Adam Schiff, MD
Orthopedic Surgery and Assistant Professor
Loyola Medicine
Over the last several months, we have been running a series of Q&A sessions with some of the amazing doctors that we have close relationships with. This month we talked to Dr. Adam Schiff of the Loyola Medicine heath system. He is an Orthopedic Surgeon and an Assistant Professor teaching residents. As an avid sports fan and tennis player, Dr. Schiff has extraordinary insights into the world and mindset of all types of athletes.
Achieve: Why did you go into medicine?
Dr. Schiff: I was a high school and college tennis player, so I was exposed to sports medicine in the field. That piqued my interest in orthopedics in general. I saw healthcare as an opportunity to help solve problems by treating patients and getting them back to doing the activities that they want to do. So orthopedics was a natural fit in terms of quality of life type issues, sports medicine, improving patients ability to walk, and all those kinds of things. No one plans to get hurt. No one plans for an accident. No one plans for an injury. These are potentially life-altering events, and I have been through them myself and through family members and friends. I saw orthopedics as a way to be part of that process and be part of a team to help patients get back. I think now, we try to focus on a patient-centered approach. Every patient has different goals and different expectations. I am one part of the team to help patients return from injury, but our team also includes our nurses, the physical therapists, the trainers, and many others. They are all necessary along the way. Someone gets hurt. Someone has to diagnose them. Someone has to start the treatment. Someone has to get them walking. And someone has to get them rehabbed. I view this as my way to be a part of that team to help those patients accomplish their goals and expectations.
Achieve: Explain your passion for sports. Do you still play tennis? Favorite teams to follow?
Dr. Schiff: I was a tennis player through Juniors on the Regional National level. I played collegiate tennis. I still continue to play although the past couple of years has been rough getting older and my abilities are declining quickly, but I still try to play at a competitive level. I am a fan of every and any sport. I love all athletics. I love the psychology that goes into practicing and competing. It’s a thrill to partake in that and to see other people’s perspective and all aspects of sports. I’m a diehard baseball fan. I grew up a Cubs fan. I went to Cleveland for Game 7. Blackhawks fan. Grew up going to Bears games. Those are the 3 big ones, but the Cubs and the Blackhawks kind of make my life go around.
Achieve: How does your knowledge of sports help you with diagnosing patients?
Dr. Schiff: I think the biggest thing is that athletes have a different drive than other people. They have different pressures. External pressures, but also internal pressures. They are driven to try to be the best, and they are hard wired for that level. I think their drive affects them in a competitive way, but that drive also allows them to push themselves to the limit. Both as an individual and for a team. I think that trying to understand and see that mindset is really important in understanding athletes’ problems on how to get better. We treat everyone differently based upon what their goals and expectations are. But athletes have a different drive and different goals than many other people. I think that being part of that lifelong involvement in athletics has allowed me to see and understand their goals. Being and athlete and a fan of sports gives you those inner workings. You also speak the same language, and that makes it easier to relate to. I think for athletes who are mostly younger, being able to talk to someone they can relate to -partially because I was an athlete, partially because I’m a similar age and demographic – makes for a better experience. I don’t think that medicine is paternalistic. I don’t think that we tell people what to do anymore. We now make decisions together as a team. It’s not just the athlete and the doctor. It’s the athlete, their parents, their trainers, their coaches, the therapists. It is everyone making decisions together in athletics. You don’t get that in all aspects of medicine. I think that having someone who they can relate to gives them a level of comfort to really open up about their hopes, dreams, goals, and expectations.
Achieve: Please explain the difference between you and a podiatrist, and what sets you apart?
We both do foot and ankle care. As an orthopedic surgeon, I have the training and the capability of taking care of essentially all injuries. Although I specialize in foot and ankle, particularly foot and ankle sports medicine, I can still do all orthopedics- knees, hips, shoulders, ect. I have had extensive training in all of that. I think those transferable skills help with the foot and ankle very much. Ankle scopes are fairly new, but I am well trained in scoping other joints. There are many skills from other areas of orthopedics that we are able to bring to the foot and ankle to help us be ahead of the game. Being an orthopedic surgeon gives me a multidisciplinary approach to foot and ankle care.
