Manual The little ortho book : the bare bones of orthopedics

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    I was pleased but not surprised that he too found meaning in its pages, and that its ideas were most pertinent to understanding our own place in helping others, regardless of circumstance. In short, as a student, teacher, and physician, that night was an opportunity to understand and learn the difference between the mere laborer, or even craftsman, and instead behave as the artisan that this young man was clearly becoming. My only concern is perhaps a disappointment that our system of health care can allow us to get lost in the detail of protocols, technology, objective measures of cost, and arbitrary definitions of outcome.

    My comfort though will come from people like Grace who do cherish our relationships and who teach us about ourselves. It will also come from the knowledge that there are, and will be after I am gone, people like my resident, my fellow physician, who will rightly see patients as people rather than procedures.

    The Little Ortho Book: The Bare Bones of Orthopedics

    I was working as a hospital volunteer during college, and I was invited to follow an orthopedic surgeon around. Watching his skilled hands restore damaged bones and tissues, my future became clear. I knew in that moment there was nothing else I wanted to do. Our freshman year of medical school included a quick course on National Health Insurance. What a great idea! Great - I could do what I loved, and make a nice living. By the time I finished a residency at Cook County Hospital, I had a sense of entitlement for the good life that was sure to come.

    However, my academic career was to be short-lived. A fraction the size of Cook County, the orthopedic department had twice as many attendings, and I was low on the list for surgical cases. Job offers came from local orthopedists, and I left the world of academia behind. Private practice in San Francisco offered few cases. I was advised to be patient and wait my turn, but soon a request came to work at an east bay trauma center. Enthusiastic and longing to get back in the OR, I joined 3 hospital staffs and signed up for 20 call nights a month. There I was, in the middle of a major case at one hospital, with an injured patient waiting at another.

    Orthopedic Surgery

    My reward was a BMW and a big house on a hill, but I had no life outside the hospital walls. A nurse would bring a cake to the OR on my birthday: I no longer made it to the gym and would stress eat half the cake; I gained 60 pounds. At three AM one morning, while nailing a difficult tibia fracture, the life drained out of me. I knew that was my last surgery, and entering a depression confirmed it.

    I had done enough surgery for one career and became busy as a non-surgical orthopedist. Focusing on rehabilitation and pain management, I found I could keep a surprising number of patients out of the operating room. I have a deep interest in networking to use cognitive science to reframe our message to better reach the voting population.

    Obtaining access to healthcare for all is a multi-level project; the more one digs, the deeper it gets. It was very rewarding to be invited to join the Society for Patient Centered Orthopedics.

    The Little Ortho Book: The Bare Bones of Orthopedics

    It takes courage to look beyond the immediate rewards of our specialty, and pave the way for physicians to take part in solving the healthcare crisis. Healthcare reform will move forward with or without us, but it is widely held that it is better with physician leadership. The health of our country depends on it. Paul Levin Being a physician is the greatest honor in the world. They share their lives with us and put their trust in us to heal them.

    Unfortunately, the complex nature of the American health care system and the present models of specialty care in medicine and orthopaedic surgery often prevent us from caring and healing our patients. As orthopaedic surgeons, we see patients most frequently for episodic conditions, never develop relationships and tend to focus on the musculoskeletal complaint instead of the individual seeking help. Our intentions are pure and we strive to care for our patients, but at times we also may become victims of a hammer seeing everything as a nail.

    We completely loose our focus of caring for an individual and the imperative of patient centered care. Patient centered care is the embodiment of everything we all aspire to as physicians, healing our patients. Patient centered care readily incorporates the four principles of bioethics, shared decision-making and informed consent and also allows us to meet our fiduciary responsibilities that are the foundation of professionalism. I am a fellowship trained orthopaedic trauma surgeon. I spent the first 18 years of my professional career as a fracture specialist and the rewards of being part of a team that is able to restore function of individuals with multiple injuries and severe extremity fractures is immeasurable.

    I have worked as the head of the division of orthopaedic trauma at SUNY at Stony Brook for nine years and subsequently in both solo practice and group practice in a community hospital setting. Over the past ten years I have been the vice-chairman of orthopaedic surgery at Montefiore Medical Center.