Orthopedic Referral | Capital Orthopaedics & Sports Medicine

Frequently
Asked Questions

What are your office hours?

Main office: 7:30 am to 5:00 pm, Monday through Friday
Walk-In Clinic: 7:30 am to 4:00 pm, Monday through Friday
Phones: 8:00 am to 5:00 pm, Monday through Friday
MRI: 7:00 am to 6:00 pm, Monday throughFriday

How do I get in touch with my medical team if I have more questions?

You can get in touch with your physician and team through the patient portal (online or in theAthena app)and/orby calling our main number–515-440-2676.Our clinical staff is doing something different every day–they may be seeing patients in clinic, working with a different physician and/or at a different location, or on the phone with another patient. Due to this, you will almost always be transferred to their voicemail to leave a message and then receive a call back from either the lead assistant or the triage nurse once they are able to answer your question. Depending on the content of your message, they may not be able to call you back until they have conferred with your physician.

What holidays is the office closed?

2021 Holiday Office Closures
Friday,12/31/2021 Observance of New Year’s Day
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2022 Holiday Office Closures
Monday, 5/30/22 Memorial Day
Monday, 7/4/22 Independence Day
Monday, 9/5/22Labor Day
Thursday, 11/24/22 Thanksgiving
Monday, 12/26/22 Observance of Christmas Day
Monday, 1/2/23 Observance of New Year’s Day
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2022 Special Office Hours
Friday, 11/25/22Office closes at noon (day after Thanksgiving)

How do I contact you after-hours?

In the event of an emergency, you should always call 911.We are available when you need us; a medical answering service will connect you to our physicians should an issue arise outside of business hours that requires immediate attention.A surgeon who specializes in general orthopaedic surgery, one who specializes in hand surgery, and one who specializes in foot & ankle surgery will be available at all times to ensure appropriate care is provided for our patients.

What is an Orthopaedic Surgeon?

An Orthopaedic Surgeon is a medical doctor who specializes in treating the musculoskeletal system, which includes bones, joints, muscles, ligaments, tendons, nerves, and sometimes even skin. After receiving an undergraduate degree, Orthopaedic Surgeons attend medical school for four years, where they learn about and do rotations in many different fields of medicine. Following medical school graduation, ortho residency programs are typically 5years (the 1st year usually covers general surgery, and then the subsequent 4 years focus specifically onorthopaedic surgery.) Many orthopaedic surgeons then continue their training in a 1-year Fellowship program to further specialize in the field and hone their skills to that particular type of surgery.

What is a Podiatrist?

A Podiatrist is a licensed Doctor of Podiatric Medicine (DPM).These physicians are devoted solely to the treatment of the foot, ankle, and related structures of the leg.Podiatrists go to medical school for the standard four years, and then train intensively for multiple years in residency–the same path as an MD or DO.Capital Orthopaedics has 3 physicians who are DPM’s, and they all are even further trained than the stereotypical Podiatrist. Dr. Lee, Dr. Frerichs, and Dr. Evans all trained in special residency programs that are surgically focused. Not all Podiatrists perform surgeries in the OR, but we are lucky enough to have all of ours double-board certified in foot and ankle surgery, along with podiatric medicine.

What is the difference between a physician who is an MD vs. a DO?

The credentials “MD” stands for “medical doctor”, while “DO” stands for “doctor of osteopathy.”The main difference between the two programs is thatMDs learn allopathic medicine, and DOs learn osteopathic medicine.According to the American Medical Association (AMA),osteopathic medicine was founded on the belief that all systems in the body are interrelated, while the allopathic approach focuses on scientifically diagnosing and treating the symptoms at-hand.Criteria to apply/get into MD and DO programs are virtually the same and the coursework between the programs is very similar. Both programs spend the first 12-24 months largely in the classroom, and nearly all remaining time in a clinical setting.

The differences between the 2 types of physicians grow fewer as time goes on.They now use the same Match program for residency selection, take the same licensing exams, and fulfill the same roles. Today in America, 1 in 4 medical students attends a DO program.As time moves forward, physicians and patients alike seem to be less concerned about the credentials behind the name and more focused on the“Dr.” in front.

What is a PA/PA-C/Physician Assistant?

PA stands for “Physician Assistant” and the “-C” at the end simply means they are nationally certified through the required testing.(You’ll seePA credentials written both with the C and without, though they’re likely all certified; it just depends to how the person or company is used to writing the credentials.) PAs are “mid-level” health providers; they have greater responsibilities in patients’ care than a nurse but still less than doctors. PA scan diagnose and treat patients by themselves as well as independently prescribe medications,

Why do you spell“Orthopaedics”with an “a”?

