It was an orthopaedic thing to “stay close to the bone, drain the pus, and don’t damage any organs.” The official color of orthopaedics was salmon, made up of three colors: blood, sweat, and pus. How unappealing orthopaedics was!


Published 3/1/2008

It’s An Orthopaedic Thing

Do you know what an “orthopaedic thing” is? Here’s an example—the number 3. Almost everything in orthopaedics involves the number 3—triangulation, triple arthrodesis, three-point fixation, triplane fracture, triradiate cartilage, triple innominate osteotomy, and three planes in space forming a point. I tell my residents if they are asked a question to which they don’t know the answer, they should just say “3” because it’s an orthopaedic thing and they have a three-times better chance to be right than not.

Once, it was an orthopaedic thing that the specialty attracted former athletes, especially football players. It was an orthopaedic thing to be “strong as an ox and twice as smart.” But today, orthopaedic residencies are among the most sought-after positions of all specialties. Now it’s an orthopaedic thing to have only the cream of the medical crop becoming orthopaedists—the best and brightest physicians in all of medicine. Now, it’s an orthopaedic thing to be stronger than an internist and twice as smart!

In the past, it was an orthopaedic thing for the specialty to be the “groundhog” of medicine. It was less than glamorous, encompassing diseases such as tuberculosis (TB) of the bone, osteomyelitis, polio, trauma, and career-ending sports injuries. Willis Campbell was a huge man, a pediatrician who scared not only children but their mothers as well. In desperation, he went to Vienna, studied osteomyelitis and TB of the bone, and started in orthopaedics. Later, he helped to found the AAOS.

But 75 years later, it’s an orthopaedic thing today to be in the most satisfying of all medical specialties: it’s glamorous, even glittering. Orthopaedists are the envy of most other specialties. As the population lives longer, we offer our patients a better quality of life so they can enjoy those extra years with advances in joint replacement and reconstruction, trauma care, sports medicine, hand surgery, and foot surgery. How rewarding it is to help an individual with traumatic injuries return to a normal life, an aged invalid become more mobile, a hobbled athlete return to competition, and the mangled and malaligned regain the use of their hands and feet.

It’s an orthopaedic thing to be in the most satisfying of all medical specialties.

Formerly, it was an orthopaedic thing to be an orthopaedic “surgeon”—a technocrat and jet-fighter pilot ace, often wrong but never in doubt. Orthopaedists were technicians, who measured in micrometers but cut with a hatchet. Someone once jokingly described the difference between an orthopaedist and a carpenter, saying the carpenter knows more than one antibiotic.

Today that image has changed. We no longer “give the cortisone shot through the sweater.” It is an orthopaedic thing to be thought of as an orthopaedist, not just a surgeon, who can empathize and communicate with his or her patient. How did this happen? Well, you can say it’s because the reimbursement rate is now just as good in the office as in surgery, but I don’t believe that this is the case.

Communicating with the patient has become an orthopaedic thing, and orthopaedics leads the medical field in techniques of patient-physician communication, in part due to the efforts put forth by John Tongue, MD, and the Academy. Teaching communication skills to orthopaedists hasn’t been easy. Learning to listen, being empathetic, practicing shared decision-making and patient-centered care are techniques that must be learned.

“Patients don’t care how much you know until they know how much you care.” Now that’s a powerful orthopaedic thing.

The AAOS is an orthopaedic thing
I used to play football, and the older I get, the better I played! I may have been barely first-string in college, but a few years ago, I recalled being All-American; any day now I may win the Heisman. It was an orthopaedic thing to say that the older the Academy got, the better it used to be. But I don’t believe that.

God made time so everything wouldn’t happen at once. The Academy has grown with time, and I believe it is now the finest of all medical associations, offering the best in continuing medical education, two top peer-reviewed journals, a range of print and online educational offerings, and our own newspaper. Our communications, public relations, image, and visibility programs are the envy of every other medical specialty. We have a 200-employee, seven-story office in Rosemont and a 16-employee orthopaedic advocacy office in Washington, D.C. We helped create the Orthopaedic Learning Center, a state-of-the-art skills center. We even have an adjacent hotel.

Today the public knows what an orthopaedic surgeon is, what we do, and the difference we make in the lives of our patients. Now that’s an orthopaedic thing.

I have been involved with the Academy for almost half of its 75 years. There is no other medical association like it; other medical societies follow our lead. We used to call the American Medical Association for advice. Now they call us.

In summary, we’ve come a long way in the past 75 years. Look at the following “orthopaedic things:”

  • It’s now an orthopaedic thing for the cream of the medical school crop, the top 10 percent, to join our ranks.
  • It’s now an orthopaedic thing to be in the most rewarding and satisfying of all medical specialties.
  • It’s now an orthopaedic thing to be an “orthopaedist,” giving complete and empathetic musculoskeletal care to our patients.
  • It’s now an orthopaedic thing to belong to the finest medical association in all of organized medicine.

Orthopaedic things don’t just happen
All of these great orthopaedic things of today didn’t just happen. They came about because today’s orthopaedists stood on the shoulders of previous orthopaedic giants and reached for only the finest. The greatness of orthopaedics came about because of that salmon color of blood, sweat, and pus and hard work.

Now it’s your turn. Start volunteering, don’t pass up opportunities to volunteer. Volunteer at your local hospitals, with local medical and orthopaedic societies, at state and regional societies, and at national organizations such as the AAOS and other orthopaedic societies. The new fellows of 2008 will have the opportunity to celebrate both the 75th and 100th anniversaries of the AAOS. It is now your turn—your “orthopaedic thing”—to stand on the shoulders of today’s leaders—James H. Beaty, MD; E. Anthony Rankin, MD; and Joseph D. Zuckerman, MD—and keep orthopaedics the crown jewel in all of medicine for the next 25 years.

Welcome to the finest group of physicians anywhere—your AAOS.

AAOS Now editor-in-chief, S. Terry Canale, MD, presented the Welcome to the Class of 2008 at the 75th AAOS Annual Meeting in San Francisco. His remarks reflect the changes in orthopaedics and are excerpted here.