Once interested only in the hearts and minds of surgeons, orthopedic device manufacturers are now taking full aim at the patient as a consumer. While not as common as ads for erectile dysfunction medications, patients and doctors alike are seeing more ads for “the latest and greatest orthopaedic device.”
One ad currently running shows a woman driving an SUV with oblong wheels, the message being that if one would not drive a car with such an impediment, then why would you want your new knee replacement to be “out of round.”
The ad provides no scientific basis for the design. In fact, a scientific article published in a recent edition of the Journal of Orthopaedic Research suggests that there may be a real disadvantage to this “round” design in terms of stability of the implant after surgery.
Many orthopedic implant companies do a good job of educating patients with respect to their upcoming arthritis surgery, and they do so without overtly trying to influence the patient’s choice of implant or surgical approach.
A 2006 survey of orthopedic surgeons, however, revealed that 88 percent of them felt that direct-to-consumer advertising was causing surgeons to change their practice and that 44 percent felt pressured by patients to use a particular device between one and five times in the previous year.
In my own practice, when a patient comes in with a specific request, I try to turn it into a positive learning experience by explaining why I do things the way that I do, and I am very open with them regarding my results and my technique.
Most will accept that explanation while a few will move on to their third and fourth consultations as they search for a surgeon that can match their consumer expectations.
If you are a physician, here are four key points for handling these types of situations:
- Be upfront about why you do or do not use the device.
- Do not disparage other providers who use the device or technique.
- Encourage them to go to an unbiased site such as OrthoInfo.org, a peer-reviewed patient education web site authored by the American Academy of Orthopaedic Surgeons.
- Ask them to look at the larger picture of their total care experience such as the number of cases performed by both you, the surgeon, and by the hospital.