1

2

3

4

5

6

7

8

9

10

11

12

13

I 

I 

Flom Vltfll and Health Statlstlcs of the National Center for Health Statlst[cs Number 117. May 2, 1986 

Office Visits to Orthopedic Surgeons, 

National Ambulatory Medical Care Survey: 

United States, 1980-81 

by Raymond O. Gagnon, Division of Health Care Statistics 

Introduction 

This report presents statistics on the 55.5 million ambulat(u-y visits mwic to orthopedic surgeons during the years 

1W()-ii 1, The dtitti were collected by means of the National 

Ambukttory Medical Care Survey (NAMCS), a sample survey 

of privute office-based physicians in the United States, excluding Akska and Hawaii. NAMCS was conducted annually 

from 1973 through 19S1 and periodically thereafter. Data 

wet-cagain collected in 19S5. An earlier report’ on orthopedic 

surgwms covered the years 1975–76. This report serves as 

;m upd:k of that earlier report, comparing the data between 

thusc two different points in time, and including summary 

dtitu on the use of medications not available in the earlier 

rvport. 

BL_xwrsethe estimates presented in this report are based 

{m it wnple mther than on the entire universe of office visits, 

they m wbjcct to sampling variability. A brief description 

of the stimpk design and sampling errors is provided in the 

“Technical notes” at the end of the report. Definitions of 

Iwy terms used in the survey are also provided. The figure 

is u fticsimile of the 19S0-S 1 NAMCS Patient Record used 

hy purticiptiting physicians to record information about their 

offkw visits. The Patient Record can be a useful reference 

us survey tlndings are reviewed. 

‘Nutiwxd Center for Health Statistics, H. Koch: Office visits to orthopedic 

sorgcorss, Nutiunti[ Ambulatory Medical Care Survey, United States, 1975-76. 

AAWIIC.C,DtIkJ From Vital aod Health Statistic.r. No. 33. DHEW Pub. No. 

(PHS) 78-1250. Public Health Service. Hyattsville, Md., July 18, 1978. 

Data highlights 

During 19S0-S 1there were an estimated 55.470,000 visits 

made to the offices of orthopedic surgeons. Of the 13 most 

frequently visited specialities, orthopedic surgeons ranked 

seventh, just behind general surgeons (table 1). 

In 19S0-S 1 an estimated 69 percent of the visits to orthopedic surgeons were made to physicians in multiple-member 

practice arrangements, a proportion that substantially exceeded 

the average of 45 percent in overall office-based practice 

(table 2). Notably, the specialties of pediatrics and urology 

had similarly high proportions of visits to physicians in partnership or group practice. 

Table 1. Number of office visits to the 13 most frequently visited 

specialties, by type of speciafty and rank ordec United States, 1980-81 

Number of visits 

Rank Type of specialty in thousands 

General and family practice . 381,710 

Internal medicine . 144,172 

Pediatrics . . . . . . . . . . . . . 128,762 

Obstetrics and gynecology . 109,035 

Ophthalmology . 62,485 

General surgery . 61,013 

Orthopedic surgery . . . 55,470 

Dermatology . . . . . . . . . . . 51,262 

Psychiatry . . . . . . . . . . . . 31,610 

Otolaryngology . . . . . . . . . 26,151 

Urology . . . . . . . . . . . . . . 19,470 

Cardiovascular diseases . . 14,781 

Neurology . . . . . . . . . . . . . 6,379 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Publlc Health Service 
,,, ,, ,,,, )),

------

c WWul --w 

ASSURANCE OF CONFIDE NTALITY-.V ,, 8,,,.,,,,,,,,, ,-,,,, h ,., ,,,,, .,.rm,, !,,, ,,, ,,,, .,,,,,, U,’.,, !m, rr! “1 H<Jtlh, E,iw.rron, ,mi WI!.?. ,!!,!1,.!,,,,,,,, ,,,-, ,.,, ,,,,, !,,,,,,,,,,,, ,.,,!,,,I,(.,,,,1,,,, .!,,,1 W!ll,, !., !.!![!>!,,” P“!,!,. H..l, h %“,.. ANo. 003939 h, ,!<,,!)!! . ?!,,,,,4 ,! !!! ,,., ! !.! ,),,. ,). ?,>,,,,. ,!! !,,!. ..,,,,, , ,,,,,, ,.,1, ,,,,, ,!,. ,,, ,.,,, ,,,, l,, ,,. nl let, r>!Hw., [,h Rwmr.h. S,,,,,,,,,.s,,,”6 T“ctmo,qv

(,...,, ! ,,) ,,,,,!, p., ,$,,!. ,!, ,,,,, !,1 !!,, .,!7,.! ,!!,!,,!! ! FJ,!!r!n.’l C“rr!er10! H,.,1,h S,.,,,,,., 

