May 12, 2008
 

 
TOA President's Update: NOLC Wrap Up
  

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

As Chairman of the AAOS Board of Councilors, I recently had the honor of hosting the National Orthopaedic Leadership Conference in Washington DC. There were over 300 registered for the meeting, made up primarily by the Board of Councilors, the Board of Specialty Societies, the Leadership Fellows and Mentors and the State Orthopaedic Societies leadership.

The Board of Councilors is your national house of representatives in orthopaedics. There are just over 100 councilors, every state has at least one, and some states have proportionally more depending upon the number of AAOS members in that state. Texas has five councilors, Tim Beck (Tyler), Mark Brinker (Houston), George Brindley (Lubbock), David Teuscher (Beaumont), Andy Kant (Houston) and myself as Chairman. We meet in person three times a year, at the Annual Meeting, in Washington DC in the spring, and a Fall Leadership Meeting, this year in Dallas.

Featured speakers throughout the three day event included, former Speaker of the House, Newt Gingrich, former Governor and US Senator from Virginia, George Allen, and Congressman Michael Burgess of Texas. We spent one entire day on Capitol Hill calling on our legislators. The Texas contingent met in person with over half of the 34 elected members of Congress from Texas, including both of our Senators, and met with staff or dropped by all of the remaining offices.

The message to members of Congress was that the SGR Medicare payment system is broken and must be replaced, that Medicare and Medicaid patients should not be restricted from utilizing safe, high quality physician owned hospitals and facilities, and the introduction of a new bill, the Americans Access to Orthopaedic Services (AAOS bill) which you will be hearing more about later.

In all, fifteen orthopaedic surgeons from Texas attended and participated at this year’s NOLC. They give up a lot of days from the office and their families to represent the profession and our patients in Washington DC. And I must say, from observing and participating at all levels in this body, “Texas, you are extremely well represented by this group.”

Hope to see you all soon in San Antonio at the TOA Annual Meeting!
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TOA Executive Directors Update: Annual Meeting Program
     

By Jeseka Wallace-Kreitner
Executive Director, Texas Orthopaedic Association

 

Register for the TOA Annual Meeting Today to receive 10.5 AMA PRA Category 1 Credits plus 1 Ethics Hour!
 

BELOW IS THE 2008 TOA ANNUAL MEETING PROGRAM:

(Times and Topics subject to change.)

Thursday, May 22nd
 

8:00 am – 5:00 pm
Camino Real Room

Reimbursement & Coding For Orthopaedics
with an update on Workers’ Compensation

5:00 pm – 6:30 pm
Villa Room

Board of Directors Meeting

7:00 pm – 10:00 pm
Zapata Room

Leadership Dinner (Invitation Only)
   

Friday, May 23rd
   

7:15 am - 9:00 am
 Navarro B Ballroom & Foyer

Registration & Continental Breakfast

7:00 am – 8:00 am
Zapata Room

Past Presidents’ Council

8:00 am - 8:06 am
 Navarro A Ballroom

Scientific Sessions
 Welcome and Announcements
John T. Gill, MD, TOA President, Dallas
Omer A. Ilahi, MD, TOA Program Chair, Houston

8:06 am - 8:12 am

The Influence of Titanium Roughness on Arachidonic Acid Metabolism in Osteoblasts
 Brandon Tinkler, MD, San Antonio

8:12 am - 8:18 am

Percutaneously Assisted Total Hip Arthroplasty (PATH): A Less Invasive Technique
 Eugene Schoch, III, MD, Austin

8:18 am - 8:24 am

Metal Ion Levels in Hip Implant Patients Having Bearings with and without Differential Hardness
 C. Lowry Barnes, MD, Arkansas

8:30 am - 9:00 am

Minimally Invasive Hip Replacement
 Michael Huo, MD, Dallas

9:00 am - 9:06 am

Arthroscopic Suprascapular Nerve Decompression Using Anterior Portals
 Sumant Krishnan, MD, Dallas

9:06 am - 9:12 am

The Effects of Radiofrequency Energy on 5 Suture Materials Used in Arthroscopic Rotator Cuff Repair
Derek Kroll, MD, New Caney

9:12 am - 9:18 am

Cementless Hemiarthroplasty for Proximal Humeral Fractures
 Keith Watson, MD, Fort Worth

