Orthopaedic & Fracture Clinic P.A.

September 1, 1999 Daniel Vance

Please forgive Dr. Wynn Kearney, Jr., senior partner and president at Orthopaedic & Fracture Clinic P.A. (OFC), if he seems preoccupied with the future.

For thirty years his specialty has been in a state of constant flux, and the next thirty won’t be any different. He doesn’t know yet whether OFC’s Mankato office will expand on-site, out to land on the outskirts of Mankato, or over to Immanuel St. Joseph’s Mayo Hospital. And there’s more: demand for OFC’s services has increased so much it recently had to thoroughly and tirelessly search for a new physician with the “right stuff.” Other exhaustive recruitment forays are on the horizon.

Dr. Paul Gislason founded OFC in 1957, at a time when family practitioners were handling most bone fractures. To survive he had to create a market niche. “Paul built his practice on laminectomies,” said Dr. Kearney while resting cross-legged in a conference room at OFC’s Holly Lane headquarters in Mankato. “It was a unique procedure family practitioners couldn’t offer. No one in this area did them.” A laminectomy is a specialized back surgery that removes a ruptured disk.

“[Dr.] Paul [Gislason], and his first partner, Dr. Don Meredith, were outstanding spinal surgeons,” said Kearney, a Northwestern University Medical School graduate.

In the early ’70s, OFC created another niche by being on the cutting edge of orthopaedic surgery again. “I was on the team that performed the first total knee joint operation anywhere in the U.S. when I was at Mayo,” added Kearney. “Then in 1972, after completing my residency, I came here and performed the first total knee joint operation ever at OFC. Since then we’ve done nearly 6,000 total joint replacements.” About the same time, OFC began replacing other joints, including shoulders and elbows, but it’s the hip and knee operations that are most in demand.

In 1974 OFC’s four surgeons were the only orthopaedic surgeons in southern Minnesota outside the Metro or Rochester areas. But that changed over time. Currently there are 22 orthopaedic surgeons in south-central Minnesota alone eleven with OFC and eleven others. OFC has about 100 employees and four main sites: Mankato, Faribault, Owatonna, and Northfield. Nearly 40,000 patients visit each year. Mankato alone handles almost 25,000 patients, or about 60 percent of the business.

They must stay state-of-the-art to survive. Compared to the relatively lengthy post-op recovery periods of past decades, high-tech knee arthroscopies are a day surgery now, and torn cruciate ligaments are reconstructed with the belief the patient will fully recover. Kearney said: “One of my patients, a defensive back at Mankato State University, played four years of college football after an ACL [anterior cruciate ligament] knee reconstruction, and four years of professional football. Thirty years ago his career would have been over the moment he tore his ACL.”

When Dr. Kearney performs laminectomies today, his patients have an inch-long incision and most leave for home within 24 hours. Compare that to Dr. Paul Gislason’s state-of-the-art 1970s technique that left a six-inch incision and a week-long hospitalization.

Besides the continuing challenge of staying up-to-date with surgical techniques, OFC currently stands at a major business crossroads. The partners haven’t decided yet whether to move onto the ISJ-Mayo campus, remain at their existing location and expand, or move the practice to a completely different site in Mankato. OFC needs more room to offer additional services for patients. “The ISJ-Mayo campus would be our first choice and a good fit,” said Kearney, “because it would be convenient for patients and we would have expansion room.”

OFC and ISJ-Mayo have met regularly to hammer out a partnering agreement, but progress has been slow. What if they can’t agree? “If we can’t reach an agreement, we probably will have to move our whole practice to an offsite location where we have an option on some property,” Kearney said.

OFC must expand somewhere soon because its business is bursting at the seams, he said. He’d like OFC’s Back Care Center, which is an affiliated enterprise developed in response to requests from insurance companies in the workers’ compensation area, moved from North Riverfront to either Holly Lane or the other property. OFC’s physical therapy department, located in the facility’s lower level, needs more room. The practice recently added a $1 million open-sided MRI scanner that would be the only one within at least seventy miles of Mankato. Open-sided MRI scanners make the whole process much more comfortable for overweight and claustrophobic patients.

Over the last 30 years, most changes in orthopaedics have been surgical in nature. In the future, according to Kearney, nonsurgical treatments such as diet, exercise and dietary supplements will become even more important. Recent studies have pointed to smoking as a major factor in orthopaedic problems. “Take a hundred smokers,” he said, “follow them over time, and you will find they have several times the number of disk rupture problems and back surgeries versus a nonsmoker. Smokers heal slower when they have a fracture, and they have a much higher incidence of osteoporosis.”

On the horizon are hormonal and chemical agents that may obviate the need for fracture surgery. Bone Morphogenic Protein (BMP), a technology currently being developed, could even be injected into wrist fractures, for instance.

HMOs and Congress are raising Kearney’s blood pressure. One proposal before Congress, the Patient Protection Act, “reflects the pendulum swing away from the initial excitement of cost savings with managed care,” he said, “and more towards people receiving the care they need.” He believed managed care has been necessary, but when over-aggressively enforced it affects people’s lives negatively. “Some people were being denied access to the world’s leading expert on a problem because that expert wasn’t in their insurance plan system,” he said. He also cites Minnesota state employees past frustrations with a very restricted plan that limited access to only some physicians and not other physicians in the same plan.

