June 2014 Briefing - Surgery

Here are what the editors at HealthDay consider to be the most important developments in Surgery for June 2014. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

New Plan Would Permit Doctors to Treat Patients in Other States

MONDAY, June 30, 2014 (HealthDay News) -- A proposal to make it much easier for doctors licensed in one state to treat patients in other states in person, online, or by videoconference has been prepared by the Federation of State Medical Boards, which includes the agencies that license and discipline doctors.

Health Highlights: June 30, 2014

Complications Only Account for Some Variation in Hospital LOS

MONDAY, June 30, 2014 (HealthDay News) -- For patients undergoing colorectal resection, much of the variation in extended length of stay is not due to patient illness or complications, according to a study published online June 25 in JAMA Surgery.

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UnitedHealth Cutting More Docs From Medicare Advantage

FRIDAY, June 27, 2014 (HealthDay News) -- UnitedHealth Group's Medicare Advantage network has begun notifying physicians of a new wave of cuts to its network, according to an article published June 17 in Medical Economics.

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Court: Patients Responsible for Outcomes of Risky Behavior

FRIDAY, June 27, 2014 (HealthDay News) -- The Colorado Supreme Court has ruled that patients can be at least partially responsible for their health outcomes resulting from their own unhealthy behavior, according to the American Medical Association (AMA), which supported the physicians in the case.

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Almost Three-Quarters of Skin Cancers OK for Mohs Surgery

FRIDAY, June 27, 2014 (HealthDay News) -- Application of recently published appropriate-use criteria suggests Mohs micrographic surgery (MMS) can be used in nearly three-quarters of skin cancers, according to a study published in the July issue of the Journal of the American Academy of Dermatology.

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PCP Follow-Up Cuts Readmission After High-Risk Surgery

THURSDAY, June 26, 2014 (HealthDay News) -- For surgical patients at high risk of readmission, especially those with surgical complications, early primary care provider (PCP) follow-up reduces the rate of readmission, according to a study published online June 25 in JAMA Surgery.

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Wikipedia Drug Entries Often Not Up-to-Date

THURSDAY, June 26, 2014 (HealthDay News) -- Patients frequently turn to digital media for drug information; however, many Wikipedia entries about medications aren't up-to-date and accurate, according to a perspective piece published in the June 26 issue of the New England Journal of Medicine.

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Standardized Instructions Improve Preop Med Compliance

WEDNESDAY, June 25, 2014 (HealthDay News) -- A standardized, pictorial "Preoperative Patient Medication Instruction Sheet" can improve patient medication compliance on the day of surgery, according to a study published in the July issue of Anesthesiology.

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Medicaid Backlog May Have Financial Ramifications

TUESDAY, June 24, 2014 (HealthDay News) -- There is a considerable backlog in Medicaid enrollment applications, which may have financial ramifications on physicians and practices, according to an article published online June 10 in Medical Economics.

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Pre-Op Genetic Testing Impacts Surgical Choice in Breast Cancer

MONDAY, June 23, 2014 (HealthDay News) -- For women with breast cancer, preoperative genetic testing affects surgical decision making, according to a study published online June 5 in Gynecologic Oncology.

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CMS Launches Initiative to Assist Newly Insured

MONDAY, June 23, 2014 (HealthDay News) -- A national initiative has been launched to help answer questions that people may have about their new health coverage and to offer health providers the tools needed to promote patient engagement, according to a press release from the Centers for Medicare and Medicaid Services (CMS).

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14.4% of Kids' Scoliosis Surgeries Have In-Hospital Complications

MONDAY, June 23, 2014 (HealthDay News) -- From 2000 to 2009, the overall in-hospital complication rate for pediatric patients with idiopathic scoliosis who underwent spinal fusion was 14.4 percent, with respiratory complications having the highest rate, according to a study published June 15 in Spine.

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Complex Electronic Record Safety Issues Surface Long After Launch

MONDAY, June 23, 2014 (HealthDay News) -- Electronic health record-related safety concerns involving both unsafe technology and unsafe use of technology persist long after "go-live," according to a study published online June 20 in the Journal of the American Medical Informatics Association.

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Racial Disparity Seen in Use of Sentinel Lymph Node Biopsy

FRIDAY, June 20, 2014 (HealthDay News) -- While sentinel lymph node biopsy (SLNB) use has increased in all patients with breast cancer, black women are consistently less likely than white women to have SLNB, according to a study published online June 18 in JAMA Surgery.

