Today’s Top Story
Study data suggest widespread issues with patient storage, disposal, and sharing of opioids.
A research letter published online in the journal JAMA Internal Medicine finds that patients who are prescribed opioids often keep extra pills after completing treatment, and many of those patients report sharing their prescription with another person. The research team surveyed 1,032 individuals who had used opioids within the previous year. Overall, 20.7 percent of those surveyed reported having shared opioid medications with another person, with 73.0 percent reporting they did so to help the other person manage pain. At the time of the survey, 440 respondents (46.7 percent) were still using opioids, and 57.2 percent had or expected to have leftover medication. Among those with leftover opioid medications, 61.3 percent reported keeping them for future use. Further, 48.7 percent of respondents did not recall receiving information on safe storage, and 45.3 percent did not recall receiving information on proper disposal.
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Other News

Supreme Court ruling could pave the way for more False Claims Act cases.
The U.S. Supreme Court has issued a unanimous decision that may allow a legal theory known as “implied certification” to increase the number of False Claims Act cases filed against healthcare providers. The False Claims Act imposes liability on entities that defraud governmental programs. As reported in Modern Healthcare, a Medicaid patient received psychiatric care at a counseling service and later died due to an adverse drug interaction. It was later discovered that the counseling service had few clinicians who were licensed to provide mental health care, and little supervision of unlicensed staff, who counseled patients and wrote prescriptions in violation of federal and state standards. The Supreme Court remanded the case back to the appeals court, but the ruling gives credence to the implied certification theory, suggesting that hospitals and other healthcare organizations could be liable under False Claims Act penalties if they violate some Medicare and Medicaid rules not related to conditions of payment.
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Study: Surgical treatment of acute Achilles tendon rupture linked to improved recovery of calf muscle strength compared to nonsurgical treatment.
A study published online in The American Journal of Sports Medicine compares outcomes of surgical and nonsurgical treatment of acute Achilles tendon rupture. The authors conducted a randomized, controlled trial of 60 patients with acute Achilles tendon rupture treated nonsurgically with 1 week of cast immobilization, followed by a functional orthosis for 6 weeks, with full weightbearing after 1 week and active plantar flexion after 5 weeks; or surgically, via simple end-to-end open repair, followed by a postoperative regimen identical to nonsurgical treatment. At 18-month follow-up, they found that the mean Leppilahti score was 79.5 in the surgical cohort and 75.7 in the nonsurgical cohort. Overall, angle-specific peak torque results of affected legs demonstrated that surgery was associated with faster and better recovery of calf muscle strength over the entire range of motion of the ankle joint compared to nonsurgical treatment. In addition, the RAND 36-Item Health Survey indicated better results in the domains of physical functioning and bodily pain for surgical patients.
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Survey: Employed and self-employed physicians report similar levels of career satisfaction.
A survey of employed and self-employed physicians conducted by Medscape finds similar levels of career satisfaction in both groups. The researchers surveyed 3,960 employed physicians and 1,027 self-employed physicians across specialties. They found that 72 percent of employed physicians and 73 percent of self-employed physicians described themselves as satisfied with their careers. Other findings include:

  • 65 percent of employed physicians say their institutions put patient outcomes before financial interests; 14 percent disagree
  • 85 percent of physicians overall say that quality of patient care is “good” or “very good” in their setting
  • Identical levels (81 percent) of employed and self-employed physicians feel a sense of pride and accomplishment in their work
  • 54 percent of employed physicians say their work-life balance improved after they left private practice, while 19 percent say it became worse

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The Pittsburgh Post-Gazette reports that medical liability jury verdicts hit a 15-year low in Pennsylvania during 2015. The paper notes that in 2004, juries issued verdicts in 449 medical liability cases, with 78.4 percent of those verdicts in favor of the defendant; in 2015, there were 101 verdicts, with 78.2 percent favoring the defendant. The Physician Insurers Association of America notes that verdict cases represent less than 9 percent of resolutions in medical liability cases, with the majority dropped or dismissed.
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Young investigators: Apply now to participate in USBJI career development and grant mentoring program.
The United States Bone and Joint Initiative (USBJI) has developed a grant mentoring program to provide early-career investigators an opportunity to work with experienced researchers to develop skills required to pursue an academic career. The program is open to promising junior faculty, senior fellows, or post-doctoral researchers nominated by their department or division chairs, as well as to senior fellows or residents who are conducting research and have a faculty appointment in place or confirmed. Basic and clinical investigators, with or without training awards (including K awards) are invited to apply. Investigators selected to take part in the program attend two workshops, 12 to 18 months apart, and work with faculty between workshops to develop their grant applications. The next workshop is scheduled to take place Nov. 4 to 6, 2016, in Toronto, Ont. This program is unique in that it provides attendees the opportunity to maintain a relationship with a mentor until their applications are funded. The deadline to apply for the fall 2016 workshop is July 15, 2016.
Learn more and submit your application…

Call for volunteers: OLC Board of Directors.
July 15 is the last day to submit your application for a position on the Orthopaedic Learning Center (OLC) Board of Directors. Members of this board provide governance for strategic planning and oversight for the OLC. Applicants for this position must be active fellows with experience conducting surgical skills courses at the OLC.
Learn more and submit your application…(member login required)