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| News and Notes
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Pennsylvania's physicians currently enjoy the ability to call their own shots at the surgery centers they own stakes in, but a bill under consideration in the state's House of Representatives seeks to restrict that ability.
House Bill 305, introduced on Feb. 7, proposes prohibiting physicians from referring patients to health care facilities in which they have financial interests.
The bill also proposes reinstating the state's certificate of need requirement, setting capital expenditure thresholds as follows: Any ASC with an expenditure of $1 million or more, any hospital with expenditures of over $2 million and any institution with equipment upgrades costing more than $500,000 would have to justify the need for the new services and provide a cost impact analysis to the state in order to receive a CON.
The bill has been referred to the House Health and Human Services Committee, where it awaits a hearing, says Health Department spokesman Richard McGarvey. Similar legislation was introduced last year but failed to make it beyond that stage. A press release from FASA opines that the current legislation won't progress past committee hearings.
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| Pa. Lawmakers Seek Referral, CON Rules
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Pennsylvania's physicians currently enjoy the ability to call their own shots at the surgery centers they own stakes in, but a bill under consideration in the state's House of Representatives seeks to restrict that ability.
House Bill 305, introduced on Feb. 7, proposes prohibiting physicians from referring patients to health care facilities in which they have financial interests.
The bill also proposes reinstating the state's certificate of need requirement, setting capital expenditure thresholds as follows: Any ASC with an expenditure of $1 million or more, any hospital with expenditures of over $2 million and any institution with equipment upgrades costing more than $500,000 would have to justify the need for the new services and provide a cost impact analysis to the state in order to receive a CON.
The bill has been referred to the House Health and Human Services Committee, where it awaits a hearing, says Health Department spokesman Richard McGarvey. Similar legislation was introduced last year but failed to make it beyond that stage. A press release from FASA opines that the current legislation won't progress past committee hearings.
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| Video Games Said to Improve Surgeons' Skills
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Perhaps buying a PlayStation for your staff lounge isn't such a bad idea after all. A study published in the February issue of Archives of Surgery claims that surgeons with video game experience excelled in a simulated laparoscopic surgery skills course, making fewer errors and operating faster than their non-gaming colleagues.
Researchers at Beth Israel Medical Center in New York City questioned 21 residents and 12 attending surgeons about their video game playing habits and assessed their performance at the Rosser Top Gun Laparoscopic Skills and Suturing Program. Surgeons were also awarded a composite score after 25 minutes of play on three over-the-counter video games: Super Monkey Ball 2, Star Wars Racer Revenge and Silent Scope. These games, say the researchers, require skills similar to those needed for the successful completion of the Top Gun test, including fine motor control, visual attention processing, spatial distribution, hand-eye coordination, targeting, non-dominant hand emphasis, reaction time and depth perception.
Researchers determined that surgeons who had played video games in the past for more than three hours per week made 37 percent fewer errors in the Top Gun test, were 37 percent faster and scored 42 percent better overall than the 15 surgeons who had never played video games. Physicians who currently play video games made 32 percent fewer errors, were 24 percent faster and recorded overall scores that were 26 percent better than non-gaming surgeons. Among the players, game skill apparently transferred to Top Gun performance, since gaming surgeons who scored in the top one-third made 47 percent fewer errors, performed 39 percent faster and scored 41 percent better in overall scores than gaming surgeons who scored in the bottom one-third.
"Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery," report the study's authors. "Video games may be a practical teaching tool to help train surgeons."
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| Spine, Knee and Wrist: Highlights from the AAOS Annual Meeting
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Highlights of the studies presented at the American Academy of Orthopedic Surgeons' annual meeting, held Feb. 14 to Feb. 18 in San Diego:
- Cut calories, cigarettes to prevent spine complications. Researchers at the University of Pennsylvania Medical School analyzed the cases of 185 patients who underwent procedures for non-traumatic back pain. Smokers were not only 148 percent more likely than non-smokers to require such procedures, but also 370 percent more likely to suffer complications than their non-smoking counterparts. Further, for each 5kg/m2 increase in body mass index, there was a 97 percent greater chance of post-op pain and 44 percent greater chance of complications when compared with patients of a healthy weight.
- Socioeconomics may not impact total knee results. Previous research has shown that socioeconomic status negatively affects patient outcomes and, in the case of total knee arthroplasty, patients with lower incomes have a greater need for the procedure, according to researchers from St. Michael's Hospital in Toronto. However, when the researchers looked at 974 patients with osteoarthritis who were scheduled to undergo TKA at 13 medical centers in four countries, they found that lower-income, less-educated patients had the same results after total knee arthroplasty as any other socioeconomic group. Barriers to TKA may include patient factors such as difficulties in negotiating the healthcare system, unwillingness and lack of desire to receive treatment and potential differences in physicians' management of patients in both referral for surgery and decision to operate, researchers say.
- Carpal tunnel release may not be the answer. The casual relationship between carpal tunnel syndrome and repetitive hand use is much weaker than previously assumed. Who suffers from CTS — and who doesn't — appears to be genetic, according to researchers at Massachusetts General Hospital in Boston. They evaluated data for the cause of CTS using a quantitative scale to determine causal relationship; average scores for biological factors (including genetics, race and age) were double those of occupational factors (such as occupation, repetitive hand use and vibration).
- Younger patients have better outcomes. Researchers at the Washington University School of Medicine in St. Louis found that patients older than 69 are about nine times more likely to suffer complications after spine surgery. Patients older than 60 had an overall complication rate of 37 percent and one in five had major complications.
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