Orthopedic surgeons get a new chief Focus is on education, not politics

June 08, 1993|By Donna E. Boller | Donna E. Boller,Staff Writer

7/8 TC It's an old Irish curse: "May you live in interesting times."

Dr. Donald I. Saltzman, newly elected president of the Maryland Orthopaedic Society, takes office in what is -- for anyone involved in the nation's health care industry -- an interesting time.

The Maryland Orthopaedic Society's purpose is education for its members, not political activism, Dr. Saltzman explains. The members meet to hear lectures by specialists in the field, and the organization does not lobby or field a political action committee.

But at a time when health care reform is one of the hottest items on the national agenda, medical issues have become political issues.

Dr. Saltzman is one of six orthopedic specialists who own the Carroll County Center for Orthopedic and Sports Medicine in Westminster and also practice in Pikesville.

The 50-year-old orthopedic surgeon divides most of his in-hospital time between Sinai and Carroll County General hospitals, and Northwest Hospital Center, where he is chief of orthopedic surgery. He is also on the staffs of Johns Hopkins, Children's and Kernan hospitals and is a consultant at Francis Scott Key Medical Center.

As president of the society, Dr. Saltzman attended the National Orthopedic Leadership Conference, a session in Washington last month to go over health care issues. But he sees some of them in his practice.

One source of frustration is getting clearances for procedures from health maintenance organizations. "It's very difficult when you have a patient you've just taken the cast off and you need to get an X-ray and they don't want to authorize it," he says.

Another frustration: being called on in an emergency when the HMO specialist is unavailable and then not being able to follow the patient through his or her recovery.

Dr. Saltzman worries that in the debate over health care reform, "A lot of what physicians in general say should be [done] is perceived as self-interest from a financial standpoint."

He hadn't expected to be seen as the bad guy for earning a high income. Doctors do have high incomes. But, Dr. Saltzman says, physicians' fees account for just 18 percent of total health care costs.

When Dr. Saltzman applies his intellect to looking for answers, he sees Americans having to set priorities among quality of care, cost and the expansion of services that will come with universal health insurance coverage. Should an AIDS patient with a few months to live at best be placed in intensive care? Will we accept waits of up to one year for nonemergency surgery? What happens if a patient needs a specific hip prosthesis that costs $5,000 and the government will reimburse only for the $3,000 model?

Dr. Saltzman is not one of the disillusioned doctors who think about giving up in the face of restrictions on the way they practice. Ten years from now, he sees himself "practicing orthopedic surgery in Carroll County and Baltimore County, God willing, with a son who is in practice with me."

Robert, Donald and Helen Saltzman's middle child, is in medical school and interested in orthopedic medicine. His older brother, Kenneth, is an attorney who is selling commercial real estate. Shari, the Saltzmans' daughter, graduated from the University of Maryland last month with a degree in accounting.

Dr. Saltzman grew up on Long Island, graduated from the University of Rochester and Albert Einstein College of Medicine in New York, then moved to Maryland for internships and residencies at what was then Baltimore City Hospital, Children's and Johns Hopkins hospitals.

He and the other members of his group opened an office in Carroll County after Interstate 795 opened.

Dr. Saltzman says his practice in Carroll is primarily outpatient. Equipment required for orthopedics is very expensive, he says, so it's more practical for Carroll County General Hospital to transfer many of these patients.

Dr. Saltzman has been actively involved in academics and in professional associations. He is an assistant professor of orthopedic surgery at the Johns Hopkins University School of Medicine and has been administering oral exams to candidates for certification in orthopedic surgery since 1978. He belongs to 12 academic and professional societies and served as secretary-treasurer and vice president of the Maryland Orthopaedic Society before being elected president.

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