Politics 101 for Orthopods

by Alan S. Routman, MD

If you ever get the chance, stop and take a look around at the way you practice orthopaedic surgery these days.  Certainly we have much better tools, devices, and technology than any of us ever imagined when we began our training years ago.  Some of these have improved patient outcomes, and some maybe not, but that’s a discussion for another day.

I’m thinking more of the government intrusion, the ever growing wedge that is being driven between us and our patients, and is radically shifting the landscape of our day to day practice.  Some guys simply dodge the oncoming train, and become employees of hospitals and multi-specialty groups and depend on practice administrators to steer them through the maze of new and burgeoning regulation.  The rest of us, in private practice, solo, or small groups, have to wonder if we can actually keep up with all the new rules and continue to maintain our medical lives the way we would like it to be.  Personally, I’m a patient oriented guy and can’t stand the thought of looking at an EMR on a computer screen instead of looking my patient in the eye.

This all brings me to the fact that our profession as orthopaedic surgeons is really worth fighting for.  Our training and skills, and what we can deliver to people in the ER, the OR, and in the office is truly wonderful.  And most of the time it’s fun, except when the paperwork and the intrusions drag us down and take us away from our work.

Remarkably, these are all the reasons why I believe it is incumbent on us, as surgeons, to take our message about patient care to the people who make the decisions that control our profession.  Those people are the politicians, and they know little to nothing about the practice of medicine.  We have to teach them.

Politics is a necrotic component of our society that seems to be completely devoid of any real knowledge or expertise about which many of the laws are made that govern us.  In medicine, this is having disastrous consequences and requires our immediate attention.  If we cannot educate and influence the people making laws, then we will (soon) witness the demise of the practice of medicine as we know it.  It is happening now, and not only in medicine.

I submit that my time can be better spent doing other things, based on my training and experience as a surgeon.  Unfortunately, I cannot afford to be a spectator to the debacle that is occurring before my own eyes.  If we do not act as a profession to stop this trend, then we too are guilty of the same negligence as the politicians.

Political advocacy is distasteful for many physicians, but, the practice of medicine is like a form of freedom. It may not be appreciated until it’s gone.  I write this to encourage all of my colleagues to consider political activism as important as anything else that one can do in their professional lives.  Forces are in place that will make physicians mere tools in the coming medical-industrial triangle of insurers, hospitals, and pharmaceutical giants.  Historically, those guys know how to play politics, and we don’t, and guess who the politicians are listening to.

Even if political involvement is personally distasteful, all of us can participate by speaking the language of politics, i.e., money.  Even if you can’t develop personal relationships with your local elected officials, you can still be a player by becoming an active member of your state and federal orthopaedic PACs, and also helping out when one of your colleagues asks for a check for a medicine friendly candidate running for office.  Don’t just walk away when you have the opportunity to support other surgeons who are working hard to make a difference in your profession.  Think in terms of making a major commitment, just like our competitors do, in your political involvement.  Checks for candidates at $500 are baseline, and $1000 annual contributions to your AAOS PAC (think Stu Weinstein) should be as automatic as paying the mortgage.  If you sit on the med exec committee of your hospital, you can play a huge role by ensuring its participation in political fundraising using those available (and painless) staff dollars.

Percentage of participation by orthopaedic surgeons is increasing, but is still miniscule compared to attorneys, chiropractors, podiatrists, and the like.  We have everything to lose, and they have everything to gain by the changing political landscape.  Together we can preserve and protect our profession.  Get off your financial butt, and develop a passion for the rising tide of physician advocacy.  Together we can have the influence and power that will make a difference in the evolving healthcare debate.  We need you to be on the team and play this important role in the fight for our future.

Dr. Routman is an orthopaedic surgeon in Fort Lauderdale, FL.  He has been President of the Florida Orthopaedic Society and a member of the Board of Councilors of the American Academy of Orthopaedic Surgeons.  He is currently the Vice Chairman of the Broward County Health Facilities Authority Board, on the Board of Governors of the Florida Medical Association, and is the Vice Chairman of the Florida Medical Association Council on Legislation.

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