The drawbacks of orthopedic surgery?

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Who dared to bump this thread.............
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Makaio said:
I'd say the drawbacks of Orthopedic Surgery are uncontrollable work hours. When a case needs to get done, you're going to stay until its done.
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There's very little in ortho that needs to be done urgently. There's often lots to do, but you can bump most things to the next day if you feel like it.
 
How's specialization affecting the field? Many orthopods seem very specialized nowadays, like doing only one joint.
 
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In 2011, orthopedic surgeons saw the cost of running their practice significantly increased while reimbursement steadily declined — and 2012 promises more of the same. Meaningful use requires groups to implement expensive electronic medical records, absorb more overhead costs and spend more time filling out forms than seeing patients. At the same time, Medicare and private payors have such low rates that seeing some patients becomes unprofitable.

"There is a constant downward pressure on what we are paid to deliver care," says Frank Kolisek, MD, orthopedic surgeon and president of OrthoIndy, an Indianapolis-based orthopedic practice. "Something has got to give because it's becoming more and more difficult for us to keep our practices afloat."

In addition to his clinical work, Dr. Kolisek and his group's leadership are politically active and often meet with Congressmen and advocates for medical professionals in Washington, DC, and in the state of Indiana. One of the anecdotes he uses to illustrate the financial hardship of physicians today harkens back to his first practice, opened in 1992. At that time, his Medicare reimbursement for a hip and knee replacement procedure was 55 percent more than it was in 2011. That is a 45 percent decrease in the surgeon fee over the past 19 years. Over the same time period, overhead costs have increased about 65 percent. Therefore, it costs much more now to run a medical practice than it did 20 years ago and we get paid less for the medical care we provide. This is what is driving physicians to retire and/or seek employment by a hospital system.

"I have performed a total hip replacement for a [patient on Medicare] and received Medicare reimbursement rates," says Dr. Kolisek. "[The same patient] took her Labrador retriever to the veterinarian for a hip replacement and had to pay cash upfront for the procedure and it was more than twice what Medicare paid me. The vet made 56 percent more to replace the dog's hip than I did to replace the owner's hip. I do not mean to be critical towards the vet, but rather to point out that physicians can't withstand anymore cuts in Medicare reimbursement for medical care we deliver to patients."

"When I began my practice in 1992, my overhead was around 40 percent, so I got to keep 60 cents of every dollar collected for personal income," says Dr. Kolisek. "My overhead now is 78 percent so I get to keep only 22 cents on every dollar I collect; at the same time, I'm collecting fewer dollars than I did 20 years ago as reimbursements have decreased. The increased government regulations make it difficult to practice medicine and the overhead costs make it hard to keep our lights on."

http://www.beckersorthopedicandspin...gest-concerns-for-orthopedic-surgeons-in-2012
 
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The pods V.S. orthos are one of my favorite grudge matches. Optometry V.S. ophthalmology isn't as entertaining. Oral surgeons V.S. ENT aren't as common place on here. That's too bad.

Anyway, carry on.
 
Lets not forget the psychiatrists and psychologists, the CRNAs and anesthesiologists, or the family docs and med/peds folks. Either way, its too bad "professionals" bicker as above. Malignant personalities abound in all specialties, albeit more commonly in the overworked surgical specialties.
 
thethom said:
Lets not forget the psychiatrists and psychologists, the CRNAs and anesthesiologists, or the family docs and med/peds folks. Either way, its too bad "professionals" bicker as above. Malignant personalities abound in all specialties, albeit more commonly in the overworked surgical specialties.
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The funny thing is that most of this goes away in the real world. Heck, two of my co-residents were hired by ortho groups as the foot/ankle guy. I was trained in all aspects of foot and ankle surgery by a mix of podiatrists and orthopods as are many podiatrists at this point. We all do what we are good at. Where I'm at, who gets what generally depends on who the ER attending is and who is available. I don't get all the trauma nor do I want it. Last week I did two bunions, a met fracture, and an ankle fracture. This week I have an ankle fracture and a retrograde tibial nail.

I know some phenominal podiatrists and I know some that aren't very good. The same can be said for ortho or any other specialty for that matter.
 
Talk about antagonism between podiatrists and orthopedic surgeons. You guys are crazy.

Psychiatry resident here casually perusing the boards, expecting to hear about interesting challenges facing orthopedic surgery today. Instead, this is a comical and insulting-to-both-parties thread... that makes me share the same sentiment, "What's going on in this thr...Oh Lawd!" LOL.
 
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Leo Aquarius said:
Talk about antagonism between podiatrists and orthopedic surgeons. You guys are crazy.

