Physician Profile: Meet Dr. Gurtej Singh
At The Centers for Advanced Orthopaedics, we are proud to give our patients options. Whether they have a procedure done by one of our surgeons, or they choose the non-operative route, we take pride in offering the highest quality of care. This is why we are always looking for talented healthcare professionals to join our team. Earlier this summer, Physical Medicine and Rehabilitation Physician Dr. Gurtej Singh joined us at the Orthopaedic Associates of Central Maryland Care Center. We had a chance to get to know Dr. Singh and learn how he’s at the forefront of an exciting new field within pain management.
Tell us a bit about your specialty as a board certified Physical Medicine and Rehabilitation physician. What does that entail?
Physical Medicine and Rehabilitation physicians are also known as Physiatrists. Physiatrists are specialists who do a hybrid of things, including nonsurgical orthopaedics, nonsurgical sports medicine, nonsurgical spine care, and what I call functional neurology. I use this approach with sports medicine and spine patients, trying to help them maintain and regain as much function as possible without surgery. Many patients will see a neurosurgeon or orthopaedic surgeon right away if they experience back and neck pain, but in reality, they should see a physiatrist first, because we can often treat them non-operatively. The Orthopaedic Associates of Central Maryland Care Center is well positioned to treat these patients because we have two physiatrists on staff, myself included, who focus on pain management and injections, and we also have a spine surgeon. We work together closely on cases to best help the patients. Patients find that this team approach provides them the best care in the short-term and in the long-term.
Physiatrists are not just non-surgical orthopaedic doctors. We take a more global approach to patient care. And, within the realm of Physiatry, I would consider myself as an interventional pain specialist, spine specialist and rehabilitation specialist. I see myself as a separate entity working in partnership with orthopaedics. Physiatry has really only been around for 60-70 years, and interventional pain management has only been around for 20-30 years or so. It’s a very new field of medicine. I live and breathe it, and I love my job.
How does your additional board certification in Pain Management extend your specialty?
By completing a fellowship in Pain Management, I am absolutely able to see a wider spectrum of patients than if I was just a physiatrist. My Board certification offers me a lot more education in pain medication and how to safely prescribe them with other medications, has taught me the full breadth of injection procedures to treat pain, as well as minor surgical procedures to treat acute and chronic pain conditions. My fellowship now allows me to offer my patients even more options for pain management.
Having done the interventional part of the fellowship, I specialize in spinal cord stimulation, which helps patients with chronic nerve pain. If nerve pain is from a spine surgery that has left a lot of scar tissue, or from peripheral neuropathy, which is becoming a larger issue as a result of cancer treatments and diabetes, we can work with patients to stimulate and block nerves in the spine rather than using medication with side effects.
With your specialties, what is the most common procedure you perform?
The most common thing I do for patients is the combination of injections with cortisone and medication management.
Why would a patient seek treatment from a physical medicine and rehabilitation specialist? Are there certain injuries or conditions that you commonly treat?
Anyone with head, neck, upper or lower back pain should see a physiatrist. Also, patients who may not want surgery for their sports-related injuries such as knee arthritis, hip arthritis, rotator cuff injuries or carpal tunnel. I can offer the whole spectrum of treatment options minus the surgery.
You also treat spine fractures and spine pain. Can you talk about that area of expertise as well?
Spine fractures and osteoporosis are growing issues, not only because we are getting older and living longer, but because we don’t get enough Vitamin D. Even when we are outside, and even with supplements, we don’t get enough. Osteoporosis is common in women above the age of 55 and men above the age of 65, and many patients are now living into their 70s and 80s. They can injure themselves doing common tasks, like moving furniture or slipping on the rug, and we typically see compression fractures in the spine as a result. With a minimally invasive outpatient procedure, we can put cement into a fractured bone and, when done correctly in the right patients, they are seeing about an 85% improvement in pain in a day or two. They can go home on the same day with just a band-aid. What I love about this is that we can ease their pain right away. As a pain management doctor, we see patients who are experiencing pain at a level 6-8, and we can usually get them down to a 4-6, but it’s hard to get them down to a 1-2. This can be frustrating, but these fracture patients go from not being able to walk, or being immobile in bed, to almost normal function in a few days. It’s very rewarding.
