Integrity in delivering care, making disclosures

The study of SLAP lesion repairs by young orthopaedists is most disturbing. It shows repairs on patients as old as 88 years old, and our newly minted orthopaedic colleagues, far from starting their careers by practicing medicine conservatively, are performing these repairs at 3 times the rate deemed appropriate by our orthopaedic literature. These repairs accounted for an astonishing 10 percent of all shoulder surgery performed by the ABOS candidates in the final year of Dr. Weber’s study.

As an orthopaedist who has been in private practice, I fully understand that the incentives all weigh heavily upon these young doctors to generate these surgical cases. We must teach young surgeons the fundamental rule of medicine: the patients are not there to service our desires, whether this is for status, ego fulfillment, or financial reward. Rather, we are practicing medicine for the benefit of our patients. The overuse of surgical procedures to benefit the surgeon has absolutely no place in compassionate or ethical medical care; it is a violation of the trust that our patients place in us and we must respond aggressively whenever it is discovered.

James B. Rickert, MD
Bloomington, Ind.

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