The article “Drivers wearing arm slings shouldn’t drive” (AAOS Now, October 2012) was great. I want to give a copy to all my shoulder surgery patients.
Charles L. Metzger, MD
Bellaire, Texas

I very much enjoyed the December 2012 edition of AAOS Now. It was terrific—one of the best. The subjects of importance to our profession heavily outnumbered the “necessary” trivial ones.
Augusto Sarmiento, MD
Miami, Fla.

I just read Dr. Canale’s recent editorial, “A Nation in Motion Looking Down” (AAOS Now, January 2013) and just wanted to say that I enjoyed it. It was thoughtful, insightful, and entertaining. Good job!

Although I’ll still be a member of the AAOS, today is my last day of regular practice, after about 40 years of doing orthopaedic surgery. It’s been a great journey and a great profession ... and I’m glad I’m not just starting out. LOL.

Here’s to looking up!
C. Bruce Schwartz, MD
The Dalles, Ore.

I would like to respond to an item in AAOS Headline News Now (“Report: Electronic records have spawned a wave of inflated billing,” Oct. 19, 2012). The probable reason codes are higher is that electronic medical records have made it easier and faster for physicians to document everything they actually do during a visit. Before, when a physician had to dictate everything, it was not cost-effective to take the time to document everything that was done or pay a transcriptionist to type it all.

The purpose of a medical record used to be for notes to jog the physician’s memory of the previous visit to provide continuity of care for a previously identified problem. Now, the record is used for multiple other reasons, including justification for payment, quality measure reporting, legal documentation, and meeting regulatory demands.

The focus of the chart shifted away from direct patient care, and picky coding rules evolved. In response, doctors simply provided all of the information they gathered at a visit to comply with the rules.

The government’s rules of the game have backfired. Now the government wants to change the rules. Enough of these games. Let us physicians just get back to taking care of patients and don’t interfere with our patient care by forcing us to play such silly games. The patients (public) are going to be the losers if this keeps up.
Douglas E. Duncan, MD
Marshall, Texas

Setting Now Straight
AAOS Now 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 aaoscomm@aaos.org