This blog site is dedicated to the latest, coolest and most controversial topics in orthopedics from the way I see it. Since this is my inaugural blog I beg your indulgence. From time to time, we will have guest bloggers share their erudite perspectives on unique and pertinent opinions, treatments, techniques and experiences.

The hope is that our opinions and discussions will be informative, instructive and in tune with our orthopedic population in need wherever they may be. It is my intent to offer a serious but in many instances humorous perspective of orthopedics at large. Many of our discussions will be technique driven and pertain to the how and why selected procedures are chosen and who is a candidate for these procedures.

Many patients have experienced the very basic fact that if you have insurance coverage you are a candidate for any procedure (that is until you need it). Conversely, we all know what happens when you don’t have insurance: the procedure you require suddenly and miraculously has never existed, has never been tried, is considered experimental and is currently not available in the Continental United States although your friend from down the street with Anthem just had it performed and is doing great.

All in all this is an exciting field. The capacity to do big things for the acutely and chronically hurting has its own rewards. Like the Red Cross says,” Need knows no season”. Even though there has been immense changes to the landscape of our profession the latitude to help those in need is great. Innovations in this profession are great and sweeping but unfortunately sometimes introduced too soon and before enough data has been collected and analyzed to ensure safe and predictably good outcomes. Nonetheless, the American Academy of Orthopedic Surgeons remains one of the largest medical organizations in the United States to date. Their commitment to research and providing the safest experience for both patient and physician alike is unparalleled. More on the Academy in another blog.

As an independent Orthopaedic Surgeon, who has remained a solo practitioner, I have had the luxury of surrounding myself with some of the best and brightest employees and Physician’s Assistants since Hippocrates penned his Hippocratic oath. It did not hurt that I refused to sell my practice to the regions competing hospitals. This allowed me to keep my private practice intact, pursue innovative ideas, keep skilled and dedicated employees, and not have to go to never-ending bureaucratic gatherings about meeting benchmarks, surgery block time, medical chart completion and that you better get along or you will be considered a hostile physician, whatever that means. So as a rule, I can be as hostile as I like. Besides, their approach destroys innovation and creativity, and truthfully, some of my patients require as much creativity as I can muster.

By now you’re getting a general idea of what it’s like and where I am coming from in the ever changing Mad Max terrain of orthopedic surgery. Innovations are wide and sweeping and have a certain aesthetic appeal when it comes to treating the myriad of problems that we encounter as clinicians and surgeons. It is my intention and hope that you will follow along as we go over the river and through the woods to the Trauma Center we go. Just kidding. Fasten your seat belt anyways.

Jonathan Paley, M.D.