DR. DARYL PETERSON, DISCUSSES HOW HEALTH INSURANCE IS AFFECTING THE PRACTICE OF MEDICINE

Legal Lines with Locke Meredith
Darryl Peterson

Mr. Meredith: Hello. I’m Locke Meredith. Please join me on the next Legal Lines. I’m going to have on the show Darryl Peterson. He is in orthopedic surgeon here in Baton Rouge. He also served in the military and graduated from West Point. He is going to talk to us about being an orthopedic surgeon and how health insurance has affected the practice of medicine along with workers comp and many other numerous items. So join us on the next Legal Lines with Doctor Darryl Peterson.

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Mr. Meredith: Welcome to Legal Lines. I’m Locke Meredith and I am very pleased to have on the show Dr. Darryl Peterson. He is in orthopedic physician here in town. Darryl, thank you so much for coming on the show.
Dr. Peterson: Thank you for having me Locke.
Mr. Meredith: Tell the folks a little bit about yourself so they know why they should listen to you.
Dr. Peterson: I am a native of Hammond, Louisiana. I attended college after finishing Hammond High School in the late seventies; I attended the academy at West Point. After that I went on with the U.S Army where I finished medical school and I did an orthopedic residency in San Antonio. I served the last six years of my obligation at Fort Hood, Texas.
Mr. Meredith: You actually served in Desert Storm you were telling me.
Dr. Peterson: For a short time and then came to Baton Rouge in 1998 where I have practiced since.
Mr. Meredith: It’s interesting we were talking. You had four years of college, four years of med school, five years of the residency training, then one year because of your specialty, very interesting. Then you were the Chief Surgeon at the largest Army base in the U.S.
Dr. Peterson: Right. Fort Hood, Texas. Its fifty thousand soldiers and their dependants. It’s located in central Texas. It was a very busy place; you got a lot of experience, and a well managed facility. I was responsible for the largest concentration of American combat power in one place.
Mr. Meredith: You were also telling me that you’ve probably done well over ten thousand surgeries.
Dr. Peterson: Probably yes. As you say, we’ve been trained and it’s been a great process to get there. I tell students all the time when I go talk at their school that you don’t jump from a third grader to doing a surgery. We have a lot of training and experience to get to that point.
Mr. Meredith: It’s amazing. Tell the folks how you decided to become a doctor.
Dr. Peterson: I tell people that when I was growing up in Hammond I lived on my great grandparents little strawberry patch. One day I was with my great grandmother and she gets a call that the neighbors daughter was going into labor. We ran down there with some buckets and towels and I am sitting there watching her help this child come into the world and I know a lot of people are afraid of blood but I was excited.
Mr. Meredith: So a child was born and a doctor was born.
Dr. Peterson: The fire was kindled right there.
Mr. Meredith: Let’s explain to the folks the specializing of the hand surgery. Why did you do that? How does that differentiate you from the other orthopedic guys?
Dr. Peterson: What happens is we all get training, as you said, you go to medical school. Then all physicians are required in order to have specialty training to go on to what’s called residency. Very much like what you see on television shows now, if you watch ER or some the other shows.
Mr. Meredith: I guess its like on the job training?
Dr. Peterson: On the job training. You need that kind of hands on training in order to be able to provide care to the society at large. You can’t learn it all just reading a book. You have to be able to get that experience. In the middle of that training I was exposed to two types of procedures that I thought were fascinating. Construct and complex injuries to the hand and the opportunity to replant several limbs. People who cut off their thumbs or fingers, ya know four years ago that would be the end of your career. Now we have the ability to reattach those and get you back on your same life plan.
Mr. Meredith: That’s amazing. What happens during the residency stage because I think a lot of people think that a new student gets out of school and then he is in there doing surgery? I assume it is a process.
Dr. Peterson: You are exactly right. You are gradually doing more and more procedures and you get exposed to more and more patients and you supervised under a fully trained teacher physician.
Mr. Meredith: In fact, you have taught in the past?
Dr. Peterson: I have done that in past positions correct.
Mr. Meredith: You have been or are currently board certified in six other specialties.
Dr. Peterson: Yes. Specifically when I spent most of my time in Texas. So what happens is you gradually get exposed to more and more procedures as your training process is coming towards it end. By the time you are in your last year you are pretty much functioning almost as you will when you graduate but still under a lot of supervision.
Mr. Meredith: Let’s explain to the folks what an orthopedic physician is compared to a general practitioner or a neurosurgeon.
Dr. Peterson: We basically take deformities of the bones, joints, muscles, tendons and ligaments and we correct them. We do that through surgery or medical treatment or the use of devices. That’s our specialty and that is why you would come to an orthopedic surgeon or seek that. So if you have problems of the bones, joints, ligaments or tendons, sports injuries, injuries on the job or if you have pain or numbness and tingling you should come to an orthopedic surgeon.
Mr. Meredith: Let’s explain to the folks how technology has changed medicine. I know we know have all these machines that have changed the testing and diagnostic systems. Explain that.
Dr. Peterson: We have the ability to diagnosis things we have never seen before. Through MRI’s, CAT Scans, which are a computerized way to look at the body, then with the advent of arthroscopy in the sixties and seventies we can look inside with small incisions for things that we used to make twelve inch incisions when I started my practice. Those are some of the major technical advances. In my practice with hand surgeries the advances with optics we can now repair vessels that are the size of human hair. All of those things we bring to the forefront of our community.
Mr. Meredith: And we have all of that technology here?
Dr. Peterson: We have all of that now.
Mr. Meredith: So the MRI’s and CT scans are really a way to look into the body without having to cut the body open.
Dr. Peterson: Exactly. It’s basically as if you want to travel somewhere and you have to figure out where you want to go. You need the best road map you can get. That’s what they do without having to walk the ground or haven’t been there before. It allows us to save time, save money and most importantly it allows you to get results without as much, we get better results.
Mr. Meredith: You know where you are going because you’ve already seen it.
Dr. Peterson: As being in the military before, it’s the kind of information a combat commander wants before going into war.
Mr. Meredith: Then the arthroscopic component is where you enter the body where years before you would have had to make a huge incision so you could get in with your hand.
Dr. Peterson: Correct. You can see more with the optics than you can with the naked eye because you can get around corners so you can do a better diagnostic check, you can do a better treatment job, and it allows us an opportunity to give the person a better chance of recovery without complications.
Mr. Meredith: Does it have the capacity to magnify the area you are looking at?
Dr. Peterson: It does.
Mr. Meredith: That’s amazing. Let’s continue talking about technology and how it’s affecting the practice on the next segment. This is Locke Meredith with Legal Lines and Dr. Darryl Peterson. We will be right back.

