Orthopaedists and industry: Working together—at arm’s length

Mary Ann Porucznik

One year later, uncertainty continues This time last year, the orthopaedic industry was struggling to respond to the terms of a settlement reached by the US Attorney’s office for New Jersey (Department of Justice, DOJ) with five major orthopaedic hip and knee manufacturers. The settlements appear to have permanently altered the relationships between orthopaedic surgeons and industry. They continue to have a ripple effect in education funding, research, clinical care, and humanitarian efforts.

Preparing to close your practice

Frank M. Griffin, MD

There’s lots of work to do before you retire According to the last AAOS census (2006), more than half of all orthopaedic surgeons in practice today are older than age 50. Although many of these surgeons may continue in practice for several more years, concerns about decreasing reimbursements and increasing practice and liability insurance costs may cause others to consider cutting back on their practices or retiring at an early age.

Cornerstones of effective governance: Values and ethics

Marty Krawczyk

Basing decisions on ethical values is good business The word “governance” became a common business buzz word following the headline-making corporate scandals of companies such as Enron and WorldCom. The Sarbanes-Oxley Act of 2002 aimed to prevent the recurrence of such white-collar crimes through strict corporate governance guidelines that hold management, boards, and accounting firms accountable for the reporting of financial information.

Metrics, benchmarks add value to your practice

William R. Pupkis, CMPE

Your practice can become a “Better Performing Practice” For nearly a decade, the Medical Group Management Association (MGMA) has designated “Better Performing Practices,” based on a series of benchmarks and metrics. Capital Region Orthopaedics, where I serve as the chief executive officer, has earned the “Better Performing Practice” distinction from the MGMA in each of the last 6 years. Significant effort is required to earn this distinction.

Physician extenders: PAs, NPs, and…athletic trainers?

Carolyn Rogers

Athletic trainers moving from the sidelines to the doctor’s office These days, you’re just as likely to find an athletic trainer (AT) in an orthopaedic exam room—taking a patient’s history or applying a cast—as in a sweaty locker room. With a growing number of orthopaedic surgeons seeking to enhance their practices through physician extenders, certified athletic trainers are stepping up to the plate.

Are you spending too much on supplies?

Steven E. Fisher, MBA

By Steven E. Fisher, MBA AAOS Group Purchasing Program announces new price reductions How much is your practice currently spending on medical, pharmaceutical, and office supplies? What if you could get those same supplies—but for even lower prices than you’re currently paying? Wouldn’t that be a boost for your bottom line?

Nuts and bolts of e-prescribing

Jackie Ryan, MPA

Government initiatives are encouraging adoption of eRX solutions Outside of surgical intervention, the physician’s most frequently used, efficacious, and potentially dangerous therapeutic tool is a prescription for medication. In 2007 alone, more than 4.5 billion prescriptions were written—literally.

Red flag regulations effective Nov. 1

Marty Krawczyk

On Nov. 1, 2008, new rules and guidelines intended to detect, prevent, and mitigate identity theft go into effect. These “red flag rules” focus on implementing technologic and procedural frameworks to support fraud detection and prevention. The financial arrangements inherent in the physician/patient relationship would classify medical practices as creditors and subject to the rules.

Medical liability in the developing world

Douglas W. Lundy, MD, FACS

Increasingly, the specter of medical liability threatens humanitarian missions Humanitarian missions to developing nations are both personally and professionally rewarding. Whether through secular or faith-based organizations, physicians perform a noble service in caring for the poor in countries with few doctors and scarce resources.

Medical peer review and risk management

S. Jay Jayasankar, MD

Risk management aims to lessen the likelihood of harm materializing from hazards. The goal of medical peer review is to improve quality and patient safety by learning from past performance, errors, and near misses. Thus, medical peer review is a risk management tool. In a 2006 survey, however, nearly a quarter of the responding Massachusetts physicians said that they would be afraid to refer a colleague for peer review, and a third admitted to fearing referral for peer review.