Today’s Top Story
Medscape report finds orthopaedics to be highest-compensated specialty.
Medscape has released its Physician Compensation Report 2017, in which orthopaedics again tops the list of highest-paid specialties. The report states that average annual pay for self-employed specialist physicians is $368,000, compared to $278,000 for employed specialists. In addition, it finds a 37 percent pay gap between male and female specialists overall, but notes that some of that trend may be explained by a smaller percentage of women among higher-reimbursed specialties. Overall, 68 percent of emergency medicine physicians and 48 percent of orthopaedists described themselves as fairly compensated. The report also notes a strong upward trend in physicians who participate in accountable care organizations, from 3 percent in 2012 to 36 percent in 2017.
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View the report…(registration may be required)

Other News

Study: Diabetes mellitus linked to increased risk of postoperative complication for patients undergoing ACDF.
Data from a study published in the April issue of the journal Spine suggest that patients with diabetes mellitus may be at increased risk of postoperative complication following anterior cervical diskectomy and fusion (ACDF). The authors retrospectively reviewed prospectively collected data on 1,603 adult patients, of whom 193 were non-insulin-dependent diabetic and 87 were insulin-dependent diabetic. Compared to nondiabetic patients, they found that non-insulin-dependent diabetic patients were at increased risk of urinary tract infection and return to operating room at 30-day follow-up. In addition, insulin-dependent diabetic patients were at increased risk of reoperation, readmission, and total length of stay of greater than 5 days. After adjustment, the authors found that only insulin-dependent diabetic status was an independent predictor for 30-day readmission.
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Study: OCA may be viable treatment option for active patients with knee cartilage injury.
According to a study published online in The American Journal of Sports Medicine, osteochondral allograft (OCA) transplantation may be a successful treatment option for active patients who sustain a cartilage injury to their knee. The researchers reviewed information on 142 highly active patients (149 knees) who participated in sport or recreational activity prior to a cartilage injury and underwent OCA transplantation. At mean 6-year follow-up, they found that 75.2 percent of knees had returned to sport or recreational activity Based on a survey of patients who did not return to sport, knee-related issues and lifestyle changes were cited as reasons. Overall, patients who did not return to sport were more likely to be female, have injured their knee in an activity other than sport, and have a larger graft size. The researchers note that after OCA transplantation, 25.5 percent of knees underwent further surgery, with 14 knees (9.4 percent of entire cohort) considered allograft failures. Among the patients (135 knees) in which the graft had remained in situ, 91 percent were satisfied with the results of the surgery.
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Study: Scaffold/adult stem cell combination may help improve healing of rotator cuff tears.
Findings from an animal study published online in the journal PLOS ONE suggest that a combination of advanced scaffold material and adult stem cells may improve healing of rotator cuff tendon tears compared to surgery alone. The research team tested clinically two types of biodegradable poly (lactic acid-co-glycolic acid) scaffolds as transient carriers for genetically modified cells. They found that human fibroblasts adhered to both scaffolds, although proliferation and transgene expression capacity were higher on one type, possibly due to a different scaffold architecture. In addition, the research team notes that cultivation of the cells on the scaffolds did not alter their biomechanical properties.
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Study: How reliable is self-reporting?
A study published in the March issue of the journal Medical Care finds little association between The Leapfrog Group’s voluntary Safe Practices Score (SPS) and compulsory Medicare outcomes and penalties. The researchers compared 2013 data from Leapfrog Hospital Safety Scores against central line-associated bloodstream infection and catheter-associated urinary tract infection standardized infection ratios (SIRs), and Hospital Readmission and Hospital-Acquired Condition (HAC) Reduction Program penalties incorporating 2013 performance. They found that no SPS measures were associated with SIRs, and only one SPS (feedback) was associated with reduced likelihood of HAC penalization. “With increasing compulsory reporting,” the researchers write, “Leapfrog SPS seems limited for comparing hospital performance.”
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Arizona.
The Arizona Republic reports that the state of Arizona has enacted a law that allows manufacturers to promote off-label uses of drugs and medical devices. The measure will allow company representatives to share information with medical practitioners as long as it is “not misleading, not contrary to fact and consistent with generally accepted scientific principles.” Critics of the move argue that off-label promotion could lead to improper prescribing, wasteful spending, and inappropriate treatment for patients. Despite the new law, some observers note that manufacturers may be hesitant to change current promotional practices, as they must answer to the U.S. Food and Drug Administration under federal law.
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     In January, FDA issued a memo addressing the issue of manufacturer communications regarding unapproved uses of approved or cleared medical products.
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Call for volunteers: MACRA Episode-Based Cost Measures Clinical Subcommittee.
AAOS seeks to nominate members to the Medicare Access and CHIP Reauthorization Act (MACRA) Episode-Based Cost Measures Clinical Subcommittee—Musculoskeletal Disease Management—Non-Spine. The objectives of the subcommittee are to advise the U.S. Centers for Medicare & Medicaid Services to refine episode triggers from the draft list of episode groups posted by the agency in December 2016, and recommend what services should be included in episode costs. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted by April 9, 2017 at 11:59 p.m. CT, to Kyle Shah, at shah@aaos.org.
Learn more and submit your application…(member login required)