Member of the Month: Rathna Nuti, MD

Frisco physician practices sports medicine with a family medicine touch

By Perdita Henry

posted 10.03.18

Rathna Nuti, MD, is in the process of crafting her career as a primary care sports medicine physician. It’s been a little more than a year since she completed her fellowship in sports medicine at Drexel University in Philadelphia, but she has wasted no time getting situated in the field and utilizing her talents with local teams. She practices medicine in Frisco at the Texas Metroplex Institute for Sports Medicine & Orthopedic Surgery, and she’s the assistant team physician for the Dallas Stars NHL Hockey Club and the team physician for the Dallas Stars Ice Girls.

For as long as she could remember, medicine held her interest but it took some time to find sports medicine. “I didn’t even know sports medicine existed until I started my family medicine residency at UT Southwestern,” Nuti says. “There was a graduating senior who was accepted into a sports medicine fellowship at the University of California, San Diego. Talking to her, led me to cultivate that interest and speak to mentors in the field.”

Born in Milwaukie, Wisconsin, Nuti and her family relocated to the Dallas-Fort Worth area when she was just 6 years old. “My interest in medicine began when I was 2 or 3 years old,” Nuti says. “My grandfather had a stroke and suffered from paralysis. The whole family pitched in to help him out. I realized how people can become helpless when they aren’t completely healthy. That idea struck me profoundly.”

As she moves forward in what promises to be a bright and successful career, Nuti was kind enough to share her insights on the field of sports medicine, how family medicine’s ideas on comprehensive care compliment sports medicine, and share some of the lessons she’s learned while assisting in the immense task of opening a new practice.

You finished your sports medicine fellowship a little over a year ago. What’s your biggest realization as a new physician?
The business aspect. I joined Texas Metroplex Institute for Sports Medicine & Orthopedic Surgery in Arlington, and we opened a brand-new location in Frisco this past February. That has been a huge learning curve. I’ve learned how to start a practice, how to make ourselves known in the community, and how to reach out to various people. It’s been a growing experience, but it develops you more as a person. You learn to appreciate the things that don’t come to you easily. Before you experience this challenge, you’re thinking, “Oh, I’ve been through so many years of schooling and now I get to see patients.” It doesn’t work that way. Two of my other colleagues and I were hired on at the same time. We are all from UT Southwestern and from an academic practice environment. Now we have to work to get our patients, gain their trust, and make ourselves known in the community. That has been a very humbling experience for us.

How would you define the personal mission of your practice?
My mission is to provide comprehensive care for anyone engaging in sports or recreational activity and give them the best care possible, in terms of injury prevention and treatment. I want to ensure they stay healthy, so they can continue doing the activities they enjoy.

If you can provide comprehensive care for anyone, then you are able to help them continue their level of activity. As physicians, we can fall into the trap of, “Hey, go be active and lose weight.” But if we approach it from a different angle by saying, “Here’s how I can help you become more active and here’s what I can do to help you sustain your activity level.” People are more receptive and appreciate that approach more. That is where my family medicine background comes in, it’s from both the preventative and treatment aspects.

For example, if a girl comes in talking about leg pain and I find out she has a low vitamin D level, I would supplement her vitamin D level. I can at least prevent her from having other types of bone problems, in terms of stress fractures and stress injuries. Addressing those things early on is key. Sometimes physicians can fall into the trap of, go do this, go do that, or don’t do this, don’t do that. It’s more important to provide the quality of care in a comprehensive manner. We will be more effective because of it.

As a sports medicine physician, what makes what you do different and unique from other practices?
My interest is in female athletes. I target women and girls and treat them using the female athlete triad perspective, which means I’m looking at their nutritional intake, their activity levels, and their bone health.

Regenerative medicine is a hot topic right now. It’s something we’re still exploring and needing more research on in terms of using biologics in our field to treat common issues, such as osteoarthritis, tendinitis, and tendinosis. There is value, not only from a sports medicine perspective, but from an orthopedic perspective in terms of novel ways of approaching healing or diminishing pain beyond the typical, “avoid those activities, take some meds, or I have no other options for you. It’s nice when patients have options.

Can you tell me more about regenerative medicine?
When it comes to regenerative medicine we are really talking about biologics — for example, platelet rich plasmas and stem cells. There are so many things out on the market right now. Regenerative medicine’s role in sports medicine is to diminish pain for those suffering from osteoarthritis and tendinosis. Whether or not it regrows damaged tissue is debatable, and there’s still more research that needs to be done to adequately address that, but I think the public gets the wrong notion that we are trying to regrow or reverse something that has been diseased.

I consistently counsel my patients to let them know I’m not re-growing anything. I don’t have enough evidence to support that. What I can do is somehow diminish your pain level, and again, we are still figuring out how we are doing that. I would advise patients thinking about regenerative medicine to speak with their physician, because not everything on the market is most appropriate for them or their health.

The focus on sports injury and the health of athletes generally centers the male athlete. What do you wish more physicians and researchers spoke about regarding female athletes?
From the women’s perspective, it would be great if there was more emphasis on injury prevention and the importance of nutritional intake. Even though those things are emphasized, I don’t think it’s as adequate as it could be.

There have been a lot of debates about approaching female athletes in terms of their bone health. It does get complex with women when addressing their menstrual cycles and trying to accurately understand their bone health. When I see women and girls in my clinic, they don’t always understand the importance of bone health or why it’s important to think about while they’re still young. That kind of emphasis is complex and can be difficult to address. It’s hard to get teenagers to understand the importance of it, in comparison to someone older who wished they’d done more while they were young.

What’s a real-world lesson about being a family physician that medical school didn’t teach you?
The practicality of patients coming to you. In med school, you’re taught how to be compassionate, how to listen to patient problems, and how to treat patients for what ails them. Real world experience has taught me is it’s not just about listening to the patient. It’s sometimes about re-directing the patient to things more relevant to the clinical setting.

There are also times when your beliefs get challenged because of patient wants and demands. When facing that, you must stick by the fact that you are the physician, rely on what you’ve been taught, and what you can consciously do. It can be a challenge to balance those things, but that’s when you must take a stand and say, “No, this is what I am going to do.”

TAFP’s Member of the Month program highlights Texas family physicians in TAFP News Now and on the TAFP website. We feature a biography and a Q&A with a different TAFP member each month and his or her unique approach to family medicine. If you know an outstanding family physician colleague who you think should be featured as a Member of the Month or if you’d like to tell your own story, nominate yourself or your colleague by contacting TAFP by email at tafp@tafp.org or by phone at (512) 329-8666. View past Members of the Month here.