Steven Zeitzew

Advocate of science based medical treatment, patient safety, improved quality of medical care

[Steven Zeitzew @StevenZeitzew]

@generalorthomd Same; I’ve been happy to be a generalist, and happy to have subspecialist back up when needed

[Steven Zeitzew @StevenZeitzew]

Gardens of Stone https://t.co/JvRhaOe3Qo via @YouTube
A tribute to those who have served and those who are serving, Bette Jane Cohen, 2008 short film
#MemorialDay

[Steven Zeitzew @StevenZeitzew]

@Kekius_Sage @alicecooper told us 50 years ago: “If I may put forward a slice of personal philosophy; I feel that Man has ruled this world as stumbling, demented child-king long enough, and as his empire crumbles my precious Black Widow shall rise as his most fitting successor." #BlackWidow

[Steven Zeitzew @StevenZeitzew]

@jointdocShields Friend by the kitchen door

[Steven Zeitzew @StevenZeitzew]

It was a Scottish Surgeon, John Lind, in the British Navy, whose experiment, 20 years before this, showed citrus treated scurvy on voyages, (1747 study, published in 1753). This may have been the first controlled clinical trial in medicine. (Yes, there is Vitamin C in sauerkraut, and it did take a long time for the Navy to adopt it, but it is why they were called limeys).

[Steven Zeitzew @StevenZeitzew]

@NeilFlochMD This was a problem at the Veterans Administration I was unable to solve; parts of a patient’s medical record were sometimes hidden from me although I was the attending orthopaedic surgeon caring for them. Also, patients were sometimes able to have parts of their records redacted

[Steven Zeitzew @StevenZeitzew]

The most shocking revelation starting practice after Orthpaedic Surgery residency was that without a supervising attending surgeon nobody in the OR was qualified to know if I was doing a good job. None of them had the knowledge or training. They were too busy doing their own job to scrutinize mine

[Steven Zeitzew @StevenZeitzew]

@LaidaniMohamed8 @traumaticum @Davembmd Appearance concerning for pathological fracture; urgent further diagnostic evaluation and advanced imaging recommended to permit optimal treatment planning

[Steven Zeitzew @StevenZeitzew]

Orthopaedic Surgery In the years just prior to the Polio Vaccine there were 50,000 American Children paralyzed annually by the disease, with orthopaedic wards or dedicated hospitals full of children with the disease. The last epidemic year was 1956. There were empty wards and hospitals, and idled orthopaedic surgeons, but not for long. This was what allowed modern orthopaedic treatment to begin. Modern fracture surgery began with AO/ASIF, founded in 1958. Sir John Charley performed the first modern hip replacement in 1962. Now, instead of treating the crippling effects of Polio, Orthopaedic surgeons enable those crippled by arthritis to function again with joint replacement surgeries that are some of the most successful and beneficial of all elective surgeries. Fracture treatment was transformed. Previously devastating fractures can now be safely and effectively treated restoring function after terrible trauma.

[Steven Zeitzew @StevenZeitzew]

Bone union with good alignment, after weeks of daily traction monitoring and adjustments, and a nightmare spica cast. Spica required anesthesia, fracture table, many hands, tons of plaster, and reinforcement with broomsticks. Hygiene was a challenge. Office visits for x-rays, cleaning, and repairs. Imagine what a baby does to a spica and put that on an adult in your office waiting room until the 4 month cast removal.

[Steven Zeitzew @StevenZeitzew]

Gus Sarmiento also described results of functional fracture brace treatment of femoral shaft fractures in the 1981 edition of his book (a great resource). I once treated a mid dyaphyseal femoral fracture (6’6”, 250lbs, schizophrenia) in traction 6 weeks followed by 1 1/2 spica (refused surgical treatment and deemed competent by psychiatry). Uninsured, so functional brace not an option

[Steven Zeitzew @StevenZeitzew]

@EPotterMD I moved from independent private practice of orthopaedic surgery to the VA mid career, 1999, to have more time with my family. I gave away the practice to one of my former medical students who was part of a group. Independent practices no longer had economic value in Los Angeles

[Steven Zeitzew @StevenZeitzew]

The first half of my career was private practice Orthpaedic surgery. I was cheated by Insurance Companies, hospitals, Medicare, Medicaid, and patients. I spent at least 25% of my time trying to get authorizations for clearly needed care, billing, and administrative crap, working 7 days a week and many nights. The majority of my work was uncompensated trauma and peds. To have more time with my family I transitioned to the VA. No approvals were needed to schedule needed care for grateful patients. As Chief of Orthpaedic Surgery I improved the system of care, efficiency, and quality. Teaching was a joy and privilege. They also cheated me, but I was able to do good work without the fighting while having time with my wife and son that I am grateful for.

[Steven Zeitzew @StevenZeitzew]

@elonmusk “I see four lights! There are four lights.” - JLP

[Steven Zeitzew @StevenZeitzew]

Safety, life enrichment, comfort. You, or an Occupational Therapist, can evaluate him and his house. Look for, eliminate, safety hazards, clutter, loose rugs; add shower grab bars, etc., it will make his life better. Accidents can be tragic. My mom, 99 today, takes online courses from a community college, is in a book club over Zoom, uses Grocery delivery and other conveniences. Maximize the love

[Steven Zeitzew @StevenZeitzew]

Unfortunate and not unique or just recent. I’ve had authorizations for orthopaedic surgeries, including treatment of acute fractures, withdrawn and reversed after I had already performed surgery. Authorizations for clearly necessary care were routinely denied. Fighting for my patients required substantial time and effort.

[Steven Zeitzew @StevenZeitzew]

@WilliamShatner Captain, I am interested in participating. Please put me on your list

[Steven Zeitzew @StevenZeitzew]

Maybe my residents sometimes doubted me also, but I agree that if the patient looks sick and feels sick, they ARE sick, so perhaps your attending was teaching you an important medical lesson. Also; healthy people don’t just fall over and break bones

[John Shields, MD, FAAOS @jointdocShields]

@SPuro88 @EvanThomas84 On one hand - offensive

On the other hand - as a resident I had an attending force me to call a medicine consult because he thought the patient looked sick

[Steven Zeitzew @StevenZeitzew]

Yes, you are exactly right. Physicians must again lead the way using this opportunity, and availability of hospital beds, to provide more effective care. In the years just prior to the Polio Vaccine there were 50,000 American Children paralyzed annually by the disease, with orthopaedic wards or dedicated hospitals full of children with the disease. The last epidemic year was 1956. There were empty wards and hospitals, and idled orthopaedic surgeons, but not for long. This was what allowed modern orthopaedic treatment to begin. Modern fracture surgery began with AO/ASIF, founded in 1958. Sit John Charley performed the first modern hip replacement in 1962. Now, instead of treating the crippling effects of Polio, Orthopaedic surgeons enable those crippled by arthritis to function again with joint replacement surgeries that are some of the most successful and beneficial of all elective surgeries. Fracture treatment was transformed. Previously devastating fractures can now be safely and effectively treated restoring function after terrible trauma. #orthopaedic

[Steven Zeitzew @StevenZeitzew]

@DirtyTesLa https://t.co/Oa7gMIHsdE
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