Now, we are witnessing developments that concern all of us. For example, neurosurgeons, plastic surgeons, podiatrists, chiropractors, general practitioners, rheumatologists and others have become responsible for the care of an increasing larger number of patients with conditions of the musculoskeletal system which previously were managed entirely by the orthopaedist. As a I reflect on the possible outcome of the Academy's efforts to stem the tide and encourage the orthopaedist to assume once again the care of those patients, I worry over the best way to accomplish that goal. It is not an easy task, but a tall order. Words and good intentions will not do any good.
Action is essential.
We must realize that effective change cannot take place unless a rather revolutionary joint effort of multiple segments within our profession can be orchestrated. Without major restructuring of residency education nothing will ever be accomplished. If future generations of orthopaedists are not appropriately trained in the surgical and nonsurgical management of musculoskeletal conditions, nothing will change. Assuming that such a reorganization takes place, the question of who in academic medicine will do the teaching must be answered. For the most part, orthopaedists knowledgeable in the nonsurgical management of musculoskeletal conditions are not found in the full-time faculty of medical schools.