Abstract：
BACKGROUND:Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. QUESTIONS/PURPOSES:This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. METHODS:The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. RESULTS:The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. CONCLUSIONS:In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Probe RAdoi
10.1007/s11999-013-2950-6subject
Has Abstractpub_date
2013-06-01 00:00:00pages
1784-91issue
6eissn
0009-921Xissn
1528-1132journal_volume
471pub_type
杂志文章abstract：:For stabilization of the lower thoracic and lumbar spine, an external spinal skeletal fixation (ESSF) system has been developed and clinically used since 1977. The system consists of two pairs of Schanz screws and an adjustable external fixation device. The Schanz screws are firmly anchored through the pedicles into t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:The absolute treatment of extensively involved cases of Legg-Calvé-Perthes disease (LCPD) remains unsolved. The basic principle of adequate containment of the capital femoral epiphysis in its acetabulum while minimizing the disability time is widely accepted, but the definition of adequate containment and methods of a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-07-01 00:00:00
abstract：BACKGROUND:Patients have high reinjury rates after ACL reconstruction. Small knee flexion angles and large peak posterior ground reaction forces in landing tasks increase ACL loading. QUESTIONS/PURPOSES:We determined the effects of a knee extension constraint brace on knee flexion angle, peak posterior ground reaction...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1633-9
更新日期：2011-06-01 00:00:00
abstract：BACKGROUND:Preoperative depressive symptoms have been shown in some but not all studies to be associated with poor self-reported pain and function outcomes. In addition, depressive symptoms after surgery have been shown to improve relative to preoperative levels. QUESTIONS/PURPOSES:We hypothesized that (1) preoperativ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：10.1007/s11999-015-4203-3
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND:Osteochondral allografting is an option for successful treatment of large articular cartilage defects. Use of osteochondral allografting is limited by graft availability, often because of loss of chondrocyte viability during storage. QUESTIONS/PURPOSES:The purpose of this study was to compare osteochondral ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3773-9
更新日期：2014-11-01 00:00:00
abstract：:Total hip arthroplasty (THA) or total knee arthroplasty (TKA) is indicated for patients with juvenile rheumatoid arthritis (JRA) when marked joint destruction is present and pain or deformity compromises function despite optimal medical therapy. Relief of pain, reduction of the deformity, and dramatic improvement in f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:The purpose of this study was to compare the success rate of bony fusion and the clinical results of rigid instrumentation, nonrigid instrumentation, and no instrumentation for a single level lesion for degenerative lumbar spondylolisthesis. Thirty-three patients with degenerative spondylolisthesis of L4 who had under...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1999-11-01 00:00:00
abstract：:Posterior glenoid osteotomy (posterior glenoplasty) is a standard surgical reconstructive operation for recurrent posterior instability of the shoulder. A 34-year-old man was treated by glenoid osteotomy and subsequently developed significant glenohumeral arthritis. Following several surgical procedures, only total sh...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-07-01 00:00:00
abstract：:The Rhodococcus species rarely cause musculoskeletal infections, with only two cases reported in the literature. We report the case of a 53-year-old woman who had an infection develop after first metatarsophalangeal joint fusion. A year after surgery, she continued to have pain and swelling with nonunion. She underwen...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0901-z
更新日期：2009-11-01 00:00:00
abstract：:Computer-aided design and computer-aided manufacturing (CAD/CAM) systems for the design and manufacture of limb prostheses have recently become commercially available. However, rigorous evaluations of these systems have not been performed to determine whether they produce sockets that fit as well as or better than soc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
abstract：:A simple but efficient way to secure the biceps tendon after it has been detached at its upper end by either trauma, attrition or surgical interference is the use of the keyhole in the upper humerus. A tied or rolled knot of tendon inserted into a keyhole shaped opening in the bicipital groove permits firm attachment ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1975-10-01 00:00:00
abstract：BACKGROUND:Healing and functional recovery have been reported using an extensively porous-coated stem in Vancouver B2 and B3 periprosthetic fractures; however, loss of cortical bone has been observed when using these stems in revision surgery for aseptic loosening. However, it is unclear whether this bone loss influenc...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2845-6
更新日期：2013-12-01 00:00:00
abstract：:A bolt-plate device for fixation of distal thoracic and proximal lumbar vertebral bodies has proved effective in a variety of surgical situations. The instrumentation is designed to obtain the optimum conditions for the healing of cancellous bone, namely, rigid immobilization and, if possible, close apposition of surf...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-02-01 00:00:00
abstract：:To investigate if an intensive rehabilitation program has a positive influence on the late course of an old, isolated anterior cruciate ligament rupture, patients were evaluated at an average of 8 years after injury. Seventy-five percent had acquired the injury during sporting activities. After diagnostic arthroscopy,...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199607000-00025
更新日期：1996-07-01 00:00:00
