Today’s Top Story
Study: Experienced orthopaedic surgeons may be best choice to assess traumatic anterior shoulder instability–related lesions on MRAs.
Data from a study published in the September issue of the Journal of Shoulder and Elbow Surgery suggest that experienced orthopaedic surgeons may be more accurate than radiologists in assessing traumatic anterior shoulder instability–related lesions on magnetic resonance arthrograms (MRAs). The researchers had 45 surgically confirmed MRAs assessed by four radiologists, four orthopaedic surgeons, two radiologic teams, and two orthopaedic teams across two medical centers. They found no significant difference in diagnostic accuracy between cohorts of radiologists and orthopaedists. However, at each center, the most experienced orthopaedic surgeon was more accurate than others in diagnosing lesion type, and in three of four cases, the difference was significant. Read the abstract…
Other News
Study: Prescribing patterns of attending physicians may influence younger residents.
According to a study published in the July issue of the Journal of General Internal Medicine, the prescribing of brand-name medications by attending physicians may have a significant influence on prescribing patterns of PGY-1 residents, but such influence may wane over time. The authors conducted a retrospective review of statin prescriptions by 342 residents and 58 attending physicians at two internal medicine residency programs. They found that the brand-name prescribing rate of supervising attending physicians in the quarter preceding the encounter was positively associated with the prescribing of brand-name statins by PGY-1 residents, but not for PGY-2 or PGY-3 residents. However, a higher PGY level was associated with an increase in brand-name prescribing overall. Read more…
Read the abstract…
Study: Similar outcomes for patients treated with hemiarthroplasty or arthrodesis for advanced OA of the first metatarsophalangeal joint.
Findings from a study published online in The Journal of Foot & Ankle Surgery suggest similar outcomes using hemiarthroplasty or arthrodesis for patients who are surgically treated for advanced osteoarthritis (OA) of the first metatarsophalangeal joint. The research team evaluated outcomes for 58 primary arthrodesis patients and 36 hemiarthroplasty patients. At mean 4-year follow-up (range 1 to 7 years), they found that the average American Orthopaedic Foot and Ankle Society hallux metatarsophalangeal interphalangeal scale score was 77.5 in the arthrodesis group and 77.8 in the arthroplasty group, with no difference in the rate of revision between cohorts. However, the research team noted that patients who were treated with hemiarthroplasty reported greater mean satisfaction than those in the arthrodesis group. Read the abstract…
Communication and resolution models may reduce likelihood of legal action, but many hospitals slow to take that approach.
An article published in Modern Healthcare looks at institutional policies regarding actions after medical errors. The writer notes that survey data suggest that patients and family members are more likely to pursue legal action when they experience a lack of accountability, disrespect, or poor communication from providers. “In recent years,” she writes, “a few hospitals have developed nontraditional communication-and-resolution models that allow physicians and hospital officials to immediately apologize, investigate, and quickly offer financial compensation if a medical mistake has been made. Such initiatives have led to improved transparency and better physician-patient relationships, as well as significant reductions in the frequency of malpractice claims and the amount facilities spend on patient compensation.” However, she notes that such polices require a culture shift that may slow their adoption in many facilities. Read more…(registration may be required)
Study: Rural Medicare beneficiaries may experience lower-quality post-discharge care.
According to data from a study published in the September issue of the journal Medical Care, Medicare patients in rural settings are likely to receive lower quality post-discharge care compared to those who live in more densely populated areas. The researchers conducted a retrospective analysis of elderly Medicare beneficiaries discharged to home between 2000 and 2010. They found that beneficiaries in both large and small rural settings had a greater risk of emergency department visits and readmission compared with urban beneficiaries. Read more…
Read the abstract…
Florida.
Findings from a study published online in the journal JAMA Internal Medicine suggest that implementation of two Florida laws may have been associated with modest reductions in opioid prescribing and use. The research team conducted comparative interrupted time-series analyses to characterize the effects of the state’s Prescription Drug Monitoring Program (PDMP) and pill mill laws. They found that implementation of the laws was associated with statistically significant declines in opioid volume and morphine milligram equivalent (MME) per transaction, without any change in days’ supply. At 12 months after the laws took effect, there was an approximately 1.4 percent decrease in opioid prescriptions, 2.5 percent decrease in opioid volume, and 5.6 percent decrease in MME per transaction. Read more…
Read the abstract…
Massachusetts.
An article in The Boston Globe looks at the efforts of one Massachusetts hospital to teach empathy to physicians. Under the initiative, healthcare providers view videos that contrast higher-stress scenarios with those that demonstrate improved physician empathy. The writer notes that high physician empathy has been linked to a decrease in medical liability claims. Read more…
Call for volunteers: Patient Safety Committee.
Aug. 21 is the last day to submit your application for a position on the Patient Safety Committee (three member openings). The Patient Safety Committee organizes and directs Academy initiatives and programs designed to promote orthopaedic patient safety. Applicants for this position must be active fellows with an interest, knowledge, and clinical experience with spine or adult reconstruction in relation to patient safety issues and musculoskeletal infections and infectious disease. Learn more and submit your application…(member login required)
