On Volunteerism and Orthopaedics

Abstract

Sometimes give of your services for nothing. And if the opportunity for serving a stranger in financial straits, give full assistance to all such. For wherever the art of medicine is loved, there is also a love of humanity—Hippocrates As the quotation above suggests, the selfless giving of one’s services and time has been recommended by generations of medical leaders since medicine’s earliest emergence as a paid profession. Whether such recommendations are prescriptive (i.e., what a physician should do if he or she is so inclined) or descriptive (i.e., what a physician is obligated to do, given his or her skills, as part of being a physician) has long been a subject of debate. The philosophical center of the debate is whether health care is a “right”—regardless of one’s ability to pay for it or deliver himself or herself to a physician. For if it is indeed a “right,” we are obligated to provide care to all. One man’s right is another man’s moral and ethical obligation. In this spirit, a recent American Orthopaedic Association (AOA) symposium and round table discussion (at the 2012 annual meeting) explored whether volunteerism should be considered a “core competency” and, if so, how we might implement it as we do the other competencies outlined by the Accreditation Council for Graduate Medical Education (ACGME). It is our opinion that a careful reading of the currently accepted ACGME competencies indicates that volunteerism clearly falls under the “professionalism” umbrella and should be considered part of what we must do (and must teach) to be (and to produce) complete, competent orthopaedic surgeons. In an on-site survey, the audience felt strongly that role modeling by faculty is an important predictor of resident behavior. Although most of the audience felt neutral about incorporating an international elective in a resident curriculum, …