Published 7/1/2009

Second Look

If you missed these Headline News Now items the first time around, AAOS Now gives you a second chance to review them. Headline News Now—the AAOS thrice-weekly, online update of news of interest to orthopaedic surgeons—brings you the latest on clinical, socioeconomic, and political issues, as well as important announcements from AAOS.

AAOS, ACS address surgeon shortage
The AAOS has been working with the American College of Surgeons (ACS)-led Operation Patient Access (OPA)—an
initiative designed to help increase the number of surgeons available to meet future needs. According to Modern Physician, a shortage of surgeons exists in both inner cities and rural areas, and many medical students who take up surgery now opt for minimally invasive specialties. Additionally, a 1997 law created to address a potential surplus of physicians caps the number of residency slots available for federal funding. OPA is advocating for more residency slots, student-loan forgiveness programs, more funding for surgeon education, and expansion of the National Health Services Corps.

California MICRA law is constitutional
According to California Physician News, the 5th District Court of Appeal has unanimously upheld as constitutional
California's Medical Injury Compensation Reform Act (MICRA). Under MICRA, injured patients are entitled to unlimited medical and economic compensation and an additional $250,000 in noneconomic or “pain and suffering” awards. The law also limits contingency legal fees.

Medical residents subject to Social Security taxation
federal appeals court has ruled that medical residents may be considered full-time employees and therefore subject to Social Security taxes. The U.S. Congress has traditionally exempted students whose work is linked to their studies from paying Social Security tax, but a 2005 Internal Revenue Service (IRS) regulation specified that anyone who works at least 40 hours per week is a full-time employee subject to Social Security tax—even if their work has educational or training aspects. The court did not make a decision on whether residents should be considered students, but determined that the IRS regulation did not conflict with existing statutes.

FTC has online tool for “Red Flag” rules
The U.S. Federal Trade Commission (FTC) has designed an
online program to help medical practices and other businesses comply with its Red Flags Rule. The “Do-It-Yourself Program for Businesses at Low Risk for Identity Theft” includes questions to help you determine if your practice is at low risk for identity theft, and a guide through the four steps required to comply with the requirement of a written identity theft prevention program. Practices have until Aug. 1, 2009 to comply.

OIG: OK to compensate physicians for call
One hospital has received an
advisory opinion from the U.S. Department of Health and Human Services Office of Inspector General (OIG) stating that its plan to compensate physicians for on-call coverage for its emergency department is unlikely to be a conduit for kickbacks. The unnamed 400-bed facility is the only acute-care provider in its county and does not have enough physicians willing to take call. Under the proposal, the hospital would pay physicians fixed sums when their on-call duties require them to treat uninsured patients. According to the OIG, the hospital appears to have a legitimate rationale for revising its on-call coverage policy.

Panel updates sports concussion guidelines
An international panel of neurologists has released a
consensus statement on recommendations for concussion care in sports. The statement, published in the British Journal of Sports Medicine (May 2009), states that athletes 18 years of age or younger who are believed to have sustained a concussion during a game or practice should never be allowed to return to the playing field the same day.