Surgeon Voice
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Sound Off: Alan Hilibrand on Hospitals Partnering with Physicians to Run Hospitals
by Elizabeth Hofheinz, M.P.H., M.Ed., October 29, 2019 When it comes to partnering with physicians to manage hospitals, some hospitals “get it” and some don’t, says Alan Hilibrand, M.D. the Joseph and Marie Field Professor of Spinal Surgery and Professor of Orthopaedic and Neurological Surgery at the Rothman Orthopaedic Institute and the Sidney Kimmel Medical College of Thomas Jefferson University. Dr. Hilibrand states, “There is a real chance that we are close to a lifting of the moratorium on physician-owned hospitals that was instituted as part of the Affordable Care Act (ACA).” But, wonders Dr. Hilibrand, will traditional hospitals be…
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Technology Tricks Body into Healing
by Elizabeth Hofheinz, M.P.H., M.Ed., October 29, 2019 It is sometimes said that you can fool the mind, but not the body. But Wellington Hsu, M.D., the Clifford C. Raisbeck, M.D., Professor of Orthopaedic Surgery at the Northwestern Medicine Feinberg School of Medicine, is indeed aiming to trick the body. “We are in the process of developing a novel technology that can replace autograft. In conjunction with my wife, Erin L. Hsu, Ph.D., our bone biology lab, working in collaboration with biomaterial naonscientists from the Simpson Querrey Biomedical Research Center at Northwestern, is focusing on a new platform to facilitate…
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Insurers Throwing Ethical Wrench in Spine Care?
by Elizabeth Hofheinz, M.P.H., M.Ed., October 24, 2019 You spot a young man on the ground, holding his neck and writhing in pain…would you help? You would, but an insurance company wouldn’t, says one spine surgeon. “I am so sick of insurers finding any excuse to deny coverage,” he states. “They really love to say that a procedure is ‘experimental’ and are not at all clear about when exactly something reaches the point of being nonexperimental. The insurers hide behind the argument of ‘protecting patients’ from ‘experimental treatments.’” “For example, if a surgeon wants to perform a fusion for discogenic…
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50% of Total Joint Surgeons in the Dark About RUC Codes Controversy
by Elizabeth Hofheinz, M.P.H., M.Ed., October 21, 2019 For years they have participated in bundled care programs, saving millions of dollars for the healthcare system while maintaining quality…and they are the last ones to leave when the complications hit the fan. They are the hip and knee surgeons of America…and they are in trouble. James Huddleston, M.D. is an Associate Professor of Orthopaedic Surgery at Stanford University Medical Center. Dr. Huddleston, who serves as Chair of the Advocacy Council of the American Association of Hip and Knee Surgeons (AAHKS), told OSN, “There are high-volume codes that are reviewed by the…
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Excess Testing Does Not a Good Surgeon Make: Dan Riew Sounds Off
by Elizabeth Hofheinz, M.P.H., M.Ed., October 16, 2019 Daniel Riew, M.D. “There is too much unnecessary and irrelevant testing of medical students and residents,” says cervical spine surgeon, Dan Riew, M.D., director of cervical spine surgery at Columbia University in New York. “It all starts in high school where the SATs and related tests are flawed in many ways. We are likely missing out on some talented individuals because those from disadvantaged backgrounds cannot partake of expensive test prep courses. We should instead just rely on how well someone performs in school.” “Then there is the MCAT, which, in my…
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Jeff Wang, M.D. on Steering NASS
by Elizabeth Hofheinz, M.P.H., M.Ed., October 15, 2019 Jeff Wang M.D. To some, the NASS ship appeared to be going in two different directions in recent years. But Jeff Wang, M.D., the Immediate Past President of the organization, got the group back on course. Dr. Wang: “In the past, we tried to integrate the operative and nonoperative portions of NASS. Unfortunately, the fact is that we couldn’t do a perfect job of satisfying either side. Before the 2019 annual meeting a lot of surgeons said that the focus of the meeting was overly nonoperative; the nonoperative attendees said just the…
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Study: High Surgeon Satisfaction Using Patient Decision Aids
by Elizabeth Hofheinz, M.P.H., M.Ed., October 11, 2019 In examining 1,220 pre-visit and 967 post-visit surveys, a team of researchers has found that surgeons using patient decision aids (DAs) reported high satisfaction and no additional time needed to use this tool. Their work, “Decision Support Strategies for Hip and Knee Osteoarthritis: Less Is More,” appears in the September 18, 2019 edition of The Journal of Bone and Joint Surgery. But why OA? Lead author Karen Sepucha, Ph.D. is Associate Professor of Medicine at Harvard Medical School and Director of the Health Decision Sciences Center at Massachusetts General Hospital. Asked why…
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Jim Bradley, M.D. Sounds Off: EMRs Violating Sanctity of Physician-Patient Relationship
by Elizabeth Hofheinz, M.P.H., M.Ed., October 10, 2019 Hippocrates probably didn’t have to contend with an EMR. In fact, being old-fashioned, he probably actually touched his patients. And that last part—the personal touch—says Jim Bradley, M.D., president of the American Orthopaedic Society for Sports Medicine, is what we are losing. “EMR systems are burying us. We can hardly spare a few seconds to look at patients and more and more we are hearing that they miss having a personal interaction with their physicians.” Not to mention that staring at a screen all day might be detrimental to a surgeon’s eyesight.…
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Constance Chu, M.D. on Blood Tests for “Pre-Osteoarthritis” to Help Prevent OA
by Elizabeth Hofheinz, M.P.H., M.Ed., October 4, 2019 Constance Chu, M.D., professor and vice chair of Research in the Department of Orthopedic Surgery at Stanford University doesn’t “horse around” when it comes to joint preservation and osteoarthritis (OA) prevention. Dr. Chu, a Kappa Delta Award winner for her work on visualizing “pre-osteoarthritis” (‘pre-OA’) using quantitative MRI, notes that her team is now advancing the field of OA prevention with development of blood testing protocols to help provide early warning of joint ‘aging’ and increasing OA risk. Early detection system… Dr. Chu: “We have shown that quantitative MRI mapping can reveal…
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Spine Having an Identity Crisis?
