Choices

Having a choice in anything is incredibly empowering. We are quite accustomed to having options and the liberty to choose what is best for us at any given moment and in any given decision. And as the cliché goes, with choice comes responsibility. In healthcare, even greater responsibility is shouldered, because choices are being made entirely for people. If you are not part of the cycle of surgical care, you would be amazed by how many choices are made for an unbeknownst patient.

Lately, the big choice in healthcare is about value and the responsibility is enormous for surgeons. There’s a lot of pressure. So much so, that the President of the Orthopaedic Trauma Association took some time to address it in his farewell speech to the OTA membership at last week’s annual meeting. Admittedly taking a radical stance to prove a point, the president reminded the OTA’s base that maximizing delivered care is the surest option for a good outcome. To date, this has been the sole focus of a clinician. He went on to give the most relatable example possible (for an ortho-traumatologist, of course) by presenting device options for a hip fracture. The choice was between a sliding hip screw plate and an intramedullary nail. While the sliding hip screw is a fraction of the price of the intramedullary nail, the president candidly admitted that either would do intraoperatively. However, he continued by stating that the nail, despite costing so much more, would be better because of the uncertainty patients face on the post-op road to recovery.

While the point was clearly made, in the adjoining exhibit hall, a device was on display that would no doubt provide a surgeon with a choice overlooked in the address. It was, indeed, an intramedullary hip nail – one that costs the same as that sliding hip screw. There’s nothing special about this nail’s design. There’s no patent nor feature that makes it stand out. Simply put, it works very well. To boot, a study was presented at the meeting proving this nail’s clinical equivalency to premium brand nails. The study goes beyond proving clinical equivalence, capturing the savings this nail generates. The value is what makes this nail special. No longer do those surgeons who believe that an intramedullary nail is superior feel the need to comprise on technology in order to save costs.

You see, there’s a company out there who is providing surgeons with the technology they have come to rely on with the value they need while continuing to have a choice. Or more appropriately put, this company exists so surgeons aren’t made to feel that they have to make choices beyond the scope of doing what’s best for their patients clinically.