Richard T. Laughlin, M.D., Chair
Department News
Wright State Orthopaedics offers March 19 educational session on plastic surgery at Wright State
Wright State Orthopaedics will offer an educational session on plastic surgery on Tuesday, March 19, at 7 p.m., in the Family Medicine Conference Room in the Wright State Physicians building on the campus of Wright State University (725 University Blvd.). The session, “Plastic Surgery: It Is More Than Just Cosmetics,” is free and open to the public.
Salim N. Mancho, D.O., assistant professor of orthopaedic surgery, division of plastic surgery at the Wright State University Boonshoft School of Medicine, will speak about types of breast reconstruction, pediatric craniofacial surgery and how to safeguard or minimize the complications of cosmetic surgery at the March 19 session.
Mancho completed a craniofacial fellowship at the University of Southern California. He is the chief of craniofacial/pediatric plastic surgery at the Boonshoft School of Medicine.
In addition to the March 19 educational session, Wright State Orthopaedics will offer other sessions on a variety of topics from hip and thigh problems to wrist and hand injuries. These sessions will be offered through May 2013 on the third Tuesday of the month at 7 p.m. in the Family Medicine Conference Room in the Wright State Physicians building at Wright State University. For more information and to register, contact Julie Knauff at jrknauff@mvh.org or (937) 208-2741.
Wright State Orthopaedics offers educational session on shoulder pain on Feb. 19 at Wright State University
Wright State Orthopaedics offered an educational session on shoulder pain on Feb. 19, at Wright State University.
Michael A. Herbenick, M.D., associate professor of orthopaedic surgery, sports medicine and rehabilitation at the Wright State University Boonshoft School of Medicine, spoke about common causes of shoulder pain at the session.
Herbenick is certified by the American Board of Orthopaedic Surgery in orthopaedic surgery and in the orthopaedic sports medicine subspecialty. He is fellowship-trained in sports medicine. He also serves as residency program director and as a team physician for the University of Dayton Flyers.
Wright State Physicians Concussion Clinic opens
Under a new law signed by Gov. John Kasich, beginning this spring coaches and referees will be required to pull young athletes out of practices or games if they show signs or report symptoms of a concussion. They will not be allowed to play until they are cleared by a physician or authorized licensed health care provider.
Locally, these athletes can be seen at the new Wright State Physicians Concussion Clinic on the campus of Wright State University at 725 University Blvd. The clinic is now accepting new patients. Student athletes who are experiencing symptoms of a concussion can call the clinic at (937) 208-2091 for an appointment.
“A concussion is a brain injury resulting in physiologic changes in how the brain works. It is a blow to the head or body that then transmits force to the brain,” said Corey Ellis, M.D., director of the Wright State Physicians Concussion Clinic and assistant professor of orthopaedic surgery, sports medicine and rehabilitation and family medicine. “Even what seems to be a mild bump or blow to the head can be serious and should be evaluated to determine an appropriate treatment plan.”
Wright State Orthopaedics offers educational session on knee pain on Jan. 15
Wright State Orthopaedics offered an educational session on knee pain on Tuesday, Jan. 15. L. Joseph Rubino, III, M.D., associate professor of orthopaedic surgery, sports medicine and rehabilitation at the Wright State University Boonshoft School of Medicine, was the presenter.
Rubino is certified by the American Board of Orthopaedic Surgery in orthopaedic surgery and in the orthopaedic sports medicine subspecialty. He is fellowship-trained in sports medicine. He also serves as director of resident education and as a team physician for Miami University Middletown and the University of Dayton Flyers.
Wright State Orthopaedics will offer more educational sessions on a variety of topics from shoulder and elbow injuries to hip, thigh and knee problems on the third Tuesday of each month, from January through May 2013, at 7 p.m,. in the Family Medicine Conference Room in the Wright State Physicians building (725 University Blvd.). For more information or to register, contact Julie Knauff at jrknauff@mvh.org or (937) 208-2741.
Wright State Orthopaedics to offer public educational sessions beginning Nov. 20
Wright State Orthopaedics is offering public educational sessions on common orthopaedic problems in the Family Medicine Conference Room in the Wright State Physicians building on the campus of Wright State University. The sessions are free and open to the public.
