December 1998 Bulletin


Write to The Editor, AAOSBulletin, 6300 North River Road, Rosemont, Ill. 60018-4262


None of the letters regarding diversity (October 1998 Bulletin) were supportive of the concept of diversity. Each letter exhibits varying degrees of misunderstanding of this important effort.

Dr. Philip Lascelle's letter and comment regarding professional sports and selection of the most qualified player can actually be used to underscore the importance of promoting diversity in orthopaedics. To illustrate how lack of opportunity, rather than being unqualified, influences a situation one need only to look at the relatively recent increase in the number of black quarterbacks in the NFL, compared to 10 years ago. Surely the talent was there for black players to play that coveted position, but not the opportunity due to prevailing attitudes in earlier times. This increase in the numbers of black quarterbacks is also occurring in colleges as a result of increased opportunity due to evolving attitudes. To the contrary, the paucity of black head coaches today at both the professional and collegiate level is reflective of the earlier held attitude that blacks were not qualified to play quarterback (nor coach).

Diversity does not imply advance of less qualified-rather it is a promotion of opportunity for individuals not previously included. The exceedingly low numbers of women and minorities in our specialty is no doubt multifactorial. The Academy's diversity effort can help address this underrepresentation not by exclusion, but by inclusion of all. Making orthopaedics attractive to women and minorities will serve to assure that we continue to appeal to the brightest and the best.

Edward A. Rankin, MD

Washington, D.C.

I am writing you this letter in regard to the letters that were published on diversity in the October 1998, issue of the Bulletin. As an orthopaedic surgeon and more importantly, a citizen of the United States of America, I was disappointed but not surprised by the letters which were published in that issue. All three letters presented a negative opinion in regards to the recent efforts of the AAOS to push for diversity within the profession of orthopaedic surgery. Our country is based on the diverse population with everyone having an opportunity to compete on a level playing field. As we all know, because of past history, nepotism, distribution of wealth, and connections, there are members of our society that start out with a large advantage over other segments of the population.

In order to correct these past disparities and also to allow every American regardless of race, sex, religion or sexual orientation to participate in the American dream, efforts should be made to correct these large disparities which have been institutionalized. None of the groups who had a difficult time getting their fair share of the American pie want a hand-out, but I think it would only be fair if the disparities in our society are kept in mind and efforts made so that our specialty more closely represents society as a whole and not a small minority who have been privileged. In the long run, patients will benefit and the fundamental ideas of equal opportunity on which our country is based will be realized.

James A. Hill, MD

Chicago, Ill.

Congratulations to the Bulletin for the publication of articles on diversity in both the August ("Diversity in orthopaedics") and October ("Treating Minorities") issues. This is in keeping with the enlightened philosophy of the Academy as outlined in the strategic plan for 1999. ("Patient Care"-1. Goal, 1.1 Objective "to promote policies that will provide access to musculoskeletal care for the underserved population.").

The lack of diversity either in manpower or in policy can lead to the disparities in healthcare that is seen in the underserved communities. The federal government has recognized this and this year is allocating $4 million to help decrease this discrepancy.

I am concerned that Drs. Farris, Pashman and Lascelle got the wrong message from the report of AOS symposium. The entire symposium will soon be published in a peer review journal. I am hoping that after they review the entire symposium they will better understand the intent of it.

R.O. Pierce, MD

Indianapolis, Ind.

I am responding to your article "AOS told more minority orthopaedists needed," in the August issue of the Bulletin. This is an area of our society that has been and continues to be controversial. Affirmative action leading to a color-blind society has been only partially successful. The idea of quotas does not really suit our goals and the maiming of affirmative action into racial/gender quotas is to blame.

The practice of orthopaedic surgery is not for everyone. The skills and demands of the profession do not suit everyone. We have therefore a small group from the medical schools to select for the decreasing (I hope!) residency slots in orthopaedics. It is ridiculous to complain about not enough minorities/women when so few apply. The vast majority of my fellow minorities in medical school would never consider orthopaedics because of a lack of interest in the field. You can't solve that with a quota. The Academy could initiate an outreach program to medical schools encouraging minority/women to consider orthopaedics.

We could also stop the equally ridiculous policy of choosing people based on test scores alone. Who is the better doctor-the one with a 98 percent exam scores or the one with 87 percent? Who has the better surgical skills-the one with a 98 percent exam score or the one with 82 percent? How does exam scores correlate with success in practice? We should have standards that must be met, but not allow blind choice by test scores.

I submit that our profession is better served by choosing people based on acceptable academic standards, the intangibles of "people skills" and aptitude, and stress tolerance.

Loren Jenkins, MD

Portland, Ore.

Allow me to add my strong support to the various letters you published condemning the Academy's dabbling in the area of "diversity." This term is a code word for affirmative action, itself a code word for reverse discrimination. Stick to being a professional organization and an educational engine for our profession. Don't waste my dues on something so manifestly far afield and foreign to the notion of achievement by merit as the silly concept of "diversity."

Richard Hurd, Jr., MD

Alpharetta, Ga.

Wrong site surgery

I read with concern the letter from Dr. Prasanna L. Soni, Canton, Ohio (October 1998 Bulletin) regarding the wrong-site surgery article of August 1998. Dr. Soni reports "your preoccupation with wrong-site surgery is truly absurd." Dr. Soni then states that one of the "old boys" in town was protected by the medical community while performing wrong-site surgery on a regular basis.

The most competent, responsible physician may inadvertently perform wrong-site surgery. Periodic review of wrong-site surgery issues can only help heighten surgeon vigilance. I applaud the Bulletin for the practical suggestions to avoid wrong-site surgery. Dismissal of this issue as something that may occur only in the hands of "that good old boy surgeon" smacks of over-confidence and lack of self examination.

T. Craig Derlan, MD

Durham, N.C.

Would you like to comment on something you read in the Bulletin? Let's hear from you. Send your letter to the Editor, Bulletin, AAOS, 6300 N. River Rd., Rosemont, Ill. 60018. Fax (847) 823-8026.

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