Today’s Top Story
Study: Surgical and nonsurgical interventions produce similar long-term outcomes for lumbar disk herniation.
A study published in Clinical Orthopaedic and Related Research reports similar outcomes for surgical and nonsurgical treatment of intervertebral disk herniation and symptomatic radiculopathy at 8-year follow-up. The study involved patients from the Spine Patient Outcomes Research Trial with symptomatic lumbar radiculopathy lasting at least 6 weeks and associated with a clinical diagnosis of nerve root irritation or neurologic deficit and imaging-confirmed disk herniation. Consenting patients were randomized to either surgical diskectomy (n = 245) or nonsurgical treatment (n = 256). At 8-year follow-up, 145 patients (60 percent) randomized to surgery had undergone surgery; 122 patients (48 percent) randomized to nonsurgical treatment had undergone surgery. The intent-to-treat analysis of the randomized cohort showed no difference in SF-36 bodily pain, SF-36 physical function, and Oswestry Disability Index between the surgical and nonsurgical treatment groups. Read the study…

Other News

AAOS urges support for bill exempting meaningful use penalties.
The American Association of Orthopaedic Surgeons is calling on members to contact their representatives in Congress to ask them to become cosponsors of the Meaningful Use (MU) Hardship Relief Act of 2015. The bill, which was introduced by Rep. Tom Price, MD (R-Ga.), would enact a blanket exception from the application of MU penalties for the 2015 electronic health record (EHR) reporting period. According to the AAOS, the bill recognizes that the delayed release of changes to Stage 2 of the MU program by the Centers for Medicare & Medicaid Services “makes it impossible for physicians to meet the new criteria and creates undue hardships” on physicians as they strive to provide high-quality care. Thomas C. Barber, MD, chair of the AAOS Council on Advocacy also expressed disappointment that CMS did not delay rulemaking for MU Stage 3, “so that it would better align with the Merit-based Incentive Payment System.” The AAOS notes that currently fewer than 20 percent of physicians meet MU Stage 2 attestation. Read more…
Click to contact your Congress member…

American College of Radiology releases evidence-based guideline updates.
A newly issued set of Appropriateness Criteria from the American College of Radiology (ACR) provides guidance on imaging, radiological intervention, and radiation therapy for more than 1,050 indications. The criteria include updates of 19 topics and the following additional topics: suspected pulmonary arteriovenous malformation, nasopharyngeal carcinoma, and adjuvant therapy in vulvar cancer. The guidelines, developed by physicians in a number of specialties, can be used via the ACR Select platform, which can be integrated with electronic health record systems. Read more…

Study: Opioid addiction in women frequently begins with prescription painkillers.
Legally prescribed painkillers were the gateway to opioid addiction for more than half of female patients in methadone clinics in Canada, Newswise reports. The study, published in the journal Biology of Sex Differences, involved 503 patients attending Ontario methadone clinics. More than half (52 percent) of women and more than a third (38 percent) of men reported prescribed painkillers as their first contact with opioid drugs including OxyContin and codeine, as well as illicit drugs like heroin. The reasons that women are disproportionately affected by opioid dependence originating from prescription painkillers are not clear but according to the study’s lead author, one reason may be that women are more likely than men to seek medical care. According to the World Health Organization, Canada consumes more opioid painkillers (mg/capita) than any other country, in part due to its heavy reliance on hydromorphone. Read more…

Florida.
This week, Florida’s healthcare and hospital commission met for the first time since Gov. Rick Scott identified allegations of hospital price gouging as an area of focus for the commission, the Naples Daily News reported. During the meeting at Florida Gulf Coast University, a Naples, Fla., resident asked the commission how his son’s visit to an emergency department, radiographs, and a visit to an orthopaedic surgeon’s office the following day for a cast could add up to three bills totaling $5,000. A commission member who is also a surgeon attempted to explain the complexity of medical billing codes as well as the negotiated rates for the amounts insurance companies pay for services. Thus far, 100 Florida residents have submitted their stories related to hospital pricing to the commission’s website, with hospital names and personal data redacted. Read more…

Colorado.
On Monday, Colorado Secretary of State Wayne Williams announced that Colorado residents will vote next year on whether to establish the country’s first statewide universal healthcare system. The “ColoradoCare” campaign has submitted more than enough signatures to qualify for the 2016 ballot, according to a random sampling completed by Mr. Williams’ office. Amendment 69 aims to eliminate all of the existing health insurance plans currently being sold in Colorado and replace them with the plan offered by a state-chartered organization to be funded by a 10 percent payroll deduction per employee. Supporters assert that the program would save roughly $5 billion on healthcare spending by doing away with administrative expenses associated with the insurance industry, which would be eliminated in the state, and by making it possible to negotiate bulk rates for pharmaceuticals. Read more…

Call for volunteers: Central Evaluation Committee.
Nov. 30 is the last day to submit your application for a position on the Central Evaluation Committee. Members of this committee write questions for the Orthopaedic In-Training Examination annually and for the Orthopaedic Self-Assessment Examination triennially. The following openings are available:

  • Oncology (one member)
  • Pediatric Orthopaedics (one member)
  • Trauma (one member)

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