Reaching people through the language of sports: shadowing Rosemary Agostini, MD, Group Health Cooperative



Rosemary Agostini, MD, Service Line Chief, Activity, Sports, and Exercise Medicine, Group Health Cooperative View on Flickr.com

Watching Rosemary Agostini, MD, the Service Line Chief of the Activity, Sports, and Exercise Medicine (ASEM) Department of Group Health Cooperative (@GroupHealth) reminded me of why I like shadowing so much. 

At some level, you can never really know someone until you observe them doing something they are passionate about. It would be kind of like knowing an elite athlete socially but never having seen them play their sport.

Yesterday I got the opportunity to watch Rosemary practice at the new Group Health Cooperative Bellevue Specialty Center in Bellevue, Washington. This facility was just a twinkle in the eye of Group Health when I left Seattle (well, it was like 50% built).

There’s a lot that’s new here, including the Activity, Sports, and Exercise Medicine Department, which Rosemary started. She explained to me that what’s unique about ASEM is that it is not part of another Department like it is in other health systems – it is own entity, set up to support the musculoskeletal health of a whole population. (See: Q&A With Dr. Rosemary Agostini)

Rosemary is Board Certified in both Family Medicine and Sports Medicine, and integrates the two specialties into her care, which also incorporates the latest health information technology to connect with patients (“When I email patients, I ask how they are doing as people as well as how their bodies are.”).

One of her hallmarks, she told me, is that she communicates with her patients in the language of their sports, from teens to seniors. She has learned to do this in the 30 years of her medical practice, often on the sidelines of a high school football field. “Everyone else looked at the cameras and scoreboard, I watched people move,” she said.

I had to ask why she developed this approach, and she told me it’s because she learned early in her practice that when she began to talk to athletes about their sport activities, she could connect in ways with them that she could not as a traditional physician. For her, this is a way to reach the sometimes unreachable, or to listen to people who sometimes aren’t heard. This reminds me a lot of the work of one of my other favorite physician innovators, Brigid McCaw, MD (@BrigidMcCaw) (See: Giving the voiceless a voice using social media, family violence prevention, and a walk with Brigid McCaw, MD | Ted Eytan, MD). Isn’t it interesting that some of the greatest innovation I see in medicine involves better listening to people, rather than doing more things to people…

Compassionate Concussion Care

Rosemary’s other passion is managing concussion, which is now recognized as a life threatening brain injury. She told me about Washington State’s Zackery Lystedt law, whose namesake, a 17 year-old nearly lost his life on the football field (See: Dr Stanley Herring – Zackery Lystedt – Lystedt Law). She sets up Statewide video conferences to teach Group Health Physicians how to manage concussions and creates tools in Group Health’s comprehensive Electronic Health Record to help physicians and patients (and their families) heal from concussion.

She showed me one of the tools she provides to patients and families as part of concussion evaluations, embedded in the Group Health EHR. There are lots of all caps words, including the sentence:

“Your BRAIN has been INJURED. Your BRAIN is essential to your whole life!”

If you read Zackery’s story or think about your own life experience, you know that there are so many forces pushing young adults and their families to forgo a healthy life (or even a life at all) in the hope of greater life success. The Lystedt law was passed to keep children alive, and from watching Rosemary practice, I can tell that it is an important role for a physician in practice (and in society) to be a force for prevention and health as part of this goal. She is definitely that force for prevention – while I was waiting to meet her in the morning, I noticed on the metrics on the wall that she provides after visit summaries for nearly 100 % of her patients. 

Musculoskeletal Health is part of Total Health

I came to see Rosemary because of my interest in walking and physicians walking with patients. I learned that this is a part of an overall commitment to musculoskeletal health. Rosemary’s patients, who are ultimately the teachers, (and who consented to me observing me their visits), showed the diversity of ways that musculoskeletal health is related to overall total health – everything from the minor to the heartbreaking. I got to see her listen to their stories in the language of their activity while gently and continuously promoting the safe pursuit of what she at one point said are the “zillion reasons that physical activity is good for you.”

Rosemary and Ginny Sugimoto, MD are setting up a program at Group Health Cooperative that involves physicians, members, and community leaders, including Seattle Police and Fire Departments. We share the same interest and passion for activity, and I think this is one of the most important things the medical profession will contribute to society in the next many years – promoting the activity of the human race. She shared the kit that participants are given as part of the Group Health “Walk and Talk” program. See the photos below (note the GHC / SPD partnership on the ball cap).

I am here this week as part of physician leadership history in the making – it is the first time Group Health Cooperative / Group Health Physicians are hosting the Permanente Medicine and Management Program. Twitter hashtag will be #GHMM12. In the meantime, thank you, Group Health members, staff, and Rosemary Agostini, MD for allowing me to spend time amongst the hailstorm of innovation happening here.

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