April 1996 Bulletin

Usurping functions of physicians

The January 1996 issue of the Bulletin is just excellent in epitomizing the schizophrenic approach we have been forced to take as orthopaedic surgeons in the 1990s. We have an article by Dr. (Kathleen) McHale about the wisdom of pinning the contralateral hip in slipped capital femoral epiphysis and her concerns about cost-effectiveness while in the same paragraph she discusses the use of MRIs to make a decision. Then, we have an article by Drs. (Richard A.) Berger and (Joshua J.) Jacobs on the cost of prostheses.

The government, through Medicare, has forced hospitals and will soon force us as physicians to make decisions solely on the basis of short-term cost and with absolutely no regard to long-term patient benefit in the selection of prostheses.

The same issue of the Bulletin then goes on to detail how the manufacturers of implant materials have discontinued the manufacturing of such materials because the liability is outweighed by any profit available to the manufacturers.

It is quite apparent that the government has been able to provide regulation in terms of its own cost expenditures with complete disregard to benefits or the economic and legal considerations that they have thrust upon manufacturers of medical devices.

It is high time that the citizens and the lawyers of this country be forced to examine the fruits of what has been thrust upon us by our focus on dollar costs and unfair treatment of the medical supply industry in this country. Something is not right with our system because we have allowed lawyers and the government to usurp the legitimate function of treating physicians.

Richard A. Maun, MD

Whittier, Calif.

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