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Published 10/1/2012

From Responsibility to Records, Readers React

I read the article “Whose Responsibility Is It to Reduce Healthcare Spending?” (August 2012) with morbid fascination. The usual payers in the healthcare market (government and insurance companies) were discussed, and each was trying to cut costs. But none of the areas mentioned has shown significant cost savings and improved care simultaneously. The usual arguments for and against different ideas and plans enumerated in the alphabet soup of electronic health records (EHRs), the Independent Payment Advisory Board (IPAB), and accountable care organizations (ACOs) could be trotted out.

My primary objection to the article, however, is that nowhere in the text was personal, individual responsibility to improve health and cut costs mentioned. I tell my patients that if they want to put healthcare providers out of business, they can just do a few simple things:

  • Weigh a reasonable amount.
  • Wear their seatbelt.
  • Don’t smoke.
  • Eat their fruits and veggies like their mother said.
  • Have no more than one alcoholic drink per day.

John A. Gracy, MD
Chattanooga, Tenn.

Peer support
I am writing in response to the article on peer support (
“Peer Support When We Need It Most,” July 2012). I applaud AAOS Now for writing about this important endeavor at Brigham and Women’s Hospital. I want to remind readers that several years ago, under Frank B. Kelly, MD, who was then chair of the Board of Councilors, a cadre of “peer counselors” was assembled to render support to AAOS fellows who were experiencing emotional strife secondary to malpractice-related stress.

Approximately 10 veteran AAOS members received very basic counseling training from Wayne Sotile, PhD, and many remain “ready and willing” to offer support and encouragement to younger AAOS fellows who may be going through their first medical liability case. I have had the personal satisfaction of using my “battle experience” to help several younger fellows get back on track. Members interested in using this service may contact staff liaison Susan Koshy at koshy@aaos.org
John D. Kelly IV, MD

Philadelphia, Pa.

EMR impact
AAOS needs to do a study on the impact of electronic medical rec-ords (EMRs) and the economic viability of practices. As a solo practitioner, I initiated EMRs and digital radiography approximately 3 years ago. I am currently beginning the process of meaningful use. So far, I’ve received no funding from the government for this transition. In the meantime, the initial expense plus maintenance fees have dramatically increased my overhead expenses, while reimbursement has decreased. I believe the government does not understand this, and it will probably result in insolvency for many physicians in both solo and group practices.
Howard B. Cotler, MD

Houston, Texas

Setting Now Straight
welcomes reader comments and efforts to “set AAOS Now straight.” We reserve the right to edit your correspondence for length, clarity, or style. Send your letters to the Editor, AAOS Now, 6300 N. River Rd., Rosemont, Ill. 60018; fax them to 847- 823-8033; or email them to