About

Meet Our Team

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Jared Toman, MD, MBA

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Dr. Toman started his medical career at the College of Physicians and Surgeons at Columbia University where he received the Admiral Lyons Award for being the top military medical graduate. He accomplished his post-graduate training in Boston with an Internship at the Harvard-affiliated Beth Israel-Deaconess Hospital and residency in Orthopedic Surgery at Boston University.   Never shying away from hard work, he completed a Master of Business Administration at the University of Massachusetts while still in residency.

As a member of the United States Air Force, Dr. Toman served with distinction as an orthopedic surgeon at Walter Reed and Andrews AFB, caring for Wounded Warriors, their families and elected officials in our nation’s capital.  He was then recruited to rebuild the orthopedic surgery department at a regional medical center in Georgia.   Just two years later, it was recognized by JAACO with the prestigious Gold Seal Certification in Joint Replacement.

During his time in military and civilian orthopedic practice, Dr. Toman sought out opportunities to learn the best and most current techniques in both surgical and non-operative management of musculoskeletal disease, and bring those techniques to his local patient.   Since deciding to come home to Southern New England, he has continued to do so with the help of his efficient and friendly orthopedic team.  When not at work, Dr. Toman likes to train for running and triathlon events, building boats and most enjoys spending time with his wife and four kids on their small farm.

Dr. Toman’s primary practice is conveniently located at the primary Heywood Healthcare locations in Gardner, MA and Athol, MA.

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Emily Diconza

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Emily Diconza PA-C has been in practice as a Physician Assistant since 2013.  Her clinical skill, dedication and compassion are integral to our clinical practice. During her training in Worchester, she was elected to two separate Honor Societies and carries a deep understanding of the injured athlete stemming from her background in high school and collegiate athletics.  Originally from Fitchberg, Emily is proud of the part of the premier orthopedic surgery practice serving her hometown. 

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Bruce Hitchinson

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Bruce Hitchinson PA-C spent most of his medical career at a high-volume orthopedic hand practice where he developed considerable expertise in the management of hand and upper extremity problems.  Prior to training as a PA, he worked in physical therapy and is able to draw on that experience in the care of surgical and non-surgical patient.  Bruce is a well-read Cross-fit enthusiast, and his winning personality consistently garner high praise.

Teamwork, Safety, Outcomes

Dr. Toman's vision for Heywood Orthopedics and Sports Medicine

Surgergy Care Philosphy

 
The Heywood Orthopedics and Sports Medicine Team provides both operative and non-operative musculoskeletal care.  When a patient chooses us to provide surgical care and embarks upon surgical relationship, they become a member of our Haywood family.  My commitment to my patients who have trusted my team and I with their operation extends not just through the first few follow-up visits, but for life.  Our mutual goal for our joint replacement and sports medicine operations is to restore the desired level of function and have patients forget the joint had been a problem in the first place.  However, I firmly believe the best outcomes are not just 'good', but durable as well.  The implants I place and repairs I perform are intended to decrease pain and restore satisfactory function, but should also be monitored on a regular basis to assure that they continue to function properly.  
 
Successful outcomes in orthopedic surgery and sports medicine require an equal partnership between providers and the patient.  We commit to our patients that we will work to the best of our abilities and use the the best evidence-based techniques to give you the outcome you expect. In return, we expect our patients to fulfill their end of the relationship in terms of being active participants in their recovery (ie, pre-op medical optimization, following post-op protocols, being on time for appointments, etc).

Results and Outcomes

Our goal is to improve each patient's quality of life with the least possible risk.  As part of our ongoing commitment to providing the best care, my staff and I will spend time collecting data from our patients.  The data we collect helps to 1)  compare my performance with that of other surgeons and national benchmarks, 2) monitor clinical progress over time, and 3) assure that the operations reliably and significantly improves patient's quality of life.  Towards that end, we request and expect patients to help us gather this data by filling out short survey forms evaluating their own personal function and their experience with our 'customer-service' on a regular basis to help obtain these important metrics.  In this way, patients can not only benefit personally from the strategies we offer, but can also meaningfully help improve the care of others in our community, and the population reserve and large.

