Implant and patient tracking: the opinion of a patient.

A paper such as this deserves to begin with a personal word of introduction. Although a lawyer by education, I have during the last twenty-five years of active career been a newspaper publisher. In that capacity I have engaged very fully in the close international collaboration which exists between newspaper publishers in all parts of the world, always participating in the annual world newspaper congresses. They are important gatherings, with everyone present who plays a role in newspaper publishing, to say nothing of the heads of state and politicians of the host countries. Everyone, that is, except one vital category: the newspaper reader. I have never met a reader, nor yet a representative of the reader, at any of these meetings. At this medical congress you have done better; you have at least one patient present and that is myself. Perhaps, then, I have a certain right to your attention. Fortunately, I am not speaking merely on my own behalf; I am speaking on behalf of the organization which represents orthopaedic patients here in The Netherlands. Founded some five years ago, at the initiative of the Amsterdam orthopaedic surgeon Prof. Marti, its main activities were in the beginning the answering of questions from orthopaedic patients, naturally in a manner which did not infringe upon medical privilege, and the twice-yearly publication of a patient information journal with a circulation of sixty thousand. Two years ago we developed a policy plan. It was decided that one of our major priorities must be to conduct a survey into the bottlenecks standing in the way of orthopaedic care in this country, and into the social relevance of orthopaedic care. There were good reasons for this choice. In The Netherlands, patients unfortunately often have to cope with relatively long waiting lists for orthopaedic treatment, naturally with regional and individual variations, and suspect that these waiting lists are often longer than those for other forms of specialized medical treatment. The goals of this survey are firstly to determine where in the orthopaedic field in our country bottlenecks exist, with the result that a patient may not receive the right medical treatment in good time, or without incurring greater expense than necessary, or at all. Secondly, we are seeking to determine the social relevance of orthopaedic care, and especially the increased costs of providing social security benefits (or the greater loss in labour productivity) which Dutch society has to bear as a result of this less than optimal treatment of many patients. Thirdly, we have set out to forecast the influence of demographic developments on the future level of need for orthopaedic care. Fourthly, we want to identify those circumstances of developments which could guide our activities for the coming years in attempting to improve the conditions under which orthopaedic care is made available in this country.