He summed up his outlook for OFC this way: “In the next year there will be many major decisions setting the tone for our future. We want to do the best we can and not make any mistakes.”

The Doctors

“It’s a special challenge recruiting surgeons to rural southern Minnesota,” said Dr. Kearney. “We have to interview quite a number of physicians. The more physicians we have to choose from, the better the choice. The candidate must be someone we’re comfortable having here.”

Interviewees seem very interested in OFC’s history, its commitment to patients, and the level of ideals its staff shares. “A physician who may be joining us later this year said the single thing that impressed her the most about us is that most of our employees stay on and end up retiring here,” he said. Potential physicians are lured with a simple promise: After a two- or three-year probationary period, a new physician may buy an equal partnership interest in this physician-owned, -governed and -managed enterprise.

OFC hires board certified physicians. The American Academy of Orthopaedic Surgeons (AAOS) and the American Board of Orthopaedic Surgery (ABOS), both begun in the 1930s, are two of the oldest specialty groups in American medicine. They work to maintain a high level of professional training, education, and practice standards. To become certified by ABOS, for example, a physician must pass written and oral examinations, and complete an approved residency training program in a practice setting.

Current physicians at OFC are: Dr. R.W. Kearney; Dr. Michael Kearney; Dr. Gene Swanson; Dr. William Laney; Dr. Paul Matson; Dr. Robert Shepley; Dr. Bradley Wille; Dr. Steven Curtis; Dr. John Springer; Dr. Christopher Daley; and Dr. Scott Stevens. Daniel J. Menden is the business administrator.

An unspoken expectation exists that physicians and office employees become active in their profession and in the community. Dr. Paul Matson is Chairman of the Board of the Minnesota Medical Association. Dr. Swanson is a former Chairman of the Board of Counselors of the American Academy of Orthopaedic Surgeons. Dr. Wynn Kearney is a former president of the Minnesota Orthopaedic Society. Office employees are active in everything from scouting, church, Habitat for Humanity, VINE, YMCA, Mankato Symphony, and Special Olympics, to Minnesota State University activities.

Softball Has Been Very Good

OFC has provided healthcare for Minnesota State teams for years. Dr. Kearney has served as a team physician, and OFC’s Dr. Steve Curtis currently holds that position. The WCHA requires that an orthopaedic surgeon attend all MSU home hockey games. An OFC physician provides the same service at all MSU home football games.

“We mainly sew up lacerations at hockey games,” he said. “It’s not unusual to have up to two or three players per game with a laceration. With more serious injuries we assess them, and decide whether they can return to the game or require further treatment. Nearly always we provide treatment from on-field assessment through treatment to rehabilitation and return to action.” Sports medicine challenges an orthopaedic surgeon’s abilities because of the game’s time constraints, and the tendency of players to downplay injuries in order to return to the fray.

“I often joke that softball has been very good to our practice,” he said. In terms of volume, OFC physicians see more injured recreational softball players than from any other sport. Mankato has over 3,000 active softball players. Coed games, he said, are the worst because guys show off when they shouldn’t, and people are sliding into bases when they don’t know how.

Wynn Kearney Jr., Former Bachelor

“My wife rescued me from myself,” stated Kearney with a slight grin as he recalled how “life seemed to be passing [him] by.” He married for the first time at 50 to his wife Pam, whom he’d known since Franklin Junior High in Mankato. “The greatest thing that ever happened to me was becoming a father to those two little twin boys, who are now four.” Just like his father, the late Dr. Wynn Kearney, Sr., a prominent Mankato physician, he enjoys being called “Daddy” a lot more than “Doctor.”

“My grandfather was 43 when my father was born,” he said. “My father was 33 when I was born. I was 51 when my boys were born. Apparently being a father late in life has become a family tradition.”

Besides the effect marriage and twin boys have had, he was also softened by an event in 1978 that changed the way he practices his specialty: he had a back injury while vacationing in Africa. “To physicians everywhere I recommend getting on the other end of the knife or examining table. It made me more understanding of what a patient goes through,” he said. After his laminectomy in Mankato, people would ask him why he flew home to have the operation when he’d been hurt in Africa, and flown over London, Boston, and Mayo. “I was very comfortable with my two senior partners, Dr. Don Meredith and Dr. Paul Gislason. It turned out very well.”

With all the stress surrounding work and his twin boys, Kearney needs a diversion now and then, and his minority ownership in the Minnesota Timberwolves provides it. When he heard that Glen Taylor’s offer for the Minnesota Timberwolves had been accepted by the then-present owners, he immediately called Taylor and asked whether he “had room in the deal for the ‘little’ guy.” Glen said, Yes. Kearney referred to the Timberwolves ownership group as “Glen and The Eleven Dwarfs.”

“It has been great fun for me, my wife, and our children,” he said, “to travel with the team and participate in various events. We’re looking forward to flying to Tokyo this year to see the Timberwolves and Sacramento open the NBA season.” The Minnesota Timberwolves and the Minnesota Lynx have two minority owners from Mankato: Kearney and Fred Lutz.