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Published 1/1/2011

Second Look—Advocacy

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.

Are private practices disappearing?
Results of a survey commissioned by the not-for-profit The Physicians Foundation find that the traditional private physician practice is on the verge of disappearing. The national survey of 2,400 physicians found that 74 percent of respondents expect to retire, work part-time, close their practices to new patients, become employed and/or seek nonclinical jobs during the next 1 to 3 years.

According to a survey from the Medical Group Management Association (MGMA), the number of hospital-owned physician practices is increasing. In the 2009 MGMA survey, 55 percent of responding practices were hospital-owned, compared to 50 percent in 2008 and around 30 percent in 2003. In addition, more physicians seem to be seeking hospital employment; for the 12 months ending March 2010, more than half (51 percent) of the searches conducted by a large recruiting firm were for hospital positions, up from 45 percent in 2009 and 19 percent in 2003.

OIG: Adverse events cost $4.4 billion per year
A study released by the Office of Inspector General (OIG) for the U.S. Department of Health and Human Services finds that adverse events add at least $4.4 billion per year to government health costs and contribute to the deaths of about 180,000 patients each year. The OIG report states that 44 percent of adverse and temporary harm events are “clearly or likely preventable.” Overall, the report estimates that 69 adverse events and temporary harm events combined occur per 1,000 patient-days, and 36 such events per 100 admissions.

Survey: EDs report inadequate specialist coverage
According to a survey of 442 emergency department (ED) directors published in Academic Emergency Medicine (December 2010), 74 percent report inadequate specialist on-call coverage, and 60 percent have lost 24-hour coverage for at least one specialty during the last 4 years. Geographically, hospitals in the Midwest reported the lowest rates of inadequate coverage, at 62 percent, while 81 percent of ED directors in the South and 79 percent of ED directors in the Northeast responding to the survey reported coverage problems.

OSHA reminder: Blood-borne pathogen training
Blood-borne pathogen training for physicians is required by the U.S. Occupational Safety & Health Administration (OSHA). Physicians who are owners of a practice are subject to OSHA requirements, just as all staff members who are occupationally exposed to blood-borne pathogens. Noncompliance with training rules can have financial consequences to the practice in the form of OSHA fines.

Federal judge rules mandate unconstitutional
The Associated Press reports that a federal judge has ruled that the mandate for individuals to purchase health insurance, a part of the Patient Protection and Affordable Care Act (PPACA), is unconstitutional, on the grounds that the federal government overstepped its authority. Other lawsuits regarding the PPACA are pending and the constitutionality of the individual mandate will likely be determined by the U.S. Supreme Court. The ruling will have little immediate effect because the coverage mandate does not take effect until 2014.

Number of U.S. uninsured increasing
According to the Centers for Disease Control and Prevention (CDC), nearly 59 million Americans went without health insurance coverage for at least part of 2010—many of them with conditions or diseases that needed treatment. CDC analyzed data from the National Health Interview Survey for 2006, 2007, 2008, and 2009 and the first quarter of 2010. The number of those who went a year or more without health insurance increased from 27.5 million in 2008 to 30.4 million in the first quarter of 2010. CDC also finds that half of the uninsured were over the poverty level, and one in three adults under age 65 in the middle income range were uninsured at some point during the year.