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28 April 2021

This time BTPL Editor Chris Thorpe catches up with Consultant Radiologist Adam Mitchell and Business Development Manager Annette Naughton from Fortius to discuss our Health and Medical partner’s involvement with the club.

About Fortius

Fortius Clinic was launched in 2009 by a group of consultants who set out to create a centre of excellence in the field of orthopaedic and musculoskeletal (MSK) healthcare. After 11 years of organic growth, Fortius is the largest single group of orthopaedic and MSK consultants in Europe, with more than 100 leading specialists, and ranks among the top 20 orthopaedic groups in the world. It operates three outpatient and diagnostic clinics in central London, as well as Fortius Surgical Centre and an orthopaedic partnership with Cromwell Hospital. Fortius is a recognised FIFA Medical Centre of Excellence.

Fortius outpatient clinics provide outpatient consultations, diagnostic scans, and interventional radiology services. Patients are treated by sub-specialists in hip, knee, groin, shoulder, foot, ankle, spine, hand and wrist, podiatry and pain medicine who cover the full range of orthopaedic conditions and sports injuries.

Autumn 2020 marked two historic moves for both Fortius Clinic and AFC Wimbledon. Fortius opened a state-of-the-art orthopaedic and sports injury treatment clinic in Worple Road, Wimbledon, expanding its London footprint and bringing outstanding surgical and medical care to patients in the South West. AFC Wimbledon returned to its original home in Plough Lane with a brand-new stadium after 20 years away. Fortius Clinic joined forces with AFC Wimbledon as the club’s official Health and Wellbeing Partner in October 2020.

Fortius is delighted to have had the opportunity to partner with AFC Wimbledon and to support the SW community. We offer world-class care and first-class service to patients and referring doctors and have a well-earned reputation for excellence. We look forward to continuing to meet the needs of the private patient population in Wimbledon and beyond.

Thank you for taking the time out of your day to speak to us. How did the Clinic first form and how has it progressed over time?

AN: Fortius was formed in 2009 with a number of consultants, who got together and decided that they wanted to set up a private orthopaedic clinic and offer the best treatment available.

The first clinic was opened in Marylebone and this was followed by a clinic in the City. We also have a surgical centre in Marylebone. Recently we opened a clinic in Wimbledon. We now have around about 100 consultants including radiologists and rheumatologists who work within the Fortius group. They treat players from all types of sport, whether it’s football, ice hockey or rugby, alongside everyday people who have musculoskeletal issues.

Fortius and its consultants have an outstanding reputation in orthopaedics.

Many of our consultants treat elite sportspeople including those from the Premier League, and we have become the clinic of choice for them.

AM: We have a lot of consultants who are used to dealing with Premier League players and top end sports people.

The clinic also divides itself into various specialist areas – if you come to us with a knee problem, you’re going to see a knee expert, not a general orthopaedic surgeon.

We’ve also got sports physicians and rheumatologists. The rheumatologists are important because we see problems in day-to-day life which also occur in sports people, so we must be aware that they don’t just get elite injuries, they suffer from all the other ailments that the rest of us suffer from, so it’s important that we make sure that they’re well looked after.

And then of course there’s the radiologists who sit in the dark! There’s a plethora of us and there are a few of us who do the elite work.

The real aim of Fortius is to deliver top level care to not only the super athletes but also to the non-sporting patients.

We deliver three aspects of care. One is patient care - we look after the patients, we see them through their patient journey, from the beginning of the injury to the end of the injury. There’s also a teaching aspect, the teaching aspect is important as you can bring people on and you leave some kind of legacy. And then of course there’s the academic side, which is also important, and we need to deliver high quality academic work to maintain our FIFA mark.

The FIFA mark means that we not only deliver high quality care but also good quality academic work that is published. If your work is published, others can take a look at your work and understand how it works.

So, there’s three key aspects of patient care.

How did Fortius first become involved with the Dons and what do you offer the team and its supporters?

AM: We originally got involved slightly accidentally as AFC Wimbledon, many years ago, required specialist intervention and they would use some of the surgeons and the physicians of Fortius.

