After studying in Oviedo and doing the MIR residency in Burgos, the traumatologist Ricardo Hueso Rieu ended up at the Álvarez Buylla Hospital in Mieres, where he entered by the then head of the service, Dr. Albertino Amigo, a benchmark in traumatology.
Why did you decide to study Medicine?
I liked the world of healthcare a bit, but I had no direct connection to it. As a result of a vacation that I spent with some relatives who were doctors in San Sebastián, I ended up hooked. It was when I was doing my third year of BUP, it was the moment in which I had to decide what to do and that’s how it all started.
And why the specialty of traumatology?
Well, because one of those relatives I was with was a traumatologist. After seeing what he did, I realized that it was what I liked and where I could focus my specialty once I finished my degree.
What has your professional career been like up to now?
After finishing medicine, I did the MIR and chose a place in Burgos, where I did my residency. But the last year as a resident I could do a special rotation in something that I liked and I coincided with the one who was then head of Traumatology in Murias, Albertino Amigo, in an arthroscopy course in Barcelona. I struck up a conversation with him and, although my initial idea was to do that last year in Madrid, I decided to come to Asturias to find out how Asturian hospitals work. That was in 2007. I spent three months in Murias and, from there, they began to offer me contracts. I worked in Mieres, Jarrio and Jove. And when the job offers began to open, I stayed in Mieres. First covering a leave, then I spent three or four years as temporary, later as an interim and until I got a permanent position.
He talks about Dr. Amigo, already retired.
Yes, he is an old school doctor. Although he is retired, he continues to work. He is one of those pure workers for whom everything that is not working seems to bore them, they are hard as stones. He is a great professional, very active, he was always taking courses, especially on arthroscopic issues.
How would you define the Mieres Trauma service?
Traditionally it has always had a lot of prestige in Asturias. And at a convulsive moment in public health due to the pandemic and the massification of waiting lists, a very important generational change is taking place in our service, with a renewal in which we have people with a lot of training capacity and knowledge. We will have to see if this translates into a quality of care like the one we have now, which I consider to be very good.
How has the impact of the pandemic been?
As a specialty, we had to be on the front line of battle, except for emergencies. Due to the pandemic itself and the situation at that time, in which people left the house much less, emergencies in our case were greatly reduced and, therefore, our activity as well. In the case of scheduled surgery, it had to be put on hold because resources were concentrated on the pandemic.
And did it affect the waiting lists?
Of course, they have tripled and they have had to refer treatments to concerted centers. I believe that we are at a crucial moment to establish the most effective management possible to return to the path that health care had in Asturias. Especially in a center like Mieres, which is very manageable due to the volume of population, something very different from what happens in HUCA or Cabueñes. It will take a while, but I hope it can be put back on track.
Among the changes that had to be applied due to the pandemic, were any of them here to stay?
Yes, for example, in pandemic periods, a lot of telematic or telephone consultation was carried out to discriminate patients, that is, to see who could be seen in the hospital and who could be spared that visit to minimize the risk of contagion. In fact, of the 35 patients that we have on average in consultation, with this discrimination we only quoted 10 or 12, it was impossible to remove the entire consultation. Now we have maintained, when we do the morning consultation, reviewing the patients the next day on the computer to see if they are pending the test, that there are no delays or to prepare the approach. Everything to minimize the surprises that you can take in the consultation the next day. Also in case there are failures in the appointments, so that the patient does not have to miss the appointment. These are useful things, not so much the protocols for the operations that go with covid tests, because the patient who is going to have surgery tomorrow and has the test done the day before tests positive and has to disrupt the entire operation as a result of it. .
Talk about teleconsultations, are they useful in your area of work?
In traumatology, contact with the patient is essential, although there are times when you only require a follow-up that can be transmitted if there are no setbacks. But in a specialty like ours, you have to have the patient in front of you, because it is important not only to have imaging tests, but to see how they affect the patient’s situation. If you don’t see the patient and do exploratory tests, you can’t conclude the diagnosis.
Is your service more linked to people of advanced age?
Our specialty is traumatology and orthopedics. Traumatology for everything that comes from traumatisms, blows; while orthopedics is for patients who have wear and tear and everything that can be done to improve their quality of life. There are cases that are in a certain advanced state that require surgery as the best solution. But there is also a range of therapeutic options that do not always make surgery necessary. As for physical wear and tear, it is usually associated with age, but there may also be causes that produce premature wear due to rheumatic or metabolic pathologies, or being overweight. There are a lot of variables that can make joint quality worse.
In other words, they do not only carry out surgical activity?
In a hospital like ours we have a lot of surgical activity, but we also carry out conservative therapies that we combine with rehabilitation services, preventive treatments or infiltration techniques that do not depend solely on us and allow us to control this type of injury.
The Medicine career should be even closer to the development of the profession
What novelty have you introduced in the service?
Well, one of the main improvements that we have had in recent years is having a geriatrician on our staff, who usually specifically takes patients over 75 to control their needs, such as pathologies they may have, medication adjustments or maintain its stability. Surgery is an attack on the body and can cause some decompensation that requires stabilization. Having a person specially dedicated to controlling this stability has improved the quality of service, and it shows, because before you had to carry out this control with interconsultations with other services.
What are the main ailments in traumatology?
As for the traumatology itself, there is the urgent or semi-urgent, which occurs in the guard or deferred; As for orthopedics, there is elective surgery, that is, it is chosen as a solution to a type of pathology. As a regional hospital, we are general traumatologists, we do a bit of everything, although with seniority you become more established in certain pathologies. In our hospital, fractures of the hips, ankles or shoulders occur mainly; and prosthetic or orthopedic surgeries of the spine, or hip, knee and shoulder with prosthesis. There is a second step, with surgeries that try to alleviate reaching that point, such as techniques…