As the AAOS promotes a “nation in motion” and is urging our patients to get out and get moving, I have noticed that our nation is in motion but isn’t necessarily watching where it’s going. Lots of people are looking down—at what, I’m not sure, but I’ve got some good guesses. Take drivers, for example. Lots of people are looking down while they are driving. Usually, they’re texting while driving—a dangerous habit.

AAOS Now

Published 1/1/2013
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S. Terry Canale, MD

A Nation in Motion Looking Down


S. Terry Canale, MD

Or people in meetings who are looking down. Most of them are checking their smart phones, which they hold beneath the table, thinking no one can see them. I was recently at a meeting where more than half of the participants were looking down below the table at their smart phones—texting, emailing, checking out YouTube videos. Unfortunately, I was the speaker! Others had their laptop computers on the table and were looking studious, but they didn’t fool me—when you can see their fingers moving constantly on the mouse, you know they’re playing Star Wars, Solitaire, or Texas Hold ’em!

It’s hard to walk down the sidewalk or through a department store without bumping into someone who’s looking down while texting. I “bumped” into a friend at the grocery store who was looking down at his smart phone. His wife had actually taken photos of all the grocery products he should buy and put them on his phone. It was just a collision of shopping carts—a few broken eggs and a couple of squashed grapes, nothing serious—but it could have been a high-speed motor vehicle accident.

It isn’t all bad to look down—better to look down than to trip, but you’ve still got to watch your head!

To be good at some sports, you have to look down—golf, swimming, and diving come to mind—and, of course, you should look down on Groundhog Day (to see if you and the groundhog have shadows) and when you’re walking in a cow pasture or a dog park.

Obviously, I’ve given considerable thought to this issue, and I’ve even come up with some inventions to enable people to look down and up at the same time:

  • A small periscope that can be attached to a smart phone that would allow you to look straight ahead while still viewing your phone
  • Prism glasses, so you could look up while you check your iPad
  • A message keyboard on the steering wheel
  • A voice-activated keyboard

Most of these are about as useful as my earlier invention of a “screen door for a submarine.”

What might work?
Luckily, automobile manufacturers are way ahead of me in developing cars that can stop themselves if you get too close to the car ahead and have monitors that can turn off your cell phone once you get behind the wheel.

As the AAOS promotes a “nation in motion” and is urging our patients to get out and get moving, I have noticed that our nation is in motion but isn’t necessarily watching where it’s going. Lots of people are looking down—at what, I’m not sure, but I’ve got some good guesses. Take drivers, for example. Lots of people are looking down while they are driving. Usually, they’re texting while driving—a dangerous habit.
Courtesy of iStockphoto\Thinkstock

As for the AAOS campaign, it’s definitely making headway, despite what you see when you look at the driver in the car next to you. Already, 39 states have laws against texting and driving, so this may turn into a “white hat” issue similar to the campaign waged by AAOS President John R. Tongue, MD, about seat belts several years ago.

The AAOS effort is making the public more aware of unsafe “distracted driving” habits and is beginning to reach young drivers through school-based campaigns. Nationally, the AAOS has engaged and partnered with the Auto Alliance and it seems just about every other organization has jumped aboard the “Avoid Distracted Driving” bandwagon. Law enforcement also has stepped in to help, and I even saw an “Amber Alert” sign reminding drivers to avoid distracted driving.

As for keeping this nation in motion, I say thanks to the members of the AAOS Communication Cabinet, especially Chairman Michael F. Shafer, MD, and the Academy’s public relations department, headed by Sandy Gordon, for promoting a nation that stays in motion because of orthopaedics and orthopaedists. I hope all AAOS members visit anationinmotion.org, share their stories, get their patients to share their stories, and write an “ortho-pinion.”

Down and depressed
But there’s another reason that some people are looking down, and it has nothing to do with cell phones or iPads or golf. They’re the 48 percent of Americans who voted against President Obama, many of whom believe things are just going to get worse until 2014 and may not get better then.

Many orthopaedists voted Republican, and I just want to remind them that the world isn’t coming to an end because Mr. Obama was re-elected. The economic situation can’t get much worse; in fact, it probably will get better—in spite of, not because of, the Obama administration. Regardless of which party won the White House, we’d probably see improvement in both the job market and real estate market because both are cyclical. Entitlement programs may continue, and balancing the budget may get harder, but the Republican House of Representatives will hold both entitlements and the national debt in check.

The remaining piece of this “cloud of depression” is Obamacare (the Patient Protection and Affordable Care Act, or PPACA) and its impact. It will be almost impossible to repeal, and we may have to live with it. It’s not all bad. I worked in a “fracture clinic” for children for 30 years and never got paid. Now I’m seeing the same types of pediatric fractures, but I’m getting paid. The reimbursement isn’t anything to brag about, but it is better than in the past.

This issue of AAOS Now looks at the future of Obamacare from several angles. Two of the Washington Health Policy Fellows—David B. Bumpass, MD, and Julie Balch Samora, MD, PhD, MPH—take a look at the upcoming changes that will go into effect this year (see story). The article on the impact of the fiscal cliff (“The Simpson-Bowles Plan and the Fiscal Cliff,”) looks at how budget negotiations could affect PPACA provisions. And Stuart J. Fischer, MD, a member of the AAOS Now editorial board, presents a compelling argument that Obamacare may not be as bad as some folks think.

Dr. Fischer, in particular, has considerable insight, and his article is worth reading, if for no other reason than to encourage us to quit looking down and get on with what we do best: look our patients—whoever they are—straight in the eyes, give them quality care, and put our nation orthopaedically back in motion!

S. Terry Canale, MD, is editor-in-chief of AAOS Now. He can be reached at aaoscomm@aaos.org