I don’t know about you, but this has been a tough year for many of us in orthopedics. Being in the news business, we probably see more than our fair share of depressing news.
New regulations, Milliman, transitioning from ICD-9 to ICD-10, politics (of all stripes), chaotic hospitals, the growing number of unemployed and uninsured patients, rising malpractice premiums, Department of Justice prosecution agreements, warning letters from the FDA or rule changes from Medicare.
So, for many of us in the musculoskeletal repair business, it’s been a tough year.
And yet… when the news of the day fades into the background like so much white noise…when we start to reflect on the good and positive aspects of orthopedics, then I think we can see how incredibly blessed we are individually and how much good we collectively do as an industry.
So pat yourselves on the back. Here are the top ten things we can all be thankful for as we wind our way to the end of another year.
You – in the mirror: Yes, you. We work with people who are smart, educated, dedicated and who have a heart—after all, you entered this profession to help people. So we’re thankful for you—the people of this industry who work so hard on behalf of those in pain and with disability. You are all men and women we respect and admire so much.
Patients:Â Thank you for thinking of us when you are in need. We got into this industry to find better ways of relieving your pain and fixing your aging frame. We particularly appreciate the opportunity to get you up and going again. There is no better feeling than that.
Family: Thank you for your patience and understanding—especially when we didn’t really deserve it. Like when we had to man our company’s booth at the fifteenth surgeon meeting this year. Or when we agreed to be on-call for the month of November. Or when we missed your ballgame/concert/play/pageant because we were at the hospital. Or when we weren’t home when it snowed six inches and you strained your back shoveling. We don’t say it near often enough, but we love you and we thank you.
Start-up companies: Thank you for being such a merry band of guys and gals nutty enough to attempt the impossible, improbable and utterly essential task of turning ideas into improved care for patients. You’re our kind of crazy. Thank you for being creative, for working with new paradigms and for finding a future where there are no pre-determined formulas. Without you, we’d still be using leeches to extract bad spirits.
Mentors: Eighty percent of what we know, we learned after medical school. It was our mentors who helped us frame up the flow of new information. It was those tough, demanding, occasionally irrational mentors who helped us see our skill gaps, helped us access new resources and exposed us to diverse perspectives. Their insights and support inspired and guided us. Because of that, we now know how to pass along perspective and experience to the next generation of clinicians, inventors and executives. In short, our mentors gave us the foundation for a lasting and successful career in orthopedics.
John Charnley / Leon Wiltse / John Harrington / Gary Michelson and every visionary past, present and future: Like Christopher Columbus you set sail on uncharted waters and showed the rest of us how to navigate past rocky shores and dangerous currents. Along the way you endured crushing failures, withering attacks and professional ridicule. Yet today your inventions and techniques are standard of care and we use your ideas to save literally millions of lives from early disability, pain or even death. Last, but not least, thank you for creating this industry which gives us and our families a livelihood.
DePuy / Stryker / Zimmer / Smith & Nephew / Medtronic: We also give thanks for the big guys of our industry. You deliver a level of efficiency, quality and consistency that helped make orthopedics the most reliably successful set of patient treatments in all of medicine. You also have taken the lead (we know, with a little help from the U.S. Attorney) in ensuring that we are also practicing unbiased medicine. At the end of the day, we couldn’t maneuver through the problems of irrational reimbursers, shifting demands from patients, hospital administrators, and licensing agencies without your help.
Biologics: Marshall Urist pointed us in the direction of a particular protein—which he named bone morphogenic protein (BMP). We’ve learned to use BMP as a component of DBM (demineralized bone matrix), or harvested bone marrow, or in its recombinant form (InFuse) or any one of several other forms. The impact of protein biologics as adjuncts to surgery has had a significant impact on orthopedics. But 40 years of learning to use BMP appear to have been just a prologue to a future of living cells, human collagen sheets and new schemes for harvesting cells, proteins and other regenerative materials from the patients themselves. Biologics in all of its regenerative, anti-inflammatory and immune privileged glory is on the scene and promises to improve patient outcomes in significantly cost effective ways. What a time to be in orthopedics!
American Academy of Orthopaedic Surgeons (AAOS): We give thanks for AAOS. While we appreciate very much AAOS’s consistency, annual meeting, ORS (Orthpaedic Research Society) and dozens of other affiliated surgeon groups, it is in fact their remarkable advocacy in Washington where AAOS has earned our special thanks. AAOS’ staff tirelessly and effectively promote and represent the orthopedic community before Congress, the FDA and CMS (Centers for Medicare and Medicaid Services). Under their remarkable leadership, over 200 orthopedic surgeons visit Capital Hill every year to lobby on our collective behalf for more rational Medicare reimbursement and medical liability reform. In this time of a shrinking public purse and unfair stereotypes regarding surgeons and their role in patient’s lives, AAOS fights the good fight for us all in Washington.
Digitalization of Medicine: Finally, we’re thankful for digitized medicine. Unless we stop and think about it, we probably don’t realize how completely our lives have changed because of digitalization. Digital X-rays are just the tip of the ice berg. Because of dirt cheap memory, powerful processors and programming that has more in common with Halo 2 (if you have to ask…) than Excel, we are treating our patients with robots, punching up wireless formulary apps that fit on our smart phones and using RFID (radio-frequency identification) data to track implants, equipment, laptops and even wheelchairs. On the near horizon is registry data tailored to our personal or patient needs. How long ago were we sharing information with our colleagues by faxing or hand-carrying paper charts? Seems like ancient history, but it was really just a few years ago.
So, we’re going to keep the whining to a minimum and reflect on how lucky we are to live and work with such phenomenal people in the greatest industry on earth. Orthopedics.