Very local to where the club was (at Kingsmeadow) there was a scanner which was used quite a lot and Fortius did a lot of the sports work. So slightly by default we started doing that for AFC Wimbledon and our work with the club built upon that.

We talk about the three ‘A’s in medicine. Availability, which we like to think we’ve nailed. Affability, which means that you can get on with us and we speak a normal language that everybody understands. Ability which is our ability to be able to provide a good quality report from a radiological point of view and good quality consultations from our clinical colleagues.

So, I suppose that’s how our relationship grew, and this was helped by the opening of Fortius Clinic Wimbledon last year.

I’d also like to add something that is slightly off topic. The Sportsman was a pub that was just off the old ground and that was the first pub that I ever went into at the age of 18.

So, Wimbledon has great memories for me, and I do remember the old days, I remember seeing Vinnie Jones playing there as well.

How has the medical side of football progressed over the years and how has your involvement as a business in the game changed?

AM: With regards to medicine and football, it’s come on so much. You know pre-me starting it would be someone on the side lines with a bucket and a sponge, and that was the best treatment you got.

We’ve all seen what some people would call acts of terror, with players running on with a sponge strapped to their heads and that just wasn’t the right way forward.

We’ve seen head injuries happen on pitches and now there’s a lot more management for head injuries, everyone knows what to do, everything has protocols.

Which means that the players and the teams are well looked after, and they return to play after an injury a lot quicker.

Our original ethos at Fortius was to have a small clinic where we could look after the elite players in relative privacy and that’s what as doctors we want, but as an ongoing business that wouldn’t have been viable. So, we got in touch with the professionals including our CEO Jim McAvoy. Jim brought in some other people who really wanted to serve our purpose and look after the business side - most doctors aren’t particularly good at business.

They gave us a good understanding of how the business works, they still look after it and they have managed it brilliantly and have allowed us to create what we wanted, and I think they have enjoyed doing it as well.

What importance does orthopaedic and musculoskeletal (MSK) healthcare have in football?

AM: It’s extremely important, but in some places, such as America for example, they don’t believe in any form of imaging of muscle injuries because they say it doesn’t get them any further.

Some people would suggest that we over image, but scans provide information that allows us to speak to the management, speak to the player and in some cases the player’s agent as well.

All these people come into the mix, it’s not quite normal medicine, it’s medicine with a lot of angles to it, all generally pulling in the right direction. That’s not always the case but as doctors we must try and manage those various facets.

What challenges has the pandemic brought about for the business to overcome?

AM: During the first lockdown, the clinic doors were locked and that was that. Nobody was given care but there weren’t any players playing. But I think it was challenging for the non-sports patients to go without that sort of care.

But as time went on it was clear that these orthopaedic and MSK cases weren’t even going through the NHS because the NHS was totally focused on COVID, so as the restrictions relaxed bit by bit we were able to see more patients.

There were lots of other little issues as well, I’m sure you remember non-steroidal anti-inflammatories were at one stage regarded as dangerous with COVID patients, so we were telling all our patients that they shouldn’t take these.

Then the following week the trial came out which said they’re fine, so now we’re telling them all that they can take them again.

Eventually some of the footballers will be having their vaccinations and this may become an issue that we all need to start talking about and in the end work out between us.

How do you see the partnership between Fortius and the club developing in the long term?

AM: I hope it will continue to progress. The best way to make things like this progress is to get on and be available, you know there will sometimes be disagreements, there will be points where we must discuss issues and manage those issues, so it really is all about management.

We have had a great relationship with Wimbledon, and we hope to develop that and create even more bridges between us as we do with other professional clubs.

Working with professional clubs and in that arena has allowed us to take what we learnt from one and pass it on to another, so it’s sort of self-perpetuating and I hope we’ll be able to really develop things.

And through the closer relationship, hopefully we can start talking about some of the other facets such as teaching, which could be beneficiary to your club’s medical department.

We would also like to develop some form of academia. Football is a sport where injuries occur and actually looking at how injuries are diagnosed and treated and whether we can improve that further would be something that we would be happy to contribute to.

So, there’s lots of facets that we can look at to take things forward.

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