lm DATE OF VISIT PATlENT RECORD 

NATIONAL AMBULATORY MEDICAL CARE SURVEY 

Zm:3:HOF 3mSEX 4. COLOR OR RACE 5. ETHNICITY & PATIENT’S COMPLAINT(S), SYMPTOM(S), OR OTHER 

REASON(S) FOR~VISIT /1npatienr3 aw,nfi.cfrds/ 

, n,,”,,, 

2 � E31.ACI. L � H15PANIC a MOST IMPORTANT 

~ ;:::” ‘ C1’:::g$y” 2 � NOT 

,.,,,”,,, D,, \,.,t HISPANIC b OTHER 

.! D.4MERICAN lN131APJ/ 

ALASKAN NATIVE 

* 

ORIGIN 

& DIAGNOSTIC SERVICES THIS VISIT 9, PHYSICIAN’S DIAGNOSES 

7- :;TR~$.~ze~R ‘His [Check all ordrrtid ,m prcwidedj 

1 HMO., 8 � EKG a PRINCIPAL DIAGNOSIS/PROBLEM ASSOCIATED WITH ITEM Ed. 

1 � AC”TE PROBLEM 2 DLIMITED HIST(2RY,EXAM 9 � VISICIN TEST 

2 � CHRONIC pROBLEhI, ROUT, NE 3 OGENEF7AL H!STOR’.’,EXA,, 10 � ENDOSCOPY 

3 � CHRONIC PROBLEM. FLAREUP 4 DPAP TEST 11 n MENTAL STATUS 

EXAM b OTHER SIGNIFICANT CURRENT OIAGNCJSES J l_JPOST5URGERYPOST IMJW+> 5 nCLINICAL LAB TEST 

5 � FJON.ILLNESS CARE (ROUTINE 

PRENATAL, GENERAL EXAM 

WELL BA8Y, ETC I 

.nx RA, 

7 � L3L0CH3FRESSIJRE CHECK 

,2 (J OTHER LWClf}) 

10, HAVE YOU SEEN 11 � MEDICATION THERAPY THIS VISIT � NONE 

PATIENT BEFORE?	 [ L’sing brand m generic names, reconi all new and continued mealcations ordered, injected, administered, or otherwise 

prowded a t this virt, Include immunizing and desensitizing agen tz] 

a. FOR PRINCIPAL DIAGNOSES IN ITEM 9.. b. FOR ALL OTHER REASONS 

IDYES ,HNO 

I 1 

+ 

IF YES. FOR THE 

CONIJITION IN 2 2. 

ITEM 9,3J 

3 3, 

1 � YES 2 � NO 

4 4. 

12.	 NON-MEDICATION THERAPY q 3my.a;y.;mgw 14m:;:WS;IC)::C):,WT 15. C#l&ON 

[Check all services ardersd or provided this visif/ 

FOR THIS VISIT VISIT


BY A~HER 1 � NO FOLLOWUP PLANNED [Time actuall}


lDNONE 6DOIETCOUNSELING PHYSICIAN? 2 � RETURNATSPECIFIEO TIME	 spent w,irh 

physician 

2 l_JPHySIOTHERApY 7 � FAMILY/SOCIAI_ 3 � RE7LIRNIF NEeoEo,P,R.N. 

COUNSELING 

. � FAMILY PLANN,NG 

9 � OTHER (SP, C,JY) 

s � REFERRED T00TtiERpHysk21AN 

3 HPSYCHOTHERAPYI 

THERAPEUTIC LISTENING ,Dluo 6 QRETWSNEOTOREFERRING PHYSICIAN 

7 l_JAoMITTO HospwA1. 

8 � OTHE R /SPCCify) 

Minutes 

,,t, e =.,.. . ,., ,70, CIMR No. 6R. RIA~ 

3 � OFFICE SURGERY 

8 � MEOICAL COUNSELING , l-J ,,s 4 � TELEPHONE FOLLOW.UPPMNNEO 

-. ..-. rrla-u ,“a-J’. ,=, J =, 

Fgure. 19S0-S1 National Ambulatory Medal Care Survey Patient Record form 
advancedata 3 

Table 2, Number and percent distribution of office visits to orthopedic surgeons, and percent distribution of office visits to all specialists, by location and 

type of practice: United States, 1980-S1 

Visits to orthopedic surgeons Visits to all specialists 

Location and type of practice Number in thousands Percent distribution Percent distribution’ 

AIIVISIIS. . . . . . . . . . . . . . . . 55,470 100.0 100.0 

Location of practice 

Metropolitanarea;’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46,530 83.9 76.0 

Ncmmetropofitan wea . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,940 16.1 24.0 

Type of practice 

solo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17,220 31.0 54.8 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38,250 69.0 45.3 

‘Bowl on an sstimaled 1,160,922,000 visits made to sII office-based physician in 198C-S1. 

“Loccdlm within a standard metropolitan statistical area (SMSA). Composition of SMSAS does not rsflect 1979 adjustment. 

Table 3. Number and percent diatributimnof offiie visita to orthopedic surgeons, and percent diatnbution of office visits to all specialists, by 

characteristic of the patient United States, 1980-81 

Visits to orthopedic surgeons Visits to all specialists 

Patient characteristic Number in thousands Percent distribution Percent distribution’ 

Allvlsits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age 

Under 15 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

15-24years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

25-44yeare . . . . . . . . . . . . . . . . . . . . . . . . . . 

45-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65yeiwsandov er . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Sex 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Prior visit status 

Newpafient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Oldpat[ent, newproblem . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Oldpatlent, oldproblem . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Referred by another physician 

Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

‘13nsf?dcman estimated 1,160,922,000 visits made to all office-based physicians in 1980-61. 

NOTE Flgums may not add to totals due to rounding. 

