tag:blogger.com,1999:blog-6760873683081651675.post7065573161248787385..comments2024-01-18T04:16:57.545-06:00Comments on Orthopaedic Residency: The attending perspective: All good things have to come to an end ...Anonymoushttp://www.blogger.com/profile/18071954032609414825noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-6760873683081651675.post-69857279873538154282007-06-16T12:27:00.000-05:002007-06-16T12:27:00.000-05:00i do see in the future having other providers assu...i do see in the future having other providers assuming the role of the pediatric orthopaedist. at the recent POSNA meeting, one of the scenarios to help the foreseen shortage used pediatricians trained as non-op orthopaedists (similar to family practice sports medicine)<BR/><BR/>as far as the senior people, some do want junior partners so they can possibly focus their practice (spine, hips, limb deformity). the problem is not just in larger centers where you can focus but it is in the smaller towns where you can't focus. it is an issue with only ~20 fellows graduating every year.<BR/><BR/>peds ortho has become more operative. classically femur fractures where treated in traction then spica casts. today, we are operating on more femur fractures. is it because society is asking for "quicker recovery", do not tolerate the casts, or is it our surgical slant now, do younger orthopaedist look for more reasons to operate. i do feel that the casting skill set id being lost. residents are using plaster less and less, spica cast are used less, cast techs do many casts. so is it because they are less skilled at casting? <BR/><BR/>the issue of medicaid is a sore point because i believe that there are some who do the wallet biopsy and send patients. we are seeing more and more patients transfered from an outside facility for the malignant buckle fracture or toddlers fracture (an example used in a lecture from the AOA today) because "the orthopaedic surgeon is uncomfortable with pediatric fractures."<BR/><BR/>issues of more sub-specialization in recent graduates and the desire not to be on call and only see X patient or only do out patient surgery.<BR/><BR/>a statement of altruism was unintended.Someonecthttps://www.blogger.com/profile/01098940208758613514noreply@blogger.comtag:blogger.com,1999:blog-6760873683081651675.post-34554776455886758592007-06-16T11:18:00.000-05:002007-06-16T11:18:00.000-05:00I know of at least one hospital that has begun acc...I know of at least one hospital that has begun accepting podiatry resident graduates as (un-accredited / thus fully privileged) pediatric orthopaedic fellows.<BR/><BR/>Don't many senior peds ortho people often look for new partners so that they can focus more on their spine practice though? I have seen a growing trend of peds orthopods in my region fixing fractures we left years ago. I have not seen the data to support it - long term clinical disability. Most of them site patient tolerance of casting and follow-up. Apparently surgery is safer now. Transient titanium or stainless implantation apparently has been definitively shown not to increase any cancer risk. I am skeptical. Some of those kids came back with casts that would rival most high school yearbooks. I wonder again if the one shot operative code hasn't won out over serial visits. Last, I thought the studies from California showed that most peds ortho people restricted access to Medicaid patients. I felt your description was more altruistic than perhaps deserved.Anonymousnoreply@blogger.com