Ten years ago we were told to close beds and scale back in preparation for the pending healthcare crisis. We braced for the federal subsidy reductions to academic teaching hospitals and began, like you, to see reductions in reimbursements. Over the past five years, we have faced a continuation in these reductions, a shift in the emphasis from specialty care to primary care, and a need to both reduce hospital stay and shift business to satellite facilities for economic reasons. We have faced the realities that clinical dollars were less available to fund research and education.
“A rising tide floats every boat.” Amongst these threats were opportunities that I think have made our program stable and has allowed the training program to maintain its rich tradition. The changes in the training program that you have heard Jim Herndon relate, and the threats to all of the hospitals, have helped to consolidate the Executive Committee toward a common goal. Our patient base has not “dried up” and our volumes continue to increase. In the past year, office visits at the Brigham and satellite facilities increased from 20,860 to 26,714 (21% increase) and surgical cases increased from 3200 to 4200 (23% increase). While we are a different Orthopaedics Department at the Brigham than we were 10 years ago, we think we have maintained a balance within the Brigham and throughout the Harvard Combined Residency Program.
They are going to want to know what Clem Sledge, Fred Ewald, and Bill Thomas are doing now that they've retired, so why don't you start there. You don't seem to require too many facts to make a statement.
Fortunately, we have the largest clinical Rheumatology department in the country, and the leadership of the Departments of Orthopaedics and Rheumatology has rejuvenated their long-time association that began at the Robert Beck Brigham Hospital. The Brigham Orthopaedic and Arthritis Center is jointly developing satellite facilities, and within each of our programs (Spine, Sports, Foot & Ankle, Upper Extremity, and Arthroplasty) we are involving rheumatologists in the out patient setting.
Sports Medicine facility at 850 Boylston Street, Chestnut Hill, had over
8000 patient visits last year and continues to grow. Charlie Brown has developed
an International Program in the Middle East, which we hope to expand and
integrate into our other services. Scott and Tammy Martin have been active
in local high school collegiate and professional sports teams. We look to
further integrate sports medicine across the Partners Network.
This past year we opened the Cartilage Repair Center under the leadership of Dr. Tom Minas. This is also based at 850 Boylston Street, Chestnut Hill and it is a consolidation of Tom's clinical and laboratory interests in non-arthroplasty options for treatment of cartilage injuries. Tom has an extensive program in both cell based and marrow-derived therapies. He has a keen interest in a variety of osteotomies about the knee and he has put together an excellent outcome analysis program that allows us to prospectively evaluate the efficacy of these procedures (refer to his manuscript in this Review). Tom now has the largest experience in autologus chondrocyte implantation in the United States and is carefully looking at these patients on a long-term basis so that we can define the role of this procedure. We have taken advantage of the synergy between our clinical and lab interest in cartilage repair. Dr. Julie Glowacki and Dr Suichi Mizuno are working with Tom in a variety of projects as we pursue very exciting areas in cartilage biology translational research.
In July of this year, we will open our Foot & Ankle Center at the Faulkner Hospital under the direction of Dr Michael Wilson. We are pleased that Chris Chiodo, M.D.D., who is finishing a Foot Fellowship with Dr Mark Myerson in Baltimore, will return to join us in the Foot & Ankle center. We have also added Dr. Jim Ioli, who will head the Podiatry section of the Foot & Ankle Center and will work at the Brigham, Faulkner and in our unit in Braintree. Dr.Tammy Martin will continue to divide her time between the Sports Medicine Center and the Foot & Ankle Center.
The integrated Partners Shoulder Service, under the direction of Dr. J.P. Warner, is growing at both institutions. We look forward to the addition of another individual during the coming year who will work both at the Brigham and the MGH. We are excited about the clinical and basic science research efforts of this group as well
Dr. Mark Vrahas, the new Partners trauma chief, has been an invaluable addition to the Brigham Orthopaedic faculty. Mark has focused our attention on trauma, increased our volume (especially of referrals), and has been a great resource to our chief resident.
Our Orthopaedic Research labs were well represented at this year's Orthopaedic Research Society. We had several podi-um presentations and posters from our cartilage biology, tissue engineering and bioengineering nanotechnology group. With the addition of Dr. Chris Evans, as director of the Partners Center for Molecular Orthopaedics, and our increasing research collaboration and association with the Department of Rheumatology, our labs are well positioned to participate in new and exciting technologies in musculoskeletal disease. We still face the day-to-day problems of funding and space, and I hope that next year I can present a more integrated research program that crosses the Partners Department of Orthopaedic Surgery.
And now the important stuff, Tammy and Scott Martin's twins are growing and doing fine. Tom and Dana Minas' twins are thriving as well. Clem tells me that his grandchildren are doing fine. Clem and Georgia moved but stayed in Marblehead. They divide their time between Marblehead and Maine. Bill and Dickie Thomas surface for some social events but spend a great deal of time in Florida, on the Vineyard and in Brookline. Fred and Sara Ewald bought a new place near Vail and seem to be there both winter and summer. For all that they taught us, perhaps the most important may be that life after. Orthopaedics can be fun
The fellowship program at the Brigham remains strong. After a few years of a decreasing applicant pool in the arthro-plasty fellowship, we had an all-time high number of applicants this past year. The quality of the applicants was outstanding, and we accepted our top three choices. The International Fellowship program is expanding such that at any one time, we will have between 3-7 arthroplasty fellows at the Brigham. The Hand Fellowship under the direction of Dr. Barry Simmons is thriving as is the Foot & Ankle fellowship program. Please remember to send your best residents our way.
Our plans for the coming year are to manage and contin-ue our double-digit increase in volume, and to continue to fight for more research space and operating time. A final plug: Dennis Burke and I, along with the rest of the Knee Committee, are planning our Harvard Knee Course for Spring of 2001. You will receive further information on this, but hopefully many of you interested in Knee Arthroplasty will be able to attend. We always look forward to seeing all the alumni both at the AAOS event and any time your travels bring you to Boston. Please keep in touch.
of Orthopaedic Surgery, Brigham and Women's Hospital
Thomas S. Thornhill,
Orthopaedist-in-Chief, Department of Orthopaedic Surgery, Brigham and Women's Hospital
President-elect, The Knee Society
Board of Trustees;
Brigham and Women's Hospital, BWH/Faulkner, Arthritis Foundation
Robert Poss, M.D.
Vice-Chairman, Department of Orthopedic Surgery, Brigham and Women's Hospital
Board of Orthopaedic Surgery
Director, Hand and Upper Extremity Service
Board of Trustees,
Director, Sports Medicine
Mark J. Koris,
Scott D. Martin,
Team Physician: The
New England Revolution, Bridgwater College, Wellesley College, and
Team Physician: Women's
World Cup, Wellesley College, Wheelock College and Bridgewater College
Richard M. Ozuna,
John E. Ready,
Director, Tumor Service
Director, Foot and
Director, Orthopaedic Trauma Service
Clinical Faculty-Harvard Vanguard Medical Associates
Co-editor, The Aging Skeleton - Academic Press
Election to the American
Society for Bone and Mineral Research Council
in the animal
TOP OF PAGE | HOJ HOME