The majority of visits to orthopedic surgeons (59 percent) 

were made by patients in the age groups 254.4 years and 

45-64 years (table 3), The median age of patients was 38 

yems. The age distribution ofpatients visiting orthopedic surgecms more closely parallels that of neurologists than that 

of the other most frequently visited specialties; that is, the 

proportions of patients in each of the age groups in table 3 

were similar for both specialties. Table 4 contains a ranking 

of the median age of patients for all of the most frequently 

visited specialties. The distribution of visits to orthopedic 

surgeons by sex revealed that 53 percent of the visits were 

made bymales ,aproportion that exceeded the average proportion of male visits in overall office-based practice (40 percent). 

Orthopedic surgery was one of three specialties where visits 

by males exceeded visits by females; the other two specialties 

were pediatrics and urology. 

55,470 100.0 100.0 

6,619 11.9 18.6 

8,802 15.9 13.9 

17,536 31.6 26.7 

14,997 27.0 22.9 

7,516 13.6 17.9 

26,057 47.0 60.3 

29,413 53.0 39.7 

12,239 22.1 14.4 

3,922 7.1 22.3 

39,309 70.9 63.4 

6,071 10.9 4.4 

49,399 89.1 95.6 

Table 4. Ranking of the median age of patienta for the 13 most 

frequently visited specialties United States 1980-S1 

Median age of 

Physician specialty patients in years 

Cardiovascular diseases . . . . . . . . . . 

Internal medicine . . . . . . . . . . . . . . . . . . . 

Urologicalsurgery . . . . . . . . . . . . . . . . . . 

Ophthalmology . . . . . . . . . . . . . . . . . . . . 

General surgery . . . . . . . . . . . . . . . . . . . . 

Neurology . . . . . . . . . . . . . . . . . . . . . . . 

General andfamilypractice . . . . 

Orthopedicsurgery . . . . . . . . . . . . . . . . . . 

Psychiatry . . . . . . . . . . . . . . . . . . . . . . . 

All specialties . . . . . . . . . . . . . . . . . . . . . 

Otolaryngology . . . . . . . . . . . . . . . . . . . . 

Dermatology . . . . . . . . . . . . . . . . . . . . . 

Obstetricaand gynecology . . . . . . . . . . . . 

Pediatrics . . i. . . . . . . . . . . 

62 

57 

56 

56 

44 

44 

39 

38 

36 

36 

33 

30 

28 

3 
4 ZKkincedata 

Tabte 5. Number, percent and cumulative percent of of6ce visits to orthopedic surgeons, by the 25 most frequent principal reasons for visit: 

United States, Janusry 1980-December 1981 

Number in Percent of Cumulativepercent 

Princ@alreason for visitand RVC code’.2 thousands vis[t~ of visits 

l. Knee symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S925 6,821 12.3 12.3 

2. Backsymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S905 4,114 7.4 19.7 

3. Postoperativevisit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..T205 3,051 5.5 25.2 

4. Footandtoesymptoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S935 3,036 5.5 30.7 

5. Low-backsypmtoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S910 2,758 5.0 35.7 

6. Progressvisit, notelsewhereclassified . . . . . . . . . . . . . . . . . . . T800 2,682 4.8 40.5 

7. Shouldersymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S940 2,652 4.8 45.3 

8. Necksymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S900 2,071 3.7 49.0 

9. Handandfirrgersymptoms. . . . . . . . . . . . . . . . . . . . . . . . ..~. S960 1,919 3.5 52.5 

10. Anklesymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S930 1,605 2.9 55.4 

11. Wristsymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S955 1,589 2.9 58.3 

12. Leg symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S920 1,569 2.8 61.1 

13. Hipsymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S915 1,489 2.7 63.8 

14. Castsplint—application, removal . . . . . . . . . . . . . . . . . . . . T540 1,227 2.2 66.0 

15. Elbowsymptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S950 1,085 2.0 68.0 

16. Fractureofleg . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..J020 965 1.7 69.7 

17. Fractureordislocation ofarm . . . . . . . . . . . . . . . . . . . . . . . . . . J035 960 1.7 71.4 

18. Arm symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..S945 938 1.7 73.1 

19. Pain andrelated symptoms, generalized, site unspecified . . . . . . . . . S060 664 1.6 74.7 

20. Kneeinjury, type unspecified . . . . . . . . . . . . . . . . . . . . . . . . . .. J535 766 1.4 76.1 

21. Fracture, other and unspecified . . . . . . . . . . . . . . . . . . . . . . . . . J050 706 1.3 77.4 

22. Hand and finger(s) injury, type unspecified . . . . . . . . . . . J570 663 1.2 78.6 

23. Musculoskeletal deformities.. . . . . . . . . . . . . . . . . . . . . . . . . . S975 631 1.1 797 

24. Fracture ordislocation of wrist.. . . . . . . . . . . . . . . . . . . . . . . . . J040 527 0.9 80.6 

25. Other musculoskeletal orconnective tissue disease . . . . . . . . . . D91O 512 0.9 815 

113ased cm “A Reason for Visit Classification for Ambulatmy Care: (RVC).


~he ‘S codes refer to symptoms such as pain, swelling, headache, and chills. These symploms exclude sprains, fractures, cuts, burns, and othe[ injuries.


‘Based on a total of 55,470,119 visits. 

The 25 reasons most frequently given by patients for 

visiting the orthopedic surgeon are shown in table 5. The 

two most frequent complaints—knee and back problems—accounted for 20 percent of all visits to orthopedic surgeons. 

