Today’s Top Story
Study: Smoking may increase risk of complication after THA and TKA.
Data from a study published in the July 1 issue of The Journal of Bone & Joint Surgery suggest that tobacco smoking may be linked to increased risk of complication following total hip or total knee arthroplasty (THA or TKA). The authors drew data on 78,191 THA or TKA patients from the American College of Surgeons National Surgical Quality Improvement Program database. Of those, 63,971 (81.8 percent) were nonsmokers, 6,158 (7.9 percent) were former smokers, and 8,062 (10.3 percent) were current smokers. The authors found that current smokers were at increased risk of wound complications, particularly deep wound infection, while both current smokers and former smokers were at increased total complication risk. In addition, an increased pack-year history of smoking was associated with an increased total complication risk. Read the abstract…

Other News

Two studies examine risks to patients associated with resident training.
A pair of recently published studies look at the effect of resident training on patients. In the first, published in the Journal of the American College of Surgeons, researchers examined patient risk across five surgical specialties, including orthopaedic surgery, before and after the 2011 implementation of Accreditation Council for Graduate Medical Education resident duty hour reforms. They found “no significant associations between duty hour reform and the composite outcome of death or serious morbidity in the two years post-reform for any surgical specialty evaluated.” Read more…
Read the abstract…
     In the second study, published in the Journal of Neurosurgery, researchers reviewed data on 16,098 patients who underwent elective or emergent neurosurgical procedures and found that patients whose procedures were performed with the participation of a resident were at increased risk of mortality and morbidity. However, after adjustment for comorbidity, the researchers found that resident participation was not an independent risk factor for postoperative 30-day morbidity or mortality. Read more…
Read the abstract…

Study: Provider consolidation drives up pay, but could have long-term downside.
A study published in the June issue of the journal Health Affairs suggests that market consolidation among physician groups may increase healthcare costs. The research team reviewed claims data on TKA procedures over a 10-year period and found that, among markets that moved from the bottom quartile of concentration to the top quartile, physician fees paid by private payers increased by $168 per procedure. An article in HealthLeaders Media examines data from the study and argues that such an increase in costs, although beneficial to physicians in the short-term, could negatively affect them in the long-term, as increasing cost-sharing drives consumers to seek lower-priced alternatives. Read the abstract…
Read the article in HealthLeaders Media…

Study: Many physicians and advanced clinicians work through illness, despite risk to patients.
According to a study published online in the journal JAMA Pediatrics, many physicians and advanced practice clinicians (APCs) work while sick. The authors performed a mixed-methods analysis of a cross-sectional, anonymous survey of 280 attending physicians and 256 APCs. Although 504 respondents (95.3 percent) agreed that working while sick increased patient risk, 446 (83.1 percent) reported doing so at least once during the previous year. Respondents worked through symptoms such as diarrhea (30.0 percent), fever (16.0 percent), and acute onset of significant respiratory symptoms (55.6 percent). Reasons cited for working while sick included not wanting to let colleagues down (98.7 percent), staffing concerns (94.9 percent), not wanting to let patients down (92.5 percent), fear of ostracism by colleagues (64.0 percent), and concern about continuity of care (63.8 percent). The authors also noted ambiguity among some providers regarding the definition of “too sick to work.” Read more…
Read the complete study…

Massachusetts.
HealthLeaders Media reports that a bill under consideration in the Massachusetts Senate would, if enacted, limit payments made to hospitals by private insurers to no more than 20 percent higher or 10 percent lower than the average payment for similar settings. The proposed law includes exemptions for certain isolated specialty and acute care hospitals. Supporters say that the bill will reduce payment discrepancies with the intent of stabilizing communities and certain “anchor institutions.” Critics argue that the intended solution to payment discrepancies is “overly simplistic,” and suggest that the bill’s flawed approach could potentially “destabilize the healthcare system” in the commonwealth. Read more…
Read the bill…

Act now to nominate future AAOS leadership!
The 2016 Nominating Committee is actively soliciting your suggestions for individuals to serve in the following positions:

  • Second Vice President
  • Treasurer
  • Member-at-Large [Age 45 or Older] (age 45 or older on March 3, 2016)
  • Member-at-Large [Under Age 45] (younger than age 45 on March 3, 2016)
  • National Membership Committee Member
  • Nominees to the American Board of Orthopaedic Surgery (ABOS)

Nominations will close on Friday, Aug. 14. Please submit nominations to John R. Tongue, MD, chair, 2016 Nominating Committee, c/o AAOS Office of General Counsel, 9400 West Higgins Road, Rosemont, IL 60018, or online at: http://www.aaos.org/nominations