July 30, 2007
 

 
TOA President's Update
  

By John T. Gill, MD
President, Texas Orthopaedic Association

This week in Congress, the Democratic leadership in the House of Representatives introduced and began mark-up of the Children’s Health and Medicare Protection (CHAMP) Act of 2007. The CHAMP Act would reauthorize the existing State Children’s Health Insurance Plan (SCHIP) through 2013 and reform Medicaid and Medicare policy.

At first blush, this sounds like a good idea; continue the SCHIP program that provides insurance to the children of working poor, and replace the impending 10% Medicare reimbursement cuts with positive updates for the next two years, with a promise to ultimately replace the flawed SGR system.  The devil is in the details.

Also contained deep within the bill is a repeal of the whole hospital exemption.  This would end the ability of physicians to refer or take patients to a hospital in which they had any level of ownership.  This refers not just to specialty hospitals, of which there are more in Texas than any other state, but to ANY type of hospital in which there was ownership.

The proposed legislation also places significant new requirements for diagnostic imaging services and changes in the payment formula for these tests.

The bill is nearly 400 pages in length and the medical associations are only just beginning to discover all of the ornaments hung on this tree.  Some groups jumped out in support so early that not only was the ink not dry, it was not all on the paper yet.

All the more reason to attend the TOA Socioeconomic Summit, August 10-11 in Austin, where AAOS lobbyist David Lovett will be on hand to give us an update.  Lt. Gov. David Dewhurst will join us for the Friday evening reception and State Representative John Zerwas will address us at lunch on Saturday.  In addition, we will be discussing presidential politics.  Texas continues to play a vital role in early fundraising as major candidates from both parties have passed through the state in just the past 72 hours.  Learn how you can be player.

See you in Austin weekend after next!

It Is Not Too Late to Register!
 TOA 2007 Socioeconomic Summit at The Driskill Hotel in Austin, Texas.
August 10 from 10 am to 4 pm: The Business of Orthopaedics
August 10 at 7:00 PM: Reception
August 11 from 8:00 am to 4 pm:  Session will be filled with socioeconomic issues of concern to all orthopaedic surgeons - such as the presentation “Economic Survival,” as well as a legislative update and discussions on national health care reform, our political action committees, and public relations for orthopedists with media training.
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TOA Executive Director's Update
     

By Donna Parker
Executive Director, Texas Orthopaedic Association

Please take this easy online TOA Patient Base Survey. Week before last we sent a request to TOA members and their clinic administrators to fill out a short survey entitled Do You Know Your Patient Base?

Who are your patients? What percentage are Medicare, Medicaid, Self

Pay/Directed, Workers Comp, or Commercial Insurance. Not only will these questions help you take a look at your patients, the payers and their systems, but will help TOA get anticipate certain issues we, as an Association, could begin to address on your behalf.

Please take this easy online TOA Patient Base Survey If you are not certain of your patient base, please ask your administrator to fill out this TOA survey. Your best estimate is enough to give us an idea of how to use this information. Take this easy online TOA survey here.
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Orthopaedist – Industry Conflicts of Interest

AAOS Standards of Professionalism (SOPs) on Orthopaedist-Industry Conflicts of Interest took effect on April 18, 2007 and will be enforced beginning the first of 2008.

The AAOS Communications article below only hints at the complexity of the physician-industry conflict of interest debate.  You can find clear, in depth guidelines regarding this important subject here.

Although we have abbreviated these six pages for you with bullets, we urge you to become familiar with the entire AAOS Standards of Professionalism Code and mandatory standards covering conflicts of interest and the orthopaedic industry.

  • The primary focus of the orthopaedic profession is care of the patient. As part of their lifetime commitment to patients, orthopaedic surgeons must maintain specialized knowledge and skills through participation in continuing medical education programs, seminars, and professional meetings.

  • Cooperative relationships between orthopaedic surgeons and industry benefit patients.  A collaborative relationship between orthopaedic surgeons and industry is necessary to improve patient care, but must be carefully scrutinized to avoid pitfalls of improper inducements, whether real or perceived.

  • Orthopaedic surgeons must be mindful of potential conflicts of interest with patient care in pursuing academic and commercial ventures.

  • Disclosure of a conflict of interest is required in communications to patients, the public and colleagues. The benefit to the patient must be the primary goal and must not be compromised.

  • Orthopaedic surgeons, like all physicians, have an ethical obligation to present themselves and the services they provide to patients in a clear and accurate manner.

  • When faced with a potential conflict of interest that cannot be resolved, an orthopaedic surgeon should consult with colleagues or an institutional ethics committee to determine whether there is an actual or potential conflict of interest and how to address it.

TOA is now a certified sponsor for CME programming.  CME regulations, as well as Pharma and AdvaMed guidelines, dictate compliance.  We thank AAOS for developing the Standards of Professionalism which will help TOA protect and guide the membership on these matters.
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Worth Repeating: Study Renews Debate Over Conflicts of Interest
    

The Associated Press claims that a research team examining the efficacy of hip protectors in preventing hip fractures should have disclosed the fact that some members of its group had financial ties to companies that manufacture bone-building drugs.

The study appears in today’s Journal of the American Medical Association (JAMA), and JAMA editors state that the company

connections did not violate the journal's detailed financial disclosure policy. Researchers say that they didn't believe their industry connections were relevant because the study didn't involve bone drugs and didn't recommend them. An outside expert points out that the disagreement illustrates the complexity of the issue.

For more information click here.  The abstract of the study can be viewed here.
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Upcoming TDI Workers Compensation Educational Events
  

A listing of Upcoming Workers' Compensation Educational Events is available here.

These Workers' Compensation Educational Events include:

  • TDI Health & WC Network (HWCN) Workshops (employers, health care providers)
  • DWC Education Conference (all participants)
  • DWC Seminars - Workers' Comp 101 & Return to Work (all participants)
  • DWC Field Office Brown Bag Educational Sessions (all participants)
  • DWC Workplace Health & Safety Seminars (employers, employees)
  • Texas Workforce Commission Texas Business Conferences (employers)
  • Texas Medical Association Seminars (health care providers)
  • Insurance Council of Texas Seminar (all participants)
  • AADEP Designated Doctor and Impairment Rating Trainings (health care providers)

Please click on the above link for dates, locations, and links to further details.

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