In the face of the ongoing opioid epidemic, orthopedic surgeon Dr. Kirk Campbell finds new and innovative ways to manage his patients’ pain while minimizing the risks of addiction. Hear how his childhood devotion to sports inspired his career, how his commitment to improving patient care spurred his passion for diversity and inclusion, and how he and his colleagues are leading the charge to fight the opioid crisis.
In the face of the ongoing opioid epidemic, orthopedic surgeon Dr. Kirk Campbell finds new and innovative ways to manage his patients’ pain while minimizing the risks of addiction. Hear how his childhood devotion to sports inspired his career, how his commitment to improving patient care spurred his passion for diversity and inclusion, and how he and his colleagues are leading the charge to fight the opioid crisis.
Vital Signs: Season 2, Episode 6
From Sirius XM and NYU Langone Health
Title: It's OK To Be Uncomfortable
Dr. Kirk Campbell, guest
Rose Reid, narrator
Dr. Kirk Campbell: A lot of the narcotic medications that used to be prescribed and, or are still prescribed patients don't actually use. And then it will go in the medicine cabinet and the patient may forget about it. And he, or she may have a child or somebody come over look in the medicine cabinet and see that narcotic. And that may be their first exposure to narcotic and eventual abuse. That's usually how the story goes.
Narrator: In the midst of a global pandemic, there has been an ongoing epidemic in the US: opioid use, abuse, and overdoses. According to the CDC, opioids were involved in more than 75 thousand deaths in this country in 2021, an increase of nearly 34 percent from the year before. Dr. Kirk Campbell is an Associate Professor in the Department of Orthopedic Surgery at NYU Langone Health. One reason he and other orthopedic doctors prescribe these powerful narcotics is because they work really well to reduce pain…but they also increase the risk of a lot of other problems - for the patient who is prescribed the opioids, and for anyone who lives with them.
Dr. Kirk Campbell: I want to try and do my part to hopefully prevent somebody’s sister, brother, son, from becoming addicted to the narcotics that I may have personally prescribed for something else.
Narrator: From SiriusXM and NYU Langone Health, this is Vital Signs, where medicine is made personal. I’m your host, Rose Reid.
Music Break
Dr. Kirk Campbell: I had one objective and one objective only that was to become a orthopedic surgeon, specialized in sports medicine
Narrator: Dr. Kirk Campbell grew up on the island of Jamaica, in a town not far from Kingston called Old Harbour. He lived there with his brother- and his mom, who never finished high school. When he was four years old, she moved to The Bahamas for a new job.
Dr. Kirk Campbell: She had to leave my brother and I with one of her best friends, because we didn't really have any other family in Jamaica. So although that was quite difficult for her, that was really a pivotal moment for me, just seeing the dedication she had to her family to leave for a better job. I know to provide us with support. She would come back frequently at age seven. I told her I wanted to do one of two things in life. One. I wanted to be a physician because I really enjoyed helping people. And two, at the time I had an infatuation with the military. I told him I wanted to join the military, but you know, only one of two came true. My parents spoke, uh, just from educational opportunity standpoint. Uh, they thought it would be a better educational opportunity if I moved to live with my father
Narrator: His dad lived in the U.S., in Springfield, Massachusetts, and Dr. Campbell moved there when he was nine years old.
Dr. Kirk Campbell: Every chance I got, I wanted to see something, medical, somebody who is injured, I wanted to know how I could help to make them better. Although, I didn't have the knowledge or skills. I was still very into trying to help people. Moving from Old Harbour, Jamaica to Springfield was a very, very enormously, large culture shock for me. I moved into fall. It started snowing shortly thereafter. And for me it was a big culture shock. I left everything. I knew all my friends, my brother, who, uh, had grown really attached to, he remained in Jamaica.
Narrator: As Dr. Campbell adjusted to his new life in Massachusetts, he struggled to fit in. And then, for the first of many times in his life, he found solace in sports.
Dr. Kirk Campbell: I'm approximately six four and when I first moved, I was not tall at all, but a summer or two after I hit a growth spurt and being tall has its benefits. I got exposed to basketball and it ended up being something I absolutely loved. I made some of my nearest and dearest friends through basketball, just the concept of teamwork, dedication to things that we were able to achieve. I played on a travel team during that time. I was able to see different parts of the country meet different people. So sports really kind of guided my cultural introduction to the U S and made my transition quite smooth. My parents ended up using basketball as a way to really motivate me, you know, schoolwork, homework was not completed. If grades were not maintained, then there was no basketball. So that really drove me to Excel in school because you know, basketball was really my love and still is. So I had to make sure that I maintained grades and just growing up my mother, that's the one thing that she always instilled with me. It was the importance of education. And I think that may be a result from the fact that her education was interrupted. So she thought it was extremely important for us to get an excellent education.
