{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:39:49Z","timestamp":1792435189789,"version":"4.5.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n \n \n \u27a2 Orthopaedic identity is traditionally anchored in the operating room, where technical skill, decisive intervention, and operative outcomes remain central to professional validation. Yet orthopaedic surgeons also encounter realities that no implant can fully address: motor vehicle collisions, unsafe work, poverty, delayed access, disability, rehabilitation gaps, and loss of livelihood. We argue that orthopaedic responsibility may, in selected circumstances, extend beyond direct operative care into advocacy, education, systems improvement, disability inclusion, public engagement, and health-policy work.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Drawing on examples from global surgery, surgical safety, the Ponseti method, rural fracture-care ethics, and professional identity formation, we examine how surgeons may translate clinical experience into wider public benefit. We propose that nonoperative roles should not be justified by personal fulfillment alone, but by whether they multiply benefit: improving access, safety, training, dignity, public trust, policy, rehabilitation, or community outcomes beyond an individual operative caseload.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 We also address the tension between the urgent need for operating surgeons and the potential societal benefit of surgeons serving in wider roles. In health systems already constrained by workforce pressures and waiting lists, advocacy beyond the operating room must remain accountable to patients and communities. The key ethical question is whether such work subtracts from surgical capacity or whether it strengthens the conditions under which musculoskeletal care is delivered.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Operative service remains foundational to orthopaedic identity. However, if orthopaedic surgery is understood as a moral practice directed toward restoring function, relieving pain, and protecting dignity, its responsibilities cannot be confined entirely within the operating room walls.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>","DOI":"10.2106\/jbjs.26.00935","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:00:39Z","timestamp":1792432839000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Beyond the Operating Room: Orthopaedic Advocacy, Identity, and Wider Impact"],"prefix":"10.2106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6893-7922","authenticated-orcid":false,"given":"Yogesh S.","family":"Salphale","sequence":"first","affiliation":[{"name":"Shushrusha Multispecialty Hospital, Chandrapur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2286-2600","authenticated-orcid":false,"given":"Sushrut S.","family":"Babhulkar","sequence":"additional","affiliation":[{"name":"Sushrut Institute of Medical Sciences, Nagpur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0185-7530","authenticated-orcid":false,"given":"Anuradha Y.","family":"Salphale","sequence":"additional","affiliation":[{"name":"Shushrusha Multispecialty Hospital, Chandrapur, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"issue":"1","key":"bib2-20261019","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1001\/jama.291.1.94","article-title":"Physician-citizens\u2014public roles and professional obligations","volume":"291","author":"Gruen","year":"2004","journal-title":"JAMA."},{"issue":"1","key":"bib3-20261019","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/ACM.0b013e3181c40d40","article-title":"Perspective: Physician advocacy: what is it and how do we do it?","volume":"85","author":"Earnest","year":"2010","journal-title":"Acad Med."},{"issue":"9","key":"bib4-20261019","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1097\/ACM.0b013e3182621c25","article-title":"Perspective: Agency and activism: rethinking health advocacy in the medical profession","volume":"87","author":"Dobson","year":"2012","journal-title":"Acad Med."},{"issue":"9993","key":"bib5-20261019","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S0140-6736(15)60160-X","article-title":"Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development","volume":"386","author":"Meara","year":"2015","journal-title":"Lancet."},{"issue":"5","key":"bib6-20261019","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1056\/NEJMsa0810119","article-title":"A surgical safety checklist to reduce morbidity and mortality in a global population","volume":"360","author":"Haynes","year":"2009","journal-title":"N Engl J Med."},{"issue":"5","key":"bib7-20261019","doi-asserted-by":"crossref","first-page":"585","DOI":"10.5312\/wjo.v5.i5.585","article-title":"Worldwide spread of the Ponseti method for clubfoot","volume":"5","author":"Shabtai","year":"2014","journal-title":"World J Orthop."},{"issue":"6","key":"bib8-20261019","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1097\/CORR.0000000000003974","article-title":"Virtue ethics in a value-driven world: when cost shapes choice-ethical decisions in rural fracture care","volume":"484","author":"Salphale","year":"2026","journal-title":"Clin Orthop Relat Res."},{"key":"bib9-20261019","doi-asserted-by":"crossref","first-page":"E4","DOI":"10.1051\/sicotj\/2026007","article-title":"Embracing uncertainty: a core competency for the global orthopaedic surgeon","volume":"12","author":"Salphale","year":"2026","journal-title":"SICOT J."},{"key":"bib10-20261019","article-title":"Delivering world-class health care","author":"Govindarajan","year":"2013","journal-title":"affordably. 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