TY  - JOUR
T1  - Correspondence
AU  - Bowles, David L.
AU  - Kreder, Hans J.
AU  - Deyo, Richard A.
AU  - Koepsell, Thomas
AU  - Swiontkowski, Marc F.
AU  - Kreuter, William
Y1  - 1998/04/01
N1  - 
JO  - The Journal of Bone & Joint Surgery
SP  - 606
EP  - 606
VL  - 80
IS  - 4
N2  - 
    I read with interest "Relationship between the Volume of Total Hip Replacements Performed by Providers and the Rates of Postoperative Complications in the State of Washington" (79-A: 485—494, April 1997), by Kreder et al. I have the utmost respect for the clinical studies performed by this group in Seattle, and over the years their contributions to the knowledge and patient care in the orthopaedic community have been invaluable to all of us. However, when we start doing studies that lump together all orthopaedic surgeons, whether they have a high-volume or low-volume practice, we are inviting trouble. Certainly there are orthopaedic surgeons who would be considered to have a low-volume practice but who perform total joint replacements (many times in rural situations) and perform them well. To suggest that these surgeons need to stop doing joint replacements sentences their patients to either not having a total joint replacement done or having it done tens if not hundreds of miles away from home and family. In many instances, the patient will choose not to have the replacement, thereby decreasing his or her quality of life. There may also be surgeons who, for economic reasons, are forced to relocate, thereby depriving their communities of all of their orthopaedic care. I, for one, do not believe that this is good patient care.

SN  - 0021-9355
M3  - doi: 
UR  - http://dx.doi.org/
ER  -