9:18 am - 9:24 am

Security of Knots Tied with Ethibond, Fiberwire, Orthocord, or Ultrabraid
 Shiraz Ahmad Younas, MD, Houston

9:24 am - 9:30 am

Latissimus Dorsi Transfer for the Treatment of Irreparable Posterosuperior Rotator Cuff Tears In Patients Under the Age of Sixty
 Sumant Krishnan, MD, Dallas

9:30 am - 10:00 am

It's the Little Things in Sports Medicine
 Fred Corley, Jr., MD, San Antonio

10:00 am - 10:30 am
 Navarro B Ballroom & Foyer

Exhibit Visitation

10:15 am - 11:00 am
Villa Room

Educational Workshop
Venous Thrombo Embolism and Patients Undergoing Knee/Hip Replacements Surgery
Facilitator:  Michael Huo, MD, Dallas

11:15 am - 12:00 pm
 Navarro A Ballroom

Diagnosis and Management of Biceps Tendon Pathology in the Shoulder
 Keynote Speaker: Stephen Weber, MD, Sacramento, CA

12:00 pm - 1:30 pm
 Hidalgo Room

TSSM Annual Business Luncheon

1:30 pm - 1:36 pm
 Navarro A Ballroom

Recessed Femoral Interference Screws in Anterior Cruciate Ligament Reconstruction
 Anup Ajit Shah, MD, San Antonio

1:36 pm - 1:42 pm

Growth Factor Concentrations Across a Spectrum of Injury Levels in Platelet Rich Plasma
 Ravi Karia, MD, San Antonio

1:42 pm - 1:48 pm

Nitric Oxide Donor Compounds Effect Upon Collagen Production In Diabetic Wounds
 Brandon Seifert, MD, San Antonio

2:00 pm - 2:30 pm

The Downside of BMP
 Ronald Lindsey, MD, Houston

2:30 pm - 2:36 pm

A Comparison of Tip to Apex Distance and Quadrant Placement Between Cephallomedullary Devices and the Hip Screw Side Plate
 Sonya Ahmed, MD, Galveston

2:36 pm - 2:42 pm

Improved Soft Tissue Perfusion Following Application of Temporizing External Fixation in Complex Distal Tibia Fractures
 Stacee Kessinger, MD, Fort Worth

2:42 pm - 2:48 pm

Intraarticular Injuries Associated with Acute Ankle Fractures
 Niki Leontaritis, DO, Galveston

2:48 pm – 2:54 pm

The Use of a Kickstand Modification for the Prevention of Heel Decubitus Ulcers in Trauma Patients with Lower Extremity External Fixation
 Chad Conner, MD, Galveston

3:00 pm - 3:30 pm

Current Thoughts in Transient Quadriplegia
 Mark Wylie, MD, Fort Worth

3:30 pm - 4:00 pm
 Navarro B Ballroom & Foyer

Exhibit Visitation

3:45 pm - 4:30 pm
Villa Room

Concurrent Educational Workshops
 Computer Navigation for Hip Resurfacing
Facilitator:  Michael Heinrich, MD, Austin

Zapata Room

Upper Extremity Prosthetic Advancements
Facilitator:  Thomas Bourgeois, San Antonio

6:00 p.m. – 9:00 p.m.
 Goraz & Olivares

TOA Member and Guest Reception

 

 

Saturday, May 24th

  

 

7:15 am - 9:00 am
 Navarro B Ballroom & Foyer

Registration & Continental Breakfast

9:00 am – 10:30 am
 Caranza Room

Spouse Breakfast

8:00 am - 8:06 am
Navarro A Ballroom

Scientific Sessions
 Welcome and Announcements
John T.  Gill, MD, TOA President, Dallas
Omer A. Ilahi, MD, TOA Program Chair, Houston

8:06 am – 8:12 am

The Cost Effectiveness of Implementing Picture Archive and Communication System (PACS) in the Operating Room Setting
 Paul Rath, MD, Galveston

8:12 am - 8:18 am

Distal Radius Fractures: New Techniques to Obtain Anatomic Reductions
 Chad Conner, MD, Galveston

8:18 am - 8:24 am

A Five-Minute Exposure to the Volar Aspect of the Distal Radius for Plating Distal Radius Fractures
 Hussein Turki, MD, San Antonio