Both orthopaedics and orthopedics are correct ways to spell the word, you’ll often see the 2 version seven used interchangeably. Some people simplify the difference by saying “ae” is the British version, while dropping the “a” is more Americanized spelling; however, which one people use often comes down to personal preference or a person’s roots in academia.All medical school programs and corresponding textbooks will spell the word using “ae”, and it is difficult to find a professional medical organization in the field that does not use the “ae” version (e.g. American Academy of Orthopaedic Surgeons, American Association of Orthopaedic Medicine, American Orthopaedic Society for Sports Medicine, etc.)

Do I need a referral to be seen at your office?

This is completely dependent on your insurance carrier and further more, the specific plan.Oftentimes, if your insurance requires a referral–that information will be indicated somewhere on your physical insurance card.However, this is not always the case–and it is always the best and safest idea to contact your insurance company to verify.

What is an EMG?

EMG is a shorthand for “electromyogram”or“electromyography”.An EMG is a diagnostic test that can provide your physician with information about a potential nerve or muscle injury/condition.When muscles are active, they create/produce electrical current... the greater the current, typically the greater the activity.Most often, a nerve conduction velocity(NCV)is lumped in with an EMG.That way, both the nerves and the muscles are tested simultaneously.Surface patch electrodes are placed on different areas of the body part, and the EMG machine sends a mild electrical impulse to stimulate the nerve(s).The NCV measures how long it takes for your nerve(s) to register that there has been stimulation, or in other words, how long it takes before the nerves sense the electric stimulation.This test can help differentiate if weakness is being caused by your muscle damage vs. nerve damage vs.being weak simply because you are in pain for a reason unrelated to either your muscles or nerves. Furthermore, it helps your physician to pinpoint exactly where the nerve damage is located and/or which muscle is damaged and to what extent.An EMG/NCV will often be ordered if a patient has symptoms of weakness, numbness, tingling, etc. and has the ability to help detect and diagnose many diseases and conditions such as muscular dystrophy, peripheral nerve damage(nerve damage in legs/arms),ALS, disc herniation, pinched nerves, inflammation of muscles, carpal tunnel, cubital tunnel, tarsal tunnel, neuropathy, etc. The experience of an EMG varies greatly depending on the patient.There will be some discomfort, as it includes the insertion of needles into the skin. However, it is usually well tolerated.Only one insertion is made at a time and you receive warning before it happens, as well as guidance of how to minimize pain.The physician conducting the test(s) will talk to you about what is happening and being seen in the moment. Unlike an imaging test (i.e. MRI), you will know your results the same day before leaving the office.There is nothing you need to do to prepare for an EMG, except to perhaps avoid using lotions in the area being tested. You should take all of your medications as usual, including pain medications and/or anti-inflammatories. You should not need a driver to take you home.If you have any soreness after the test, we recommend taking over-the-counter medications such as Ibuprofen, Aleve, or Tylenol

What is PRP?

PRP stands for Platelet-Rich Plasma, and it is an injection commonly used to treat tendon injuries or joint pain from osteoarthritis.Capital Orthopaedics does have physicians that administer these injections to patients if the circumstances present a scenario where it would be beneficial.The entire procedure takes roughly 60 minutes and is never covered by insurance, as the treatment is still considered investigational.PRP injections can be performed in our Clive office or at a surgery facility for patients who are interested in having the injection done while having surgery.The process is as follows:-Blood is drawn from your arm, as if you’re getting routine lab work done.-That blood is spun in a centrifuge for 15 minutes. This is a fancy machine you may have seen inBiology Lab that uses high force and speed to separate different components of a liquid. (They’re separated based on differing densities, states of matter, etc.)-When the machine is done spinning, the centrifuge will have separated the blood into3 different sections–red blood cells, plasma, and platelet-rich plasma.-The platelet-rich plasma is extracted from the vial and injected using an ultrasound to guide the needle *exactly* where it needs to go.Platelet-rich plasma contains 4-10 times the concentration of platelets in your blood. Platelets contain hundreds of proteins called growth factors, which are important in and can help promote the healing of injuries.

What is a gel/Visco injection?

These injections are used as a treatment for arthritis; and while it is not a cure or a permanent solution, it can provide great relief for people experiencing joint pain.Where each of your bones meet (i.e. joints), there is cartilage in-between so that the bones glide smoothy against one another. However, as the body ages, that cartilage is naturally worn thinner–and in some people (especially those who genetically start out with less cartilage to begin with), is is essentially completely rubbed away. This leaves your bones sitting on top of each other and causing pain when you move as they knock against each other with no cushion.This type of injection is a thick fluid that can mimic the role of articular cartilage.It is important to note that these types of injections require an authorization process through your insurance company, so they need to be planned for ahead of time.Additionally, you may only have a gel injection in a specific body part every 6 months.

