On (and Off) the Record | Orthopedics This Week
Large Joints and Extremities

On (and Off) the Record

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Dear OTW Reader:

“Who will see Medicare patients?” wonders an anonymous total joint surgeon…Jim Andrews, M.D. joins IntelliCell board…Do balloon tamps trump open reduction?“Mac” Evarts, M.D. to lead OMeGA Medical Grants Board…and more.

Getting to Know China

Dr. Stephen Hochschuler, M.D. founder of the Texas Back Institute (TBI), tells OTW, “I was in China recently for the grand opening of the Bonovo Academic Alliance, an impressive event that included many spine dignitaries. Dr. Hansen Yuan gave a speech, as did the former head of the Chinese Orthopaedic Association. There are a lot of orthopedic initiatives going on in China, but this academic alliance really differentiates Bonovo. TBI has been working on this with Bonovo for about five years; we regularly get visitors from China who stay anywhere from a week to six months. The challenges? Learning the customs and meeting the right people…too many Americans are ethnocentric and want to approach business in China the way they would in the U.S. In China, you don’t just do a deal—there are many ‘get to know you’ visits and dinners. At TBI we stress research, something that we hope to bring to the Bonovo initiative in China.”

Jim Andrews, M.D. Joins IntelliCell Board

Famed sports medicine specialist James R. Andrews, M.D. has joined the IntelliCell BioSciences Medical Advisory Board. Dr. Andrews is internationally known throughout the world for his scientific and clinical research contributions in knee, shoulder, and elbow injuries as well as his expertise as an orthopedic surgeon. He is a past president of the American Orthopedic Society of Sports Medicine and a member of the American Academy of Orthopedic Surgeons. He is the Senior Orthopedic Consultant for the Washington Redskins professional football team, and the Medical Director for the Tampa Bay Rays professional baseball team. Dr. Andrews is a past member of the Sports Medicine Committee of the U.S. Olympic Committee and he currently serves on the Medical and Safety Advisory Committee of USA Baseball.

Orthopedic Oncology on the Rise?

Richard Lackman, M.D., immediate past president of the Musculoskeletal Tumor Society, says things are looking up for orthopedic oncologists. He tells OTW, “For the longest time, reimbursement for orthopedic oncologists lagged far behind that of other orthopedic subspecialties. If you looked at the intra-operative work per unit of time (IWPUT), spine procedures were reimbursed at $1.00 per unit time, total joints were reimbursed at .75 cents per unit time, with tumor surgery at a mere .34 cents per unit time. Following a review by CMS [Centers for Medicare and Medicaid Services], relative value units for orthopedic oncology procedures increased by about 40% overall. As such, things are much better now for orthopedic oncologists. Honestly, I had quite a few colleagues throw in the towel in our subspecialty because they refused to work so hard for so little. Obviously, the fact that seasoned specialists were leaving the field was not great for patients. Now up and coming orthopedists see our subspecialty as a viable alternative for a career.” 

No One to See Medicare Patients?

A total joint surgeon tells OTW, “Many of us have our eyes of the upcoming presidential election, especially with the issue of the sustainable growth rate fix. If there is no patch then Medicare reimbursement will likely be cut 30%. If that happens, surgeons who are more well-established and who can afford to stop taking Medicare patients probably will. They may turn to a concierge model or become a cash only practice. There are a couple of markets that are already doing that successfully now. The government is in a tough position because they have a budget that keeps going up and the percent spent on healthcare keeps going up…and at some point someone’s got to make some unpopular decisions. But the fact is that there is no good plan and we are just putting patches on the problem. There are a lot of older guys taking a reactionary approach, saying, ‘I would stop seeing Medicare patients the next day!’ We just may end up like a lot of other countries, i.e., with a two tiered system—private and public. It would be like flying in an aircraft...if you can afford first class so be it…if not, then you’ll be flying in the back of the plane near the bathroom.”

