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Professionalism in 21st century professional practice: autonomy and accountability in orthopaedic surgery.
Clin Orthop Relat Res. 2009 Oct; 467(10):2561-9.CO

Abstract

Orthopaedic surgical practice is becoming increasingly complex. The rapid change in pace associated with new information and technologies, the physician-supplier relationship, the growing costs and growing gap between costs and reimbursements for orthopaedic surgical procedures, and the influences of advertising on the patient, challenge all involved in the delivery of orthopaedic care. This paper assesses the concepts of professionalism, autonomy, and accountability in the 21st century practice of orthopaedic surgery. These concepts are considered within the context of the complex value chain surrounding orthopaedic surgery and the changing forces influencing clinical decision making by the surgeon. A leading impetus for challenge to the autonomy of the orthopaedic surgeon has been cost. Mistrust and lack of understanding have characterized the physician-hospital relationship. Resource dependency has characterized the physician-supplier relationship. Accountability for the surgeon has increased. We suggest implant surgery involves shared decision making and "coproduction" between the orthopaedic surgeon and other stakeholders. The challenge for the profession is to redefine professionalism, accountability, and autonomy in the face of these changes and challenges.

Authors+Show Affiliations

WP Carey School of Business, Arizona State University, Tempe, AZ 85287-4506, USA. gene.schneller@asu.eduNo affiliation info available

Pub Type(s)

Historical Article
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19377906

Citation

Schneller, Eugene S., and Natalia A. Wilson. "Professionalism in 21st Century Professional Practice: Autonomy and Accountability in Orthopaedic Surgery." Clinical Orthopaedics and Related Research, vol. 467, no. 10, 2009, pp. 2561-9.
Schneller ES, Wilson NA. Professionalism in 21st century professional practice: autonomy and accountability in orthopaedic surgery. Clin Orthop Relat Res. 2009;467(10):2561-9.
Schneller, E. S., & Wilson, N. A. (2009). Professionalism in 21st century professional practice: autonomy and accountability in orthopaedic surgery. Clinical Orthopaedics and Related Research, 467(10), 2561-9. https://doi.org/10.1007/s11999-009-0836-4
Schneller ES, Wilson NA. Professionalism in 21st Century Professional Practice: Autonomy and Accountability in Orthopaedic Surgery. Clin Orthop Relat Res. 2009;467(10):2561-9. PubMed PMID: 19377906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Professionalism in 21st century professional practice: autonomy and accountability in orthopaedic surgery. AU - Schneller,Eugene S, AU - Wilson,Natalia A, Y1 - 2009/04/18/ PY - 2008/12/01/received PY - 2009/03/31/accepted PY - 2009/4/21/entrez PY - 2009/4/21/pubmed PY - 2009/10/16/medline SP - 2561 EP - 9 JF - Clinical orthopaedics and related research JO - Clin. Orthop. Relat. Res. VL - 467 IS - 10 N2 - Orthopaedic surgical practice is becoming increasingly complex. The rapid change in pace associated with new information and technologies, the physician-supplier relationship, the growing costs and growing gap between costs and reimbursements for orthopaedic surgical procedures, and the influences of advertising on the patient, challenge all involved in the delivery of orthopaedic care. This paper assesses the concepts of professionalism, autonomy, and accountability in the 21st century practice of orthopaedic surgery. These concepts are considered within the context of the complex value chain surrounding orthopaedic surgery and the changing forces influencing clinical decision making by the surgeon. A leading impetus for challenge to the autonomy of the orthopaedic surgeon has been cost. Mistrust and lack of understanding have characterized the physician-hospital relationship. Resource dependency has characterized the physician-supplier relationship. Accountability for the surgeon has increased. We suggest implant surgery involves shared decision making and "coproduction" between the orthopaedic surgeon and other stakeholders. The challenge for the profession is to redefine professionalism, accountability, and autonomy in the face of these changes and challenges. SN - 1528-1132 UR - https://www.unboundmedicine.com/medline/citation/19377906/Professionalism_in_21st_century_professional_practice:_autonomy_and_accountability_in_orthopaedic_surgery_ L2 - https://link.springer.com/article/10.1007/s11999-009-0836-4 DB - PRIME DP - Unbound Medicine ER -