The newest component to spine fractures are patients who have metastatic cancer disease. Patients with breast, lung, colon or prostate cancer can get lesions inside one of their vertebral bones, which will cause pain or a fracture. With heat, we can try to kill off nerves inside the lesion and fill it in with cement, so again, they get great pain control and can resume radiation and chemotherapy while their back pain is carefully managed.
You also recently completed certificate training in Stem Cell and Regenerative Medicine. Why did you choose to pursue this further training?
It is a new field in medicine, and has huge potential. Getting involved at the grassroots stage allows me to participate with some of the leading experts in the field around the country in helping to understand how this therapy works, the best ways to apply the therapy, and what kinds of patients are best suited for a regenerative procedure. It’s an exciting time for Physiatrists, and many specialists are jumping in to get involved. There is an opportunity here to do high quality work in a new and up-and-coming field, and to generate data to prove this is a viable alternative for patients.
As this is a newer field of medicine, can you talk about your work with Stem Cell and Regenerative Medicine? What types of patients and injuries do you see through this method of treatment?
The best way to explain regenerative therapy is that we are able to take your own natural healing tissues and chemicals, and reinject them back into a location that is injured. We are finding very good results with rotator cuff sprains and tears. On an MRI and ultrasound, we are able to get a good image and see exactly where the tear or fraying of the rotator cuff is occurring. We take your own blood, and spin the blood down to take out Platelet Rich Plasma (PRP). We inject it under ultrasound guidance into where the tear is located. Instead of a cortisone shot, we can do the PRP injection, which allows the natural chemical healing process to occur. Many other diseases in orthopaedics could be treated this way, such as Achilles injuries, golfer’s elbow, tennis elbow, and knee arthritis, where we can add stem cells in addition to PRP injections. We harvest stem cells from the body, spin them down to extract what we need, mix it with the PRP and inject to help with these injuries to promote natural healing.
This field is growing and expanding. I like being at the forefront of what is coming out in medicine, and helping patients with a treatment that is new and scientifically backed.
Why did you choose to specialize in Physiatry?
When I was a kid, I wanted to be the team doctor for the Philadelphia Eagles. During my residency, I was the team doctor for one of the local high school teams in suburban Detroit and had an interest in sports medicine. Then I did a pain rotation, and while I was in the pain clinic, they allowed me to do injections. I quickly realized I had a knack for this area of medicine. I applied for a pain fellowship and the rest is history.
Do you have any additional interest areas within your specialty, or within orthopaedics?
I am very passionate about the spine and this new area of regenerative therapy.
Where did you receive your medical degree and complete your residency?
I went to medical school at Penn State University - Hershey Medical Center, and did my residency at Wayne State University - Detroit Medical Center - Rehab Institute of Michigan. Then I did my pain fellowship in the Department of Pain Medicine and Palliative Care at Beth Israel Medical Center in New York City. I joined the neurosurgery team at Greater Baltimore Medical Center before coming to The Centers for Advanced Orthopaedics.
As a new physician, what has been your experience with The Centers for Advanced Orthopaedics thus far? How has the transition been?
It has been fantastic working with the entire group. We collaborate on patient cases in a more sophisticated manner than I have in the past. Our spine team, Dr. Oren Blam (spine surgeon) and Dr. Michael DeMarco (Physical Medicine and Rehabilitation), has expertise in a variety of areas, and between the three of us, there is nothing about the spine that we can’t treat or care for.
What do you feel are the benefits of treating patients through the private practice model?
My interaction and the care that I give patients has not changed, whether I am working in private practice or in a hospital. To me, the care that I give the patient in the room or on the operating table should never waver one bit. Patients deserve the best care all the time. We do have much more freedom to make decisions here in private practice, which I value.
What are your interests outside of work?
I’m a big sports junkie and a huge Philadelphia Eagles fan. The only thing I don’t like about Baltimore is that we don’t have a hockey team, and I miss watching the Flyers. I play golf and tennis.