The most challenging aspects of an orthopedic surgeon's role


Beyond the operating room, orthopedic surgeons can face challenges in their work and with balancing their personal lives.

Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

Next question: Why are so many orthopedic groups dropping out of bundles?

Please send responses to Carly Behm at by 5 p.m. CDT Wednesday, Oct. 26.

Editor's note: Responses were lightly edited for clarity and length.

Question: What's the most challenging part of an orthopedic surgeon's role today? 

Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): In residency and fellowship, we undergo relentless training on becoming technically competent in the operating techniques, diagnosing various pathologies, and understanding all the possible anatomic variants that exist. Unfortunately, in the real world, our roles require much more than those skills. Here are a couple that I think about the most.

1. We need to be A leader of A team. Not necessarily THE leader of THE team, as there are often multiple colleagues that we can share the leadership roles with and multiple teams that we need to help lead. This has never been more true than now, as we navigate a cost-constrained, short-staffed and burnt out healthcare landscape. Although patient care remains paramount, we must provide missions/visions, encouragement, opportunities, support, guidance, solutions and ongoing energy to our staff and organizations along the way. No lecture, presentation or textbook will ever train us for this — and yet, upon graduation, we are placed in a position to play this role.

2. Finding the balance between workload and "work growth." Our hospital systems are in financial distress and we are facing severe backlogs in the number of patients who need to be treated. Yet, we must not fall into the trap of treating the patients the same way over and over again in order to work down the waitlist and generate critical revenue for our practices and systems. A part of us must remain focused on learning new evidence, techniques and approaches to patient care. Finding the right investments of time, energy, and resources (with a growing set of enabling technologies available) to improve our care for patients and simply learning. Trying to strike this balance is and will forever remain a challenge.

Anthony Melillo, MD. Bay Oaks Orthopaedics & Sports Medicine (Houston): The most challenging part of an orthopedic surgeon's role today is finding time to properly address the multitude of daily demands of my life.

There are always patients needing my consultation, elective and emergency surgeries to perform, administrative duties to complete and professional education to review.

I'm still amazed at how much my colleagues and I do in an 18 hour day! I'm up at 3:30 a.m. and go to sleep at 10 p.m. Monday through Friday. Every hour of my day and week is accounted for.  

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