8:30 am - 9:00 am

Management of Posterior Tibial Tendon Disease
 Kevin Varner, MD, Houston

9:00 am - 9:06 am

Outcomes of Idiopathic Clubfoot with Delayed Treatment
 Clint Barnett, MD, Temple

9:06 am - 9:12 am

Is the Distribution of Left, Right and Bilateral Developmental Dislocation of the Hip Equivalent between Males and Females?
 Clifford Evans, DO, El Paso

9:12 am - 9:18 am

Biomechanical Study of Fixation Length of Flexible Intramedullary Nails
Clint Johnson, MD, Galveston 

9:30 am - 10:00 am

Get Active! Texas Campaign Presentation
 John Gill, MD, Dallas

 

Coordinated Approach to Child Health
 Nancy Murray, PhD, Houston

10:00 am - 10:30 am
 Navarro B Ballroom & Foyer

Exhibit Visitation

10:15 am - 11:00 am
Villa Room

Concurrent Educational Workshop
 Cartilage Restoration and Joint Resurfacing 2008
Philip Davidson, MD, Stoughton, MA

Zapata Room

Distal Radius Plating
Korsh Jafarnia, MD, Houston

11:45 am - 1:30 pm
 Hidalgo Room

TOA Annual Business Luncheon
 Keynote Speaker:
U.S. Senator John Cornyn

 

2008-2009 Officer Induction

1:30 pm - 2:30 pm
 Navarro A Ballroom

6th Annual Resident Quiz Bowl

2:30 pm - 3:00 pm
 Navarro B Ballroom & Foyer

Exhibit Visitation

3:00 pm - 4:00 pm
 Navarro A Ballroom

Ethics Hour
 Charles Rockwood, MD and Rick Peterson, AAOS Legal Counsel, will highlight the current environment regarding the relationship and potential conflicts of interest between orthopaedic surgeons and industry.  David Teuscher, MD will focus on the AAOS’ Standards of Professionalism and Orthopaedic Expert Witness Testimony. You don’t want to miss this important message!

4:00 pm - 5:00 pm
 Navarro A Ballroom

Ancillary Evaluation:  Are Your Ancillaries Producing What They Should? 

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Worth Repeating: Medicine Bests Hospital Association In Latest DC Showdown

One of the (many) reasons Austin is better than Washington, D.C., is a little rule in the Texas Legislature that requires amendments to bills to have at least something in common with the bill itself. Congress has no such requirement. That explains why the American Hospital Association (AHA) keeps trying to slap restrictions on physician ownership willy-nilly on every piece of legislation that looks like it actually might pass. The 2008 Farm Bill was the latest vehicle for such chicanery, but TMA, the

American Medical Association, and others mounted the political muscle to remove the amendment. We really appreciate the calls you made to Congress to turn that around. Speaking of appreciation, TMA congratulates U.S. Reps. Sam Johnson (R-Plano) and Rubén Hinojosa (D-Edinburg) for alerting their congressional colleagues to some AHA propaganda that misrepresents the quality of care provided by physician-owned hospitals. “Your joint letter to your colleagues proves that this is neither a Republican nor Democratic issue; rather it is an issue of immense importance to Texas physicians and our patients,” TMA President Bill Hinchey, MD, wrote in a letter to the two congressmen.

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Become One Of The First Members Of The TOF Founders Circle
    

Dear Doctors,

Please join the Texas Orthopaedic Association in welcoming our sister organization, the Texas Orthopaedic Foundation (TOF)! The Texas Orthopaedic Foundation is a registered 501(c)(3) charitable non-profit organization dedicated to research and education within the orthopaedic community. Our new Foundation is publicly supported and tax-exempt.

On behalf of the Texas Orthopaedic Foundation Executive Committee, I am writing to ask for your support in building upon our

vision to establish the primary orthopaedic education and research resource for Texas.

In addition to providing sustainable orthopaedic education and research opportunities, the Texas Orthopaedic Foundation was formed by TOA leaders to raise the publics’ awareness of orthopaedic medicine in Texas. Several years ago, I was proud to serve as president of the Texas Orthopaedic Association. I am now honored to serve as the Chair of the Foundation’s Board of Trustees.

