and so that’s a big part.  We’ve seen a good difference.  I think that’s what we’re seeing in the last 18 months is the transition to the PortableConnect, and how much better our patients have functioned, and it’s really been a success for us. 

Toree: Are your physical therapists a lot happier with patients coming in? 

Dr. Douthit: Agree.  It’s amazing to me that our home health the physical therapist have called back and says, “What are you doing different?  The results seem to be so much better.  Tell me about this.”  They don’t always get to see the PortableConnect, the therapist.  By the time they get to the therapist and see the therapist, they said, “What are you doing different?”  When they realize what we’re doing with the PortableConnect, they say, “I believe in this.”

Robotics and Efficiency

Toree: Good.  We love to hear it, we love to hear it.  Talking about technology, there’s been tremendous innovations over the past several years and one of those major ones is in robotics.  Is robotics something that you use in your process? 

Dr. Douthit: Yes.  I hope it’s okay to say this but we use the Stryker Mako robotics and we’ve been using it about four years now.  It’s just been tremendous success for us.  I don’t know of any robotic surgery that’s failed, not necessarily on my standpoint, but just in general robotic.  I was a little skeptical at first.  I heard about it years ago and I didn’t really buy into it, but since I bought into it, I firmly believe in it.  I just see the difference.  It’s so much more reproducible, and the patients seem to buy into it, so it’s been it’s been a good marriage for us, yes. 

Toree: Good.  It’s always hard, I would imagine, to be like a first adopter of something when you’re not so sure on it yet.  You want to see how it goes first. 

Dr. Douthit: It is, but we all like to see immediate gratification.  I think everyone does.  When you can do a surgery and you can look at the numbers, not only you see and feel, but when you have numbers there to back it up and show, here’s the results of this and how it matches up, it kind of gives you that good feeling and makes a good night’s rest, I’d say. 

Toree: Yeah, that makes sense.  You work in both the hospital and surgery center environment. Now, what do you see as the future for an eventual all surgery center resource for orthopedic surgeries?  Is that a thing? 

Dr. Douthit: Of course.  I may date myself now, but when I started off as an orthopedic resident, I tell patients, we used to keep our total knees in the hospital for 14 days.  They came in the night before surgery.  We worked up the H&P, and have the surgery the next day, and they stayed in the hospital 14 days.  They have their sutures removed, and they went home.  It’s gone from that now to going home the day of surgery. 

I think, over the years, of course, we’ve seen this gradual transition and I think too that COVID taught us a lot and from the fact that we continue to treat patients and get them in the hospital and out of the hospital.  We’ve learned a lot, and I think that’s the way it’s going to be continued from here on out. 

Toree: Okay.  I mean, efficiency is the name of the game, and with efficiency comes just things moving along a lot faster and convenient. 

Dr. Douthit: Obviously, patients don’t want to stay in the hospital any longer than they have to.  I think knowing that they can get out quicker, I think that’s a lot of relief to patients.  They want to be in a home environment and be able to recover at home.  I think it’s a good thing that things are trending this way, and I think they’ll continue to trend this way. 

Toree: Yeah, I do too.  I mean, the Jell-O is good in the hospital and all but you can get that at home, in the comfort of your own bed. 

Dr. Douthit: Yes. 

Preventing Knee Problems While Keeping Active

Toree: You’re pretty active yourself, and a little birdie told me you go to the gym every day at 5:30 in the morning.  Is that right? 

Dr. Douthit: I do.  I’ve been doing this now for probably about 15 years, so I enjoy it.  I like to get up, start my day early, and I feel like by the time most people are rolling over and getting out of bed, I’ve already accomplished something that morning.  It sets the tone.  It doesn’t hurt to stay in a good physical shape and I try to work on that, but it’s just good to feel like I’ve already accomplished something that morning before I get to the hospital. 

Toree: That’s a great way to look at it.  That’s a pretty good advice for lazy people like me who aren’t getting up to go to the gym at 5:30 in the morning. For those who are or those who want to maybe get a little bit more active every day, what advice could you give to protect knees and prevent injury while you’re staying active? 

Dr. Douthit: First of all, if you’ve had problems with your knees before, then you probably need to see someone to get some advice and things.  People may have had certain injuries that predispose them to further problems, arthritic changes down the road, and whether it’s their back, hip, knees, whatever.  There’s certain guidelines.  I think we can give them certain exercises that they might want to participate in, other exercises they may want to avoid and things to try to prevent problems.  

Some of it’s just a little bit of common sense but certainly it doesn’t hurt to have a professional or a trainer or someone to give you some advice.  Certainly, if you have some predisposed to certain problems, things can be an issue for you. 

Toree: Sure.  If you’re like me, listeners and viewers, and you have no idea what you’re doing in the gym, maybe hire a professional to tell you how to do things correctly for the first time. 

Dr. Douthit: I think that’s probably a good way to do, yes. 

The Future of Orthopedics

Toree: I think so, too.  Thank you so much for hanging out with us.  We appreciate your time, and I’ve just got one more question for you, Dr. Douthit. 

Dr. Douthit: Okay.

Toree: What is your hope for the future of orthopedic and patient care

Dr. Douthit: I hope that everything has gotten so in person.  As far as conversations and things, I still think it’s a big part of the interaction between the patients.  I don’t want to see us lose that.  I think it’s just real important that the physicians are able to have a good rapport with their patients.  I do hope that we find ways to continue to keep medicine available to everyone, be able to keep things affordable, especially to the patients.  

I don’t want to see it get to the point that medicine gets rationed because patients can’t afford it.  I think we’ve got a good trend.  I feel like if we can keep on going the way we’re going and keep that relationship with the patient, I think we’d be good.  

I’m excited at what the future may hold.  Like I said, I’ve been practicing now 30 years.  I’ve seen a lot of changes over the years, and a lot of these are good changes.  I’m excited on what’s going to happen in the future. 

Toree: Yeah, absolutely.  Us too.  Well, thank you so much, Dr. Douthit for hanging out with us.  We really appreciate all that you do and all of the great information that you’ve shared with us today. 

Dr. Douthit: Well, thank you.  Like I said, I had a wonderful experience with the PortableConnect and ROMTech.  They’ve  been a great company to work with and I’m excited for the future of this company.  

Toree: Well, thanks so much.  We appreciate it.  Folks, please check out Dr. Douthit at www.northeastorthopedics.com, and all of his contact information and where to find him is going to be in our description box.  Don’t forget to follow us on our website, Facebook, Instagram, and to subscribe to our YouTube channel.  All of that info is below as well. 

Thanks again. Dr. Douthit, and until next time, everybody, stay well and keep moving.  Bye. 

Dr. Douthit: Thank you, thank you, thank you. 

Toree: Of course.

Dr. Douthit: Yes.

Disclaimer: The content discussed on this program is often medical in nature and is used for informational purposes only.  No content discussed should be taken as medical advice.  Please consult your health care professional for any medical questions.

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