Narrator: He loved school, and like basketball, he was good at it. As he got older, Dr. Campbell never wavered on becoming a doctor, but it was in high school that he realized just what kind of doctor he wanted to be.
Dr. Kirk Campbell: At age seven I told my mother, I wanted to be a pediatrician because I love children. In high school. I played varsity basketball. I mean, I had a few bumps and bruises, injuries along the way. I remember it quite well, I saw a sports medicine physician and our interaction was phenomenal. I was hooked. I could not believe that people actually got paid to do sports medicine. I actually, I still can't believe I'm compensated to do sports medicine because it's something I thoroughly enjoy. From that point forward, I had one objective and one objective only that was to become an orthopedic surgeon, specialized in sports medicine. Of course, during medical school, I explored other fields to really reaffirm my desire to do orthopedics and sports medicine, but nothing ever came close to it.
Narrator: Most people don’t end up doing what they dream of as a child. If that was the case, there would be way more astronauts and fire fighters out there. But Dr. Kirk Campbell made it happen: he attended medical school at NYU Grossman School of Medicine, went on to specialize in orthopedics and sports medicine, and has worked with all kinds of athletes at every level - including the Chicago Bulls and Chicago White Sox - helping them prevent and manage injuries.
Sports Highlight: Puts it up and scores! At the buzzer! Michael Jordan has won it for Chicago!
Dr. Kirk Campbell: I think the fact that a lot of my colleagues, myself included, were athletes ourselves or are avid sports fans really impacts the care that we provide to our patients. We understand what it's like being unable to be out there, with your teammates, we understand the rigors of rehabbing from a injury and we understand overall impact it has on your life being unable to you know if you're a runner and getting out there and just going for a run, it's difficult. It affects the rest of your life you know, it affects your social interactions, it affects you from a psychological standpoint. So being former athletes, I think gives us a unique perspective to understand and provide really outstanding care for our patients.
Narrator: His expertise, training, and history as an athlete, are all essential tools for Dr. Campbell. As he takes care of patients, he also draws on other experiences.
Dr. Kirk Campbell: Diversity and inclusion is something that I'm quite passionate about within medicine itself. Unfortunately, the physician workforce is not representative of the patients that we see. You know a lot of studies showing that patients have sometimes better outcomes when they're cared for, by people who may look similar or have similar backgrounds or cultural similarities. There may be little subtleties that someone else may not pick up on. So I think it's important to really promote diversity and equity within medicine. Whether it may be a cultural similarity or racial or something else they have in common. I think patients overall are more likely to follow through on the treatment plan when they’re invested and feel that the provider is invested in their care. Unfortunately it's not very common to have an African-American orthopedic surgeon. Just yesterday in the office, I had a patient who said he specifically came to see me because he was shocked that there was a African-American orthopedic surgeon. So he specifically looked out for that. And uh, he said, you know, he wanted care at NYU Langone orthopedics. And he specifically came to see me because he's never seen an African-American orthopedic surgeon. I have had interactions with patients who might have known, I guess they didn't look online to see what I look like. You know I'll walk in and say, hi, I'm Dr. Campbell. Like, Oh, you're Dr. Campbell. I'm like, I'm pretty sure I am Dr. Campbell. (laughs) I think, you know, they’ll see a tall African-American guy walk in with a name like Kirk Campbell, which I guess classically may not be associated with a tall African-American gentlemen and they may be taken aback. You know, more of a young Denzel slash Sydney,[laughs]
Narrator: Less than two percent of orthopedic physicians are African American. It’s not a problem that’s unique to one field: just 5.4 percent of all physicians are African American, according to the latest data from 2018. And this sort of representation matters
Dr. Kirk Campbell: We need more female physicians within medicine, especially within orthopedics. not a lot of African-American or Hispanic orthopedic surgeons either. So when I see diversity and equity or I mean in really the true sense of the word, different cultural backgrounds, gender, gender identity, all of these things are important because patients want that. And our overall system really benefits from a diversity of ideas and backgrounds.
News Clips:
“At least 91 Americans die everyday from an opioid overdose. Drug overdoses now kill more people than guns or car accidents.”
“19 times this year, they’ve had to respond to calls for children with opioids in their system”
“Nationally, there were 81,000 drug overdose deaths from May 2019 to May 2020. The highest number of overdose deaths ever recorded in a 12 month period according to the CDC.”
Narrator: Orthopedic surgeons are among the most likely physicians to prescribe opioids, and for good reason.
Dr. Kirk Campbell: Unfortunately orthopedic injuries hurt, surgery unfortunately also hurts. And thats something that I personally discuss with my patients is that we will do a outstanding job of managing your pain, but you're not going to have zero pain. You are going to be uncomfortable. It's okay to be uncomfortable. We should not be an extreme pain, but it's okay to be uncomfortable.
