April 11, 2018 | Today’s News

Report finds orthopaedists second in physician compensation, with lowest percentage of women

Medscape has released its 2018 Physician Compensation Report. The report finds the mean compensation for orthopaedic surgeons to be $497,000, second to plastic surgeons at $501,000. On average, compensation for orthopaedic surgeons increased by 2 percent over the previous year, and 51 percent of orthopaedists consider themselves fairly compensated. Overall, 76 percent of orthopaedist respondents would choose to enter the medical field again and 98 percent would choose the same specialty. However, with only 8 percent women, orthopaedics ranks last of all specialties in diversity by sex The researchers surveyed more than 20,329 U.S. physicians across 29 specialties; three percent of respondents identified themselves as orthopaedists.

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CMS final rule allows states to determine essential health insurance benefits, expands hardship exemptions for consumers

The U.S. Centers for Medicare & Medicaid Services (CMS) has issued a final rule that among other things, will allow states to define essential health benefits as described under the Affordable Care Act (ACA), give insurers more options when reporting medical loss ratios, and eliminate standardized plan options. In addition, to relieve insurers of the burden of identifying, tracking, and reporting actual expenses related to quality improvement activities, the agency will allow insurers the option of reporting a standard 0.8 percent of earned annual premium for a minimum of three consecutive years. In separate guidance, CMS plans to expand hardship exemptions for consumers so that people who live in counties with one or no exchange insurer will be exempt from paying the ACA tax penalty for not carrying insurance.

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Findings published in the April 15 issue of the Journal of the AAOS suggest that routine radiographs rarely affect management of atraumatic shoulder pain, particularly among younger patients. Members of the research team conducted a diagnostic study of 343 patients. For each patient, they considered medical history and physical examination, and developed a preliminary diagnosis and tentative treatment plan. They then considered whether additional information obtained through routine radiographs would alter the diagnosis or treatment. The researchers found that age older than 50 years and weakness in forward elevation were associated with radiographic findings. They found that routine radiographs altered the proposed diagnosis in 14.9 percent of cases, although clinical management was changed in only 1.7 percent of cases. The researchers note that plain radiographs had no effect on clinical management in 97.4 percent of patients younger than 50 years.

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According to a study published online in the journal Spine, single shot low thoracic epidural anesthesia with general anesthesia may offer improved pain control compared to general anesthesia alone for patients who undergo lumbar spine surgery. The authors conducted a randomized, controlled trial of 22 patients scheduled for elective lumbar spine surgery who were randomized to receive a single-shot epidural block with 0.25% bupivacaine plus 4 mg of morphine with a total volume of 10 ml prior to general anesthesia with desflurane and cisatracurium, or general anesthesia with desflurane, cisatracurium and any systemic analgesia deemed appropriate by the attending anesthesiologist. They found that patients who received epidural anesthesia consumed less fentanyl compared to control patients both at the postanesthesia care unit and at 24 hours postoperative. Overall, pain measured with numerical rating scale, surgical field rating score, blood loss, and complications were similar across cohorts.

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A research letter published online in the journal JAMA Internal Medicine suggests that payments to physicians from a pharmaceutical manufacturer may be associated with an increase in prescribing of that company’s products. The researchers reviewed data on oncologists from the CMS Open Payments system and the Medicare Part D Prescriber Public Use File and found that, for metastatic renal cell cancer, physicians who received any payment in 2013 had twice the likelihood of prescribing that company’s drug, and for chronic myeloid leukemia, physicians who received any general payment had 29 percent higher odds of prescribing that company’s drug.

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Call for abstracts: AAOS 2019 Annual Meeting

Share your knowledge with orthopaedic surgeons from around the world at the AAOS 2019 Annual Meeting, to be held March 12–16, 2019, in Las Vegas. Nowhere else will your discoveries reach such a wide-ranging orthopaedic audience. Please note the following deadlines:

• May 1, 2018—Applications due for instructional course lectures and symposia
• June 1, 2018—Paper presentations, posters, or scientific exhibits
• July 16, 2018—Orthopaedic Video Theater presentations

Presenters and all coauthors must disclose financial relationships in the AAOS Disclosure Database Program prior to abstract submission. Disclosure reported on April 1, 2018 or later is acceptable.

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April 13 is the last day to apply for chair of the Shoulder & Elbow Evaluation Committee. Members of the Evaluation Committees write questions for the orthopaedic self-assessment examinations. Applicants for this position must be active or emeritus fellows with extensive knowledge and experience in shoulder and elbow.

Learn more and submit your application…  (member login required)