Of a more general nature, symptoms referable to the musculoskeletal system (RVC codes S900-S999) accounted for 15 

of thetop25 reasons. (Reasons forvisit arecoded and grouped 

in eight modules according to a classification system that 

is described in “A Reason for Visit Classification for Ambulatory Care” (RVC)).2 

The 30 most frequent principal diagnoses rendered by 

orthopedic surgeons are shown in table 6. Excluding a followup 

exam after surgery and certain congenital deformities, all the 

diagnoses listed in the table are contained in two major classes: 

1.	 Diseases of the musculoskeletal system and connective 

tissue (ICD-9-CM codes 710-739). 

2. Injury and poisoning (ICD-9-CM codes 800-999). 

In addition to most of the diagnoses in table 6, these two 

classes accounted for 84 percent of all the diagnoses rendered 

by orthopedic surgeons. (Diagnostic terms and codes were 

derived from the International Classij7cation of Diseases, 9th 

Revision, Clinical Modification (ICD–9-CM)).3 

2National Center for Health Statistics, D. Schneider, L. Appleton, and T. 

McLemore: A reason for visit classification for ambulatory care. Vital and 

Health .$ratisfics. Series 2, No. 78. DHEW Pub. No. (PHS) 79-1352. Public 

Health Service. Washington. U.S. Government Printing Office, Feb. 1979. 

3U.S. Public Health Service and Health Care Financing Administration: lnterna[ional Clas.rification of Diseases, 9th Revision, Clinical Modification. 

DHHS Pub. No. (PHS) 80-1260. Public Health Service. Washington. U.S. 

Government Printing Office, Sept. 1980. 

Because the orthopedic surgeon deals mtiinly with spruim, 

strains, and fractures, it follows that the dia~nostic scrviccs 

provided would be directly related. The logical course (If 

treatment for a sprain, strain, or fracture would be a phy>icul 

examination followed by an x ray, if warranted. This is gcnwally what is revealed in table 7. A limited histtwy mNJ/~jr 

exam was conducted in 69 percent of the visits to (u-thupcdic 

surgeons, and an x ray was taken in 39 percent of the visits. 

The latter proportion is more than 5 times greater thun the 

average proportion of 7.5 percent of the visits in overall 

office-based practice where an x ray is taken. 

Two diagnostic services that are rarely provided in the 

offices of orthopedic surgeons are clinical lab tests and blood 

pressure checks, which are provided in 2 percent and 3 percent 

of the visits, respectively. In overall office-based practice, 

clinical lab tests are provided in 22 percent of the visits, 

and blood pressure is checked in 34 percent of the visits. 

The lower proportion of these services provided by orthopedic 

surgeons reflects the types of problems presented to these 

specialists which simply do not require the rendering of such 

services. 

Of the nonmedication therapy services provided, physiotherapy and office surgery were provided more by orthopedic 

surgeons than by most other specialties. Physiotherapy wus 

provided in 22 percent of the visits to orthopedic surgeons, 

a proportion not only higher than the proportion for any other 

specialty, but 4 times higher than the average proportion of 

5 percent for all office-based practice. Office surgery wm 

provided in 12 percent of the visits to orthopedic surgeons, 

and this proportion was surpassed only by general surgeons 

(15 percent) and dermatologists (35 percent). 
advancedata 5 

Table 6. Number, percen? and cumulative percent of office visits to orthopedic surgeonq by the 30 most frequent principal diagnoses 

United States, January 1960-December 1981 

Number in Percent of Cumulative percent 

Principal diagnosis and ICD-9-CM codeq thousands visit.+ of visits 

1.Peripheral enthesopathies and allied syndromes . . . . . . . . 726 2,629 5.1 5.1 

2. Sprains andstralns ofother andunspecified patis of back. . . . . . . 847 2,484 4.5 9.6 

3. Fraclure ofradius and ulna.... . . . . . . . . . . . . . . . . . . . . . . . 813 2,462 4.4 14.0 

4. Other disorders of synovium, tendon, and bursa . . . . . . . . . . . 727 2,295 4.1 18.1 

5.1ntervertebral discdisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 722 2,234 4.0 22.1 

6. Foliowup examination, following surgery . . . . . . . . . . . . . . . . . . V67.o 2,217 4.0 26.1 

7. Osteoarthrosis and allied disorders . . . . . . . . . . . . . . . . . . . . . . 715 2,195 4.0 30.1 

8. Other and unspecified disorders of back . . . . . . . . . . . . . . . . 724 1,740 3.1 33.2 

9. Dislocation of knee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 836 1,685 3.0 36.2 

10. Sprains andstrakts ofankle and foot . . . . . . . . . . . . . . . . . . . . . . 845 1,394 2.5 38.7 

11. t+acture of ankle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e24 1,374 2.5 41.2 

12.1nternal derangement of knee. . . . . . . . . . . . . . . . . . . . . . . . . . 717 1,358 2.4 43.6 

13. Sprains andstrains ofknee and leg . . . . . . . . . . . . . . . . . . . . . . . 844 1,251 2.3 45.9 

14. Sprains and strains of sacroiliac region . . . . . . . . . . . . . . . . . . . . . 846 1,199 2.2 48.1 

15. Fracture of humerus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 812 1,110 2.0 50.1 

16. Other and unspecified disorders of joint . . . . . . . . . . . . . . . . . . . . 719 1,090 2.0 52.1 

17. Fracture of one or more phalanges of hand . . . . . . . . . . . . . . . . . 616 906 1.6 53.7 

18. Fracture of carpal bone(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 814 904 1.6 55.3 

19. Othri?r andunspecified arthropathies. . . . . . . . . . . . . . . . . . . . . . 716 858 1.5 56.8 

20. Spondylosis and allied disorders . . . . . . . . . . . . . . . . . . . . . . . . 721 850 1.5 58.3 

21 Fracture oftiblaandfibula . . . . . . . . . . . . . . . . . . . . . . . . . . . . 623 632 1.5 59.8 ~~, other acquired deformi~es of~mbs . . . . . . . . . . . . . . . . . . . . . . . 736 809 1.5 61.3 

