Michelle Kha 1

15 September 2017

Research Assessment #2
Source:

Schneller, Eugene S., and Natalia A. Wilson. Professionalism in 21st Century Professional

Practice: Autonomy and Accountability in Orthopaedic Surgery. Clinical Orthopaedics

and Related Research 467.10 (2009): 25612569. PMC. Web. 15 Sept. 2017.

Analysis:

The article touches on two issues of orthopedic surgery in the 21st Century: autonomy,
and accountability. Professionalism in medicine is highlighted with its code that dictates that all
healthcare workers practice in order to provide optimal care for the patient. With accountability
and autonomy factoring in with said statement, in the present century, both topics have become
skewed and in dire need of re-evaluation. Accountability has always been primarily taking care
of the patient first and foremost, but in present time it has also applied to the accountability of
suppliers in which surgeons must deal with cost effectiveness and using the generic implants that
have a history of success but yet constrain the possibility of a better device that could be more
suited to the patients condition although it costs more. In addition to the accountability of
suppliers, another factor that has played a major role in the roles of orthopedic surgeons are
hospitals. Its a reoccurring theme that there is a strained relationship between surgeons and
hospital management. The article highlights the issue stems from autonomy in which hospitals
focus on the all the details that surround the experience of surgery that deal with money while
surgeons are the ones who solely deal with the surgery itself. In essence, while the surgeons are
given the role of the major component in the grand scheme, hospitals are the ones that outline
and delegate with the financial aspects and the entire process besides the operation. Autonomy of
surgeons has been restricted by hospital management whether it be from protocols and
formalities. The independence of surgeons has been weighed down by hospitals and suppliers as
the physicians are held accountable by patients and account on the centers and sellers.
Contemporary practice has gone far from the past and is in need of restructure.
In application to my topic, one of my learning targets for the class is to learn about the
benefits and disadvantages that come with working in a hospital setting versus working in an
independent clinic that has its own management. Choosing where to practice is crucial to
surgeons as it determines the flow and influx of patients and financial aspects. The article has
revealed to me the negative side of hospitals and given me insight on contemporary practice in
orthopedics.
The article is broken down into sections of the issues regarding the accountability and
autonomy of orthopedic surgeons and into subsections of the factors that affect them, such as the
dependency on supplier and the relationship between hospitals and the physicians independence.
In the last section of the article, it outlines the issues and asserts on the what needs to be changed
and how. Before reading the article, I was not aware of the constraints that restrict and delegate
Michelle Kha 2

15 September 2017

surgeons decisions. I had not realized the significance of the dependency on suppliers. Now
reflecting upon my newly gained knowledge, I now understand why some physicians choose to
work in their own clinics and take part in partnerships rather than working with hospitals.
With this information, I plan to highlights the key points that the article had emphasized
in my interviews and my mentor on their opinions on the subjects of how they feel about their
autonomy in the field in relation to supplier and hospitals. Furthermore, I hope to touch on the
subject of private practices and public practices in the interviews to gain a sense of which I
would like to take part of in the future of my own medical career.
The information that the article has taught me has changed my perspective on orthopedic
surgeons and hospitals. While I have gained insight on the view of hospitals from a medical
standpoint that had influenced my opinion of the public centers, the information on the
dependency of the supplier relationship with surgeons had greatly discouraged my view of the
orthopedic field. I am now wary of the possibility of the cons outweighing the pros of the limited
independence of orthopedic surgeons in terms of medical decisions for my patients. More
importantly, in application to my own career clarity, will the limited independence cause me to
not pursue a career in orthopedics. The article has exposed me to new information that gave me
invaluable insight and invoked new fears of the field but I am still eager to learn more about
orthopedics and I continue to have high hopes.