Making the Case for Orthopaedic Procedures

Madeleine Lovette

The explosive growth in the number of costly orthopaedic procedures—including joint replacements, back surgeries, and other treatments—has attracted the attention of legislators, payers, employers, and experts in both health care and economics. Without scientific evidence to support the effectiveness of these procedures, many of these critics are beginning to ask questions.

Changes in reporting wound débridement—2

Mary LeGrand, RN, MA, CCS-P, CPC

Last month, AAOS Now reported on the changes made to the Integumentary System section of CPT 2011 in the reporting of wound care services. This month’s column reviews changes in the same section regarding skin repair (closure) and replacement. Guideline changes Specific guideline clarifications and changes were made to the complex repair and débridement services.

Running a business that cares for patients

Book Review This discussion about the business of running a medical practice, combined with the author’s personal philosophy of service excellence in patient care, could easily be titled “Business 101 & My Practice Model.” The author—Michael Harris, MD—is a colorectal surgeon at Mt. Sinai School of Medicine and physician manager of a “45-surgeon faculty practice.”

Benchmarking physical therapy programs

Cary B. Edgar

Use benchmarking to gauge and improve provider productivity and program profitability A successful physical therapy (PT) program requires effective management of multiple functions, including maintaining an appropriate level of provider productivity, minimizing patient cancellations and no shows, capturing all appropriate charges, effectively using support staff, and consistently collecting all payments due.

Adding physical therapy to your practice

Michael Q. Freehill, MD; William Evans, MBA

Physical therapy (PT) and occupational therapy (OT) are crucial to successful outcomes for patients with musculoskeletal problems, and many excellent reasons exist to develop in-house PT/OT. However, the success of physician-owned physical therapy services (POPTS) is not a foregone conclusion. There is an array of operational, financial and political pitfalls.

Four principles of “never events”

Leah Binder

Phrase coined by The Leapfrog Group must become a reality Lewis Blackman, an energetic and promising 15-year-old from South Carolina, underwent surgery to correct a common congenital deformity in his chest. The surgery was successful, but during his postoperative care, Lewis experienced an adverse reaction to an anti-inflammatory drug. Despite pleadings from his mother and obvious signs of deterioration, Lewis’ caregivers did not change his medication.

Update on “never events”

David H. Sohn, JD, MD

Recent legal proceedings relieve fears of “strict liability” with never events When the Centers for Medicare & Medicaid Services (CMS) initiated its project on “never events,” few imagined that it would lead to increased risk exposure for physicians.

Standard of care: A trap for the unwary?

By Brian G. McConaty, Esq. When physicians use or adopt the term “standard of care” in the context of a medical negligence case, they unwittingly play into the hands of the plaintiff’s attorney and undermine the defense. Unfortunately, the singular grammatical nature of “standard of care” implies that only one way to approach a medical problem exists, which is usually not the case.