At the first session on Nov. 20, Richard Laughlin, M.D., department chair, spoke about common problems in the adult foot, including tendon problems and soft tissue injury to the foot and ankle. Laughlin is certified by the American Board of Orthopaedic Surgery and has completed fellowships in foot and ankle surgery and musculoskeletal infection. “As faculty in the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation at the Wright State University Boonshoft School of Medicine, we are constantly updating our skills and knowledge, providing you with the latest in orthopaedic care.”
Wright State Orthopaedics will offer more educational sessions on a variety of topics from shoulder and elbow injuries to hip, thigh and knee problems on the third Tuesday of each month, from January through May 2013, at 7 p.m,. in the Family Medicine Conference Room in the Wright State Physicians building (725 University Blvd.). For more information or to register, contact Julie Knauff at jrknauff@mvh.org or (937) 208-2741.
First annual orthopaedic surgery symposium set for Oct. 26
The Department of Orthopaedic Surgery, Sports Medicine & Rehabilitation, in conjunction with Wright State Physicians Orthopaedics & Sports Medicine, will present its first annual orthopaedic surgery symposium, "Current Concepts in Musculoskeletal Care," on Friday, Oct. 26, from 8 a.m. to 4:30 p.m., in the Berry Room of the Nutter Center on Wright State University’s campus. The symposium will detail current best practices for health professionals who care for and come in contact with orthopaedic patients. Presentations will cover the areas of orthopaedic surgery, sports medicine, neurosurgery, pain management, radiology and rheumatology, and how all these specialties interrelate.
“This course will offer all members of the medical and recovery teams information on caring for a wide range of musculoskeletal patients,” said Richard Laughlin, M.D., professor and department chair. “We are inviting all surgeons, physicians, nurses, athletic trainers, physician assistants, family practitioners, residents, medical students and coaches to the symposium.”
Barbara Brush: An Inspiration to Others
Miami Valley Hospital's website features a story about a clinical nurse specialist in orthopedics who had knee replacement surgery performed by Dr. Matthew Lawless, and then underwent triple arthrodesis surgery on her left ankle performed by Dr. Richard Laughlin. (Triple arthrodesis is a procedure that surgically fuses the joints in the foot to relieve arthritis pain or correct structural issues.)
After the surgery and rehabilitation period, Dr. Laughlin “patted me on the shoulder and said that I’m a star patient,” Barbara Brush recalls. “I looked at him and said, ‘Well, I had a star surgeon.’”
Reconstruction for Deformity of the Forefoot Due to Rheumatoid Arthritis
Miami Valley Hospital has published a case study on surgery to address deformity of the foot due to rheumatoid arthritis written by Richard Laughlin, M.D., chair of the Department of Orthopaedic Surgery, Sports Medicine & Rehabilitation. The patient was a 77-year-old woman with a 20-year history of rheumatoid arthritis affecting her feet, hands, knees and hips. She had difficulty wearing shoes due to deformity caused by the condition.
Wright State Physicians building opens, new services available
Wright State Physicians (WSP), the region’s largest multi-specialty group, has opened its new building in the developing northeast corridor of Wright State’s Dayton campus. The new building will provide a convenient place for students, faculty and staff of Wright State University, as well as residents of Clark, Montgomery and Greene counties, to receive medical care. To better serve patients, it also will include Wright Health Pharmacy, CompuNet Clinical Laboratories, and an MRI facility operated by Miami Valley Hospital.
Sports Medicine Symposium features four faculty members
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Drs. Michael D. Barnett Jr., Michael A. Herbenick, Matthew W. Lawless and L. Joseph Rubino III will be presenting at a sports medicine symposium on "Surgical Management of Sports Injuries" to be held at the David H. Ponitz Sinclair Center at Sinclair Community College on Tuesday, Sept. 18. The program is designed especially for those who specialize in and refer to the field of sports medicine, including physicians, nurses, physician assistants and physical therapists. Continuing education credit will be available. The 3rd Annual Sports Medicine Symposium is sponsored by Premier Health Partners and the Sports Medicine Centers at Miami Valley Hospital and Good Samaritan Hospital. For more information or to register, call CareFinders at (866) 608-FIND or visit the Miami Valley Hospital CME website.
