DR. AVALLONE STILL LIKES THAT OLD FASHIONED MEDICINE
Dr. John Avallone, DO, an orthopedic surgeon in Yardley, PA is old school. He has been in private practice since 1994 and treated patients at or near the same place in Bucks County, PA since he started.
The LaSalle College High School graduate bristles when asked about how he feels with regards to health care issues and all the fighting going on between the different camps on how it should work.
“We are not a business,” Dr. Avallone said in a recent interview. “That’s my complaint. We should not be a business. Now the problem is you have to run a business so you can have an office, employees, Christmas parties and bonuses, things like that. I think the mistake we make in our field is we need to see this many people in this time frame and I’m an advocate that this pays the bills. However when things slow down in the office, you spend more time with patents, everybody benefits from that. There’s no clock that you have to see so many people in an hour.”
Dr. Avallone is a graduate of the Philadelphia College of Osteopathic Medicine. He completed his Orthopaedic Surgical Residency at Community General Osteopathic Hospital in Harrisburg, Pa.
Dr. Avallone has been part of the staff at St. Mary’s Medical Center in Bucks County for most of his time in practice. He specializes in orthopedic surgery including hip, knee and shoulder replacements.
He says he knows times have changed and the business side of health care is something that will never go away. But Dr. Avallone still wants to hold on to the values that had him fall in love with medicine, in particular orthopedics, when he was a standout running back for the Explorers between 1977-81.
“It’s the mentality of business, especially from the hospital down to us,” Dr. Avallone said. “Because it gets contagious and everybody’s all about business… and I think patients pick it up. I think younger people, the Millennials are used to push-button responses, Google-ing things and finding instant relief, instant answers. That, I think was instigated by this being a business. You can see it in hospitals. The last 25 years, it’s dramatically different in the delivery of care for sure. It is definitely a business.”
Dr. Avallone said the integrity of his role as a professional will always take priority over the bean-counters above him.
“It gets to the point where you have to stick your heels in the ground,” he said. “Unfortunately they carry a big stick ”
Dr. Avallone, like many others in orthopedics, was a student athlete who got hurt, then was drawn towards what the doctors who were treating him were doing and accomplishing with their patients.
“I got hurt a few times and ran across a couple orthopedic surgeons that I kind of bonded with the medicine they were doing,” Dr. Avallone said. “That is what got me hooked into [orthopedics].”
“I come from a father who was a family physician,” Dr. Avallone continued. “So I knew some medical background. I knew I didn’t want to do that, I wanted to get into orthopedics.”
Was he smitten with orthopedics as a youth?
“That’s a good word,” Dr. Avallone said. “You’re sitting around talking to these guys, talking to the trainers, you can see people have surgery and get better…that part was appealing. The helpful part. You saw the disappointment when people blew their knee out, their senior year was over, or they were done for their career…smitten is a great word for it.”
Dr. Avallone was a running back at LaSalle under the coaching of the late John “Tex” Flannery and was good enough to play at the collegiate level. Dr. Avallone played four seasons for Delaware Valley College (now University).
He is an avid Eagles and NFL fan and lists Wilbert Montgomery has his favorite NFL player as well as fullback Marv Hubbard, a three-time Pro-Bowler with Oakland and helped the Raiders win Super Bowl XI.
Dr. Avallone, now 53, says he will always keep his basic surgical skills in tune but embraces all the new technology as well as the vastly improved joint replacement parts manufactured today by companies Zimmer Biomet.
“The advancements are that the incisions are smaller then back in the day,” Dr. Avallone said. “But it’s the equipment and the knee replacement, we have robotics now which are making their footprint in this area of orthopedic joint replacements. Joint replacements have made strives with navigation systems, computerized robotic programs…they’re kind of like a little GPS. There’s a version I’ve been using you can set up that we use that can help us be more accurate in the cutting of the knee. A lot of our results are based on our accuracy. So it’s helping us be more accurate, which obviously helps everybody. That advancements been great.”
Dr. Avallone says he looks back on what orthopedic surgeons has to work with before he entered the arena.
“The equipment…Our forefathers had much less and more inferior equipment than we do,” Dr. Avallone said. “Incisions are seen by the eye, but the proof is in the pudding beneath the skin incision. Pioneer surgeons weren’t at an advantage as we are with the equipment that we have.”
The actual knee and hip replacement part is now so durable and long-lasting, most joint replacement surgeries are now one-and-done operations. People are having it done sooner in life because they know they won’t have to come back in ten or 15 years to have the procedure done over again.
“There are different materials and some of the plastic that we use for hip and knee replacements are coated with vitamin E or impregnated with vitamin E,” he said. “The latest on that is, it looked and sounded like it was going to be a pioneering thing. There’s no literature yet that says this is the Gold Standard…vitamin E. So it is out there and that’s another advantage that has been around for the last decade or so.
“The materials , not alone the vitamin E, but the plastic that we use for these joints is a better grade plastic machine than it was 20 years ago,” Dr. Avallone continued. “Some of the metals are definitely different and available now that they weren’t 15-20 years ago. We use a lot of titanium, ceramic is out there for hips and knees now and we’ve made great strides in replacements to the shoulder joint as well.”
Will it be important for future surgeons to still have the basic skill set to perform surgery old school, no help, even with all the advancements that take the human error out of these important procedures? Dr. Avallone addressed the question about always teaching basics first and to make sure the talent is there.
“I agree personally with that one thousand percent,” Dr. Avallone said. “Because yes, you have to learn the basics first and then rely on those things because relying on those things alone, if you don’t get the certain feel or get the experience of it you may go down a primrose lane, you might get misguided. Obviously you have to know everything.”
Where would Dr. Avallone like to see orthopedics go? Conspiracy Theorists say medicine today is about treating people, not curing people as it is much more profitable to treat people over an over.
“Specifically for joint replacement? It’s the favorite thing I like to do,” Dr. Avallone said. “We dedicated our adult life learning how to do these things. It’s still something we should do when appropriate. It sounds like we’re cutting off our nose to spite our face by saying let’s treat people that are not that arthritic and needing the surgery. I’m alright with that because there are times when joint replacement may not be appropriate because a person may not be healthy enough or motivated enough, or you don’t get the response and the joint replacement goes south, it can be a problem. So it’s (joint replacement) not for everybody, medically, physically or mentally.”
That’s honesty, that’s old school. *