Workload and decreasing reimbursement in medicine, specifically orthopaedics, have been chronic causes of physician dissatisfaction and complaints, and, in my opinion and experience, no more so than by the adult reconstruction surgeon1,2. In their nicely studied evaluation of touchpoints (calls or electronic messages to and from patients undergoing total knee arthroplasty or total hip arthroplasty) in a total joint arthroplasty practice, Lam et al. show the growth of these necessary touchpoints that represent the modern avenue for patients to contact their doctor. Remember that reducing patient anxiety from “fear of the unknown” is critical for patient well-being, recovery, and pain control, and patient calls and messages are part of that process for healing3. Albeit a heavy lift, these touchpoints are a necessary component (not evil) for a successful adult reconstruction practice caring for an older patient population. I was once told by an older surgeon, the late James K. Weaver, MD, “I never regretted making a phone call to a patient,” an adage that seems sadly out of date in this era of patient care4. However, at the end of the day, the authors answer their own question: Surgeons are not “touched out,” as most of the touchpoints documented in this study were handled by physician extenders and staff, rarely the surgeon. Spoiler alert for the readership: thinking that a surgeon will be compensated more for a physician extender’s work will not be convincing to the U.S. Centers for Medicaid & Medicare or policymakers from the data presented in this ingenious article from a modern adult reconstruction practice.
Robert C. Schenck (Thu,) studied this question.