Orthopaedists Respond

The Atlantic hurricane season has been unusually intense this year, spawning five major hurricanes. Hurricanes Harvey, Irma, and Maria, in particular, were especially destructive due to their intensity, duration, and sheer physical size. Although so many different geographic regions were severely impacted by devastating winds and flooding, the hurricanes did not cause high numbers of musculoskeletal injuries.

Las Vegas Crisis: Preparation Saves Lives

On Oct. 1, 2017, 59 people were killed and nearly 500 more were injured at a Las Vegas concert in what is classified as the deadliest mass shooting in U.S. history. The tragic event tested the resolve and capacity of the entire healthcare community in Las Vegas. Fortunately, the medical system had prepared for a chaotic, mass-casualty event, and was able to respond to the Route 91 Harvest Festival shooting with an organized, coordinated effort.

What OPUS Reveals About Practice Settings and Productivity

John Cherf, MD, MPH, MBA; Angela Buckley, MPA

Editor's note: This article is the final installment of a three-part series that summarizes the results of the biennial orthopaedic census. Previous articles include "Orthopaedic Practice in the United States" (AAOS Now, July 2017) and "Census Examines Orthopaedic Workforce Trends" (AAOS Now, August 2017). Since 1985, 16 surveys on Orthopaedic Practice in the United States (OPUS) have been conducted. Also known as the Census Survey, OPUS gathers demographics and practice data of U.

Bundled Payments: Early Lessons from NYU

Terry Stanton

The payment model for healthcare services is shifting, spurred in no small part by the federal government. In 2015, the U.S. Department of Health and Human Services set a goal of providing 30 percent of Medicare payments through an alternative payment model by the end of 2016. That goal was met by March 2016.

Dispensing DME in Orthopaedics for Medicare

Sarah Wiskerchen, MBA, CPC

Orthopaedic practices often provide patients with supplies, such as casts and canes, integral to patients' treatment plans. This article covers the essentials of coding and claims submission. Understanding the definitions and rules for DME can help practices make more effective decisions on which supplies to offer patients as well as help them ensure that items are both accurately reported and appropriately paid. The article also focuses on Medicare policy, which applies nationally.

How to Prepare for the American Board of Orthopaedic Surgery Exam

David Hamilton, MD

Taking the American Board of Orthopaedic Surgery board examination can be an intimidating experience for orthopaedic surgery residents. Recently, David Hamilton, MD, a PGY-5 resident at the University of Kentucky, spoke on behalf of AAOS Now with A. Jay Khanna, MD, of Johns Hopkins Medicine, on how to best prepare for the exam. Dr.

FDA Guidances on Physician-Directed Use

William M. Mihalko, MD, PhD; Katherine Sale, MPH; ; S. Raymond Golish, MD, PhD, MBA

The U.S. Food and Drug Administration (FDA) has issued several guidances—documents that outline the agency's current thinking about regulatory policy—concerning physician-directed use of medical devices. Before a guidance is finalized, the agency releases a draft guidance to solicit feedback from stakeholders. In January 2017, the FDA issued two new draft guidances, using a question/answer format.

Tales from the Hurricane Front

Terry Stanton

It's not that the healthcare system in Houston wasn't prepared for Hurricane Harvey. Having seen the devastation in New Orleans after Hurricane Katrina in 2005 and, before that, tropical storm Allison, which inundated Houston in 2001, the city's hospitals and medical network were ready as Harvey bore down on the Texas coast. As ready as anyone can be for a once-in-five-lifetimes storm.

On Duty

It was the water of Hurricane Harvey, not the wind, that caused most of the billions of dollars in destruction, and the experiences reported by orthopaedic and other medical personnel speak to that fact. At the Memorial Hermann trauma center at Texas Medical Center—one of two Level 1 facilities in the region—the days of the storm were mostly quiet, even uneventful for what by some measures is described as the nation's busiest trauma center.

In the Firehouse

Amy Cockerham is a nurse practitioner who works in orthopaedic trauma with Joshua Gary, MD, at Memorial Hermann's Level 1 trauma center in Houston and lives in Friends­wood, a bedroom community south of the city. With the rising waters paralyzing transportation around her, Ms. Cockerham stayed in Friendswood to serve as a medical coordinator at an emergency operations center established at the fire station.

Post-Hurricane Maria: Many Ask, 'How Can I help?'

On Sept. 28, 2017, Hurricane Maria unleashed its Category 4 strength on Puerto Rico and unbridled devastation ensued, leaving much of the island in ruin. Now, a widescale humanitarian effort is managing the aftermath of the storm. As a U.S. territory, Puerto Rico is similar yet unique when compared to the states. Nearly 3.5 million U.S. citizens live in Puerto Rico. As U.S. citizens, Puerto Ricans can travel without a passport to and from the continental United States.

Medical Community Unifies in Response to Shooting

Terry Stanton

When a gunman perched on the 32nd floor of the Mandalay Bay hotel in Las Vegas rained gunfire on the crowd attending a Sunday night country music concert, the scores of wounded began flooding the city's emergency departments. Orthopaedic surgeons stepped up to provide care for the injured. Amid the chaos and the carnage, the patients arrived at area hospital, sometimes five to a vehicle, in ambulances, limousines, and pickup trucks pressed into service, many driven by valiant civilians.