Friday, September 19, 2008

"Bad doctors" resent orthopedic trauma call?

In November 2007, the American Academy of Orthopedic Surgeons (AAOS) expressed concern about the increased number of patients seen through emergency departments.

In October 2006, the AAOS Bulletin reported on the growing crisis in emergency care, including the challenges facing orthopaedists who take call. A year later, it seems that little has changed, except for the intensity of the problem.

“The number of visits to emergency departments is up 18 percent, but the number of emergency departments is down 12 percent,” said Jeffrey Anglen, MD, AAOS fellow and president of the Orthopaedic Trauma Association (OTA), who addressed the AAOS Board of Directors in September. The resulting squeeze, he noted, means that many people are not getting timely and appropriate emergency care and that multiple pressures are being placed on orthopaedic surgeons who take call.

In response to the AAOS' concern, Dr. Chris J. Dangles complained:
The stress of taking trauma call is having an impact in Urbana, Ill., where Chris J. Dangles, MD, has his practice. “We lost one of our three orthopaedic trauma surgeons, resulting in the rest of us taking more call,” he reports. “The attrition in our trauma surgeons was directly related to the stress of the job.”
Here is a thought - avoid performing unnecessary surgeries and then there may be less stress! Dr. Dangles apparently resents taking trauma call but he (Dr. Chris J. Dangles) admits that he performs unnecessary surgeries when the patient manipulates him. That is precisely what Dr. Chris Dangles testified under oath that he did to me.

Dr. Dangles' decision to perform unnecessary orthopedic surgeries brings into question his clinical judgment.

It would be a good idea if pre-1986 board certified orthopedic surgeons were required to re-certify with the American Board of Orthopedic Surgeons (ABOS). Then perhaps the older orthopedic surgeons would learn new information and (1) not perform unnecessary surgeries on vulnerable patients and (2) reduce the surgeons' level of stress.

Complicating factor: at least with Dr. Chris Dangles and Carle Clinic Association (Urbana, IL), the CCA physicians own their HMO. As such, performing procedures on HMO patients equates to $ for the procedure and $ for profits based on ownership of the HMO.

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