Psychiatry resident here casually perusing the boards, expecting to hear about interesting challenges facing orthopedic surgery today. Instead, this is a comical and insulting-to-both-parties thread... that makes me share the same sentiment, "What's going on in this thr...Oh Lawd!" LOL.
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If you're laughing about my posts, I'm a prepod and I don't know anything. :)
 
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the memes in this thread are golden
 
OKAY for F*^CK's sake can we drop the ortho vs podiatry thing? G($*DAMN...how about the real issue here? Is ortho the undeniable shiz or does the lifestyle really suck? Are salaries going down? Is the job market tightening? Are there any orthopods or residents out there who would strongly advise FOR or AGAINST ortho as a career?
 
samsoniter said:
OKAY for F*^CK's sake can we drop the ortho vs podiatry thing? G($*DAMN...how about the real issue here? Is ortho the undeniable shiz or does the lifestyle really suck? Are salaries going down? Is the job market tightening? Are there any orthopods or residents out there who would strongly advise FOR or AGAINST ortho as a career?
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you're the one that bumped this thread that has been dead for quite some time...
 
Wow... Seems like binging and regurgitating all that information to be at the top of the class required defecating maturity and professionalism.

I've seen undergraduates with better conduct... You should be ashamed of the example you're setting to young premeds like myself. I was hoping to find some guidance from real people who endured the difficulties of being an orthopedic surgery.

Instead, I got some egomaniacal frothy dialogue about a tangential topic. If people like you behave like fiends on a forum, I can only imagine how child-like you all act in real life. God forbid I ever have to work with the likes of such ogres.
 
BMEZephyr said:
Wow... Seems like binging and regurgitating all that information to be at the top of the class required defecating maturity and professionalism.

I've seen undergraduates with better conduct... You should be ashamed of the example you're setting to young premeds like myself. I was hoping to find some guidance from real people who endured the difficulties of being an orthopedic surgery.

Instead, I got some egomaniacal frothy dialogue about a tangential topic. If people like you behave like fiends on a forum, I can only imagine how child-like you all act in real life. God forbid I ever have to work with the likes of such ogres.
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Get over yourself. Why don't you get into medical school first before worrying about working with "such ogres" in the future.
 
Magillicutty said:
^ bump
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Why did you feel the need to bump a thread that was fourth on the list in the orthopaedic forum (last post 2/18/13)? It was still in plain view to everyone using this sub-forum.
 
The major disadvantage of Orthopedic Surgery is during the bone treatment because bone is obtained from the pelvis which causes extreme pain and discomfort and also making walking difficult for many weeks.

_________________
Lewis Orthopaedics
 
davisjone said:
The major disadvantage of Orthopedic Surgery is during the bone treatment because bone is obtained from the pelvis which causes extreme pain and discomfort and also making walking difficult for many weeks.

_________________
Lewis Orthopaedics
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.
 
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Reimbursement cuts from Medicare and insurance companies. A knee replacement pays 1/3rd what it did in the 1990s in real terms. Even a revision total knee, which is major PITA, pays just $1400-1600 including 90 day global period. More cuts to ortho in 2013. Every time Medicare cuts, private insurers also cut their reimbursements. Meanwhile overhead does not go down and daily production is already maxed out.

Don't go into this field for the money.
 
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naus said:
Reimbursement cuts from Medicare and insurance companies. A knee replacement pays 1/3rd what it did in the 1990s in real terms. Even a revision total knee, which is major PITA, pays just $1400-1600 including 90 day global period. More cuts to ortho in 2013. Every time Medicare cuts, private insurers also cut their reimbursements. Meanwhile overhead does not go down and daily production is already maxed out.

Don't go into this field for the money.
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With growing medicare/insurance reimbursement cuts, how is it that Ortho spine surgeons continue to be the highest paid specialists?

Thanks in advance.
 
MDPhDJourney said:
With growing medicare/insurance reimbursement cuts, how is it that Ortho spine surgeons continue to be the highest paid specialists?

Thanks in advance.
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All specialties are being cut not just ortho. As they say on every SDN forum, don't pick a specialty for the money, it could change by the time you finish residency.

Despite some whining to the contrary, orthopedic surgeons will likely continue to be among the highest paid of all physicians. They won't make as much as they did 20 years ago, but they will still make more than 70% of the physicians out there.
 
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Buckeye(OH) said:
My old lady is a podiatrist attending now. The fact that her and her cronies think they can manage hindfoot and ankle trauma better than orthopaedist chaps my ass.