abstract：:The objective of this study was to reconstruct full thickness cartilage defects in rabbit knees with in vitro engineered cartilage tissue based on noncryopreserved and cryopreserved chondrocytes in polymer fleece scaffolds. Osteochondral defects in rabbits were filled with polymer cylinders with noncryopreserved or cr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200009000-00035
更新日期：2000-09-01 00:00:00
abstract：:The cases of 16 patients with Ewing's sarcoma of the proximal femur treated in the era of multiagent chemotherapy were reviewed, with emphasis on the mechanical problem of tumor involvement in this structurally demanding site. Fourteen patients received chemotherapy and local radiotherapy as the initial primary treatm...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
abstract：:Fusion indications in adult degenerative disk disease of the lumbosacral spine include isolated disk resorption, primary and secondary instability, recurrent disk herniation, and pseudarthrosis. Common to these indications are variable proportions of biomechanical insufficiency of the motion segment, instability, defo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1994-03-01 00:00:00
abstract：:Imaging, sensing, and computing technologies that are being introduced to aid in the planning and execution of surgical procedures are providing orthopaedic surgeons with a powerful new set of tools for improving clinical accuracy, reliability, and patient outcomes while reducing costs and operating times. Current com...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199809000-00004
更新日期：1998-09-01 00:00:00
abstract：:Ninety-two patients (103 hips) treated with total hip arthroplasty (THA) were assessed before and after operation to determine nutritional status and any correlation with delayed wound healing. Parameters indicative of nutritional status (serum albumin and serum transferrin) were assessed, along with immunologic and a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:Postoperative infection of elective surgical wounds with Clostridium species has been linked to gastrointestinal tract lesions. A 55-year-old man with a history of peptic ulcer disease was treated by open reduction and internal fixation with autogeneic cancellous bone grafting from an anterior iliac crest donor site f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:Augmented reality is a display technique that combines supplemental information with the real world environment. Augmented reality systems are on the verge of being used everyday in medical training, preoperative planning, preoperative and intraoperative data visualization, and intraoperative tool guidance. The basic ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199809000-00014
更新日期：1998-09-01 00:00:00
abstract：:Since 1970, 170 knees have been operated upon using the Kodama-Yamamoto knee prosthesis. Of these 127 had the revised Mark-II prosthesis and of this group 91 cases have been followed for more than a year. Interim results suggest that the total knee score has improved. on the average, from 38 points preoperatively to 7...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-11-01 00:00:00
abstract：:Many patients with acute herniated nucleus pulposus can be expected to resolve their conditions with conservative management. To date, however, no reliable sign has been described in the literature that can predict which patient will respond. This report shows that the ability to achieve normal lumbar extension repres...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：:A 27-year-old manual laborer presented with dislocation of the right elbow, complete separation of the radial head at the neck level, and avulsion of the coronoid process. Closed reduction of the elbow resulted in ulnohumeral instability. As an alternative to silastic implant, the radial head was reduced, internally f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:Movement between screw threads and bone inhibits bone formation, revascularization and remodeling of dead bone. Movement causes the screw to become enveloped by fibrous tissue in response to necrosis and resorption of adjacent dead cortical bone. This results in a radiologically discernible radiolucent "halo" about th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197509000-00032
更新日期：1975-09-01 00:00:00
abstract：:In situ hybridization was employed to study cellular phenotypes in the ossification groove of Ranvier in young rabbits. The expression of Type II collagen mRNA was seen in chondrocytes in all layers of the growth plate. Messenger RNA for the cartilage-specific Type II collagen was also detected in cells of the inner l...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-12-01 00:00:00
abstract：BACKGROUND:Decision-making regarding nonoperative versus operative treatment of patients with thoracolumbar burst fractures in the absence of neurologic deficits is controversial. Lack of evidence-based practice may result in patients being treated inappropriately and being exposed to unnecessary adverse consequences. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-011-2157-7
更新日期：2012-02-01 00:00:00
abstract：:Three cases of an isolated femoral component failure of a hip surface replacement were treated by use of a press-fit bipolar prosthesis to articulate with the retained acetabular cup. At two to three years post-surgery (average, 31 months), these three conversions had good clinical function and maintained an acceptabl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-07-01 00:00:00
abstract：:Osteochondral allograft transplantation is a well-accepted treatment for articular cartilage damage. However, chondrocyte viability declines during graft storage, which may compromise graft performance. We first tested the hypothesis that the composition of commonly used storage media affects the viability of articula...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0302-8
更新日期：2008-08-01 00:00:00
abstract：:There has been an evolution in the AO/Association for the Study of Internal Fixation plating technique during the past 3 decades that includes the use of longer plates and fewer plate screws, fewer lag screws outside the plate, fewer unicortical screws at the plate periphery, and greater use of the 95 degrees blade pl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199809000-00024
更新日期：1998-09-01 00:00:00