Ajay Piramal Joins Smith & Nephew Board

Ajay Piramal, chairman of Piramal Group, the Mumbai-based conglomerate, has joined the Smith & Nephew Board as a Non-Executive Director. Piramal Group spans the healthcare, original drug discovery, glass manufacturing, financial services and real estate industries and operates across India, the U.S., Canada, the UK and China, amongst other territories. Its businesses include global healthcare and pharmaceutical company Piramal Healthcare Ltd and Piramal Glass Limited, both of which are listed on the National Stock Exchange of India and the Bombay Stock Exchange.

Balloon Tamps Trumps Open Reduction?

Brett Crist, M.D., co-chief of Orthopaedic Trauma at the University of Missouri, is playing with balloons these days. He tells OTW, “One of the most interesting things coming down the line for treating fractures is the use of inflatable balloon tamps as reduction aids for periarticular fractures. I am one of several surgeons around the country who has been using these recently. With these tamps we have seen less surgical trauma, and we have been able to operate on patients earlier…but the challenge is meeting gold standard of open reduction. This is because we have so much experience with open reduction, and we have to convince other people that this is as effective as the tried and true technique. With the balloon tamps, when fixing calcaneus fractures, we can address them earlier and with limited incisions. Also, we can better elevate the entire comminuted segments in both calcaneus and tibial plateau fractures. We will soon undertake several prospective studies comparing outcomes.”

Grant Funding: New Board for OMeGA

The OMeGA Medical Grants Association has announced its 2012 Board of Directors. These individuals have met rigorous standards of independence, including: no current ties to the orthopedic industry, no remuneration from the orthopedic industry in the past two years, and no leadership roles in fellowship or residency programs that involves financial decision making within the orthopedic department of an institution in the previous two years. C. McCollister Evarts, M.D. of the University of Maryland School of Medicine is the new president, while Richard H. Gross, M.D. of the Medical University of South Carolina will hold the position of secretary. Alexander J. Ghanayem, M.D. of Loyola University Medical Center is the new treasurer. Other new members are David E. Attarian, M.D. of Duke Orthopaedics, James J. Purtill, M.D. of Jefferson University, and William W. Tomford, M.D. of Massachusetts General Hospital.

Bronze Star Winner Joins Orthopaedic and Spine Institute

Joel B. Nilsson, M.D., FAAOS, a board certified orthopedic surgeon who also specializes in hand and upper extremity surgery, has joined the Orthopaedic and Spine Institute located in San Antonio, Texas. Dr. Nilsson earned his medical degree from Georgetown University’s School of Medicine. He served 14 years in the Army, completed an orthopedic residency at the Texas Tech University Health Science Center/William Beaumont Army Medical Center combined program, and then did specialty training and the Curtis National Hand Center and Walter Reed Army Medical Center. The Army utilized Dr. Nilsson’s skills next at Fort Campbell, Kentucky, where some of the Army’s finest soldiers serve with the 101st Airborne Division, Special Operations Aviation Regiment and 5th Special Forces Group. As part of the Iraqi invasion force, Dr. Nilsson was recognized for treating more combat wounded patients than any other surgeon while maintaining the highest technical standards and was awarded the Bronze Star Medal for meritorious service with the 86th Combat Support Hospital.

Michael Christie, M.D. Named Medical Director

Nationally recognized orthopedic surgeon Dr. Michael Christie has been named as medical director of the Joint Replacement Center at Saint Thomas Hospital.
Dr. Christie is a founding partner of the Southern Joint Replacement Institute, which is located on the Saint Thomas Hospital campus and is dedicated to the treatment of patients receiving partial or total joint replacement of the knee, hip or shoulder. Dr. Christie received a master’s degree in epidemiology at Johns Hopkins University and his medical degree from Loyola University Stritch School of Medicine in Chicago. He completed a residency in orthopedic surgery at Loyola University Medical Center and a fellowship in joint replacement and adult reconstructive surgery at Harvard University’s Combined Orthopaedic Program. Dr. Christie was also recognized as one of Becker’s Orthopedic & Spine Review’s 70 Outstanding Hip Surgeons and Specialists in May 2011.


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