Keeping Women Moving

Introducing a new care model to keep women of all ages and activity levels healthy and moving: The Women’s Center for Motion and Performance at UConn Health offers coordinated expertise across specialties, guided by a nurse navigator to ensure the most efficient service. Hear more from Dr. Katherine Coyner, the director, and Dr. Allison Schafer, the medical director, both from UConn Health Orthopedics and Sports Medicine.

(Dr. Katherine Coyner, Dr. Allison Schafer, Chris DeFrancesco, April 2024)

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Transcript

Chris: It’s a new approach to women’s mobility: a coordination of all kinds of services under the collective known as the Women’s Center for Motion and Performance, and it’s only at UConn Health.

This is the UConn Health Pulse, a podcast to help you get to know UConn Health and its people a little better, and ideally leave you with some health information you’ll find useful.

I’m Chris DeFrancesco. From orthopedics and sports medicine, to physical therapy, to other services you may not immediately think of when it comes to motion and performance, like psychology, lifestyle medicine, or neurology, UConn Health is coordinating all its available services to offer women a full range of care.

There’s a whole lot involved, so we’ve asked some leaders from the Women’s Center for Motion and Performance at UConn Health to come in and tell us more about it. Today we have Dr. Katherine Coyner, who’s the director of the Women’s Center for Motion and Performance at UConn Health, — you’re an orthopedic surgeon — and Dr. Allison Schafer, the medical director — and you specialize in primary care sports medicine — both from UConn Health’s Department of Orthopedics and Sports Medicine. Thank you both for being here.

Dr. Coyner: Thanks, Chris.

Chris: Now that we’ve got all those introductions out of the way, so we’re launching the Women’s Center for Motion and Performance at UConn Health. What specifically is it about women that has us here?

Dr. Coyner: This is super exciting and we’re really excited to be here today to share this exciting initiative. And basically what we’re doing is we’re creating a center of excellence to treat women of all ages and activity levels with sort of their musculoskeletal complaints.

An interesting thing about women is, Both Dr. Schafer and I are former college athletes, and that doesn’t mean that you need to necessarily even be an athlete to be seen by us, but women have some musculoskeletal issues that are more common. ACL tears are nearly eight times more common than in our male counterparts. Arthritis, patellofemoral instability, and that list goes on and on and on.

The second thing is that, you know, with our research, we know that women typically make the medical decisions in households. So we want to offer physicians that look like the people that need appointments.

And then lastly, our population is nearly 50 percent women. And we really, as this population continues to increase, we need to offer health care solutions that meet their unique requirements. And I think, with the group that we’ve assembled, we really can accommodate all patients and have a comfort level that patients are going to feel well supported here.

Chris: So this is for athletes, as you mentioned, but it’s not just for athletes. Tell me who the candidates are for the Women’s Center for Motion and Performance at UConn Health: age ranges, lifestyle, those kinds of things, activity level.

Dr. Coyner: Dr. Schafer and I are both super fortunate we get to take care of amazing athletes in UConn Athletics and we, leveraging our knowledge and experience there, we’re transitioning to being able to treat everybody.

At UConn and UConn Health, we’ve always prioritized female athletes. But what I think the general population may not know is, we have all these resources right here at UConn Health to treat everybody, and that patient that we’re targeting is women of all ages and activity levels that just want to either stay active or become active. And we’re going to help them through that journey, if they’re having musculoskeletal complaints, and to be able to further their ability to perform at whatever they want. So it’s very intentional for us not to just focus on athletes. This is active women of all ages.

Chris: Let’s talk a little bit about the specialties that are involved here. We’ll start with yours. So Dr. Schafer, you’re involved in primary care sports medicine, which has a distinction within the realm of sports medicine. Tell us a little bit about that.

Dr. Schafer: Absolutely. So in primary care sports medicine, we first become primary care doctors before we get specialized training in musculoskeletal conditions. So in addition to being able to treat somebody nonoperatively for their shoulder or knee pain, we can also provide a specialized care and things like exercise prescription or how to stay active during pregnancy, a common female disorder being stress injuries and stress fractures are things that often need  a multidisciplinary approach, so we have this specialized training in some of those areas. more primary care-based conditions.

Chris: And Dr. Coyner, you’re a good old-fashioned orthopedic surgeon.

