Orthopedic Registries: Second Thoughts
Meaningful progress in managing clinical conditions, such as the ones we are discussing, is achieved not by expanding the size of a registry but by being committed as individuals to making improvements. A cursory glance at the history of hip arthroplasty easily proves the point. Registries, guidelines, and other popular systems sometimes inadvertently create an environment that inhibits independent thinking. When powerful nonmedical economic and political bodies become involved in medical issues in order to ensure their continued profit, our autonomy is lost or compromised in major ways. Such scenarios must be avoided as forcefully as possible.8
Questioning the future of AJRR does not derive from rigid thinking or from a lack of awareness or understanding of the registry’s nature, procedures, benefits, goals, or highly altruistic and noble origins. However, pointing out a lack of evidence of success is not a crime. It is incumbent on us to look at this area and others with open minds while recognizing that honest and sincere scrutiny often helps make a better future a reality. The United States is working to achieve major goals for health care—access for all, lower costs, and fewer abuses of the system. Our involvement is a mandate to be followed enthusiastically.
