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Physician Spotlight: Shining Light on Commonly Underdiagnosed Conditions in Athletes

Harvey Chim

Harvey W M Chim, MD, FACS, believes in giving every patient the same high-quality reconstructive care and getting it right the first time around, no matter how complex their condition.

Dr. Chim’s specialty areas — thoracic outlet syndrome, brachial plexus injuries, and peripheral nerve surgery — encompass often underdiagnosed conditions that can greatly affect an athlete’s performance if untreated. The conditions are underdiagnosed because they are rare and symptoms can mimic those associated with more common conditions.

As a practicing expert in upper and lower extremity surgery, Dr. Chim received the Richard H. Gelberman Scholar Award from the American Society for Surgery of the Hand in 2018. He has been invited to teach surgical techniques nationally and internationally.

We spoke to Dr. Chim to learn more about what led him to become a plastic and reconstructive surgeon, and how his experience in aiding Team USA taekwondo athlete, Faith Dillon, shaped the way he treats his patients.

How did you become interested in plastic and reconstructive surgery?

I first became drawn to plastic and reconstructive surgery because of the wide scope of the specialty, as well as the complexity of the surgeries themselves. We operate from head to toe, and a lot of our work is easily visible. In fact, it’s totally visible. Everyone can see the quality of your work. I think I was drawn to this specialty because patients really appreciate what we do, and because we’re not only helping them by treating them but also improving their quality of life. Some of the patients might have chronic, long-standing problems that can be solved with reconstructive surgery. I’ve had some particularly fulfilling years practicing hand surgery. For example, one area I specialize in is brachial plexus surgery. That is a very specialized area that very few people will do, but it has such a great impact on the patients. For example, you can get somebody who’s paralyzed in the arm and get their movement back. I believe these areas make my specialty very fulfilling and exciting.

If you did not become a plastic and reconstructive surgeon, what would you be?

I would probably have been some other type of surgeon. I thought about being a neurosurgeon for a bit. Even though I am not a neurosurgeon now, a lot of my practice is treating patients with nerve problems. So, I guess in some ways, I’m still somewhat of a neurosurgeon.

Did you play any sports growing up?

Nothing competitively. I did a bit of swimming and at some point, some canoeing, but again, nothing too vigorous.

What is your patient philosophy?

I think there are several different philosophies, like treating every patient the same and to do your best, bring the human aspect and become a friend or resource. The most important thing to me is to do it right the first time around. In my practice, I treat a lot of patients with recurrent or complicated problems. I believe that is the case because some of the patients that come to us do not get the proper surgery the first time around. When we do the right surgery the first time around, we can really give our patients the optimal outcome.

Can you tell us about your work with Team USA and the U.S. Olympic & Paralympic Committee?

Most of the athletes I see are those with, hand fractures and common hand problems, for example, problems along the lines of carpal tunnel and arthritis. These are very common, especially in athletes because they are very likely to get fractures and injuries. I remember helping one specific athlete who had what we call thoracic outlet syndrome, which is an underdiagnosed compression of the brachial plexus and nerves around the neck. It is underdiagnosed because it is more unusual and often misdiagnosed. People can search a long time before they find the right treatment.

I treated Faith Dillon, a Team USA taekwondo athlete, for a fractured hand. I used a new method of fixing her hand fracture. In the past, physicians would place wires in the hand that would stick out through the skin and cause discomfort. A newer technique is putting a nail inside the bone. Everything is inside, and the incision is smaller. This new technique allows patients such as Dillon to recover faster.

How has working with Team USA and the USOPC influenced you as a physician?

I am fortunate enough to treat patients in need, especially those competing on the world stage, and helping them get better and get back to their peak performance. Meeting these people, who are doing so well in their profession and representing the U.S., is a privilege. They are doing great things. Being able to treat all types of people in my practice has been very meaningful and continues to give me purpose.

What injuries do you see most often?

The scope of plastic surgery is very wide. Most things you see on TV represent the cosmetic side of plastic surgery. Many plastic surgeons will focus on other areas, mine being hand surgery and complex reconstructive surgery. About 30% of hand surgery represents common conditions or injuries, such as trauma, fractures, and dislocations. Other common hand conditions include carpal tunnel, trigger finger, and arthritis. The other 70% of my practice involves management of more complex conditions, one of these areas being brachial plexus surgery. Probably fewer than five doctors treat this condition in the state of Florida. Patients who need these kinds of complex surgeries might also have chronic pain. They might be paralyzed or they could have a related injury after a viral illness.

What makes you proud as a doctor?

When patients get better. Ultimately, I think that’s what drew a lot of us into medicine. I think it’s knowing people who may have a really devastating or chronic problem are able to return to daily activities or regain their independence. These can be life-changing surgeries, allowing us to really make a difference, change their quality of life, and let patients regain their independence.

How does it feel to know UF Health is now a member of the USOP Medical Network for Team USA?

I think this is fantastic! I think it is a great opportunity for UF and UF Health to show what our programs can do. It is a privilege to have athletes choosing to travel to Florida to receive care from us. I think this has been one of the most exciting parts of my practice.

What is your message to athletes?

Keep doing what you are doing. We are appreciative and proud that you’re representing the USA. And if you get injured, we are always here to help.

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Peyton Wesner
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pwesner@ufl.edu (352) 273-9620