There's actually no difference.
Ortho guys pretend they don't know anything other than "fixing bones, duuuh" and then giggle and wink. But at the end of the day, whether you want to say they're pretending or not, they don't do anything other than "fix bones." As people have noted, and as Ortho guys know, they just dump on everyone else around them. It's great for Ortho and sucks for everyone else. Unlike most everyone else, Ortho guys have no concern for anything other than their operative site. Period. There's an almost aggressive ignorance to anything else on the patient and they don't care what happens to the patient. That's pathetic and reprehensible. The problem is that, since everyone knows that's the case, they resign themselves to taking care of Ortho patients. The way it should actually work is that everyone ignores Ortho patients and they all die, but that would never happen.
ER guys pretend they know everything and can basically practice Medicine, Surgery, Pediatrics, Family Practice, and even some Neurosurgery on the side. The only reason they consult everyone else for everything is because "the hospital makes them." Most of the time they do half-assed things that they never learn are incorrect because by that time the patient has been rescued from the ER by the admitting team. I can't even get the ER to bolus IV fluids for an obstructed patient who requires aggressive resuscitation, but the ER will lecture me on how they know everything about everything. Again, the end result is the same. Everyone else resigns themselves to receiving tons of consults and poorly- or not-worked up patients from the ER because that's where people get their patients (i.e., money).
So, there's no difference. Like I said, take your pick.