Surgical Planning

When patient comes to clinic with expectation of surgery, they should plan to spend more time with us than during a standard visit.  Multiple members of the team will be involved optimizing the planning around the operation.  We will discuss objectives of surgery, post-op planning and review risks and benefits.  It is also likely that additional referrals to other participating specialists and providers will be made at that time.  There may be other visits required to discuss expectations regarding care before and after the procedure and prepare for the surgery iteself.  Although it is tempting to focus on the details of the surgical proceure, these visits are just as important.
 
Moreover, in the past orthopedic surgery patients were through of as "sick" or compromised after surgery  and in need of hospital-level care for long periods.  Our approach is to improve the patient experience to such an extent that surgical encounter requires little if any 'acute care' in the hospital.  Rather, using the best evidence-based techniques, most patients are able to get up and walk, and in many cases safely be discharged home on the first day of surgery.  Even after total joint replacement we seek to return patients home or to a supportive care environment where they can heal and recover under the best possible conditions.  With outpatient surgeries, we provide guidance in partnership with our physical therapists to get patients moving as quickly and as safely as possible.  It is our goal in everyway to make patients who have undergone surgery feel well.  Lastly, an important part of a safe discharge is close follow-up.   Towards that end, we have an open-door policy for post-operative patients should there be a concern that things not following the usual course of recovery.

Pain Control 

It is important to remember that surgery is controlled damage to your body in order the achieve a positive result.   As such, pain is to be expected.  Pain control after surgery, or even in office procedures or injuries, is a significant source of anxiety concern for many patients.  Over the past 15 years we have seen an explosion of opioid use, misuse and mortality related to these compounds.  Patient undergoing orthopedic procedure should expect some discomfort, however, this is typically short-lived, and we used a multimodal control approach to address the underlying chemical and physical causes of pain.  These modalities include ice and heat therapy, judicious use of NSAIDs (ie, Naprosyn, Meloxicam), acetaminophen (Tylenol), nerve modifying agents (ie, Gabapentin), as well as narcotics when appropriate.  During surgery, patients may also request periarticular nerve blocks performed by our highly- skilled anesthesia providers.  Similarly, I typically perform articular injections during surgery with a combination of marcaine (long-acting local anesthetic), Duramorph (R) (a long-acting morphine) and toradol (powerful non-steroidal anti-inflammatory).   Both of these inteventions work to minimize pain over the first 12-48 hours and work together with the above medications.
Heywood Orthopedics and Sports Medicine is an opiate-sparring practice.  It is our expectation that only a single ascription of narcotic medication will be prescribed following surgery, and apart from extenuating circumstances, narcotics cannot be refilled by via phone request.  Opiates function not by lessing pain, but by diminishing the bothersome and distressing nature of the pain.  In our practice, these drugs are only a small component of the overall postoperative treatment strategy.  It is important to note that using an opioid sparing approach, patient's report less pain, less nausea, less fatigue and fewer side effects from surgery, as well as a quicker overall recovery.  I have personally performed many hip and knee replacements on individuals in recovery from drug and alcohol addiction who requested that no narcotics be used in their treatment.  Their results many cases exceed the short-term results of patient's treated with larger doses of narcotic medication.

Surgical Volume

Heywood Orthopedics and Sports Medicine is one of the fastest-growing practices in Southern New England.   We are a high-volume orthopedic practice.  I typically perform over 300 primary total hip, shoulder and total knee procedures per year, as well as revision (redo or second time) procedures where necessary.  Similarly, I personally perform on average 300 sports procedures (ie, arthroscopic procedures) to the shoulder and the knee each year.   This volume is made possible by the support of Heywood Healthcare and the consistent expertise of myself and the entire operative team.  The high number of cases allows us to maintain a level of proficiency and expertise in the performance of these procedures not found at lower volumer centers.  Therefore, this volume does not diminish the importance of each individual surgery:  rather enhances it.  Although there are centers in Boston and Worchester that offer highly-specific or niche procedures, our goal at Heywood Orthopedics is to be the preferred provider of the musculoskeletal care and surgeries most demanded our community.  By being a higher-volume center, we make the procedures our patients demand safer and more effective.  Our processes are guided by best evidence based practice, and undergoing constant improvement and revision.  Towards that end, we also solicited and welcome patient feedback input as to how we can further improve our customer service while continuing to provide world-class care.