Surgery/Specialties Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule that includes updated payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule on or after January 1, 2019. Physician fee schedule rates will be updated by…
Editor's Note In this study of 34,186 surgical patients in the University of Michigan Health System, 23.1% were taking opioids preoperatively, and the use of opioids was associated with a more negative medical and pain profile. Patient age, tobacco use, illicit drug use, higher pain severity, depression, higher Fibromyalgia Survey…
Editor's Note The Joint Commission on July 11 announced that effective January 1, 2019, it will implement a revised eligibility requirement and two revised requirements for the Advanced Certification for Total Hip & Knee Replacement (THKR) program. The revised eligibility requirement and revision to the Performance Measure chapter of the…
Editor's Note Female general surgery residents work more, experience aspects of burnout more frequently, and have poorer psychological well-being, this study finds. Of 7,395 residents surveyed (response rate, 99%), females reported: more frequently staying in the hospital >28 hours or working >80 hours per week more frequently feeling fatigued and…
Editor's Note In this national study, physician burnout, fatigue, and work unit safety grades were associated with major medical errors. Of 6,695 physicians in active practice surveyed, 6,586 provided information: 54.3% reported symptoms of burnout 32.8% reported excessive fatigue 6.5% reported recent suicidal ideation 3.9% reported a poor or failing…
Editor's Note In this study, cataract surgery was associated with a patient’s reduced subsequent risk of being in a serious traffic crash as a driver. This analysis of 559,546 patients who had cataract surgery in at least one eye found that the crash rate decreased from 2.36 to 2.14 per…
Editor's Note In this study, many patients reported unused opioids after joint and spine surgery, infrequent use of nonopioid analgesics, and lack of knowledge on safe opioid storage and disposal. Of 140 patients analyzed, 35% were taking preoperative opioids. Among those who stopped taking opioids after surgery, possession of unused…
Editor's Note Patients with diabetes are more likely to have adverse outcomes after surgery, and greater risks are associated with increasing HbA1c levels, this study finds. Of 7,565 patients analyzed, 30% had diabetes and 37% had prediabetes. After adjustments, diabetes was linked to increased: 6-month mortality (9% in patients with…
Editor's Note Malnourished hospitalized surgical and medical patients who participated in a nutrition quality improvement (QI) program had improved readmission rates and length of stay (LOS), but surgical patients had a significantly greater reduction in readmissions than medical patients, in this study. Of 1,269 patients analyzed, 288 were surgical patients…
Editor's Note In patients with traumatic out-of-hospital cardiac arrest (OHCA) after traffic collisions, advanced life support (ALS) performed by physicians was associated with increased chance of 1-month survival compared with ALS or basic life support (BLS) performed by emergency medical services (EMS) personnel, this Japanese study finds. Of 4,328 patients…
