Orthopaedic Surgery/Group Practice

Each orthopedic surgeon seeks the optimal job and in some cases finds it without effort, and in other cases can never seem to find the right fit. Indeed the decision as to where to work may be governed more by priorities other than the work itself. We may be satisfied with a lower income or the need to travel to several hospitals or a demanding call schedule if the pay off in a nice home by the water's edge.

Nothing it seems will do more for your happiness in your work than finding good partners to work with. While a partnership is not a marriage there is indeed a relationship based on trust, mutual respect, and a tendency to help one another out as a matter of course and without a rigid quid quo pro approach as one might have in ones general interactions in society. It is more than just the sharing of overhead. This is the setting in which most orthopedics tend to work. A staff model or faculty position functions in much the same way although the larger the group the more difficult it is to maintain a cohesive working structure.

A group practice in orthopedic surgery is a form of kinship group.

http://www.pnas.org/cgi/content/full/102/33/11951?maxtoshow=&HITS=&hits=&RESULTFORMAT=&fulltext=work+group+size&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

The most common basis for group structure is a shared call schedule. This is generally looked upon as a shared burden. Typically the work week is split each member of the group alternating each 24hours, as in from 7:30 to 7:30. Weekends are usually covered by one member who is available to the Emergency room, to field questions from patients and to be available for referrals to the practice occurring during this time. Inpatient rounds are likewise accomplished by the physician on call for the group.

The structure of the work week creates a natural tendency for an optimal group size of 5 which allows for one member absent on vacation and the remaining 4 each taking one day during the week, and one weekend a month. In groups smaller than 5 the burden of call can be one of the most onerous aspects of the job and one which even becomes the deciding factor in a decision to retire.