Faculty member named co-chair of Operation Smile Burns Program
Michael Johnson, M.D., director of the Plastic Surgery Residency Program and an associate professor of orthopaedic surgery at Boonshoft School of Medicine, was chosen as co-chair of the Operation Smile Burns Program. In this role, Dr. Johnson will work to grow the program and contribute time, effort and his expertise in plastic surgery and burn care to bring much-needed attention to individuals in developing, underserved areas of the world who suffer from correctable burn-related deformities.
Board certified in plastic surgery, Dr. Johnson sees patients at Wright State Physicians in a large plastic surgery practice. He earned his M.D. at the University of Cincinnati College of Medicine, and completed a general surgery residency at Wright State and a plastic surgery residency at Southern Illinois University. He also sees patients at Miami Valley Hospital in Dayton.
Dayton Daily News interviews Dr. Laughlin about summer footwear
Richard T. Laughlin, M.D., chair of the Department of Orthopaedic Surgery and Orthopaedic Surgery Residency Training Program director, was recently interviewed for a Dayton Daily News article on choosing the right summer sandal.
WSU and Premier Health Partners announce clinical research initiative
Wright State University Boonshoft School of Medicine, Wright State Research Institute and Premier Health Partners have formed the Wright State University & Premier Health Partners Clinical Trials Research Alliance to increase medical research opportunities for physicians and clinicians and boost access to clinical trials in the Dayton region.
Wright State Physicians group launches online Patient Portal
Wright State Physicians has partnered with athenahealth® to launch an online portal that gives patients a secure, 24-hour, web-based way to schedule appointments, retrieve test results and communicate with their physicians' offices.
Dr. Ellis presents joint health information at women's health conference
Corey J. Ellis, M.D., presented information about maintaining healthy joints and preventing joint pain and damage at the Speaking of Women's Health Conference held in Dayton on Nov. 5, 2011.
His talk, "Healthy Joints for Life," focused on strategies to help all of us maintain good joint health. Easy things like adding walnuts and fish, high in Omega 3 fatty acids, to our daily diets is one example. He presented other strategies, as well as traditional treatment options for early arthritis and the effectiveness of new non-pharmaceutical treatment options.
Sponsored locally by ThinkTV, Speaking of Women's Health is a nationally recognized conference designed to educate women to make informed decisions about their health, well being and personal safety.
Nov. 16: Free CME Event
Common Upper Extremity Problems Seen in the Primary Care Physician’s Office
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Primary care physicians, internal medicine physicians and orthopaedic surgeons are invited to join Michael A. Herbenick, M.D., and L. Joseph Rubino III, M.D., for an interactive review of commonly seen upper extremity problems in a free Continuing Medical Education presentation on Wednesday evening, Nov. 16, at Bravo Cucina Italiana, 2770 Miamisburg-Centerville Road.
At the conclusion of this CME program, attendees should be able to:
This event is hosted by Miami Valley Hospital, an institution accredited by the Ohio State Medical Association to sponsor continuing medical education for physicians. Miami Valley Hospital designates this educational activity for a maximum of 1.50 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Both Dr. Herbenick and Dr. Rubino are certified by the American Board of Orthopaedic Surgery with subspecialty certification in orthopaedic sports medicine. They both serve as assistant professors in the Department of Orthopaedic Surgery, Sports Medicine & Rehabilitation at Wright State University Boonshoft School of Medicine, and are orthopaedic consultants for University of Dayton Athletics. Dr. Herbenick serves as orthopaedic surgery residency program director, and Dr. Rubino serves as director of resident education.
Sign-in begins at 5:30 p.m., with the presentation from 6 to 7:30 p.m. Advance registration is required. To register, please contact the CME coordinator at Miami Valley Hospital at (937) 208-3851 or e-mail ceclark@mvh.org.
Oct. 5, 2011, CME Event
Heels to Toes — Treatment of Common Foot Ailments in the Primary Care Setting
Michael D. Barnett Jr., M.D., assistant professor of orthopaedic surgery, presented an interactive review of advancements in foot and ankle pathologies to area physicians and medical experts on Wednesday, Oct. 5, at the Beavercreek Golf Club.
Dr. Barnett is a fellowship-trained orthopaedic surgeon with Wright State Orthopaedic Surgery & Sports Medicine. He earned his medical degree from Wright State University Boonshoft School of Medicine and completed his orthopaedic surgery residency training at Akron General Medical Center. Dr. Barnett is certified by the American Board of Orthopaedic Surgery.
