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Orthopedics Today at 30 years: A view from the helm
Orthopedics Today Chief Medical Editor Emeritus Robert P. Nirschl, MD, MS, answers 4 Questions from current Chief Medical Editor Douglas W. Jackson, MD.
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There has only been three chief medical editors for Orthopedics Today in its 30 year history. The three of us have had much in common. We all have had a long-standing interest and participation in orthopedic education, private practice, socioeconomic issues and changes in health care, and been supportive and participated in research in our field. In addition, we have all really enjoyed this position as it has enabled us to to communicate with our readers and sources frequently and benefit from the feedback we received. It has allowed us to keep in touch with old friends, make new ones and keep our fingers on the pulse on the changing and new aspects of orthopedics.
To celebrate Orthopedics Today’s 30 years, I am asking the 4 Questions this month of the first chief medical editor, Robert P. Nirshl, MD, MS, to share some of his experiences in the position.
– Douglas W. Jackson, MD
Chief Medical Editor
Douglas W. Jackson, MD: When you took over the assignment of chief medical editor, what were your goals for the publication?
Robert P. Nirschl, MD, MS: When I became chief medical editor in 1983, the publication was only 3 years old. The concept of bringing information quickly to the orthopedic community is what attracted me to the position. Coverage of the selected meetings with a newspaper format and prompt reporting has been, and continues to be, highly effective. In the time period between 1980 and 1983, however, perspective, priorities of importance, as well as credibility of the information, was inconsistent. The first goal I had in 1983 was to focus on the significance of a topic and enhance the quality of the articles published.
My second goal was to bring political insight to the orthopedic community and encourage political advocacy, as I could see the changes that were coming. Unfortunately, it took several decades for orthopedic surgeons, and most physicians for that matter, to realize the importance of their participation in the political process.
Jackson: What changes occurred in the issues of Orthopedics Today during your tenure?
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Nirschl: The changes in Orthopedics Today during my tenure of 10 years from 1982 to 1993, were to focus on the information that was most helpful and beneficial to our community. This included some technique articles on the latest developing technologies. Sports medicine also came into vogue during this time, and we covered many presentations and investigations of some of the pioneers in the field.
Political advocacy slowly picked up as we entered the era of managed care, HMOs, resource based relative value unit scales, and finally “Hillary Care.” Some of my better editorials including “Flawed political priorities of health finance reform (Orthopedics Today March 1993, page 3) and ‘An open letter to Bill Clinton from a practicing physician” (Orthopedics Today January 1993, page 3) are still as pertinent today as they were when I wrote them.
When we published medical articles that needed amplification, clarification or challenge, I added an editorial comment. On the format side, more color and graphics were added and the layout was improved which enhanced readability. Mario Cavallini was the executive editor during this time and, from my standpoint, did an excellent job in bringing these changes to the publication.
Jackson:What were some of the personal satisfactions you enjoyed in your position of leadership and interacting with the readership?
Nirschl: The personal satisfaction of the chief medical editor position was the opportunity to reach a wide audience and do what I could to have a positive influence both medically and politically. It was quite satisfying as well to communicate on an individual level with many of the sources for articles and commentaries, which often added to my knowledge and insight concerning the topics that were being discussed.
Jackson:Do you recall any unusual or heated responses to any of your editorials?
Nirschl: On the heated response side, I’m sorry to say the political editorials didn’t get much response until I took on Hillary Care. When there was response from the readership to one of my editorials, it was almost always in agreement. Interestingly, I wrote some political-type articles in other publications for nonsurgeon physicians, eg, family practice and internal medicine practitioners, and as a group they never saw what was coming. As a matter of fact, even today many nonsurgeons do not seem to grasp the peril that medical practice faces.
I do recall one uncomplimentary and heated response from the author of a presentation we covered on fascicle nerve dissection for primary carpal tunnel syndrome. My editorial comment suggested that his surgical indication for a primary uncomplicated problem was inappropriate and the surgical approach cited was complex and unnecessary. Thereafter, I received letters from four orthopedic surgeons in this doctor’s community thanking me for the editorial comment. It appears the surgeon in question charged large fees and had many complications. My message for all time: Do what’s right and keep it simple.
A note from the editor
In celebration of our 30th anniversary, Orthopedics Today Editorial Board members selected the Top 5 orthopedic advancements of the last 3 decades. See it in the Spotlight on section.
- Robert P. Nirschl, MD, can be reached at 1715 North George Mason Drive, #504, Arlington, VA 22205; 703-525-2200; e-mail: nirschlorthopaedics@comcast.net.
