Today’s Top Story
Study: Older lumbar spinal surgery patients may be at increased risk of complication; readmission.
Findings published online in The Spine Journal suggest that elderly patients who undergo lumbar spinal surgery may be at increased risk of complication and readmission. The researchers conducted a retrospective cohort study of 2,320 patients older than 80 years who underwent lumbar spine surgery. They found that 379 (16.34 percent) patients experienced at least one complication or death. Overall, 75 (3.23 percent) experienced a major complication, 338 (14.57 percent) experienced a minor complication, 86 (6.39 percent) patients were readmitted to the hospital within 30 days, and 10 (0.43 percent) deaths were recorded in the initial 30 days postoperative. The researchers noted that increased surgical times, and instrumentation and/or fusion procedures were associated with increased risk of complication. In addition, they found that patients considered underweight (body mass index <18.5) or who were functionally debilitated at time of admission were at increased risk of readmission. Read the abstract…

Other News

Study: Allowing patients to enter pre-visits agenda into the EHR may help improve communication.
A pilot study of patients suggests visiting a safety net clinic suggests that letting patients type pre-visit agendas into electronic health records (EHRs) prior to seeing the physician improve efficiency and communication. The authors conducted post-visit surveys of 101 patients and 28 clinicians and found that 79 percent of patients and 74 percent of clinicians agreed that the agendas improved patient-clinician communication. In addition, 73 percent of patients and 82 percent of clinicians stated that they would prefer to continue having patients type the agendas in the future. The study was published online in the journal Annals of Family Medicine. Read more…
Read the abstract…

Could a faster FDA approval process harm patient safety?
An article in The Boston Globe cites concerns that expediting the U.S. Food and Drug Administration (FDA) review process could negatively affect patient safety. A recent report in The New England Journal of Medicine stated that FDA has approved more drugs than European regulators in recent years, and has, on average, done so 2 to 3 months faster. The writer notes that in 1992 the agency committed itself to completing standard drug reviews in 10 months and priority reviews within 6 months. A spokesperson from Brigham and Women’s Hospital in Boston says, “There’s no evidence the FDA is a bottleneck.” However, the current nominee for FDA administrator calls a choice between speed and safety in the approval process a “false dichotomy.” Read more…

Study: Hospital-employed physicians may be more likely to call for low-value scans.
A study of primary care published online in the journal JAMA Internal Medicine suggests that hospital employment of physicians may be associated with increased use of low-value imaging and increased specialty referrals. The research team reviewed data on 31,162 patient visits for upper respiratory tract infection, back pain, and headache, from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. Compared with visits to community-based physicians, they found that hospital-based visits were associated with higher likelihood of orders for computed tomography and magnetic resonance imaging, radiographs, and specialty referrals. With the exception of specialty referrals, which were more frequent in hospital-owned community-based practices, the research team found that practice patterns were similar across hospital-owned and physician-owned community-based practices. Read more…
Read the abstract…

CMS webinars to answer questions about Physician Compare and other programs.
The U.S. Centers for Medicare & Medicaid Services (CMS) is sponsoring two webinars to discuss the upcoming publication of the Achievable Benchmark of Care and 5-star ratings on the Medicare Physician Compare website. Webinar participants will also have the opportunity to ask questions. The webinars will take place at the following times:

  • Tuesday, April 25, 2017, 11:00 a.m. ET
  • Thursday, April 27, 2017, 3:00 p.m. ET

Register for the April 25 session…
Register for the April 27 session…

Pennsylvania.
The Republican Herald reports that a bill under consideration in the Pennsylvania State Senate would, if enacted, increase the autonomy of nurse practitioners. Supporters of the legislation state that it would improve patient care and access to care by increasing the pool of qualified caregivers. Opponents say that allowing nurse practitioners to practice independently without physician collaboration is an inappropriate approach to address physician shortages. Read more…

Last call: Program Committees.
April 14 is the last day to submit your application for a position on a Program Committee. Members of Program Committees grade symposia in May and abstracts in June and July, and may serve as moderators for paper session at the AAOS Annual Meeting. The following positions are open:

  • Foot & Ankle (one member)
  • Hand & Wrist (one member)
  • Practice Management/Rehabilitation (four members)
  • Spine (four members)
  • Sports Medicine/Arthroscopy (one member)

Applicants for these positions must be active fellows or international members with a practice emphasis in the relevant topic. Learn more and submit your application…(member login required)