23. Fracture of one or more tarsal and metatarsal bones . . . . . . . . . . . 825 750 1.4 62.7 

24. Olherdisorders of soft tissues . . . . . . . . . . . . . . . . . . . . . . . . . . 729 681 1.2 63.9 

25. Fracture of vertebral column without mention of spinal cord injury 805 624 1.1 65.0 

26. Olherderangement of joint . . . . . . . . . . . . . . . . . . . . 71 e 611 1.1 66.1 

27. Certain congenital musculoskeletal deformities . . . 754 577 1.0 67.1 

2& Curvature of spine... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 737 572 1.0 68.1 

99. Sprains and strains of shoulder and upper arm . . . . . . . . . . . 840 540 1.0 69.1 

30. Fracture of metacarpal bone(s) . . . . . . . . . . . . . . . . . . . . . . . . . 815 531 1.0 70.1 

‘[Lwnd cmInternational Classhc.?tmn of Diseases,9th Revision, Clinical Modification (lCO-e-CM). 

13,!wd On ,1 10tal Clt55,470,119 WSIIS, 

Table 7. Number and percent of office visita to orthopedic surgeons, and percent of visits to all specialists, by setected diagnostic services and 

nonmedication therapy United States, 1980-81 

Selected diagnostic services Visits to orthopedic surgeons ~Jisitsto all specialists 

and nonmedication therapy Number in thousands Percent Percent’ 

Diagnostic semice 

Llmitcd hbstary mtdexaminaticm . . . . . . . . . . . . . . . . . . . . . . 

Gmwvnlhistoryand examination.., . . . . . . . . . . . . . . . . . . . . 

Clinical labmatory test . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Xr, iy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

131cmct pres!+rrocheok, . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Nonmedication therapyz 

Norm, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Physiother~py . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Olfict! surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Mc!dical counseling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

‘L{,M-d On ,ln wstlmatcd 1,160,922,000 visits made to all office-based physicians in 19s!&81.


“F! ,tmntsWIIInot sdd to 100.0 because more than 1 service or therapy may have been rendered


As expected, postsurgery or postinjury was the major 

rctislm t’or 41 percent of the visits to orthopedic surgeons 

compweci with 9 percent of the visits in overall office-based 

prtictice (table 8). General surgery, with 34 percent, was 

the only other specialty to have a higher proportion of visits 

for postsurgery or postinjury than for chronic problems. 

“Disposition of visit” refers to the physician’s advice 

:it the end of the visit. For 83 percent of the visits to orthopedic 

surgeons, patients were advised to return either “at a specified 

36,136 68.8 64.4 

5,880 10.6 15.5 

1,126 2.0 21.9 

21,651 39.0 7.5 

1,617 2.9 342 

27,366 49.4 53.0 

12,004 21.6 4.8 

6,632 12.0 7.4 

9,192 16.C 23.0 

during a v!sit 

time” or “if needed. ” This proportion was the same for physicians in overall office-based practice. Admitting patients to 

the hospital is a relatively rare occurrence in office-based 

practice, occurring in 2 percent of the visits. Orthopedic surgeons, however, admitted patients to the hospital in 5 percent 

of their visits, which may be a reflection of their seeing 

more injuries than most physicians. 

A mean visit to an orthopedic surgeon lasted 14 minutes 

compared with 15 minutes in overall office-based practice. . 
6 iiKJAncedata 

Table 8. Number and percent distribution of offiie visits to orfhopedc surgeons, and percent distribution of office visits to all specialists, by 

characteristics of the visit United States, 1980-81 

Visits to orthopedic surgeons Visits to all specialists 

Visit characteristic Number in thousands Percent distribution Percent distribution’ 

All visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55,470 100.0 100.0 

Majorreasonfor visit 

Acuteproblem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,685 26.5 36.4 

Chronic problem, routine . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,695 19.6 28.1 

Chronicproblem, flareup . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,873 10.6 9.2 

Postsurgeyorposfinjuy . . . . . . . . . . . . . . . . . . . . . . . . 22,792 41.1 8.8 

Nonillnesscare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,225 2.2 17.6 

Disposition 

Nofollowup planned . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,066 9.1 11.5 

Return atspecifiedtime . . . . . . . . . . . . . . . . . . . . . . . . . 36,071 65.0 60.7 

Return ifnaeded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,042 18.1 22.7 

Referredtootherphysician . . . . . . . . . . . . . . . . . . . . . . . . . 994 1.8 2.6 

Admitto hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,506 4.5 2.3 

Duration 

Zerominutes2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468 0.8 2.6 

l–5minutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,035 19.9 12.6 

6-10 minutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,418 29.6 30.1 

ll–15 minutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13,988 25.2 27.8 

16-30minutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,936 21.5 208 

31 minutesormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,626 2.9 6.1 

‘Based on an estimated 1,160,922,000 visits made to all office-based physicians in 19S0-S1. 