We don't talk about work at home.
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OKAY if you say so .. SIR! lol! :confused:
 
shenanigans327 said:
"Podiatry = bottom of premed class. "

Here's where assumptions are problematic, do you have the stats of every applicant to Podiatry school? Do you really know what our grades/MCATs are? Did it ever occur to you that some of us might have chosen Podiatry because we enjoy the work? For me, I chose Pod over Med b/c I didn't want to go through 4 years of med school and end up in a non-surgical field...Also, what is meant by 'bottom of the barrel'? Quite a few of the Pod programs (Western/DMU/AZPOD) are affiliated with D.O. programs where the students sit in the same classes and take the same tests as the D.O. students. Please elaborate on 'bottom of the class'.

"This is the reason you were left with feet to manage. It's the only thing simple enough for you to wrap that small, insecure brain around."

And this is where you belittle every Podiatrist/ F/A Orthopod in the U.S. that have chosen to make the 'simple foot' their career choice... You're really on a roll here chief!

I'm not really sure that we're the insecure ones here...'Cheers!!'
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all i wanna say .. OKAY!!.. well good luck with what every the F!! you do.. be happy! okay! you own the world now.. bc you got into orthopedic.. now work your ass off and learn to live alone.... thanks.!
 
shenanigans327 said:
"Podiatry = bottom of premed class. "

Here's where assumptions are problematic, do you have the stats of every applicant to Podiatry school? Do you really know what our grades/MCATs are? Did it ever occur to you that some of us might have chosen Podiatry because we enjoy the work? For me, I chose Pod over Med b/c I didn't want to go through 4 years of med school and end up in a non-surgical field...Also, what is meant by 'bottom of the barrel'? Quite a few of the Pod programs (Western/DMU/AZPOD) are affiliated with D.O. programs where the students sit in the same classes and take the same tests as the D.O. students. Please elaborate on 'bottom of the class'.

"This is the reason you were left with feet to manage. It's the only thing simple enough for you to wrap that small, insecure brain around."

And this is where you belittle every Podiatrist/ F/A Orthopod in the U.S. that have chosen to make the 'simple foot' their career choice... You're really on a roll here chief!

I'm not really sure that we're the insecure ones here...'Cheers!!'
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GOOD for YOU sir good for you.... be happy .. !. if that makes you happy then so be it hahahaha!
 
How much do you work a week? Is it as bad as I hear the GS guys work? My brother is a GS and has somewhat of a life so that sort of threw me off . So I thought I should make sure . Is it hell, like 70-80 hours every week? Or is it a little better, like 50?
 
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wjs010 said:
How much do you work a week? Is it as bad as I hear the GS guys work? My brother is a GS and has somewhat of a life so that sort of threw me off . So I thought I should make sure . Is it hell, like 70-80 hours every week? Or is it a little better, like 50?
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If you think 70-80 hours a week is hell, i think you can safely forget about orthopaedic surgery as a career.
 
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Magillicutty said:
If you think 70-80 hours a week is hell, i think you can safely forget about orthopaedic surgery as a career.
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So you're saying as an ortho attending in PP , you can't work less than 80/ week? Lol. That doesn't leave any time for life. 80 hrs a week during residency is expected... I'm not even considering working less than that.. I am only talking after.
 
wjs010 said:
So you're saying as an ortho attending in PP , you can't work less than 80/ week? Lol. That doesn't leave any time for life. 80 hrs a week during residency is expected... I'm not even considering working less than that.. I am only talking after.
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About 60 hrs a week at attending level. More for trauma and spine.
 
Magillicutty said:
If you think 70-80 hours a week is hell, i think you can safely forget about orthopaedic surgery as a career.
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Doing anything for 80 hours a week apart from breathing or sleeping is hell. And if you don't understand that then you've suffered significant narcissistic injury and are trying to compensate.
 
ortho11111 said:
About 60 hrs a week at attending level. More for trauma and spine.
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60 hours a week is about what I always pictured i would be working at that point anyway. That's not too bad. Better than 80 minimum.
 
Leo Aquarius said:
Doing anything for 80 hours a week apart from breathing or sleeping is hell. And if you don't understand that then you've suffered significant narcissistic injury and are trying to compensate.
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Maybe narcissistic injury will appear in the DSM-VI. I knew something was wrong, I just didn't know what to call it.
 
This thread is gold.
 
Maybe I can get this thread back on track with some topics that might be relevant to a lot of people here. I don't have a lot of experience with this directly, but my dad's an orthopedic. He just turned 60, and I've had a lot of chances to talk about this subject and observe him over the years.

Watching him, the biggest overall headaches I've observed are lack of control over scheduling and number of hours worked.

There are some caveats to this. 1) that most specialties offer little control, and 2) that surgeons, if we're going to talk stereotypes, self-select to be dissatisfied with lack of control. My dad's definitely the orthopod stereotype. Track jock, very smart, sarcastic wit. I think surgeons in general are used to...attainment, I guess is the word? Once that person gets out into the world and realizes that someone else will be telling them when to work for the next 50 years, it doesn't make things easy.