What is a cortisone injection?

When your body experiences injury or trauma, whether acute or chronic, it becomes stressed and acts in self-defense by producing an inflammatory response. Inflammation includes the release of certain chemicals that cause swelling–a defense mechanism your body uses to isolate that area of the body from affecting other body parts/tissues. Despite the body thinking that it is acting in your best interest, the inflammatory response can cause significant pain.A cortisone(or corticosteroid) injection is a steroidal anti-inflammatory that targets small, specific areas of the body-telling them to calm down and relax their response. Due to potential side effects if taken too often over long periods of time, the number of times you can get cortisone injections in a year are typically limited by your physician. (The average amount of time required between these injections is 3 months, though can differ depending on physician and specific body part.)

Can I request an interpreter to be at my appointment(s)?

Absolutely! When you contact the patient coordinators to schedule an appointment (or they contact you), just tell them you would like to have someone there to translate for you and let them know which language. We will coordinate and provide on-site interpretation (someone that is physically there to help you check in for your appointment and remain with you throughout the appointment’s entirety) for the following languages: Spanish, Bosnian, French, Arabic, Burmese, Karen, Kunama, Polish, Nautl, Mayan, Tigrinya, Amharic, Somali, Urdu, Nuer, Korean, Lao/Laotian, Taidam, Swahili, Kirundi, French, Kinyarwanda, Hakha Chin, Nepali, Punjabi, Mabaan, Kinyamlenge, Portuguese, Vietnamese, Thai, American Sign Language(ASL), and more.

If you would feel more comfortable having a family member or friend translate on your behalf, we are more than okay with that–so long as your appointment is not going through workman’s comp and was not scheduled by an attorney (once litigation is involved, a 3rd party is typically required.)If you do not feel comfortable scheduling an appointment over-the-phone in English, you may ask to be transferred to the telephone interpreting company by our staff or call them directly at 800-735-2942.

If I have already been treated by another orthopaedic practice, what do I need to do to make an appointment atCapital Orthopaedics?

Please call the main phone number at 515-440-2676 and the patient care coordinators will determine whether you will need to provide office notes, surgery notes, imaging reports, etc. for review prior to scheduling with one of our physicians.

What is the reschedule/no-show/cancellation policy?

If you need to reschedule or cancel an appointment for any reason, we simply ask that you call to let us know as soon as possible (preferably 24 hours or more, but any notice is helpful.)There is no monetary fine or repercussion of any sort for rescheduling or canceling; we understand that life happens!However, if it is 15 minutes past your appointment time and you are neither at the office nor have we heard from you, you will be considered a “no-show.” If you amass 3 no-shows within 6months, it’s possible that you will no longer be able to schedule appointments with us. Again, there is no punishment for calling to reschedule or cancel, so kindly just give us a call if you’re unable to make it.

How do I refill a prescription?

Contact our main office via phone, 515-440-2676, or online through the patient portal. If you call, you will likely leave a message for your physician’s team indicating your request and either the lead assistant or our triage nurse will return your call to make these arrangements. If requested through the portal, staff may reach out via phone call if they have questions or instructions for you (i.e. a new medication); if it’s a refill and there’s nothing to discuss, they may simply respond to you via the portal that they have filled your request and that it will be ready to pick up at your pharmacy!Were commend that you check with your pharmacy late afternoon regarding your medication request. That way, if there is an issue with your medication request or if it is unable to be processed the same business day, you will be notified and potentially still have time to discuss this with someone at our office.Important things to note:-We only fill prescriptions during regular business hours(i.e.not after 5pm and not on weekends).There are very few exceptions to this that involve extenuating circumstances–such as postoperative complications/concerns.-If you leave a message for a prescription refill after 4pm, it is not guaranteed that your message will be attended to that same day, so please plan accordingly. This is especially imperative on Fridays, because your message may not be responded to/prescription filled until Monday.-In some instances, we may require that a patient be seen in the office prior to renewal.-Physicians and providers at Capital Orthopaedics will not/cannot prescribe medication to patients they have never seen or for an issue unrelated to what they’ve examined you for previously. If you have an upcoming appointment to see a provider at Capital Orthopaedics for the first time or for anew problem and find you are in need of a prescription or medical advice, we recommend you contact your primary care provider.

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