Dr. Dylan Kluck Talks About Providing Life-Changing Care at Shriners Children's Lexington

Dylan G. Kluck, M.D., is a pediatric orthopedic surgeon at Shriners Children's Lexington, and an assistant professor at the University of Kentucky School of Medicine. He joined the team in October 2022 and sat down for a Q&A to talk about why he went into medicine, how he came to Kentucky, what makes working at Shriners Children's so rewarding and much more.

Talk a little bit about your education, medical training and work history.

I grew up in Boulder, Colorado. I completed my undergraduate education at UC Berkeley in California, and then did my medical training in St. Louis at Washington University Medical Center, where I met my wife. We were medical students together, and then matched together at UC San Diego for residency. After orthopedic surgery residency, I did my pediatric orthopedic fellowship at Scottish Rite for Children in Dallas. I started at Shriners Children's and UK this past fall, with my wife starting in the OB/GYN department at UK at the same time.

Tell us how you became interested in pediatric orthopedics.

My love for pediatric orthopedics actually began during my first rotation of third-year medical school, working with Dr. J. Eric Gordon at Washington University in St. Louis. Dr. Gordon is a big name in the pediatric orthopedic field, but also a truly caring and nice person. I can remember scrubbing with him on several surgeries at the St. Louis Shriners [Children's] location, and was therefore introduced to the Shriners system early in my medical training. Seeing the positive difference he was able to make with his surgeries, and his incredible rapport and calm confidence with his patients and families, was inspiring. As such, my initial interest in orthopedics was specifically because of my interest in pediatric orthopedics. My interest in pediatric orthopedics was then furthered during my residency training in San Diego, where I was fortunate to work at Rady Children's Hospital with a number of renowned pediatric orthopedic surgeons.

I enjoy working with kids because there is an incredible opportunity to impact them in a positive manner for the rest of their life. By addressing a significant lower extremity deformity or some of these bigger problems that we treat, a pediatric orthopedic surgeon can have a huge impact on a child's quality of life. Even with something more straightforward like a fracture, kids are motivated and want to get back to doing the things that they love to do, and being able to participate in that process is rewarding. In addition, I really enjoy the interaction with families, as pediatric orthopedics is a team effort.

What brought you to Kentucky and Shriners Children's Lexington?

I came to Shriners Children's Lexington through a fellowship connection with several of my partners having also trained at Scottish Rite in Dallas. My interest in Shriners specifically really goes back to having been exposed to the Shriners system at an early stage in my medical career, and the amazing care that I saw Dr. Gordon and Dr. Perry Schoenecker providing as part of this healthcare system. The mission of Shriners has always resonated with me - taking care of the kids that may have no other resources, and may have no other place to go. Being able to help the families that really need us is incredibly gratifying. Walking the halls at Shriners, you see people who have been here for 15 or 20 years or longer because they're all committed to the same goal, which is trying to make sure that we're doing the right thing for each patient.

Describe your patient population and presentations?

My practice is still growing, but in general is focused on the lower extremities. For the most part, that means things like clubfoot, hip dysplasia and lower extremity deformities and deficiencies, as well as neuromuscular conditions. A lot of these kids have something that's either happened at the time of birth - or around the time of birth - and has created challenges that we can help with as they move forward. In addition, I also take care of a wide range of acute injuries. Presentations are very varied, and that is one of the things I enjoy about pediatric orthopedics. Within one clinic you can see a foot, a hip and an upper extremity issue, and that variety, as well as the ability to take care of the patient's overall health and well-being, is something that is unique to pediatric orthopedics.

Describe the challenges and rewards of being a pediatric orthopedic surgeon at Shriners Children's Lexington.

Over the last several months, I have become acutely aware of the limited health resources that a lot of our patients have. The challenge with surgery is often the perioperative care and ensuring that patients are going to be successful when they go back to their home environment. For instance, is a patient going to be able to rehabilitate from the surgery that you're doing?

One of the advantages of Shriners is that we have a lot of services on-site to help patients as much as we can during visits. For instance, we have prosthetics and orthotics, we have the therapy groups, and we have multiple different orthopedic and non-orthopedic subspecialties all under one roof. As such, when we do have these patients that travel from several hours away because they don't have access to resources closer to home, we try to provide as complete of an approach to care as we can.

The rewards of working at Shriners are part and parcel with that in the sense that we see a lot of kids that come in that have had no healthcare and need a lot of help. Oftentimes, families are not here for small problems - they're here because they legitimately need care and often have nowhere else to go. At the same time, however, my partners have worked hard to establish a sense of trust with the care at Shriners Children's Lexington within the surrounding community, and we therefore also provide care for more common pediatric orthopedic conditions and acute injuries.

Can you talk a little bit about what the partnership with University of Kentucky means in the ability to provide great care?

Shriners does have a lot of resources that we can offer but the physical Shriners Children's Lexington building is an outpatient clinic and surgery center. It is therefore really important to have that academic partnership with the University of Kentucky because it then allows us to take care of both the outpatient and the inpatient care for some of the more complex cases. For instance, my colleagues are routinely doing spine surgeries across the street and I will perform some of the bigger, lower extremity cases there as well. Having the level one trauma center and the expertise of all the personnel associated with the University of Kentucky therefore helps us take care of the unique and challenging conditions that we see at Shriners.

What are the most common misconceptions about your specialty among non-pediatric orthopedics and other specialties that you want to address?

I think sometimes primary care providers feel bad about referring something that's not obviously a surgical problem, but in truth, we see a lot of things that are not surgical, and can often still help these families by educating them on the non-operative things that we can do as part of their care. In addition, we may have the expertise to pick up on something that's more subtle and that is ultimately our role as specialists!

Describe your personal philosophy of care.

Pediatric orthopedics is unique in that care very much does depend on the collaboration between the patient, the provider and the family. To that end, one of the challenges in pediatric orthopedics is that just because you can do something doesn't mean it's the right thing for that particular patient and family. I think to have a good outcome in pediatric orthopedics, you have to have full buy-in from the family and make sure that they're comfortable with the plan of care, you have to have the patient's best interest in mind, and you have to work very closely as a team to achieve that outcome. I really try to take this dynamic into consideration as I outline a treatment plan. I strive to make sure the family understands that they have options, and that they understand the risks and benefits of the different things that we're proposing so that we can make the best decision for their child and for their family as a whole. As such, I focus on spending as much time with each family as they need to make sure they get the care they deserve.