title: Musculoskeletal health disparities: health literacy, cultural competency, informed consent, and shared decision making.
abstract: The factors that contribute to musculoskeletal healthcare disparities may influence the results of studies regarding the long-term outcome of orthopaedic implants. Patient decisions regarding their healthcare and their subsequent outcomes are influenced by health literacy. Providing patients with the information that they need to consent to treatment must be provided in a culturally competent manner. The influence of the physician or healthcare provider on the treatment choice varies depending on the type of decision-making process: patient-based, physician-based, or shared decision making. Respecting the patient's autonomy while acknowledging the knowledge and experience of the physician, we advocate for shared decision making. This may require modification of existing regulations regarding informed consent. Furthermore, federal and state directives have been put into place to address healthcare disparities, especially with respect to culturally competent care and access to proper healthcare.
authors.affiliation: Temple University Center for Health Law, Policy, and Practice, James E. Beasley School of Law, Temple University, Philadelphia, Pennsylvania.
authors.forename: Frank M
authors.initials: FM
authors.lastname: McClellan
authors.affiliation: Department of Orthopaedic Surgery, MedStar Harbor Hospital, Baltimore, Maryland.
authors.forename: James E
authors.initials: JE
authors.lastname: Wood
authors.affiliation: Beasley School of Law, Temple University, Philadelphia, Pennsylvania.
authors.forename: Sherin M
authors.initials: SM
authors.lastname: Fahmy
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Lynne C
authors.initials: LC
authors.lastname: Jones
mesh_terms: D054521:Cultural Competency; D003657:Decision Making; D057220:Health Literacy; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007258:Informed Consent; D009140:Musculoskeletal Diseases / Q000628:therapy*; D010358:Patient Participation; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence; D026684:Personal Autonomy