by Elizabeth Hofheinz, M.P.H., M.Ed., October 1, 2019 Is the spine field being carved up? “Yes,” says one spine surgeon. “The spine community is now experiencing an identity crisis similar to that which occurred in the plastic surgery/cosmetic surgery world over a decade ago. The lines between surgeons and non-surgical providers are increasingly blurred. Patients are often unclear whether the man or woman in scrubs who they are seeing an orthopedic or neurosurgery trained surgeon or an interventional pain specialist. Both groups of doctors offer patients discectomy, decompression (laminectomy or MILD), and even place implants. The recent Boston Scientific acquisition…
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NASS Welcomes William Sullivan, M.D. as President
by Elizabeth Hofheinz, M.P.H., M.Ed., September 26, 2019 As William Sullivan, M.D., a Professor of Physical Medicine and Rehabilitation (PM&R) at Vanderbilt University, takes the helm of NASS this week, he will do so on the wings of those who have gone before him. Dr. Sullivan, also Service Chief of PM&R at the Nashville VA/Tennessee Valley Health Care System, says, “I am genuinely grateful to my predecessors who have imbued the organization with a strong sense of teamwork and forged a strong bedrock from which we can move forward.” Of teamwork, Dr. Sullivan notes, “PM&R physicians have always worked under…
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OR Pet Peeves: A Spine Surgeon Speaks
by Elizabeth Hofheinz, M.P.H., M.Ed., September 18, 2019 What bugs surgeons in the OR? We decided to ask one high-volume spine surgeon. He had a lot to say. First of all, “variability” is not a word that is often welcomed in any OR. “There is significant variability in the quality of the xray techs who participate in our surgeries. Worse, it is often totally unpredictable which xray techs participate in surgery on a given day,” says this surgeon. “So often I don’t know who my xray tech is for a given case until the moment I walk in the OR.…
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The TBI Gait Lab: Making the Subjective, Objective
by Elizabeth Hofheinz, M.P.H., M.Ed., September 18, 2019 How much is, “I can bend my leg more” in concrete terms? What does, “I am a lot steadier on my feet” look like in scientific terms? Richard Guyer, M.D., Chairman, Texas Back Institute Research Foundation knows. Working with Ram Haddas, Ph.D., Director of the Spine Biomechanics Lab at Texas Back Institute, they are transforming what is traditionally a subjective arena into a dynamic one that yields objective information. Dr. Guyer told OSN, “This facility, the first U.S. spine-related human movement biomechanics lab within a private spine practice, is capable of delivering…
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50% of Revisions are Unnecessary
By Elizabeth Hofheinz, M.P.H., M.Ed., September 12, 2019 “If you look at the number of hip and knee revisions we do in this country and examine why they need to be done, then you will see that more than half of them are completely preventable,” says one high-volume hip and knee surgeon. “Had the initial surgeries been done properly the second procedures would have been completely unnecessary.” “The literature indicates that the most prevalent reasons for revisions are dislocations, infections, and fractures. And while you can’t do much to get below that national average of 1% infection rate, the other…
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OrthoCarolina Surgeons Establish First Dedicated Joint Infection Center in the U.S.
by Elizabeth Hofheinz, M.P.H., M.Ed., September 12, 2019 Every patient needs and deserves an empathic physician, especially during periods of extreme stress. As fate would have it, patients often find the best listener in a physician who has walked a similar path. Such is the case with Thomas Fehring, M.D., Co-Director of the OrthoCarolina Hip & Knee Center in Charlotte, North Carolina. At one point, Dr. Fehring, a former President of The Knee Society and the American Association of Hip and Knee Surgeons, had to undergo a two-stage knee procedure to clear an infection that had been present since his…
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