We believe you share our appreciation for the many years of easily accessible, quality medical education and public relations programs that have been offered by the Texas Orthopaedic Association. The Texas Orthopaedic Foundation will now be dedicated to providing CME programming, including resident education, best paper awards and resident events such as the Resident Quiz Bowl. Our Foundation will also be the primary funding source for the Get Active! Texas public health campaign, promoting bone health and obesity prevention.

While TOA is nationally recognized for successfully tackling critical socioeconomic concerns and the regulatory issues facing orthopaedic practices in Texas today, the mission of the Texas Orthopaedic Foundation is to advance orthopaedic education and public awareness. The Foundation and TOA will work together to build a stronger orthopaedic community in Texas.

 

The Texas Orthopaedic Foundation has the same dedicated team of physician volunteers and industry leaders as TOA. Through the Foundation, our orthopaedic leaders will be free to develop high quality continuing medical education opportunities in accordance with ACCME guidelines. Dr. Marc DeHart, of Austin, serves as the Chair of the Continuing Medical Education Committee for the Texas Orthopaedic Foundation.

The ACCME guidelines will direct our choice of speakers and programming surrounding CME events. Under the Foundation, we hope to be the source of fine orthopaedic programming and will continue selecting physician faculty known in their fields. The Foundation strives to select speakers whose expertise will equip the orthopaedic community with superior CME course instruction to secure the best outcomes for our orthopaedic patients.

The Foundation also aims to impact the lives of Texans by increasing their knowledge of preventive orthopaedic care and by stressing the importance of maintaining a healthy musculoskeletal system. The Foundation’s public awareness programs will help bring awareness to orthopaedic treatment and conditions, creating a better understanding of how the citizens of Texas can improve their health through increased activity levels.

The Mission of the Texas Orthopaedic Foundation is to:

  • Create public awareness of the importance of musculoskeletal health in the State of Texas.

  • Encourage scientific, educational, and charitable endeavors which will promote and advance the science and art of orthopaedic surgery.

  • Support research and education on diseases and injuries of bones, joints, nerves, and muscles.

  • Enhance clinical care, leading to improved health, increased activity, and a better quality of life for patients in Texas.

This is how you can help.

To fund its programs, the Texas Orthopaedic Foundation will depend on contributions from the orthopaedic community, other caring individuals and our friends of orthopaedics in business. Your contributions will be dedicated to orthopaedic research and education in Texas.

By making a donation to the Texas Orthopaedic Foundation, you will become a member of the Board of Trustees. The Foundation’s website and meeting exhibit will list you as a donor Trustee, unless you wish to remain anonymous. Memorial or tribute gifts will list both donor and the person named for tribute.

While we encourage your donations and annual gifting at any point in the future, by giving $1,000 or more during 2008, you will become a member of the TOF Founders’ Circle. Please donate today and become a founding member of the Texas Orthopaedic Foundation.

There are many benefits to supporting the Texas Orthopaedic Foundation. By donating to the Foundation you will be able to:

  • Support orthopaedic continuing medical education and research

  • Support orthopaedic residents and their Texas training programs

  • Give a gift that will remain in Texas

  • Receive an income tax deduction; reduce capital gains tax or estate taxes

  • Help the Texas Orthopaedic Foundation develop clinical treatment guidelines

  • Facilitate public education of orthopaedic surgery and orthopaedic treatment.

If your gift is intended as a memorial or tribute, please indicate such on your contribution form. The Foundation’s first Memorial pledge was in honor of Albert Tisdale, MD. Many of you may remember Dr. Tisdale as the “TOA Photographer/Historian.” He faithfully attended and photographed the TOA annual meetings and the past presidents breakfasts. Dr. Tisdale was also a former president of TOA from Austin.

Our Fund Development Committee is chaired by Dr. Jay Mabrey, of Dallas, and he welcomes any ideas for Texas Orthopaedic Foundation endowments. Ideas that have been mentioned by the TOF leadership have ranged from tributes to specific Texas orthopaedic residency training programs…to endowments to help fund orthopaedic medical missions in which our Texas pediatric orthopedists participate. Feel free to contact Dr. Mabrey or myself if you wish to serve on the Fund Development Committee.

