AANA19 Shoulder Access Pass-The Burden of Craft - Distinguished Feature Lecture-Dr. Stephen S. Burkhart, M.D.

The Burden of Craft - Distinguished Feature Lecture-Dr. Stephen S. Burkhart, M.D.

Video Transcription

Video Summary

The speaker reflects on the “burden of craft” in surgery: an ethical obligation to use one’s skills for the patient’s greatest benefit. He argues that modern “knowledge economy” and “value-based healthcare” rhetoric can wrongly treat surgeons as interchangeable commodities focused mainly on cost, ignoring that superior outcomes increase value. Drawing parallels to professional athletes gaining recognition for elite performance, he emphasizes the need to measure and acknowledge differences in surgical skill and results.<br /><br />Using rotator cuff repair as an example, he traces the evolution from large open procedures to today’s arthroscopic techniques, driven by surgeons who advanced biomechanics research, diagnostics, instruments, implants, and repair constructs (e.g., anchors, double-row repairs, SCR). He warns that newer technology often increases, not reduces, the need for craftsmanship. He criticizes choosing easier operations (like reverse shoulder arthroplasty) over better patient-centered options, urging surgeons to upskill or refer.

Keywords

burden of craft in surgery

surgical skill measurement and outcomes

value-based healthcare critique

arthroscopic rotator cuff repair evolution

reverse shoulder arthroplasty vs rotator cuff repair