‘No face-to-face contact with physician. 

Table 9. Number and percent of drug mentions and offiie visits to orthopedc surgeons, and percent of drug mentions and office visits to all specialists, 

by selected therapeutic categories and number of medwtions provided: United States, 1980-S1 

Therapeutic category Orthopedic surgeons All specialists 

and number of medications’ Number in thousands Percent Percent 

Drug mentions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,477 —. . . . 

Therapeutic categoy 

Anti-infactiveagents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 925 4.1 15.8 

Autonomicdrugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,224 5.5 3.7 

Central nervoussystem drugs.. . . . . . . . . . . . . . . . . . . . . . . 13,587 60.5 16.2 

Analgesicsand antipyretics . . . . . . . . . . . . . . . . . . . . . . . 12,071 53.7 8.8 

Sedativesand hypnotics . . . . . . . . . . . . . . . . . . . . . . . . . . 1,115 5.0 3.6 

Hormonesandsyntheticdrugs.. . . . . . . . . . . . . . . . . . . . . . . 2,414 10.7 8.3 

Skin andmucousmembranepreparations . . . . . . . . . . . . . . . . . . 2,117 9.4 7.8 

Officevisits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55,470 ..- .. . 

Numberof medications 

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39,794 71.7 38.2 

1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,792 19.5 30.9 

2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,333 6.0 17.7 

3ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,551 2.8 13.2 

1Based on the pharmacologic-therapeutic classification of the American Sosiety of Hospital Pharmacis& aalested categorfea reproduced with the permission of the Society. 

The median duration of visits to orthopedic surgeons was 

about 10 minutes, and for all physicians the median duration 

was 15 minutes. 

The number of medications shown in table 9 refers to 

the frequencyof dregs orderedor provided during office visits 

andincludesnew aswell ascontinued medications. Orthopedic 

surgeons, with 22.5 million drug mentions, ranked ninth 

among the top specialties in the number of drug mentions 

in 1980-81; however, they ranked first in the proportion of 

visits in which no drugs or medications were used. In 72 

percent ofthe visits to orthopedic surgeons ,nodrugsormedications were ordered or provided, and in 20 percent ofthc 

visitsonlyone drugwasused. 

The NAMCS drug data are classifed into several therapeutic categories, but most of the 22.5 million drug mentions 

of orthopedic surgeons can declassified into five categories. 
13JJ fur the largest single proportion (54 percent) of these 

d~ug mentions are analgesics, a finding that is not unexpected 

when tme considers that the treatment of musculoskeletal pain 

tiwms sttch u la.rgc part of the orthopedic surgeon’s practice. 

Thu findings that follow show that no other specialist chalhmgcs the orthopedic surgeon in this intensity of prescribing 

(w ordming wudgcsics. 

Analgesics as a percent of 

Spectalty all drug mentions 

Orthopedic surgery . . . 54 

General surge~ . . . . . . . . 15 

Neurology . . . . . . . . . . . . . 15 

General and family practice 10 

Internal medicine . . . . . . . 10 

Other specialties . . . . . . less than 10 

Comparing 1975-76 data with 1980-81 data 

There was an increase of 8.3 million visits to orthopedic 

stwgcons from 1975–76 to 19S0-81, but among the most 

frequently visited specialties providing ambulatory care, ortht~pcdic surgeons ranked seventh in both time periods. The 

number of visits to orthopedic surgeons per 100 persons incrctised slightly from 11.3 in 1975–76 to 12.6 in i 9S0-S 1 

(table lo). 

The proportion of visits to orthopedic surgeons in multiple–member practice arrangements increased substantially 

f’rom 55 percent in 1975–76 to 69 percent in 19S0-S 1. Orthopedic surgeons in metropolitan areas experienced a slight 

increase in the proportion of visits, but the distribution of 

visits by sex remained unchanged, with males still accounting 

for 53 percent of the visits. The increase in visits by persons 

65 years and over created an upward swing in the median 

age of patients from 35 to 3S years. 

The proportion of visits for diseases of the musculoskeletal 

system increased from 30 to 3S percent; for injuries and poisonings, the proportion of visits increased from 36 to 45 percent. 

This proportional increase in visits for problems such as 

sprains, strains, and fractures was naturalIy accompanied by 

a corresponding increase in the respective treatment or services 

provided, such as limited medical examinations. The proportion of visits in which a limited medical examination was 

performed increased substantially after 1975, from 55 to 69 

percent. 

The average duration of visit remained about the same, 

as did the proportion of visits that culminated in the patient’s 

admission to a hospital or in the patient’s being scheduled 

for return visits. 
8 acklncedata 

Table 10. Number of office visits per 100 pereons per year to orthopedic surgeons and percent of visits, by selected characteristics 

United State% 1976-76 and 1980-61 

Characteristic 1975-76’ 1980-817 

Total visits in thousands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47,152 55,470 

Visits perlOOpersons peryear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Median ageofpatients inyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Average durafion ofvisit in minutes.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Percentofall physicianvisits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Type of practice 

solo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Location of practice 

Metropolitan area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Nonmetropolitan area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Sex of patient 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age of patient 

Under25years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

25-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

45-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Prior visit status 

Newpatient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Oldpatient, newproblem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Oldpatient, oldproblem . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 

Principal diagnosis 

Neoplasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Dkseasesofthecirculatorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Diseasesofthe respiratorysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Diseasesofthedigestivesystem. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Diseasesofthegenitourinarysystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Diseases oftheskinand subcutaneooa tissue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Useases of themusculoskeletal syetemand connective tissue. . . . . . . . . . . . . . . . . . . . . . 

