DOJ settles with device makers

As this issue of AAOS Now went to press, the Department of Justice announced a settlement had been reached with five major device makers in a investigation exploring the companies’ relationships with orthopaedic surgeons. Under the settlement, four companies (Zimmer, Inc., DePuy Orthopedics, Biomet Orthopedics, and Smith & Nephew) will pay fines totaling $311 million. Stryker Orthopedics, Inc. was not fined, but will be subject to the same federal oversight and required reforms as the others.

Negotiating your orthopaedic employment contract

Stephen P. Makk, MD, MBA

Make sure you can live with the details One of the most important documents orthopaedic surgeons encounter in their professional lives is their employment contract with an orthopaedic group. The contract is just as important for surgeons entering practice as it is for surgeons switching practices midcareer. It’s no less important than a prenuptial agreement or your last will and testament.

Medical liability in cyberspace

David E. Attarian, MD

The use of computers and the Internet in health care has exploded over the past decade, producing efficiencies and improvements in communication, patient education, medical records, billing, resource allocation, and access to subspecialty care. Concomitantly, the physician employing these tools in professional practice has been exposed to novel medical-legal risks and liability that did not exist a generation ago.

Preparing for an expert witness deposition

Kathleen Delaney

If you are called upon, follow the Boy Scout motto and “be prepared.” Although most medical liability lawsuits are settled before they reach trial, settlements are often reached after expert witnesses are deposed by opposing counsel. A deposition is often viewed as the proving ground for lawsuits. Whether you are providing expert witness testimony in defense of another physician or on behalf of a plaintiff, being prepared is your best defense.

Support builds ‘bridge over troubled waters’ during lawsuits

Annie Hayashi

Two orthopaedic surgeons who have navigated their own rugged seas offer help to others “I can distinctly remember the sheriff’s deputy walking into my office and serving me with papers. I had no idea what it meant at the time,” says Glen Shapiro, MD. “I had nearly 10 years in practice and I had never been sued before. It was a huge shock.”

Pearls and pitfalls with proximal third tibial fractures

Douglas W. Lundy, MD, FACS; Robert P. Dunbar Jr., MD

Seven suggestions for avoiding potential complications Last month (AAOS Now, September 2007), we discussed pearls and pitfalls in the treatment of tibial plateau fractures. This month, the focus is on proximal third tibial fractures, such as the one depicted in Figure 1. This fracture of the proximal tibial metadiaphysis had been nailed 6 months previously. The patient had obvious angulation of the leg, a limb-length discrepancy, and significant pain with ambulation.

The emotional effects of medical errors on physicians

Physicians—particularly surgeons—hold themselves to high standards of excellence, reports the August 2007 issue of The Joint Commission Journal on Quality and Patient Safety. As a result, medical errors produce high levels of stress, anxiety, and sleep loss in most doctors, according to the results of a survey of more than 3,000 physicians in the United States and Canada.

Tips for marketing your orthopaedic practice

Thomas J. Grogan, MD

Whether you are in an academic setting, a group practice, or a solo practitioner, setting goals and developing realistic strategies will help your practice grow Marketing is the ability to promote your skills as an orthopaedic surgeon to a target group, aimed at improving the financial health of your practice.

Make documentation problems history

Margaret M. Maley BSN, MS

An easy guide to documenting the history of present illness Unfortunately, few orthopaedic surgeons enjoy learning how to code evaluation and management (E&M) services. A significant portion of practice revenues, however, can be attributed to E&M services. Neglecting the proper documentation and coding of these encounters is a common and costly mistake. Each patient encounter (e.g.

AAOS, AMA conducting physician practice information survey

The AAOS, the American Medical Association (AMA), and more than 70 other medical specialty societies are working on a comprehensive multispecialty survey of America’s physician practices. The Gallup Organization will conduct the Physician Practice Information survey among a representative sample of practices in each of the participating specialties.