Dr. Coyner: Yes, but I need everybody else around me. And Dr. Schafer and I share a lot of patients, but just to her point about, say an athlete or any person with a stress injury, they not only need her care, but then they also need potentially somebody from psychology to help with the mental aspect of that, and then potentially if there’s an eating component to that, how we can better fuel them so that this doesn’t happen again.

From my side as an orthopedic surgeon, yes, I get to operate and I do a lot of ACLs, but down that is, we also need physical therapy to rehab those patients. But even after the true physical therapy journey is sort of over and has come to a conclusion, we have that next step where they still need to train and get back to sports.

And then, you know, there is a fear of re-injury for a lot of people recovering from any injury. It doesn’t have to just be  athletes. Again, I don’t want to focus on that because this is way more than just the the athletic population. But then having psychology services and being able to have a nurse navigator walk the patient through this journey is what’s different about what we have always offered at UConn Health, and really what I would challenge that no one else is offering in the state of Connecticut, that we now have a nurse navigator that’s going to see these patients through the journey to their whatever their goal they have personally identified as, and it’s going to be specialized, personalized care, that they’re going to feel motivated and supported, and nothing is going to fall through the cracks.

Chris: Now the fact that you have a nurse navigator — just by definition to help the patient navigate through, because there’s a lot of prospective turns and twists that could be taken from entry point to care because of all the different services involved, so we’ll talk about the navigator specifically in a second — but let’s talk about a few more of the other services that are kind of under this umbrella. Again, most of them are here at UConn Health already, if not all of them, I would imagine, right? But now they’re kind of more organized and more of a collaborative way to deliver this care, make it a little easier for the patient to find her way through?

Dr. Schafer: Absolutely. So we’ve partnered with multiple subspecialties throughout the health center, including physical therapy as previously mentioned, but also neurology, osteoporosis and bone health, internal medicine, specifically the lifestyle medicine providers here. We are also partnering with psychology and our behavioral health colleagues to make sure the mental aspect of recovery and staying active is also addressed, and then of course, nutritional services as well. And that again is where our nurse navigator becomes so instrumental because as we schedule patient appointments in these different subspecialties, sometimes it can get very confusing why they’re going certain places. Sometimes it can be difficult to keep track of your appointments. So our nurse navigator is really going to help see them through each of these subspecialties. And I think one thing that’s great is we are all really working together. So instead of patients feeling like they go to one doctor and their other doctor doesn’t know really what’s going on with their care, we’re all integrated in this system to really provide this seamless, cohesive care plan for our patients.

Chris: I wonder if it would be helpful to try to do like a hypothetical, for example, right? Like you have a woman who comes in and needs some kind of surgical repair. So she’s going to end up with you to do the surgery to maybe repair the ACL, but maybe some examples of some things that may come after that?

Dr. Coyner: So our current model, I would consider it to be somewhat fragmented; they would come and see me, and then I would determine that they need surgery. I would then just recommend that they go do physical therapy without a lot of guidance. And in this model, in that step alone, they would be sort of, there would already be a held spot for them in physical therapy, so they could get plugged right in. There wouldn’t be a delay. The communication is constant between us and the physical therapist. And then simultaneously, say that I’ve identified through our prescreening questionnaire that maybe there is some mental health in regards to going back to work or how are they going to do the necessary requirements in their everyday life as mothers and as wives and people going to school, so our nurse navigator could help through some of those, get them to potentially psychology if they needed it.

Also, if we identified any other nutritional aspects, we could get them plugged into nutrition. And then once they’ve sort of so-called graduated from physical therapy, there is still, that’s where we can collaborate with the Institute of Sports Medicine and have a more performance arm to this, and then ultimately doing a functional test to get them back from a recovery and get them back to sport.

But again, I think focusing on other patients that may not be true athletes, so, people in the 30s to 60 years of age, either they are active and they have a complaint or if they want to get active, but just don’t really know what that kickstarter is to get them there. And I think those are the other things that we can really intervene in a different way than what we have historically. And mainly by being efficient for the patient, we want them to get to the correct provider the first time, so they are heard and they’re listened to, and they don’t feel like they’re wasting time with a provider that can’t necessarily offer them the services.