At the conclusion of this Continuing Medical Education program, participants were able to:
This event was hosted by Miami Valley Hospital, an institution accredited by the Ohio State Medical Association to sponsor continuing medical education for physicians.
Ground broken for new medical building at Wright State
Wright State Physicians broke ground Tuesday, June 21, on a new medical office building on the Wright State University campus. The new building will offer a full array of physician care, including orthopaedic and sports medicine specialties. Wright State Orthopaedic Surgery, Sports Medicine & Rehabilitation is partnering with Wright State Physicians, Boonshoft School of Medicine and the local community to help area athletes enhance performance while preventing and treating injury as well as to further translational research. Read the news release.
WSU hosts Ohio Orthopaedic Research & Innovation Day!
Wright State University hosted an Ohio Orthopaedic Research and Innovation Day on June 2, 2011. The free event brought together engineers and orthopaedic clinicians and researchers to exchange ideas and foster innovation in orthopaedic devices and spur economic development in Ohio.
Tarun Goswami, D.Sc., of the Department of Biomedical, Industrial & Human Factors Engineering in the WSU College of Engineering and Computer Science, and Richard T. Laughlin, M.D., of the Boonshoft School of Medicine’s Department of Orthopaedic Surgery, Sports Medicine & Rehabilitation, expressed hope that the forum would help develop strong academic and industry partnerships within the state.
Department featured in WSP newsletter
Wright State Physicians featured WSU Orthopaedic Surgery, Sports Medicine & Rehabilitation in its Winter 2011 newsletter. Read the article here.
Sports Symposium held
Area athletic trainers, coaches and primary care physicians attended a Wright State Orthopaedics Sports Symposium July 9, 2010, at Wright State University.
Presentations covered:
- ACL Tears
- Platelet Rich Plasma
- Concussions
- Cervical Spine Trauma
- Rehabilitation of Patellofemoral Stress Syndrome and Insidious Onset Anterior Knee Pain
Wright State undergrads get up-close view of knee surgery
The grinding whir of bone saws and drills filled the air as orthopedic surgeon Matthew W. Lawless, M.D., demonstrated knee-replacement surgery on a set of synthetic bones. Then came the real thing - a taped video of an actual knee operation. All eyes in the class of 50 students were drilled into the screen, watching the flurry of action as clamps, forceps, a chisel and a suction tube worked their surgical magic.
The WSU biomedical engineering class, more than half pre-med students, is taught by Tarun Goswami, D.Sc., who holds a joint appointment in the College of Engineering and Computer Science and the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation. Dr. Lawless, assistant professor of orthopaedic surgery, was peppered with questions from the students following the video.
"Orthopedics is the one discipline where you have the merger of biomedical engineering and surgery," Dr. Goswami said."What I'm trying to do is connect my students with the surgery field so they see what the surgeons are doing and how we can improve the surgical procedures, the instruments, the devices."
- Read more in this news release from Wright State University.
Neck injuries focus of major Wright State research effort
The Spine Research Group in the WSU Department of Biomedical, Industrial and Human Factors Engineering is conducting major cervical-spine research under the direction of Tarun Goswami, D.Sc., who holds a joint appointment in the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation within the Boonshoft School of Medicine. Other group members include medical students Matthew Binkley and Kelly Estes and orthopaedic surgery resident Chris Gayton, M.D., who is looking into the biomechanics of the spine.
- Read more in this news release from Wright State University.
April 2010
Joint Venture - Orthopaedic Trauma
Matthew J. Di Paola, M.D., met with Michael J. Prayson, M.D., to discuss his orthopaedic trauma service at 30 East Apple Street, Suite 2200 in Miami Valley Hospital. Dr. Prayson serves as professor, vice chair, and Orthopaedic Trauma Fellowship director for Wright State Orthopaedic Surgery, Sports Medicine & Rehabilitation. To schedule an appointment with Dr. Prayson, please call (937) 208-2091.
Q: Thanks for meeting with me today to discuss your role in orthopaedic trauma for Joint Ventures. Why don't you start by telling us how you became interested in orthopaedic trauma?