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Mr. Meredith: Welcome back to Legal Lines. I’m Locke Meredith and again I am very pleased to have on the show today Dr. Darryl Peterson. He is an orthopedic surgeon here in Baton Rouge. We were talking about the way that technology has changed the practice. You were giving the example of how you can look inside the body without having to cut it open. Let’s talk about the tools or technology that is now available to repair the damage.
Dr. Peterson: Well we touched on it with the ability to use the optics. Those tools allow us to work that we couldn’t do before without making a larger incision. It’s better in terms of healing for the patient. We have improved optics in our area that allows us to work under a microscope. We can repair vessels as small as two human hairs.
Mr. Meredith: How do you do that? Is it like you are sewing?
Dr. Peterson: You are sewing. It was only the sixties when this technology came to work.
Mr. Meredith: I can’t understand how you can move your hand small enough to suture.
Dr. Peterson: It takes training but you can get that training. That skill is available right here in our market. The other thing about technology is that we have some much better medications available.
Mr. Meredith: That seems to be constantly changing.
Dr. Peterson: We also know that the materials have gotten stronger. Stainless steel has been replaced by titanium. We have titanium rods for large bone fractures, thirty years ago you may have had to stay in the hospital for six to eight weeks if you had a broken bone now you stay for twenty four hours and you are walking on it in a week. The percentage of healing is much better. It’s all because of the size of the metals and the size of healing.
Mr. Meredith: What about the prosthetics and hip replacements?
Dr. Peterson: The materials now a lot of people fear that if you have a hip or knee replacement that you are going to wear it out in a few years, but no. The materials and engineering has become so good that now they are lasting fifteen to twenty years. Sometime in their sixties may just be looking at one time having the surgery and going back to a great lifestyle without pain. The effect of science and technology has really made an impact on what we do.
Mr. Meredith: I assume that is continuing to increase and develop.
Dr. Peterson: Yes.
Mr. Meredith: Explain to folks how the whole Katrina/Rita disaster affected the folks here in Louisiana.
Dr. Peterson: First off here in Baton Rouge it was like anything else there was more people. A large influx of people that showed up at one time with more demand on those high level practices. Secondly, the demand has stayed fairly high, I don’t know specific statistics but for our practice, at least one out of every three new people did not live in the Baton Rouge area before Katrina. Then of course there was the influx of people without health insurance. Which is a real challenge because you are trying to take care of people who before were using the charity system and the charity system isn’t working. It put a demand in both overall numbers and how you get access for those people who need care.
Mr. Meredith: Talk about what you and your medical partners did when Katrina first sent so many people here.
Dr. Peterson: myself and my partners would take people back and take care of them. We made our numbers available to the temporary shelters that were set up. We continued to maintain a relationship with those establishments. One of the biggest things that we did in our practice was recruiting another Orthopedic Surgeon. I then joined a larger group.
Mr. Meredith: As I understand it there were a lot of doctors and healthcare providers that helped with that crisis but we kind of still have a crisis because I had Dr. Bill Cassidy on and as you said it, the charity system is broken. We have so many folks that are uninsured or underinsured what are we going to do?
Dr. Peterson: It’s an interesting concept. Obviously if I had all the answers you would all know my name and I would be famous. I think that the one thing we have to do in our state is we have to decide where do we want the patients to come? Are we going to utilize existing facilities and expand them? Maybe perhaps build a university hospital so that everyone, not just indigent people, want to go there because it provides those quality services. It goes back to quality of care not indigent versus non indigent. Not poor versus payer but quality care.
Mr. Meredith: I guess it boils down to money.
Dr. Peterson: It always boils down to money but it should boil down to leadership and decisions. Once the leadership makes a decision and implements the plan the money will come.
Mr. Meredith: Tell folks when they come to you who makes the best patient?
Dr. Peterson: The best patient is someone who can articulate their problem, who is willing to go through the recommendations that you give them, and who is compliant. Most patients say give me the best treatment you can but I don’t want to do anything.
Mr. Meredith: Darryl, thank you so much for being on the show.
Dr. Peterson: Thank you.
Mr. Meredith: This is Locke Meredith with Legal Lines and Dr. Darryl Peterson. Thank you for being with us.

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