This is great stuff. An infectious disease doctor, with great priorities in life by the way, sets the record straight about orthopaedic surgeons:
That's good stuff. But mostly, it's true. I know orthopaedic surgeons are smart. We're all smart. That's how we got through medical school. Although, I think a lot of the issues are not that they can't, but that they won't be bothered with the non surgical aspects nonpaying aspects of medical care. I would hope my surgeons have the basic medical skill set all graduates of medical school have to take care of routine hospital care. Perhaps that is something their Board should address in their competency of recertification.
If surgeons are not going to manage even the simplest of medical needs of their patients, insurance companies should adjust their bundled fee downward based on the additional cost of other medically necessary unnecessary physician services, like the hospitalist charge for medical management in a patient with no acute medical issues to address.
When I am asked "to follow" an orthopaedic admission for multiple chronic stable medical issues, I kindly do my level three CPT 99233 follow up note, search for any issues to address, write a bunch of PRN house keeping orders and sign off when I determine, as a physician, that my daily MD level services are not necessary. These kind of patients would do just fine if orthopods would hire their own primary care PA and NPs to do their rounds for them and to consult the hospitalist (CPT 99253, 99254, 99255) when actual medical decision making exceeds the skill set of their mid levels. I would be perfectly happy giving up my rounding duties for medically unnecessary care.
There is no reason for a hospitalist to follow a patient with stable medical issues any more than there is for an orthoapedic patient to follow my CHF patient for stable osteoarthritis. If an issue arises that requires a medical doctor to address, I should be called. Otherwise surgeons should hire their own NP or PA, as their out, to handle the day to day annoyance calls that are part of being a surgeon doctor.
Go read the rest of this docs post. It's an exceptional read and helps put the orthopaedics vs anesthesia Xtranormal video into context.