And the hours worked have definitely impacted his family life. That really depends on the individual, of course, but in my n=1 sample, it's bad for your marriage(s) and family life. Your kids benefit materially, of course, and that's more than a lot of parents can say.

Having watched my dad, his partners, and many other professionals over the years, I've come to the conclusion that control/freedom correlates more to happiness than most things...even more than money or interest level, within limits. In other words, the most common bits of advice I get from old timers is either 1) "don't do it for the money, do it for the love" or 2) "everything becomes just a job eventually, even your dream job." So between those two bits of advice, the only thing left it seems is a job that gives you control and free time, neither of which orthopedics gives very much of.

And yet, for the right person, it's the right job. My dad's on his third marriage, half his kids don't talk to him, the lines in his face and his glasses Rx both reveal years of hard work, he'll steer you away from the field and say he wishes he had done something else....and yet, I know him. And I really think deep down inside there's nothing else he'd rather be doing.

Anyway, a good friends of mine in school with me is heading into med school to go into orthopedics. I support him because choosing a specialty is a personal choice, and he's shadowing enough orthopedics to get real first-hand advice.

So, that's my 'drawback' post.
 
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LMAO @ this topic

i know who the best docs to get a drink with are now
 
arkenstone said:
Maybe I can get this thread back on track with some topics that might be relevant to a lot of people here. I don't have a lot of experience with this directly, but my dad's an orthopedic. He just turned 60, and I've had a lot of chances to talk about this subject and observe him over the years.

Watching him, the biggest overall headaches I've observed are lack of control over scheduling and number of hours worked.

There are some caveats to this. 1) that most specialties offer little control, and 2) that surgeons, if we're going to talk stereotypes, self-select to be dissatisfied with lack of control. My dad's definitely the orthopod stereotype. Track jock, very smart, sarcastic wit. I think surgeons in general are used to...attainment, I guess is the word? Once that person gets out into the world and realizes that someone else will be telling them when to work for the next 50 years, it doesn't make things easy.

And the hours worked have definitely impacted his family life. That really depends on the individual, of course, but in my n=1 sample, it's bad for your marriage(s) and family life. Your kids benefit materially, of course, and that's more than a lot of parents can say.

Having watched my dad, his partners, and many other professionals over the years, I've come to the conclusion that control/freedom correlates more to happiness than most things...even more than money or interest level, within limits. In other words, the most common bits of advice I get from old timers is either 1) "don't do it for the money, do it for the love" or 2) "everything becomes just a job eventually, even your dream job." So between those two bits of advice, the only thing left it seems is a job that gives you control and free time, neither of which orthopedics gives very much of.

And yet, for the right person, it's the right job. My dad's on his third marriage, half his kids don't talk to him, the lines in his face and his glasses Rx both reveal years of hard work, he'll steer you away from the field and say he wishes he had done something else....and yet, I know him. And I really think deep down inside there's nothing else he'd rather be doing.

Anyway, I will be applying to dental school next summer, with eyes on oral surgery if my academic performance and personal life are in the right place. I take a long, hard glance at psychiatry every now and then b/c the subject has always been a hobby, but that's another discussion. My best friend here is heading into med school to go into orthopedics. I support him because choosing a specialty is a personal choice, and he's shadowing enough orthopedics to get real first-hand advice.

So, that's my 'drawback' post.
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Thanks for the comment. What practice setting does your dad work in... academic? private practice?
 
That's interesting, I feel like a lot of ortho folks go into hand for the lifestyle. I guess any field is what you make of it.
 
arkenstone said:
Private practice hand specialist
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Damn, hard to believe. I also got the feel that hand/UE is much more of a 'cush/lifestyle' subspecialization in ortho. I mean, those wrist fusions, carpal tunnel releases, fractures, dupuytrens surgeries don't take that long. Its not like he's repairing multiple brachial plexuses every day
 
True, although some of the attendings I worked with on hand hate the high volume clinic necessary to keep their OR day full
 
Tired said:
As with most subspecialties, the name attached to it is likely less important than the practice setting you're working in.
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Truth. I've seen hand guys work like neurosurgeons, and spine guys work like dermatologists. It is what you make of it, though I'm sure not everyone can make exactly what they want of it, nomsayin? Sports/ joints/ F&A seem to lend to good lifestyles, and spine can be OK if you stick to smaller whacks. God bless trauma and pedi ortho.

On a side note, hard to believe I started this monstrosity of a thread 3 years ago... Well, it didn't scare me from the field and I matched this year. I'll see each and everyone of you as$ holes in July...
 
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