Recently, there have been many stories in the news about the problems facing rural healthcare, with over 150 rural hospital closures since 2010, and another 450 on the verge of closing. A recent study by the Chartis Center for Rural Health, using detailed historical performance statistics for a minimum of three years, found that 453 of 1844 rural hospitals are vulnerable to closure.
How many times have we been lectured on our need to focus on and deliver value when it comes to healthcare? Whenever I see this subject appear, invariably the equation “value equals outcome divided by cost” is cited. I’ve never seen this relationship among these three variables questioned - it has just been accepted as fact. To me, this formula looks eerily similar to that for measuring productivity. Should medical value be viewed/calculated similarly to productivity? I think not - we’re not making widgets!
Why is the word NO one of the first words we learn as a toddler, and the one word that we do not hesitate to use; but when we become adults that same word is almost impossible to say? Unless you are talking to your toddler, that is.
While it’s easy to get engrossed in the educational components of each WOA Meeting, it’s important to also take advantage of its many valuable opportunities to engage with speakers and other attendees.
It’s often said that society needs to be more “tolerant.” But, is that really sufficient? To me, one tolerates something unpleasant, such as a crying infant in an airplane or a putrid odor while performing limb or life-saving I&D. So, is being tolerant of someone implying something negative about them? Would it be preferable to be “accepting?”
In the words of Will Rogers, “You must judge a man’s greatness by how much he will be missed.”
Dr. John Tongue will be missed greatly.
Thank you to our orthopaedic leadership, including advocators on behalf of the WOA, for helping to usher in the ABOS Web-Based Longitudinal Assessment (WLA). The option to choose articles to fit my own practice and educational needs, reading and preparing on my own schedule, taking the exam without requiring travel to a testing center and immediate feedback on my responses all made for a non-onerous, non-disruptive process that served as a truly worthwhile learning opportunity. I found the informational sources valuable and easily-digestible (I chose one OKU chapter, two original research articles, four meta-analyses and seven review articles on tumors and pediatrics).
Congratulations to John Tongue, MD, winner of the 2019 Blair Filler WOA Lifetime Achievement Award. Dr. Tongue’s legacy with the WOA will be forever marked as one of leadership, vision and commitment to education.
As the weather begins to warm and “trauma season” nears, I want to acknowledge everyone who is taking call as part of their practice. You are on the front lines of outreach for our specialty and provide an extremely important community service – Thank You!
Open fractures are incredibly common during this time of year, but the management is fraught with potential complications. Early treatment decisions ultimately have an outsized impact on a patient’s care, and decisions made in the emergency department can have long-lasting effects.
Before starting my intern year, I was told that residency was like a big buffet. When you go to a buffet, you don’t just nibble on the red Jello1 – you fill your plate with as much as you can carry and always go back for seconds. With so many learning opportunities, it is important to pause between bites and make sure you are absorbing as much as possible. The best way to do this is to ask for direct, specific feedback.
“Physician burnout” is characterized by emotional exhaustion, depersonalization and a diminished sense of accomplishment.
Studies show that money doesn’t produce happiness, but despite the evidence we often assume the opposite. “Affluence” usually relates to financial well-being, but there also exists “time affluence” - the sense of having plenty of time.
Our county hospital recently purchased new chairs for every patient room, hoping to encourage physicians to sit and speak to their patients. The initiative is called “Commit to Sit,” and is based on research showing that when physicians sit during a patient encounter, patients report higher satisfaction, remember the visit as longer than it actually was, and note that the physician is a better communicator than if she or he stood.
The Sports Medicine Licensure Clarity Act was signed into Law on October 5, 2018. This law provides legal protection for team physicians who cross state lines in order to care for their team members, and its passage is the result of five years of advocacy. While this effort was led by the AAOS, the WOA has been supportive of the initiative from the beginning. I lobbied on your behalf in Washington DC in support of this goal, as did several other WOA Board Members and WOA active Members who are also members of the BOC.
Three weeks ago, I received a video text on my phone from an out-of-state number that I didn’t recognize. The video was only ten seconds long, and showed a young girl of about five years old squealing with laughter as she ran about in a large yard. It took me a minute to remember.
The vast amount of information available online affects consumer trends for nearly any type of goods or services one can think of. Before committing to buying a product or even making a restaurant reservation, most of us will look at reviews beyond a recommendation from a friend.
Flash forward a few years, and today I am sitting on a flight back from Panama after volunteering for Operation Walk Denver, whose mission is to provide total joints for the indigent population. I am surrounded by my fellow teammates including nurses, PAs, surgical techs, central sterile workers and doctors. We are exhausted, but content knowing we helped give 50 fellow humans a new life.
Recently, we have featured several great Touches focusing on opioids, opioid use, and the opioid epidemic. I am in agreement with Dr. Ilahi in that pain is the fifth vital sign contributing to the current epidemic. But, I also believe that big pharma (namely Purdue) has been an even bigger contributor.
During our training as orthopaedic surgeons, we develop a strong ability to focus. Whether we are preparing for tomorrow’s difficult case, seeing the next patient in-clinic or drafting our next manuscript, we recognize the importance of what we are doing at the moment and then dedicate the time and mental energy to get it done. In many ways, this capacity to focus is a great asset. However, the downside is that, if unchecked, focusing solely on what we are doing in the present moment can make us myopic. I believe it is extremely important for us to be able to take a step back to consider our careers and lives in the broader contexts of where we have been, and where we want to go. Without a larger goal to work towards, our daily grind loses meaning and purpose.
The responsibility of on-call duty is no small task, regardless of your subspecialty interests, experience level or years in practice. Few patients challenge our on-call abilities more than the unstable patient with an unstable pelvic ring disruption. Over the past few decades, on-call orthopaedic surgeons have evolved from reactive clinicians, tasked with caring for whoever survives until morning, to being active participants in the initial evaluation and resuscitation team. No longer is memorizing the Young-Burgess (or Pennal-Tile) classification and knowing how to apply a pelvic external fixation device viewed as being sufficiently prepared.
WOA Mourns the Passing of Dr. Howard H. Steel
It is with great sadness that I report the passing of our friend, mentor and benefactor, Howard H. Steel. Howard passed away on September 5th in Kalispell, Montana, where he suffered a cardiac event in the hospital while recovering from a stroke. He was vital and engaged up to the end of his remarkable 97 years.
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