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by Howard Luks category: Cause
We as physicians are commonly trained to treat disease, not patients. Another way of looking at it is that we are trained to think mechanically. If ”X” is present, administer “y” and if “A” is broken, we must fix it. Orthopedic surgeons in particular are frequently trained to treat MRI findings and not necessarily how to incorporate patient values, or the tailor a treatment plan based on how a disease effects a patient’s quality of life. Many surgeons are not typically considering the patient’s underlying emotional status and the influence that this will have on the patient’s ultimate recovery. At risk patients have significant anxiety and other psycho-social issues that affect their ability with regards to medical decision making and recovery from medical intervention.
Research has shown that *at risk* patients are agnostic with respect to socioeconomic background, age, or gender. The at risk patient has significant anxiety, perhaps low-grade chronic depression and certainly diminished coping skills. In order to put in place or create an environment that ensures successful treatment of a disease state, it is imperative that the surgeon identify the at risk population preoperatively. This will enable us to put the proper mechanisms in place in order to insure a proper setting or environment for functional improvement in the postoperative setting. Identifying an at risk patient does not necessarily mean that the patient should not consider a proposed procedure – – – instead it should alert the physician that a multi-modal approach with the inclusion of social workers or psychiatrists and psychologists may be necessary.
A caring, engaging and patient centric Orthopedic Surgeon