“I’m from the government, and I’m here to help…”

Mary Ann Porucznik

“I’m so envious of the tools you use. Walking around the exhibit floor, I wanted to be an orthopaedic surgeon—and I’ll bet you wish I were one, too!”

Place of service affects your reimbursement

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

Facility, nonfacility designations make a difference In 2008, the Office of Inspector General (OIG) for the department of Health and Human Services intends to focus on Place of Service errors for services submitted by physicians. According to the OIG work plan, “We will review physician coding of place of service on claims for services performed in ambulatory surgical centers (ASC) and hospital outpatient departments.

The quality initiative alphabet soup

Robert H. Haralson III, MD

From AQA to P4P—developing quality measures Pay-for-performance (P4P) programs are being implemented by many payors, including the Centers for Medicare and Medicaid Services. Although P4P programs are changing and may completely disappear, the quality initiative they represent isn’t going away. From now on, physicians will be collecting and reporting quality data—and that can only improve the quality of care that patients receive.

Healthcare, medical liability, and reform alternatives

Paul Barringer; Brynna Pietz

The 2008 presidential campaign is drawing attention to healthcare reform, a focus that is likely to continue in coming months. It’s no secret why: Americans express deep dissatisfaction with the healthcare system. In a recent Gallup poll, for example, nearly three-quarters of respondents said that the healthcare system is in crisis or has major problems. Cost and access top Americans’ healthcare concerns in recent polls. Quality is also cited as a problem.

Three perspectives on expert witness testimony

Mary Ann Porucznik

Physician, defendant’s attorney, and plaintiff’s attorney offer advice It could have been your mother up on the stage, admonishing you to “dress neatly, be polite and respectful, and don’t lose your temper.” Instead, J. Kent Mathewson, JD, Christopher T. Hurley, JD, and Charles Carroll IV, MD, were providing the advice during Instructional Course Lecture 105 at the 2008 Annual Meeting.

AAOS/AMA to conduct Practice Information Study

For the first time in nearly a decade, the AAOS, the American Medical Association (AMA), and more than 70 other healthcare professional organizations have worked together to coordinate a comprehensive multispecialty survey of America’s physician practices.

Research Awards: Call for Papers

The AAOS is soliciting manuscripts for the 2009 Kappa Delta Awards and the Orthopaedic Research and Education Foundation (OREF) Clinical Research Award: Up to three $20,000 Kappa Delta awards, one of which is designated for “Young Investigators,” and one $20,000 OREF award will be bestowed. Manuscripts should be original and written specifically for these awards.

Retirement: An orthopaedic surgeon’s perspective

Frank M. Griffin, MD

Plan your retirement as you plan your surgeries—ahead of time According to recent AAOS member surveys, throughout their careers, orthopaedic surgeons tend to push back the age at which they plan to retire. Orthopaedic surgeons in their 40s generally expect to retire by around age 65. Those in their 50s expect to retire at around age 67. Perhaps most surprising, even orthopaedic surgeons in their 70s don’t expect to retire until age 76.

The orthopaedist and the workers’ compensation patient

William J. Holt, MD

A cautionary tale of patient care and professional liability Orthopaedic surgeons are commonly asked to care for patients who have been injured in the course of their employment. Some of these injuries are employment-specific, such as a mangled hand from a punch-press injury; others are similar to those encountered in everyday practice, such as an ankle fracture from a “slip-and-fall” at work, acute or chronic back pain, or carpal tunnel syndrome.

Coping with malpractice stress

John D. Kelly IV, MD

How to come back from a crisis in confidence Even the best and most innocent orthopaedic surgeons have been the targets of medical liability litigation that can result in anguish, a loss of self-esteem, a fear of treating future patients, and a shift to seeing each patient as a potential litigant. Coping with these feelings isn’t easy, but it is possible. My personal story may provide an example and roadmap for others.