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DescriptionDavid Christopher, Orthopedic Surgeon
David Christopher received his medical degrees from the
University of Kentucky and the University of Virginia. He did his
residency and early surgeries at Duke University Medical
Center. Eight years ago he set up his own orthopedic surgery
clinic in Atlanta, Georgia. Today, one other doctor has joined his
clinic in addition to 12 support personnel such as X-ray
technicians, nurses, accounting, and office support. The medical
practice specializes in all orthopedic surgery, except it does not
perform spinal surgery. The clinic has grown to the point where
both orthopedic surgeons are working long hours, and Dr.
Christopher is wondering whether he needs to hire more
surgeons.
An orthopedic surgeon is trained in the preservation,
investigation, and restoration of the form and function of the
extremities, spine, and associated structures by medical,
surgical, and physical means. He or she is involved with the care
of patients whose musculoskeletal problems include congenital
deformities; trauma; infections; tumors; metabolic disturbances
of the musculoskeletal system; deformities; injuries; and
degenerative diseases of the spine, hands, feet, knee, hip,
shoulder, and elbows in children and adults. An orthopedic
surgeon is also concerned with primary and secondary
muscular problems and the effects of central or peripheral
nervous system lesions of the musculoskeletal system.
Osteoporosis, for example, results in fractures, especially in the
hips, wrists, and spine. Treatments have been very successful in
getting the fractures to heal.
Dr. Christopher collected the data in Exhibit 10.9 as an example
of the clinic’s typical workweek. Both surgeons work 11 hours
each day, with 1 hour off for lunch, or 10 effective hours. All
surgeries are performed from 7:00 a.m. to 12:00 noon, 4 days a
week. After lunch, the surgeons see patients in the hospital and
at the clinic from 1:00 p.m. to 6:00 p.m. Over the weekend and
on Fridays, the surgeons rest, attend conferences and
professional meetings, and sometimes do guest lectures at a
nearby medical school. The doctors want to leave a safety
capacity each week of 10 percent for unexpected problems with
scheduled surgeries and emergency patient arrivals.
Both surgeons are working long hours, and Dr. Christopher is wondering
whether he needs to hire more surgeons.
Rocketclips, Inc./ Shutterstock.com
The setup and changeover times in Exhibit 10.12 reflect time
allowed between each surgery for the surgeons to clean
themselves up, rest, review the next patient’s medical record for
any last-minute issues, and prepare for the next surgery. Dr.
Christopher feels these changeover times help ensure the
quality of their surgery by giving them time between
operations. For example, standing on a concrete floor and
bending over a patient in a state of concentration places great
stress on the surgeon’s legs and back. Dr. Christopher likes to sit
down for a while between surgeries to relax. Some surgeons go
quickly from one patient to the next; however, Dr. Christopher
thinks this practice of rushing could lead to medical and surgical
errors. Dr. Christopher wants answers to the following
questions.
Exhibit 10.12
Orthopedic Surgeon One-Week Surgery Workload (These
Data Are Available in the Excel Worksheet Orthopedic
Surgeon Case Data in MindTap)
Orthopedic Surgery
Procedure
Surgeon Changeover
Time (Minutes)
Surgery Time
(Minutes)
Surgeon
Identity
Demand (No. of P
Scheduled We
Rotator cuff repair
20
45
B
2
Cartilage knee repair
20
30
B
1
Fracture tibia/fibula
20
60
B
1
Achilles tendon repair
20
30
B
3
ACL ligament repair
20
60
B
3
Fractured hip
20
80
A
0
Orthopedic Surgery
Procedure
Surgeon Changeover
Time (Minutes)
Surgery Time
(Minutes)
Surgeon
Identity
Fractured wrist
20
60
A
2
Fractured ankle
20
70
A
1
Hip replacement
30
150
A
2
Knee replacement
30
120
A
3
Shoulder replacement
40
180
B
1
Big toe replacement
20
90
B
0
Case Questions for Discussion:
Demand (No. of P
Scheduled We
1. What is the clinic’s current weekly workload?
2. Should the clinic hire more surgeons, and if so, how many?
3. What other options and changes could be made to maximize patient
throughput and surgeries, and therefore revenue, yet not compromise
the quality of medical care?
4. What are your final recommendations? Explain your reasoning.

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