Foundations for Success in Orthopaedic Surgery Empowers Readers to Navigate the Modern Healthcare System

I firmly believe that our current educational system is outstanding at training medical students to become competent orthopaedic surgeons. The rigorous curriculum of orthopaedic training has refined the process of ensuring that we will continue to produce men and women who are highly qualified to serve the public for decades to come. A looming unanswered question remaining in medical education is: “Have we trained those graduating orthopaedic residents to be successful in the modern healthcare environment?” To thrive in practice today requires so much more than just being competent in the diagnosis and treatment of musculoskeletal diseases. Personally, I have been massively disappointed with the current education of residents and newly minted orthopaedic surgeons in the complexities of understanding the nuances of the modern healthcare environment.

Foundations for Success in Orthopaedic Surgery, authored by well-known orthopaedic trauma surgeon Heather A. Vallier, MD, FAAOS, is an excellent primer for educating orthopaedic surgeons of all ages about the complexities of modern healthcare delivery. Dr. Vallier clearly and succinctly addresses the multitude of challenges and obstacles that practicing orthopaedic surgeons face outside of the clinical practice of medicine.

This book is organized into seven parts, nicely grouping similar topics into structured fields so readers can effectively focus on consistent themes. The first part introduces the concept of “Career Planning for Success.” In this section, Dr. Vallier describes an organized method of selecting a specialty as well as helping younger orthopaedic surgeons consider their first professional appointment. She approaches this discussion by exploring professional and life goals. Younger physicians will benefit from a careful reflection of this section to thoughtfully address some of the most important decisions in their professional careers.

The second section is titled “Getting Started in Practice.” Dr. Vallier takes the reader through the various business models of orthopaedic surgery as well as the basics of contracting and negotiation. Readers will benefit from the stepwise approach to consciously selecting the practice setting best suited to them. They will also gain an understanding of the skills to advocate for oneself while moving through the hiring process. The next section of the book introduces global topics of healthcare systems, insurance coverage, and healthcare economics. The basics of these topics are foreign to so many orthopaedic surgeons, and these chapters improve knowledge in these areas. These topics are critical to an understanding of the modern system in medicine.

Following these topics, the book then covers the “bread and butter” of modern practice. The section titled “Business of Orthopaedic Surgery” describes many practical aspects of orthopaedic practice that can take surgeons years to understand. This section begins with an explanation of practice management followed by specifics in personnel, medical records, documentation, and coding/billing.

Next, the author describes the economics of revenue generation, cost-effective care, and interactions with federal payers. In my opinion, this is the area of greatest benefit to most orthopaedic surgeons. The general understanding of these topics is woefully behind what it needs to be, and the comprehensive nature of this section explains them thoroughly.

Dr. Vallier then discusses issues of medical liability, workplace safety, and moral injury. These often-neglected subjects are becoming recognized as significant factors shortening the careers of many orthopaedic surgeons. The book concludes with a section covering personal insurance, financial planning, and retirement.

As you can see, this comprehensive book addresses many of the non-clinical issues that plague the modern practice of orthopaedic surgery. As the healthcare environment continues to consolidate and options for orthopaedic surgeons become more limited, it is essential that we understand the landscape of the changing competitive environment. I strongly recommend this book to all orthopaedic residents as well as physicians in the first decade of practice. These topics are also of significant benefit to more experienced orthopaedic surgeons considering a change of practice setting later in their careers. These real-world issues must be better taught to orthopaedic trainees, and this book is an excellent primer.

Douglas W. Lundy, MD, MBA, FAAOS, is chair of the Department of Orthopaedic Surgery at St. Luke’s University Health Network.