AAOS Now, August 2017
Evidenced-based Advocacy: The Argument for POHs
One of the less-discussed provisions of the Affordable Care Act is the ban on the expansion of existing physician-owned hospitals (POHs) and the formation of new ones. The ban was founded on concerns about physician self-referrals and possible conflicts of interest. Similar concerns led to the passage of the Stark Act in 1989, which prevented self-referral of Medicare patients.
Addressing Patient Preferences Appropriately
During a recent meeting of the Patient Safety Committee, Chair David Ring, MD, PhD, facilitated a discussion focused on identifying and responding to patient preferences in treatment. Participating committee members Dwight Burney, MD; Michael Pinzur, MD; Alan Reznik, MD; Andrew Grose, MD; Chris Gaunder, MD; Ramon Jimenez, MD; and Michael R. Marks, MD, MBA, shared strategies. Dr. Ring: The concept of shared decision making has had some impact, but there is still room for improvement.
What Is the True Value of the On-call Orthopaedic Resident?
"Residents provide a significant amount of care to patients with orthopaedic injuries and musculoskeletal conditions," noted J. Benjamin Jackson, MD. When the attending is not present, much of that care goes unbilled. Currently, resident education is funded by Medicare and the host institution. "The Balanced Budget Act of 1996 froze funding for graduate medical education (GME), so any new resident openings have been funded by individual hospitals.
Patients with Ankle Fractures May Be Able to Use Fewer Opioids
According to a study published in the July issue of the Journal of the American Academy of Orthopaedic Surgeons, no association exists between opioid intake and disability following surgery for ankle fracture. The study also found no link between opioid intake and satisfaction with treatment or pain management.
Understanding Shoulder Kinematics in Patients with Asymptomatic RCTs
Rotator cuff tears (RCTs) occur in more than 50 percent of people older than 60 years of age. Symptomatic RCTs typically often require surgery; however, associated risks include infection, foreign body reaction, and neurologic injury. "Symptomatic RCTs can be a disabling condition with few treatment options other than surgery, said Phillip N. Williams, MD, assistant professor in the department of orthopaedics at University of Texas Health Science Center at Houston.
Translating Orthopaedic Innovation to Clinical Use
Despite the wealth of innovation in the orthopaedic sciences, seemingly few technologies translate to clinical use. Federally funded research efforts are largely focused on understanding the mechanisms behind the development and progression of debilitating musculoskeletal diseases. There is a pressing need for researchers and surgeons to figure out how to connect mechanistic knowledge to improved clinical outcomes.
Innovation Spotlight: StreaMD
Kevin J. Campbell, MD, chief executive officer and cofounder of StreaMD, was presented the 2017 Orthopaedic Innovator Award at the AAOS/ORS Translating Orthopaedic Technologies into Clinical Practice: Pathways from Novel Idea to Improvements in Standard of Care Research Symposium. Erin Lynn Ransford connected with Dr. Campbell to discuss his product. The questions and his responses follow. Ms. Ransford: What is StreaMD? Dr. Campbell: StreaMD is a health-tech company based in Chicago.
Musculoskeletal Effects of Antineoplastic Agents in Women
Medical advances in the field of oncology have increased life expectancy and decreased mortality rate for many patients diagnosed with cancer. These improvements are associated with the administration of chemotherapeutic or antineoplastic agents. Unfortunately, these agents can result in side effects that impact the musculoskeletal system.