Clinical

Who Needs a Thumb Anyway?

In my pediatric practice, I’ve often wondered if the children that we “fixed” as a child have actually been made better or whether they would have adapted and done just fine on their own. These decisions are made by parents and surgeons since the babies certainly don’t have an opportunity to participate in the decision making. Often it seems we…
Patient Communication

The Opioid Epidemic: What is our role?

“To see what is in front of one’s nose is a constant struggle”.  – George Orwell The United States is grappling with an epidemic of prescription opioid medications, and the statistics are frightening. Opioid prescribing remains higher in the United States compared with anywhere else in the world, and 80% of the world’s opioids are prescribed and consumed in this…
Patient Communication

Forgive and Remember

Since I was informed of New York State’s investigation of my practice in 2010, when a drug-seeking patient complained that I did not prescribe postoperative narcotics, I have had ample time for introspection and self-evaluation. Indeed, I have asked myself how such a “good physician” and “good man” could be shamed so mercilessly, particularly since I, like Mark Chassin expressed…
Ethics

Often Wrong, but Never in Doubt

The popular trope of the confident, arrogant and swashbuckling surgeon is usually as far from representing reality as a Norman Rockwell painting is from representing modern urban life. "Often wrong, but never in doubt" is a phrase bandied about medical schools for laughs to describe the attitudes of those who practice surgery. I am often wrong, often in doubt, and…
Work/Life Balance

Happiness in Hand Surgery

One of the main reasons I chose the field of orthopaedics and later, hand surgery, was that my mentors along the way truly seemed to enjoy their jobs. The hand surgeons I encountered bantered with their patients in the clinic and played country music in the OR. They ran marathons and made time to attend children’s plays and sporting events.…
Clinical

What is a p-value? The problem of hypothesis testing in observational studies

At a time when cost-effective, evidence-based care is increasingly demanded by patients, payers and our own professional organizations, research on outcomes of treatment has become more common. Over the past 10 years there has been a steady increase in the  levels of evidence reported in most of the journals read by hand surgeons. While this trend is encouraging in appearance,…
Diversity

Where are the Women?

by Deana Mercer, MD and Robert R. Schenck, MD The number of women in orthopedic surgery continues to be a challenge for the  specialty.  Despite the percentage of women in medical school having increased from 6.9% in 1965 to 47% in 2014, the percentage of women in orthopedic surgery residency programs is less than 15%, the lowest percentage of women…
Patient Communication

The Power of Words

A lot of our activity as providers of health care is gathering and providing information via the spoken language. I have noted through the observation of students and residents in training and critical reflection on my own experience, the power of words to create fear, anxiety, and uncertainty, or alternatively to create calm, reassurance and hope. Words, the ones chosen,…