Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Matt Morgan raises very valid points that warrant thoughtful consideration.
As professionals it is vital to critically appraise our practise and the evidence base to support surgical interventions offered to our patients. The most invasive interventions may not necessarily be the most effective, and on occasion less is more. There is a plethora of evidence showing that a substantial proportion of patients improve whilst on a waiting list for Orthopaedic surgery.
It is equally important for each specialty not just to lobby for its own corner, highlighting the ever growing waiting lists, but to consider where its services fit in the bigger healthcare picture. When faced with limited resources, decisions ought to be based on patient’s vulnerability and clinical need, rather than simply on the duration on an elective waiting list.
It is possible that the public will be acceptive and receptive to an honest explanation of the need to prioritise as per clinical need, maybe even more than what we as surgeons think.
No competing interests
13 March 2021
Charalambos P. Charalambous
Consultant in Trauma and Orthopaedics, Honorary Professor
Blackpool Teaching Hospitals NHS Foundation Trust, School of Medicine, University of Central Lancashire
Department of Orthopaedics, Blackpool Victoria Hospital