A: Trauma is an intriguing subspecialty because it encompasses a wide variety of injuries - from head to toe. Back in residency training, I had an interest in orthopaedic trauma and decided to pursue additional training in the form of a fellowship. This was an extra year spent focusing on traumatic injuries and related complications. I discovered that I really enjoyed the subspecialty. It is challenging. It can be difficult at times and it keeps you on your toes. I've been doing it for approximately 15 years now in practice and still have a keen interest in staying involved.
Q: Describe some of the challenges of orthopaedic trauma you find on a daily basis.
A: Some of it has to do with volume. We happen to be a very busy trauma center here at Miami Valley Hospital in Dayton, and the volume can sometimes be very difficult to manage. Some would even think of it as overwhelming at times. So that can be challenging on busy days where you're trying to manage multiple patients who come in, sometimes arriving at the hospital in very close proximity to each other. You have to be intimately involved in the process and prioritize the care and management of all polytraumatized patients. Certain types of injuries we treat are also quite complex. Most notable for trauma surgeons are injuries of the pelvis and the hip ball-and-socket joint (acetabulum). Not many orthopaedic surgeons have an interest or proficiency in taking care of those injuries. Additionally, complex injuries such as significantly damaged joints, infections in bone and bones that don't heal the first time around are some of the particular complexities that we face as orthopaedic trauma subspecialists.
Q: What do you find most gratifying about being an orthopaedic trauma surgeon?
A: With trauma, you see very active, very functional people sustain serious injuries and their ability to function changes dramatically. You take them through the process of the initial surgery - but that is only a small part of it. You follow them through afterwards and see their progress and their return to their daily lives and near normal function, and that, I think, is very, very gratifying.
Q: Do you treat specific types of cases more commonly than the average orthopaedic surgeon or do you take a particular interest within trauma? Are there particular areas of the body that you see more commonly?
A: I think for the most part all orthopaedic surgeons are qualified to handle fractures - that's the basis of what we do in orthopaedic surgery. But as a traumatologist, I think your ability to handle more complex fractures - ones that are more splintered, ones that involve the joint surfaces and some areas that I mentioned before, like the pelvic and acetabular regions - certainly those types of injuries fall in the lap of the orthopaedic traumatologist just based on his or her training and proficiency in dealing with those types of fractures.
Q: You attended the American Academy of Orthopaedic Surgeons annual meeting in March. Why is attending that meeting important?
A: The Academy meeting is a large international meeting. It's one of the best-attended meetings of orthopaedic surgeons across the world, and it's a great opportunity for us to get together and focus on the latest research in our field. We have several opportunities throughout the year to do that, and this happens to be one of those meetings where we get that opportunity. Second, Specialty Day is one of the focused opportunities during the meeting. This is one full day devoted to each of the orthopaedic subspecialties and for me that's obviously trauma. There's a chance to get together, meet up with your colleagues in your subspecialty from across the nation and across the world and catch up on how things are going at other trauma centers and what people are doing to advance trauma care.
Q: Dr. Prayson, what does a typical week look like for you?
A: I take a fair amount of the trauma call here, usually about six or seven days per month. Outside of the trauma call structure, on Mondays I'm in the operating room all day performing surgeries. Tuesday we have a clinic that Miami Valley Hospital sponsors that provides care to the uninsured and underinsured - more so than any other hospital in Dayton - and I'm heavily involved in staffing that clinic. Tuesday afternoon is an open time, which I use for surgeries, meetings or research. Wednesday is another surgery day. Thursday I see patients all day in our Wright State Orthopaedic Surgery office at Miami Valley Hospital in Suite 2200. On Fridays, I am back in the operating room for more surgery. On the weekends, a lot of it depends on the trauma call schedule. This weekend for example, I am on call Friday and Sunday so I will be here most of the weekend performing surgeries and rounding on patients in the hospital.
Q: Thank you, Dr. Prayson for taking the time to discuss your area of expertise within our department.
March 2010
Joint Venture - Foot & Ankle
Matthew J. Di Paola, M.D., sat down with Richard T. Laughlin, M.D., to discuss his foot and ankle service at 30 East Apple Street, Suite 2200 in Miami Valley Hospital. Dr. Laughlin serves as professor, chair, residency program director, and foot and ankle service director for Wright State Orthopaedic Surgery, Sports Medicine and Rehabilitation. To schedule an appointment with Dr. Laughlin, please call (937) 208-2091.
