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Success!

Success!

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).

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Hats Off to John Tongue, MD

Hats Off to John Tongue, MD

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.

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Surviving Call: Open Fracture Management

Surviving Call: Open Fracture Management

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.

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Residency Education: The Importance of Asking for Specific Feedback

Residency Education: The Importance of Asking for Specific Feedback

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.

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Time for “Joy”: A Cure for Physician Burnout

Time for “Joy”: A Cure for Physician Burnout

“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.

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Take a Seat

Take a Seat!

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.

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Success From Advocacy

Success From Advocacy

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.

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Why We Do What We Do

Why We Do What We Do

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.

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Physician Rating Sites: Probably Can’t Beat Them, But Do We Have to Join Them?

 

Physician Rating Sites: Probably Can’t Beat Them, But Do We Have to Join Them?

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.

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Volunteerism and a Second Chance

 

Volunteerism and a Second Chance

My high school football team was a pre-season favorite to win the state championship, but a late season loss ended our dream of achieving that milestone as a team.

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.

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Opioids: Continued

 

Opioids: Continued

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.

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Mentorship

 

Mentorship

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.

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Surviving On-Call: Sorting Out the Unstable Patient with an Unstable Pelvic Ring Injury

 

Surviving On-Call: Sorting Out the Unstable Patient with an Unstable Pelvic Ring Injury

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.

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WOA Mourns the Passing of Dr. Howard H. Steel

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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Overcharged - A Must-Read for All Health Care Providers

 

Overcharged  ̶  A Must-Read for All Health Care Providers

We all have our own pet villain (insurance companies, pharmaceutical companies, pharmacy benefit managers, hospitals, doctors, pharmacists, nursing homes, CMS, malpractice suits, etc.) for the cause of the high cost of health care in the U.S. But deep down, we all know that the growth in the cost of health care in the U.S. is unsustainable and changes must be made.

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Pain is a Symptom; Not a Sign!

 

Pain is a Symptom; Not a Sign!

My PERSONAL belief is that the campaign entitled, “Pain is the fifth vital sign,” is at the root of this country’s current, tragic, opioid epidemic. This approach was grossly misguided – at best!  Firstly, signs tend to be objective, whereas pain is subjective. Secondly, the words “vital signs” literally mean “signs of life” or “signs of being alive.” For millennia, the very evidence of a person being alive depended on: temperature, pulse/heart rate, and respiration. Later, upon the invention of the sphygmomanometer, blood pressure was added as a fourth vital sign.

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The Sweaty Surgeon

 

The Sweaty Surgeon

With summer now in full swing, the temperature outside has risen to uncomfortable levels for many of us. However, one place we don’t expect to deal with excessive heat is in the operating room. Unfortunately, if your hospital is like mine, you may find yourself in a battle with anesthesia and nursing staff over the thermostat setting. Most frequently they will cite patient safety as a rationale for increased OR temperatures.

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Opioid Use Abroad

 

Opioid Use Abroad

The opioid epidemic continues to be an issue of growing concern across the U.S. The WOA has had several Touches and lively forum discussions on the matter.

I recently returned from a three-week AOA traveling fellowship in Japan and part of our charge while there was to develop and perform a research project. Given the nature of this topic in America, my co-fellows and I conducted a survey of Japanese surgeons’ attitudes and practice patterns regarding opioid use and prescribing.


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The Other W of the WOA

 

The Other “W” of the WOA

As many of you may know, this year’s incoming First Vice-President of the American Academy of Orthopaedic Surgeons is Dr. Kristy Weber. I found myself surprisingly emotional and proud listening to her speech at the annual Academy meeting in New Orleans a few weeks ago, and laughed as she referenced the fact that she was “the first person in heels” to address the crowd in the First VP role. As such, she is slated to be the first female President of the AAOS in 2019.

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Intended Retained Surgical Item (RSI) Not a Problem? Think Again!

 

Intended Retained Surgical Item (RSI) – Not a Problem? Think Again!

As I was placing the last stitch of the skin closure on a total hip surgery, the tip of the needle broke off. To remove the 1-cm fragment, I would probably have to reopen part of the skin incision (which could increase the risk of prosthetic joint infection), would possibly have to convert from spinal to general anesthetic, and there would be additional radiation exposure for the patient. I had intended to leave the fragment, but the hospital where I practice informed me that I HAD to remove it prior to the patient leaving the OR. It made no difference to the hospital whether this was a broken drill bit, a needle fragment or any other RSI. I subsequently had to answer to the hospital’s Peer Review Committee.

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