Hope in the Midst of Devastation

Date: February 1, 2014

Ficke aims to create same-day access to orthopaedic clinics at Hopkins

Retired Army Colonel James Ficke treated more than 600 U.S. soldiers and Iraqi patients for war injuries as deputy commander of clinical services at the 228th Combat Support Hospital in Mosul, Iraq, from 2004 to 2005.  The senior orthopaedic surgeon there, Ficke supervised 15 physicians and managed 19 mass casualty incidents resulting in 1,600 trauma resuscitations—82 percent of which were musculoskeletal injuries.

“The volume was enormous,” says Ficke, the new director of the Department of Orthopaedic Surgery and orthopaedist-in-chief of Johns Hopkins Hospital. “We managed a volume higher than most Level 1 trauma centers and saw mostly blast and penetrating-type injuries. It changed who I was. I saw humans at their best, but also a war in which humans were at their worst.”

A nationally renowned expert on the treatment of complex foot and ankle injuries, lower extremity trauma, and amputation, Ficke brings new expertise, including the specialty of limb salvage, to the department at Hopkins. “The first patient I saw here faced whether to keep her limb or go with a full amputation, something she has not elected to do,” he says. “We can help restore function to devastating limb injuries.”

A 1983 West Point graduate, Ficke earned his MD at the Uniformed Services University of Health Sciences’ F. Edward Hebert School of Medicine in 1987. He was most recently chairman of the Department of Orthopaedics and Rehabilitation at the San Antonio Military Medical Center at Fort Sam Houston in Texas, as well as the orthopaedic surgery consultant to the U.S. Army Surgeon General at the Brooke Army Medical Center in San Antonio. In this position, he ensured exceptional care in this specialty at Army health centers across the country.

He now leads a department at Johns Hopkins that is focused on adapting to change. First up, he says, is improving access, which in super-subspecialties can stretch as long as two months. The target is for patients to see an orthopaedic expert the same day. “Our goal is to create same-day-access clinics within both Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center that are staffed by orthopaedic surgeons and midlevel providers who will care for musculoskeletal injuries,” says Ficke.

“The orthopaedic surgeons provide oversight and enable us to send patients quickly to the right clinics and the right specialists. We’ll have the most customized referral process available. Our goal is to roll this out within the next six months.”

His team looks forward to working closely with other Johns Hopkins specialists, including those in physical medicine and rehabilitation, radiology, and plastic and reconstructive surgery. “A multidisciplinary team is often the best answer to serve our patients,” he says.

In the area of education, Ficke says he aims to establish a formal professional development program for department faculty. He will also work to create formalized service opportunities for residents “to go on outreach programs—locally, nationally, or internationally—so they can get an understanding of how to serve others.” Michael Keating