Q: Dr. Laughlin, thanks for joining me to kick off our new series - Joint Venture. Joint Venture is going to be a regular communication between our department's surgeons and the community at large. It will provide a more intimate look at what we do on a daily basis and how we think about some of the issues that face us daily. The term Joint Venture is a bit of a play on words in the sense that, we as orthopedic surgeons, treat joint-related problems and endeavor to do so in a combined - or joint - decision-making process with our patients. This process is critical as it underscores the true partnership necessary for the surgeon-patient relationship to function effectively.
You recently became chairman of the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation. Tell us some of your new and unique responsibilities compared to your previous department role.
A: Obviously, being chairman, you take on more administrative duties. The most important part of my job is developing a vision for the department's future. I've been with the department since 1994 and have seen its growth, which gives me a better perspective for charting a course for the future.
Q: The world is becoming more specialized in general and so is medicine - and orthopaedics. Tell us how you got interested in foot and ankle and what drew you to specialize in that.
A: As a resident in the late '80s and early '90s, I didn't have a lot of foot and ankle training - I had an interest in trauma. I noted as we followed up with patients that a lot of the trauma patients had residual foot and ankle problems that were quite debilitating. Often they recovered from their other injuries, while their foot injuries remained a limiting factor to getting them back to full function. I also watched a few orthopaedic surgeons who concentrated on trauma gravitate towards foot and ankle as they got older, which triggered my interest. As I've grown in my career, I've realized quite a lot of foot and ankle problems go untreated - mainly deformity cases such as flat feet or forefoot deformities. Often patients are told nothing can be done for their deformities, so there's a great opportunity to treat these patients. It's become a niche within orthopaedics because the rest of the field has grown so much. Now with joint replacements, surgeons can completely focus their practice in that area without having to deal with foot and ankle.
Q: Is a general orthopaedist able to handle foot and ankle issues, or are there unique anatomic aspects that make it more complex or give you an advantage in specialization?
A: Probably more so than any other spot on the body, the foot is susceptible to many complications - wound healing problems and the swelling that impedes people from getting back into a shoe. With a lot of experience in treating these issues, you can avoid a lot of these complications with good end results.
Q: What is your general patient care philosophy? How do you approach surgical discussions with patients? What do you want them to know before treating a problem operatively or non-operatively?
A: With the foot - this sounds very obvious - but people have to walk. So anything you do to the foot is going to impede their mobility. It is extremely important for patients to understand their underlying pathology or problem. Second, patients must take an active role in their care. The first time I see a patient, I explain their specific problem and get them to start a foot exercise program, possibly some type of shoe modification, or other efforts to make them more comfortable. This helps them to start understanding what is involved in their treatment. With surgery, I think it's really important to educate them on what they can expect after surgery, the length of recovery time and how that's going to affect their daily life.
Q: How important is that pre-operative discussion in their overall patient care? Do you find patients come in with certain expectations that change over time? Is it an educational process?
A: The hardest part is telling patients the magnitude of their specific problem. In general, patients understand - like if someone has knee arthritis and they need a knee replacement, patients generally understand that. That's usually the focus of our discussion. I try to explain their specific problem, but I also spend a lot of time telling them what to expect after surgery. I think patients really need to know how long it's going to take to recover from surgery and what their recovery milestones will be: When can they put weight on their foot? When can they get back to work? When can they get back into a shoe? And, of course, How long do they have to use crutches, a walker or other ambulatory aid? Obviously, these are important milestones that impact their daily life a lot more than someone who has hand surgery or upper extremity surgery who can still walk while protecting their upper extremity.
Q: How many days per week do you operate and see patients in the clinic?
A: I see patients twice a week on Mondays and Wednesdays in our office at Miami Valley Hospital. I spend half a day weekly in an MVH-run multidisciplinary wound clinic and the rest of the time - Tuesdays, Thursdays, and Fridays - I perform surgeries at Miami Valley Hospital or Far Hills Surgical Center.
Q: Thank you for your time, Dr. Laughlin. I appreciate the time spent discussing your specialty and hope people have a better idea of your clinical focus and where to find you.