Dr. Schafer: And I think so many of us have been in this situation, where we’ve been active at one point in our life and then because of whatever situation we become inactive and something happens, and you make the decision to get back at it and maybe you have a small injury, you strain your shoulder, you hurt your knee. And it is so depressing, for lack of better term, in your journey back to fitness. So we’re really trying to harness these patients and make sure we’re providing them everything they need to get back and be active. And I think that’s the nice thing about this care model. It’s so easy to go to one appointment, but it’s hard with people’s busy schedules to make multiple appointments, so making it convenient and efficient for these women, who are probably so busy in their day to day life, to make sure they continue their health journey in a positive way.

Chris: I would imagine that as this gets up and running, you’ll see a reasonable amount of, I would say, older women, due to the fact that the conventional wisdom, as a layperson like me understands it, that the more exercise you do, the more muscle mass and bone mass you maintain, the better off you’re going to be as you age, and it might be a way to encourage those women to stay active. If they previously had a challenge, like you just described, Dr. Schafer, is like overcoming that and staying active. Because if even the psychological part that you mentioned, if you’re worried about reinjuring yourself at any age and that prevents you from exercising, you’re sending yourself down a trajectory for the rest of your life that is probably not favorable.

Dr. Coyner: Absolutely. We couldn’t agree with you more. And we were very intentional with our naming. We are sports doctors through and through, but we went with “Women’s Center for Motion and Performance” to make sure that it was a catch-all because we don’t, we’re not just trying to treat athletes. We see that already, we get to take care of amazing athletes. We’re here just to help people and their outcomes and whatever they identify their goals are, that’s what we want them to achieve.

Dr. Schafer: Absolutely. Anything from being able to pick up their grandchild, throw a baseball with their son as they move through high school, all of those things are equally important as getting a high school player back on the court for their senior game.

Chris: So in the couple minutes we have left, let’s talk about the navigator’s role in this now. We’ve talked about the navigator briefly. It’s going to help the patient kind of find her way through all the different directions that can be taken with this care model. That person then is the gateway to the service, I would imagine. And do we start, does the patient start by calling her?

Dr. Coyner: Yeah, so there’s a few options that patients can get in. We have a direct line. It’s 860-679-6330, and that will be answered by our nurse navigator. She’ll then be triaged and gotten to the appropriate provider, and that’s where the journey starts. The navigator will then have periodic touchpoints, she’ll have a dashboard making sure the patients are getting the appropriate appointments and help facilitate that.

And then the second thing is, we are absolutely expanding this beyond just UConn Health and outside referrals of people that want to come to UConn for our specialty and specialized care of women patients overall. I think it will be in a really an exciting time for us as we continue to grow.

And then the third option is that that we have an orthopedic call center, which those patients, when they call there, if they identify themselves as a women’s center patient, that will be triaged also by our nurse navigator. So there’s lots of ways to get involved and come see us.

Chris: So it sounds like our job now is to spread the word, right? Let people know here at UConn Health and our own patient population and the community as well, just like, “This is what your patient will get by coming here for these types of services.”

What else, if anything, should the community know or prospective patients know?

Dr. Coyner: I would say that the last thing that we want people to know is we want to be involved in the community. So we do have an additional sort of pillar, per se, is that we have education. We have a lot of programs for high school female students, and with me being an orthopedic surgeon, which is — a very small part of orthopedics is female — sort of exposing them to more male-dominated occupations, such as orthopedics and engineering. So that will continue the pipeline. Current to date, we’ve trained over 900 high school girls here at UConn Health with these programs, and, and it’s “Inspiring Women in Engineering and Medicine.”

And then also, for example, we’re going to be at the the half marathon coming to town in Simsbury. So come find us at the booth and come find what we’re all about.

Chris: And I’m glad you brought up the marathon in Simsbury. That reminds me, Simsbury is one of the places other than main campus in Farmington where you will have a presence for this.

Dr. Schafer: Absolutely. So we will be seeing patients in Simsbury, Farmington, and Southington, with providers that are all part of the Women’s Center for Motion and Performance.

Chris: Fantastic. OK, and again, it’s 860-679-6330. We’ll put all the other information in the show notes. That is the time we have for today. Dr. Katherine Coyner and Dr. Alison Schafer from UConn Orthopedics and Sports Medicine, Dr. Coyner is director and Dr. Schafer is medical director of the Women’s Center for Motion and Performance at UConn Health.

For Dr. Coyner and Dr. Schafer, I’m Chris DeFrancesco. Thank you for listening to the UConn Health Pulse. Be sure to subscribe so you can catch us next time, and please share with a friend.