What’s New at Shriners Hospital for Children Medical Center-Lexington?

A conversation with Henry Iwinski, MD, 18 months after a big move

“I wanted to be a pediatrician, but I was drawn to the challenges of surgery and the technical aspects of orthopedics” – Henry Iwinski, MD

LEXINGTON After 60+ years as an inpatient hospital on 27 pastoral acres on Richmond Road, in 2017 Shriners Hospital moved to a medical facility near the UK medical campus. Henry J. Iwinski Jr., MD, pediatric orthopedic surgeon, is chief of staff at Shriners Hospitals for Children Medical Center —Lexington. We asked Dr. Iwinski a little about himself and the move.

Henry Iwinski, MD, at the dedication of the new Shriners Hospital for Children Medical Center-Lexington, April 2017

■ MDU: Tell us about your unique childhood.

IWINSKI: I was born in Buffalo, New York but was raised overseas. As a child, I lived in California, the Philippines, Canada, and Venezuela. I finished high school at the Colegio Internacional de Caracas.

■ Give us a synopsis of your education and medical training.

Niagara University for undergraduate in biochemistry and medical school at Brown University. I did my orthopedic training at the Medical College of Georgia and completed fellowships in pediatric orthopedics at the Texas Scottish Rite Hospital and in spine surgery at Charlotte Orthopaedic Specialists.

■ Why did you choose orthopedics and pediatric orthopedics?

Initially, I wanted to be a pediatrician, but I was drawn to the challenges of surgery and the technical aspects of orthopedics. This combined both of my passions.

■ What brought you to Lexington?

The Shriners Hospitals mission drew me here. I was able to combine an academic practice and interest in teaching with the Shriners’ passion for caring for children and their families. I joined the staff here in 1998, and became chief of staff in 2010 with the retirement of Dr. Chet Tylkowski.

■ What were the factors in the decision to move to the UK medical campus?

Primary factors were the changes in the field of orthopedics and in healthcare. When Shriners first began caring for children, the primary conditions were the results of the polio epidemic which required long hospital stays and significant rehabilitation. With polio largely cured and the advent of new surgical techniques and management strategies, pediatric orthopedics changed significantly. Our length of stay fell dramatically. Spinal fusion patients only stay two days in the hospital; over 80% of our surgeries are done as an outpatient. Our average daily census at the old facility was around two patients per day. We didn’t need 50 beds for that.

A modern medical facility has immediate access to advanced imaging, intensive care, subspecialists in numerous fields, a blood bank, onsite pharmacy, an emergency room, and the resources to incorporate the latest innovations. We can now perform very complex inpatient surgeries at UK Children’s Hospital and outpatient surgeries in our Ambulatory Surgery Center.

■ How has the new facility changed the Shriners Hospital experience?

Patients still benefit from the family centered care the Shriners offers, all done without regard for ability to pay. We were able to combine our practices, UK and Shriners, so every patient has access. Most of our surgeries are still done in our Ambulatory Surgery Center, which is specifically designed for children. The medical staff enjoys the proximity of the UK hospital and the energy of being on an active campus. It is truly a win-win situation to fulfill our shared missions of clinical care, research and education.

■ Give us an overview of your staff.

Our staff includes five pediatric anesthesiologists; eleven SHCMC board-certified physicians and surgeons; three physician assistants; seven residents; eight diagnostic radiologic technologists; 10 therapists; 14 techs; and 27 nurses.

■ What’s a normal day for you and your staff?

Our day begins at our 6:30 AM preoperative conference. We review the surgical cases for the day, the history, physical exam, indications, and procedure with the residents we are training. We review all the fractures that presented to the emergency room over the previous 24 hours to formulate a strategy for management. Following this conference, we either go to clinic or perform surgery. As chief of staff, I set aside some time for administrative responsibilities.

■ Tell us a little about the patient population.

We serve Kentucky and all of the adjacent states. Our practice has changed with the move onto campus. We now care for pediatric fracture patients in addition to those we treated at our previous facility. The most commons things we see are spinal deformities such as scoliosis, the orthopedic consequences of cerebral palsy, developmental hip dysplasia, clubfeet, limb-length deformities, genetic conditions with orthopedic manifestations, as well as conditions such as flatfeet, bowed legs, knock-knees, and gait abnormalities.

■ What are some of the most compelling innovations in pediatric orthopedic care that your staff are performing today?

We have all stayed up to date with the innovations in pediatric orthopedics. We are using magnetically driven implants to lengthen patient’s limbs or control spinal deformities in young patients. We have a hip preservation clinic utilizing the most current techniques offered at only a few medical centers. We are fortunate to have a Motion Analysis Center where we use detailed computer analysis to optimize treatment and perform research.

■ After 18 months in a brand-new medical center, what has been the most unpredicted outcome of the move? What happened as expected?

The most unpredicted outcome has been the unprecedented increase in our volume of patients. What happened as expected, is the maintenance of our culture, due to the quality of our staff. We continue to provide exceptional care imbued with the mission and vision of the Shriners Hospitals for Children.

■ What has been the most rewarding outcome of the move?

Taking care of more children. Also the energy of being on a vibrant academic medical campus.

■ What do you see in the one to five-year future?

We hope to continue to expand and reach more children in need. We will be adding a telemedicine program, expanding our service lines, adding staff, educating more residents, and continuing with our clinical research program. The future is indeed bright.