lnjuryand poisoning4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Diagnostic services 

andnonmedication therapy 

Limitedhistoryand/orexamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Generalhistoryand/orexamination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Clinical laboratorytest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

X ray . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Officesurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Duration of visit 

Lessthan 11 minutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Morethan 15minutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Disposition 

Admittohospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Return atspecifiedtime . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Return ifneeded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Nofollowup planned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

11.3 12.6 

35 38 

15 14 

Percent 

4.1 4.8 

45.4 31.0 

54.6 69.0 

77.6 83.9 

22.4 16.1 

47.2 47.0 

52.6 53.0 

32.7 27.8 

30.4 31.6 

27.4 27.0 

9.6 13.6 

22.5 22. i 

6.9 7.1 

70.6 70.9 

‘0.7 “0.6 

1.1 “0.5 

‘0.9 ‘02 

‘0.6 ‘o 1 

“0.4 “o 1 

‘1.0 11 

29.6 37.5 

36.3 45 II 

55.2 680 

10.9 10.6 

1.6 2.0 

36.3 39.0 

14.3 12.0 

46.7 550.3 

28.6 24.5 

3.5 4,5 

66.3 65.0 

16.3 181 

10.5 9.1 

lBasedon unestimated 1,155,900,000 visits.


2Basedon anestimaled 1,160,922,000 visits.


31ncludespartnership, group, and other fypes of practice.


41n1975 this category was “Accidents, poisonings, and violence.”


%cludeszero minutes.

I 

Technical notes 

Source of data and sample design 

The estimates presented in this rep&-t are based on the 

findings of the National Ambulatory Medical Care Survey 

(NAMCS), a sample survey of office-based care conducted 

annually from 1973 through 1981 by ~he National Center 

tiw Hwtl(h Statistics. The target universe of NAMCS is composed of office visits made by ambulato~ patients to non-Federal und noninstitutional physicians whb are principally engaged in office-based, patient-care prac~ice. Visits to physicitins practicing in Alaska and Hawaii are excluded from 

the tunge of NAMCS, as are visits to anesthesiologists, 

pathologists, and radiologists. I 

NAMCS uses a multistage probability sample design that 

involves a step-wise sampling of primary ,sampling units, physiciim pructices within primary sampling units, and patient 

visits within physician practices. The physician sample (5,805 

for the combined years 19S0 and 19S1) was selected from 

muster files maintained by the American Medical Association 

und the Americtin Osteopathic Association. Those members 

of the sample who proved to be within the scope of the 

survey pwticipated at a rate of 77.3 percent. The participation 

r~ttc for orthopedic surgeons, as an individual specialty, was 

S4.2 ptrcent. Responding physicians completed visit records 

(figure) for a systematic random sample of their office visits 

m.idc during a randomly assigned weekly reporting period. 

Tclcph{mc cuntticts were excluded. During 1980 and 1981 

responding physicians completed a 2-year total of 89,447 

Putitmt Record forms on which they recorded 97,796 drug 

rmmtions. Characteristics of the physician’s practice, such 

as primury specialty and type of practice, were obtained during 

an induction interview. The National Opinion Research Center, 

under contract to the National Center for Health Statistics, 

wtisresponsible for the field operations of the survey. 

Sampling errors, statistical significance, and 

rounding 

The stimdurd error is a measure of the sampling variability 

that occurs by chance because only a sample, rather than 

tin entire universe, is surveyed. The relative standard error 

of tin estimate is obtained by dividing the standard error by 

the tstimate itself and is expressed as a percent of the estimate. 

Approximate relative standard errors of estimates based on 

till physician specialties are shown in table I; the errors of 

wtimutes based on an individual specialty are shown in 

ttible II. 

In this report, the determination of statistical significance 

is htised on the t-test with a critical value of 1.96 (0.95 

Icvel of significance). Terms relating to differences, such 

as “higher” or “less ,“ indicate that the differences are statistically significant. Terms such as “similar” or “no difference” 

mcun thut no statistical significance exists between the estimtitts being compared. A lack of comment in a comparison 

hctween any two estimates does not mean that the difference 

was tested and found to be not significant. 

&ncedata 9 

Table L Approximaterelative standard errors for estimated numbers of 

office visits based on all physician specialties National Ambulatory 

Medical Care Survey, 1980-S1 

Relative 

Estimated number ofor’fice standard 

visitsin thousands error 

Percent 

150 . . . . . . . . . . . . . . . . . . 51.6 

250 . . . . . . . . . . . . . . . . . . . . . . 40.1 

400 . . . . . . . . . . . . . . . . . . . . . . 31.7 

500 . . . . . . . . . . . . . . . . . . 26.4 

1,000 . . . . . . . . . . . . . . . . . . . . . 20.2 

2,000 . . . . . . . . . . . . . . . . . . . . 14.5 

5,000. . . . . . . . . . . . . . . . . . . . . . . . . 9.5 

10,000. . . . . . . . . . . . . . . . . 7.1 

20,000 . . . . . . . . . . . . . . . . 5.6 

50,000 . . . . . . . . . . . . . . . . . . 4.4 

100,000 . . . . . . . . . . . . . . . . 3.9 

500,000 . . . . . . . . . . . . . . . . . . 3.5 

1,000,000 . . . . . . . . . . . . . . . 3.4 

NOTE: For example, an aggregate estimate of 35,000.000 office wits has a rela!iva 

standard error of 5,0 percent or a standard error of 1,750,000 visits (5.0 percent of 

