April 1996 Bulletin

Survey finds physicians buried in mail

Nine practices get 4,288 pieces of mail in nine days

The Academy's department of communications contacted 15 orthopaedic practices in February and asked office administrators and other personnel to participate in a survey of the volume of mail received by the practice. Office personnel were asked to count and categorize the mail received on nine mail delivery days between Feb. 13 and Feb. 27, 1996.

Nine practices, which included 68 orthopaedic surgeons, reported receiving a total of 4,288 pieces of mail.

The mail included: 764 items categorized as general orthopaedics (lab and X-ray reports, papers requiring doctor's signature, etc.); 603, continuing education literature; 490, insurance requests; 484, newsletters; 359, journals;
167, new products literature; 151, legal (copies of records of suits, depositions, etc.); 149, managed care; and 109, drug literature. A total of 654 pieces were miscellaneous (nonorthopaedic) and 456, personal mail. Duplicate copies were counted in the survey tally.

The journals listed by the office staff included: Journal of Musculoskeletal Medicine; Journal of the American Academy of Orthopaedic Surgeons: A Comprehensive Review; Contemporary Orthopaedics; Journal of the American Medical Association; and Journal of Bone and Joint Surgery.

Orthopaedic surgeons also received catalogs of patient education materials, state medical association communications, and Academy publications such as AAOS Report, Washington Report, and Bulletin.

William P. Hussey, office manager of Carondelet Orthopaedic Surgeons, P.C. in Kansas City, Mo., said that he had to increase his staff because mail about managed care, capitation, and malpractice has dramatically increased the volume of mail received by the practice.

"We have just been inundated with mail-everything from vendors trying to pitch drug products to companies hoping to sell health care services or seminars," said Hussey.

"Our six orthopaedic surgeons get a lot of what might be considered 'junk mail' which ends up in the circular file. But they do take time to read journals and mail from professional organizations that they are directly affiliated with, such as correspondence from the American Academy of Orthopaedic Surgeons."

"Each of the orthopaedic surgeons in Central Indiana Orthopaedics, P.C., Muncie, Ind., has two baskets-one for priority mail like telephone orders or notification letters, and the other for journals and other materials," said Scott W. Walker, MD. "Mail is piled up constantly," Dr. Scott said. "I probably average about 20 minutes per day to review mail. I do scan the article titles on the cover of journals, like Contemporary Orthopaedics, Orthopaedic Review and the Journal of Bone and Joint Surgery, and sometimes make a check mark next to the ones I want to read.

"I can't say that there is anything that I am not receiving in the mail that I need, but I like to be kept abreast of anything new, notifications of meetings, and legislative information."

Bony Fields Barrineau, MD; William D. Sudduth, MD; and Timothy D. Bassett, MD, from Alabama Orthopaedic Center, PC, Northport, Ala., each have assistants who have been advised about what mail the physicians want to read.

"With the responsibilities of surgery, industry contracts, and seeing patients at five to six satellite offices, they simply don't have time to sort through everything," said Melissa Mund-Zander, marketing coordinator. She emphasized that high-priority mail like continuing education registrations are "walked in" to orthopaedic surgeons during their office hours. "They read when they can, but it is not unusual for general mail to pile up on their desks for three weeks," Mund-Zander said.

James B. Troup, MD, Winchester Surgical Clinic, Ltd., Winchester, Va., said that he can only spend about a half hour per day reviewing mail in the office, but takes home publications to read before retiring. "I especially enjoy special articles on specific topics, like the ones on the rotator cuff and scoliosis that appeared in the Journal of Bone and Joint Surgery," Dr. Troup said.

Nothing is thrown away by the mailroom at Fort Wayne Orthopaedics in Ft. Wayne, Ind., according to Ronald W. Cousino, office manager, who said the 16 doctors in the practice individually determine what they read.

"My office staff swears that the post office waits to sort its mail on Saturdays because the volume of mail the office receives early in the week is tremendous," Cousino said. More than 200 pieces of mail arrived on a recent Monday.

Charles B. Bird, MD, Bend Orthopaedic and Fracture Clinic, Bend, Ore. says he reads certain journals, such as the Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery, and materials he receives from the International Society of Orthopaedic Surgery and Traumatology.

Dr. Bird added that he always is interested in the information on home study, such as the Academy's courses that are on CD-ROM. "I glance at the Academy catalog to see what is available and often order course materials that I can do on my own time," Dr. Bird said. "I look at information on computer classes that comes in the mail, and have taken a few courses. When the Academy has its Annual Meeting next year in San Francisco, I am thinking about signing up for Boot Camp.

"When looking at the survey, one has to remember that what I consider 'mail' is only a small percentage of what comes into the office, since my staff sorts out pieces like insurance requests, which get noted by staff in reports I read.

"I can tell you that promotional pieces from drug companies do not even make it into my office, and get thrown into the nearest round file. The big bulky ones, that I know cost them tons of money to try to convince me to use their pill, drive me absolutely insane."

Nancy Johnson, office manager of the Orthopaedic Institute for Special Disorders in Houston, said she discards credit card applications and information on disability and life insurance policies.

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