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Dr. Tomaino's Blog

What do you buy when you purchase an 1/8th inch drill?

January 24th, 2009
During my stint at Pitt's Katz School of Business, in 2001, while working full time as an Associate Professor in the Department of Orthopaedic Surgery at the University of Pittsburgh Medical Center, I had a seminal revelation about what people seek when they come to see me for care. Although access to information on the internet and "direct to consumer marketing" by companies may incite patients to specifically ask for a certain device or procedure to treat their problem, this is still not the norm. Rather, patients leave the method up to me most of the time, once they have made it clear what they want---pain relief, better strength, improved function etc. And, interestingly, depending on training, skill, experience, etc the same problem in a given patient may be addressed diferently by 3 different physicians.

This, by the way, may cause one to ask whether any of the "options" is "better" or "best" since, when their are "several ways to skin a cat", this often means that no one is more preferable. However, this may not be the case always.

My revelation developed when my Marketing Professor asked the class what we were after when we bought an 1/8th inch drill....... and the not so obvious answer was an 1/8th inch hole!!

Bringing this back to my world of Shoulder, Elbow and Hand Orthopaedic Care----the same not-so- obvious answer should apply when patients navigate their way through the various options they are presented with to address various problems.
For example: tennis elbow, carpal tunnel syndrome, thumb arthritis, shoulder pain, rotator cuff tears etc.

Which is better? Arthroscopic surgery or open incisions, metal anchors or bioabsorbable, the use of a replacement part or not............................................

Remember what it is that you are in search of---what it is that you are "purchasing".

Feeling Better. Better range of motion? Better strength? Better function? What?

Then, figure out whether your provider can get you there with his/her methods/craft/skill/expertise.

After 15 years of experience, I appreciate the role of innovation---"the new and exciting" as well as the "time-honored" but not necessarily super sophisticated alternative.

As long as you have a good chance of getting "an 1/8th inch hole" it's not critcal what the make of the drill or drill bit is----------But, you do want a sure handed carpenter.


Mark Manioci

In a world of always find the high tech solution to all of the problems that face us, sometimes we fail to see the "simple" solution that is right in front of us.

February 2nd, 2009 @ 11:26 am

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