The TOF Executive Committee has asked Howard Epps, MD, of Houston, to Chair the Grant Committee. Dr. Maureen Finnegan (TOA past president), of Dallas, has also agreed to serve on the Foundation’s Grant Committee. The Grant Committee is presently charged with selecting CME resident paper awards and research. As other programs are developed and funded, the Foundation’s Grant Committee will also be responsible for reviewing and approving scientific research grant applications, grants for clinical treatment guideline production and endowment fund distribution. Please remember that all funds are designated for Texas distribution only.

The Foundation will send an announcement, as well as the enclosed brochure, to all of our friends of orthopaedics in business and academia regarding the formation of the Texas Orthopaedic Foundation. We are certain that they will also benefit from quality orthopaedic education and will have an interest in keeping the orthopaedic community strong.

We are happy to bring this positive message to you about how and why the Foundation was formed. And, again…we ask you to join the TOA in welcoming the Texas Orthopaedic Foundation. The Foundation needs your help to support this important mission to build a stronger orthopaedic community through research and education.

I encourage you, as an orthopaedic surgeon, to accept our invitation to donate to the Texas Orthopaedic Foundation and becoming a member of the Founders’ Circle by visiting the Texas Orthopaedic Foundation website's donation page or by calling 1-512-370-1500.

With best wishes,

Bill Schreiber, MD, Chair
Board of Trustees
Texas Orthopaedic Foundation
www.toafoundation.org

P.S. As you consider my request, please know that your donation is an investment in orthopaedic education and research in Texas.

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Have Back Problems - Will Travel
 

Medical tourism grabs the attention of foreign governments, U.S. healthcare innovators and the wallets of the uninsured.

Concerned your back problems will get in the way of that vacation to Bali? No worries, now you can get both taken care of at the same time.
The Medical Tourism industry earned global revenues of $20 billion (USD) in 2005 and the Asian market comprising India, Singapore, Thailand and

Malaysia stood at approximately $2.5 billion in 2006. While the global market is predicted to double in size to $40 billion a year by 2010, it is estimated that the Asian market will generate in excess of $4.4 billion by 2012.

Governments and service providers have been quick to recognize the potential of Medical Tourism and have leveraged existing strengths and taken concrete initiatives to tap into the larger potential of this as a key revenue generator for their countries' economies. Innovators in the US are also moving quickly in an effort to reduce the nation’s healthcare burden as well as benefit financially.

The Cleveland Clinic’s CEO, Delos “Toby” Cosgrove has embraced this trend and signed a 15-year contract in Abu Dhabi to build, select the staff and manage a hospital. Cosgrove has inked similar arrangements in Vienna, Toronto, Saudi Arabia and Egypt.

The clinic has a long history of seeing patients from around the globe – as many as 5,000 patients per year. However, that’s decreased dramatically since September 11th. Now the Cleveland Clinic is meeting patients half way around the world and getting many other offers to collaborate and monetize their intellectual property.

Click here for the rest of the article.
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On The TOA Radar Screen: Trailblazer's Analysis of Your Billing
 

You may have received a letter from Trailblazer (a CMS contracted intermediary) regarding your billing practices.  CMS maintains that  you have been chosen to receive this letter because your practice billed a specific service(s) in a different pattern from your peers.  

Thanks to members’ alerts, this letter and its attached “Comparative Billing Report” have  again shown up on the TOA radar screen.

Consequently, we need to know what percentage of our membership Trailblazer has found through statistical analysis to bill the CPT codes 99201-99205 in a significantly different pattern as compared to their peers during  January through June 2007.   In the past, we felt this could be a real problem  and possibly it could be a subtle way of encouraging physicians to under-code .  However, one of the charts we saw indicated undercoding on four of the five codes and one over coding on 99204.

Please  let  the TOA Executive Office staff know if you received a similar letter...even though you know you have been coding appropriately.  This information will be kept strictly confidential.  Just identify yourself as a TOA member and let the staff know the city in which you practice.  Also, add any other comments such as, “I would consider an elderly woman’s hip revision to be a medical decision of moderate complexity.” These comments will help staff understand which codes are being questioned.

TOA  handled this problem in October of 2006 when Dr. David Teuscher was president.  Trailblazer may need to be contacted so we can address this problem again.

If you feel comfortable enough to respond by email, you may contact Donna Parker, TOA Executive  Vice President via email.  All replies to this issue will be held in confidence.

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