Narrator: One of the more critical elements of managing patients’ pain is also managing their expectations.
Dr. Kirk Campbell: I think it's important for not just orthopedic surgeons, but I think physicians in general to have these potentially uncomfortable conversations with patients about pain management and the role of prescription narcotic medications on the opioid epidemic we're currently facing. Having expectation of zero pain, I do not think is a reasonable expectation. So it should make it clear that you may be uncomfortable. We will do everything in our power to make sure you're as comfortable as possible with limited narcotic medication. If indicated is an important conversation, we have to be really good stewards of these are medication. Think by and large, the fast majority of physicians and my orthopedic colleagues, these are conversations that we're having with our patients.t a lot of the narcotic medications that used to be prescribed or, and, or are still prescribed patients don't actually use. And then it will go in the medicine cabinet and the patient may forget about it. And he, or she may have a child or somebody come over looking at medicine cabinet and see that narcotic. And that may be their first exposure to narcotic and eventual abuse. That's usually how the story goes. I want to try and do my part to hopefully prevent somebody’s sister, brother, son, from becoming addicted to the narcotics that I may have personally prescribed for something else.
Narrator: Stopping opioid abuse before it starts is crucial; by limiting prescriptions, avoiding refills, and pursuing alternate pain management approaches, physicians like Dr. Campbell can help reduce opioid addiction, and related deaths. And his research in this area has only reinforced the benefits of this approach.
Dr. Kirk Campbell: We were able to take a deep dive into post-operative pain control. We've adopted a multimodal pain management strategy. We're utilizing co-therapy with ice, we’re utilizing anti-inflammatories, uh, you know, regular Tylenol and very limited narcotic medications. We're able to definitively show that patients do not require significant amount of narcotic medications with a lot of procedures that we perform, and more importantly, patients overall satisfaction with their care and overall satisfaction with the pain management was similar. There's no difference. And that's kind of the experience I had in the office, which really led us to embark on this mission to be better stewards of their narcotic medications, that a lot of people really and truly do not need. Don't get us wrong: there is acute post-surgical pain, and that's something that we take very, very seriously and we address, but we're able to show that utilizing a multimodal pain management strategy works, and I think it's better for patients.
Narrator: Pain can be unpredictable, even when we know it’s coming. With orthopedic surgery, we know there’s going to be pain - we just don’t know how much, or what exactly it will feel like, or how long it’ll last. This unpredictability can be as much of a problem as the pain itself.
Dr. Kirk Campbell: One of the studies I did, we asked patients why they used the narcotic medication and the most common responses we got were, number one, they were afraid that they may be in pain. So they were not actually in pain. And number two, a family member encouraged them to use it rather than actual pain. That was a pretty powerful thing for us. Patients are not actually in pain. It's more the fear of being in pain and, or a family member being afraid that they may be in pain. I think is important for us to be at the forefront of really managing expectations and managing postoperative pain appropriately
Narrator: Dr. Kirk Campbell has already come a long way in his career. He has traversed countries and cultures, and turned a passion for playing sports into a career caring for athletes. He’s worked as a physician for major professional sports teams, and his opioid reduction research is sparing patients and their families additional suffering, and pain.
Dr. Kirk Campbell: So I still pinch myself from time to time because I am literally living my dream. I went from extremely humble beginnings in a small Island nation. Mine is a story of hard work, dedication, understanding, and appreciating the importance of having a good education and really embracing, seeking good mentors. And then on the backend, as you move through different levels of life, make sure you also reach back to mentor those who are coming behind you because that's the only way that you're able to change the face of medicine. I try to treat everybody with the golden rule, right. Do unto others as you'd like others to do unto you. And I think as long as you go into every interaction with this mutual respect for the patients, do beliefs, you know, your colleagues in their beliefs. I think that commonality will lead to positive interactions. I've had nothing but fantastic experiences here, you know, at, uh, NYU, I've had phenomenal mentors, I've had great patients, I've been able to participate in their care. Listen, I'm pretty lucky.
Narrator: Vital Signs is a co-production of NYU Langone Health and SiriusXM. The podcast is produced by Jim Bilodeau, Julie Kanfer, and Keith King, with sound design by Jim Bilodeau and writing from Julie Kanfer. SiriusXM’s executive producer is Beth Ameen, in partnership with Allison Clair and Jim Mandler of NYU Langone Health. Don’t miss a single episode of Vital Signs and subscribe for free wherever you listen to podcasts. To hear more from the world-renowned doctors at NYU Langone Health, tune into Doctor Radio on SiriusXM channel 110. Or listen anytime on the SXM app. To get in touch with our production team, email VitalSigns@siriusxm.com. For the Vital Signs podcast, I’m Rose Reid. Join us next time as we bring you stories of medicine made personal.