35,000,000 visits) 

Table Il. Approximate re!ative sbndard errors forestimated numbers of 

office visits based on an ind~idual physician specialty: National 

Ambulatory Medical Care Suwey, 1980-81 

Relatwa 

Estimated number of office stamim) 

visitsin thousands error 

Percent 

“150 . . . . . . . . . . . . . . . . . . ‘53.8 

“250 . . . . . . . . . . . . . . . . . . . “42.0 

‘400 . . . . . . . . . . . . . . . . . . . . “33.3 

500 . . . . . . . . . . . . . . . . . . . . . 29.9 

1,000 . . . . . . . . . . . . . . . . . 21.6 

2,000 . . . . . . . . . . . . . . . 15.9 

5,000 . . . . . . . . . . . . . . . . . 11.1 

10,000 . . . . . . . . . . . . . . . . . . . . . . . . 9.0 

20,000 . . . . . . . . . . . . . . . . . . . . . . . . 7.7 

50,000 . . . . . . . . . . . . . . . . . . . . . . . . 6.8 

100,000 . . . . . . . . . . . . . . . . . . . . . . . . 6.5 

500,000 . . . . . . . . . . . . . . . . . . . . . . . 6.2 

1,000,000 . . . . . . . . . . . . . . . . . . 6.2 

NOTE: For example, an aggregate estimsteof 7.500,000 visits hasarelative standard error 

of 10.0 percent or a standard error of 750,000 visits (10.0 percent of 7,500,000 visits), 

Estimates ofoffice visits have been rounded to the nearest 

thousand. For this reason detailed figures within tabies do 

not always add to totals. Rates and percents were calculated 

on the basis oforiginal, unrounded figures and will notnecessarily agree precisely with percents calculated from rounded 

data. 

Definitions 

Ambulatory parient—Ambulatory patients are individuals 

presenting themselves for personal health services who are 

neither bedridden nor currently admitted to any health care 

institution on the premises. 
---

10 acklrcedata 

P}ty.vician-A physician is a duly licensed doctor of 

medicine (M.D. ) or doctor of osteopathy (D. O. ) currently 

in office-based practice who spends time in caring for ambulatory patients. Excluded from NAMCS are physicians who 

are hospital based: physicians who specialize in anesthesiology, pathology, or radiology; physicians who are Federally 

employed; physicians who treat only institutionalized patients; 

physicians employed full time by an institution; and physicians 

who spend no time seeing ambulatory patients. 

O&ice-Of fIces are places that physicians identify m hwutions for their ambulatory practices. Responsibility over timu 

for patient care and professional services rendered there gcnmally resides with the individual physician rather than with 

an institution. 

Visit—A visit is a direct personal exchange for the purpose 

of seeking care and rendering health services between tin 

ambulatory patient and a physician or a staff member working 

under the physician’s supervision. 

Symbols 

Data not available 

. . . Category not applicable 

Quantity zero 

0.0 Quantity more than zero but less than 

z 

* 

# 

0.05 

Quantity more than zero but less than 

500 where numbers are rounded to 

thousands 

Figure does not meet standard of 

reliability or precision 

Figure suppressed to comply with 

confidentiality requirements 
j2 

Recent Issues of Advance Data From Vitaland Health Statistics 

No. 116. Aging in the Eighties: Age 65 and Older and LNing No. 113. Provisional Data From the Health Promotion and Disease 

Akme-Conkts with Family, Friends, and Neighbors: Preliminary Prevention Supplement to the National Health Interview Survey: 

DtitLJFrom the Supplement on Aging to the National Health Interview United States, January-March 1985 

I 

Survey: Unikd States, January-June 1984 (In preparation) No. 112.1984 Summary: National Hospital Discharge Survey (Issued 

No. 11S. Aging in the Eighties: Preliminary Data From the Supple- Sept. 27, 1985) 

mcnt on A~in~ to the N-ational Health I;terview Survey: Un;ted - No. 111. An Overview of the 1982 National Master Facility Inventory States, January-June 1984 (In preparation) Survey of Nursing and Related Care Homes (Issued September 1985) 

No. 114. Prevalence, Impact, and Demography of Known Diabetes 

in the United States (Issued February 12, 1986) 

Suggested citstion 

N,~honal Center for Health Statistics, R. O. Gagnon: 

CMIce visits to orthopedic surgeons; National Ambulator 

Medical Care Survey, United States? 1980-61. Advance 

D,{t.? From WI and Health Statistics, No. 117. DHHS 

Pub. NcJ. (PHS) 80-1250. Public Health Service, 

Ffyilffdk, Md,, APril 1986. 

U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Public Health SewIce 

Nt~fkxml Center for Health Statistics 

3700 E.%N-West Highway


Hydkwille, Maryland 20782


OFFICIAL BUSINESS


PENALTY FOR PRIVATE USE, $300


To receive this publication regularly, contact


lhe National Center for Health Statistics by


calling 301 436-6500


Copyright Information 

This report may be reprinted without further 

permission. 

THIRD CLASS MAIL 

BULK RATE 

POSTAGE & FEES PAID 

PHSINCHS 

PERMIT No. G-281 

DHHS Publication No. (PHS) 86-1250 

~ 

I