Shared Decision-Making and the Orthopaedic WorkforceLurie, Jon D. MD, MS; Weinstein, James N. DO, MSAuthor Information From the *Center for the Evaluative Clinical Sciences, and the **Departments of Medicine, †Orthopaedic Surgery, and ‡Community and Family Medicine, Dartmouth Medical School, Hanover, NH. Supported in part by NIAMS #AR45444-01. Reprint requests to Jon D. Lurie, MD, MS, SPORT/The Spine Center, Dartmouth Hitchcock Medical Center, Lebanon, NH 03756. Clinical Orthopaedics and Related Research (1976-2007): April 2001 - Volume 385 - Issue - pp 68-75 Buy Abstract Studies of physician workforce need a standard of an appropriately sized workforce to compare projections. Although many studies use average rates of healthcare use as a standard, regional benchmarks provide a pragmatic alternative approach to estimating a reasonably sized physician workforce and avoid many of the problems of needs-and demand-based planning. Wide geographic variations in the rates of many procedures, unexplained by differences in population characteristics, suggest that supply-induced demand or physician practice style or both may be the major determinates of the rates for these procedures. In the current study, the authors explore some of these differences in orthopaedic procedure rates and their implications for workforce planning. For example, the rates of hip fracture are fairly uniform across geographic regions, whereas the rates of spine surgery vary sixfold and the rates of spinal fusion vary 10-fold. Shared decision-making is the process of giving patients informed choices about their treatment options based on current best evidence. Careful studies of treatment effectiveness and shared decision-making hold the promise of allowing patients’ preferences and values to determine the right rate of healthcare use. These rates could allow workforce projections to be compared with optimal benchmarks for future planning. © 2001 Lippincott Williams & Wilkins, Inc.