The Upper Hand: Chuck & Chris Talk Hand Surgery JHS Journal Club, Part 1: Basal joint arthritis, telemedicine, and GLPs
Feb 15, 2026
A new journal club tackles recent hand surgery papers on basal thumb arthritis trends, telemedicine for post-op care, and GLP-1 medications around common hand procedures. They debate surgical choices like denervation versus arthroplasty, critique a telehealth randomized trial, and unpack limitations of large administrative datasets when studying drug-related risks.
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Visiting A High-Throughput Joint Center
- Charles Goldfarb describes visiting an Atlanta joint-surgery practice that performed 20 total joints before 2 PM.
- He found their pit-crew coordination and radical time transparency inspiring and transferable to other settings.
Design Systems Around The Surgeon
- Make the surgeon the system's constraint and design processes to maximize surgeon efficiency.
- Use parallel workflows and dedicated 'pit crew' roles to cut in-room and turnover time.
Closure Choices Enable Telehealth Follow-Up
- Charles Goldfarb shifted to dissolvable sutures and skin glue to enable optional telehealth follow-ups.
- About 20% of his eligible patients convert to virtual follow-up, saving trips and clinic time.