Achieve: Being a part of Loyola’s outstanding network of doctors and staff, how does this help you better diagnose and treat patients?
Dr. Schiff: The key to being part of a health system, like Loyola, is our multidisciplinary team approach. I think that diagnoses and treatment is not for only one person. It really takes a team, and we have several foot and ankle surgeons that we are able to discuss cases between and utilize each other’s skills. Our team provides comprehensive foot and ankle care including everything from fracture work to sports medicine to bunions to reconstructive surgery to ankle replacement. There is not a foot and ankle problem that we do not take care of. My particular interests are sports medicine and reconstruction, but our team does everything. We have musculoskeletal radiologists that we can rely on for specialized imaging. We have musculoskeletal pathologists that we can use. We have a team nature approach, so almost all of our surgeries and diagnoses are run by multiple people. We are always able to get multiple opinions. For our athletes, we aren’t just focused on getting them back to their sport today. We know the whole life cycle of foot and ankle problems, and we know what happens to injuries long term. So, we are looking to take care and prevent those things down the road as well. Likewise, the fundamental care is still a team approach which is why patients who go to Achieve still receive that team approach. That is why we have such a great relationship because we have this ability to communicate about patients. Together we are able to provide that team approach to their care. That is what I think is really important in sports medicine.
Achieve: In your opinion, what has been the greatest changes in diagnosis, conservative, and surgical treatments for the foot and ankle?
Dr. Schiff: Our ability to do faster on the spot diagnosis. The ability to get imaging faster. The ability to communicate. We can do concussion tests on the phone. It is urgency of care. I think the conservative changes are the aggressive approach to rehabilitation. There were a lot of things that we were not able to treat non-surgically in the past that we can now because we are now able to get patients to do good, effective, faster rehabilitation programs to get athletes back to play. On the surgical side, it is the minimally invasive surgery. With smaller incisions, the less scar tissue one will have. I do Achilles tendon surgeries minimally invasive or almost percutaneously. The ability to do the same surgeries as in the past but through smaller incisions with stronger implants is getting more advanced every year, and I think that is the biggest difference. Also, ankle replacements are one of the most exciting things going on with foot and ankle these days. That huge jump that we have made in the last 5 years is our ability to now do ankle replacements successfully.
Achieve: How do you keep up with all the new technologies and advancements that are up and coming in the medical field?
Dr. Schiff: I read a lot! I am a member of the AAOS, American Academy of Orthopedic Surgeons. I am a member of the American Orthopedic Foot and Ankle Society. Through these opportunities is a chance for us to share our knowledge with our colleagues. Most importantly, I work for an academic medical center. We are the cutting edge of care. We are the ones who sort of push the envelope in terms of our treatment options. Teaching residents forces me to stay up to date on everything. I have to answer not only to patients; but also to residents. Being part of an academic medical center holds you accountable to all these things.
Achieve: From diagnosis to intervention to rehabilitation, how do you work physical therapy into your recovery protocols?
Dr. Schiff: I think that physical therapy is essential to every aspect of foot and ankle care. I think that therapy before surgery is often necessary to help patients recover from surgery faster. In foot and ankle, it is unique that a lot of times the patient can’t walk for a time after being non-weight bearing. Being able to get around, for athletes in particular, while not losing function as they recover from surgery is important, so that is why we start them with physical therapy immediately. They can work on everything else- their other leg, their arms, their thigh, their knee- to make their recovery from a foot and ankle surgery faster. Everything from gait training to strengthening to proprioception to actually being able to go back out there and compete, everything needs to be monitored, changed, and pushed in the right way, and physical therapy is the essence of that. That is why I think physical therapy is crucial in recovering from foot and ankle injuries.