April 1998 Bulletin

Orthopaedic surgeon attitudes about current practice conditions


General
orthopaedic
surgeons
in %
General
orthopaedic
surgeons
with specialty
in %
Subspecialty
orthopaedic
surgeons
in %
All
orthopaedic
surgeons
in %
There are too many orthopaedic surgeons being trained 72.777.0 69.873.2
There are too many subspecialists being trained 70.363.0 52.361.7
In my practice community, there are the right number of orthopaedic surgeons to meet patient demand 37.336.8 30.234.8
I work more hours than I want to 34.841.9 47.641.5
I am not busy enough and would like to see more patients 35.530.4 24.430.0
I want to expand my patient case load 46.946.8 44.246.0
I wish I had more time to perform orthopaedic surgery 26.141.6 35.734.6
I would like to limit my practice to nonsurgical orthopaedics11.3 3.81.7 5.5
I feel comfortable asking colleagues for advice on difficult cases90.9 86.792.2 89.9
I refer complex cases to orthopaedic specialists 79.269.0 62.069.9
I am no longer enthusiastic about the practice of medicine38.0 32.826.8 32.5
I plan to retire from orthopaedics sooner than I expected 47.537.8 34.639.9
I carefully screen patients to eliminate those who are potentially litigious 32.233.2 32.732.7
It is hard to keep up with all the changes being made in medical practice 60.656.5 62.860.0
Orthopaedic surgeons should only see patients on referral14.7 10.17.9 10.9
Managed care had made practicing medicine more complicated88.4 85.587.2 87.0
Physicians should discuss costs of alternative treatments with their patients 63.662.1 63.162.9
Medicare reimbursement levels reflect fair payments for the majority of my geriatric cases 5.12.8 2.73.5

Moderate or a lot of competition from:


General
orthopaedic
surgeons
in %
General
orthopaedic
surgeons
with specialty
in %
Subspecialty
orthopaedic
surgeons
in %
All
orthopaedic
surgeons
in %
Other orthopaedic surgeons 59.8 59.250.8 56.6
Orthopaedic group practices 47.1 51.440.7 46.4
HMO/Managed care plans 51.057.8 50.6 53.2
IPA/Managed care plans 48.848.8 46.0 47.9
Osteopathic surgeons 9.08.3 6.3 7.8
Primary care/general practice physicians 13.1 15.410.1 12.9
Neurosurgeons14.3 15.5 16.015.3
Podiatrists28.5 24.4 13.121.4

Source: 1998, "Estimating Orthopaedic Provider Supply and Demand" RAND


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