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Patient Variables Predict Expectations in Spine Surgery

FRIDAY, June 20, 2014 (HealthDay News) -- Clinical and demographic variables can predict patients' expectations regarding anticipated improvement from cervical spine surgery, according to a study published June 15 in Spine.

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Guidance Offered for Protection When Firing Employees

FRIDAY, June 20, 2014 (HealthDay News) -- Steps can be taken to protect employers in the case of termination of an employee, according to an article published online June 10 in Medical Economics.

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Significant Risk for Major Surgery in Low-Weight Infants

FRIDAY, June 20, 2014 (HealthDay News) -- In very low-birth-weight infants, major surgery is independently associated with more than a 50 percent increased risk of death or neurodevelopmental impairment at 18 to 22 months' corrected age, according to a study published online June 16 in JAMA Pediatrics.

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NCHS: Insurance Coverage Expands, Gaps Remain

THURSDAY, June 19, 2014 (HealthDay News) -- Two new U.S. government reports provide a statistical snapshot of health and health insurance coverage in 2013, before new coverage options took effect under the Affordable Care Act.

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Higher Operator Volume Linked to Better PCI Outcomes

THURSDAY, June 19, 2014 (HealthDay News) -- Higher individual operator percutaneous coronary intervention (PCI) volume is associated with better outcomes, according to a review published online June 17 in Circulation: Cardiovascular Quality and Outcomes.

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Anesthesiologists Issue Choosing Wisely Recommendations

THURSDAY, June 19, 2014 (HealthDay News) -- A list of the top five unnecessary medical services in anesthesiology has been developed as part of the Choosing Wisely campaign, according to a study published online June 16 in JAMA Internal Medicine.

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Preop β-Blockers Don't Improve CABG Outcomes

WEDNESDAY, June 18, 2014 (HealthDay News) -- Preoperative β-blockers do not improve perioperative outcomes in patients undergoing nonemergent coronary artery bypass grafting (CABG) surgery, according to a study published June 16 in JAMA Internal Medicine.

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Cost of Prostate Cancer Surgery Varies Widely in the U.S.

WEDNESDAY, June 18, 2014 (HealthDay News) -- The open market cost of a radical prostatectomy (RP) varies widely in U.S. hospitals, according to research published in the March issue of Urology.

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Obstetric Safety Program Improves Liability Exposure

WEDNESDAY, June 18, 2014 (HealthDay News) -- A comprehensive obstetric safety program can improve liability claims exposure, according to a study published online June 10 in the American Journal of Obstetrics & Gynecology.

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ACA May Mean Healthier Young Adults, Study Suggests

WEDNESDAY, June 18, 2014 (HealthDay News) -- A popular provision of the Affordable Care Act that allows young adults to stay on a parent's health insurance plan up to age 26 may be good for their health and financial security, a new study suggests. The study was published as a research letter in the June 18 issue of the Journal of the American Medical Association.

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U.S. Health Care System Ranked Last Again: Report

MONDAY, June 16, 2014 (HealthDay News) -- The United States' health system once again comes in last when compared to 10 other rich nations, according to the latest Commonwealth Fund report on the issue.

Health Highlights: June 16, 2014
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Clinicians Often Fail to Empathize After Adverse Event

MONDAY, June 16, 2014 (HealthDay News) -- The health care industry is recognizing the benefits of prompt and transparent physician communication with patients and families about bad outcomes, according to an article published June 10 in Medical Economics.

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Physician Leadership, Ownership Dominates ACOs

MONDAY, June 16, 2014 (HealthDay News) -- Physicians are playing strong leadership and ownership roles in accountable care organizations (ACOs), according to research published in the June issue of Health Affairs.

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Pre-Op Serum Cholesterol Tied to Survival in Renal Cell Carcinoma

MONDAY, June 16, 2014 (HealthDay News) -- For patients with renal cell carcinoma (RCC), preoperative serum cholesterol is an independent prognostic factor, according to a study published online June 12 in BJU International.

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Surgeon's Radiation Exposure Higher With 'Freehand' Technique

MONDAY, June 16, 2014 (HealthDay News) -- During pedicle screw placement with the freehand technique, radiation exposure for the surgeon is nearly 10 times higher than with the use of navigation, according to a study published in the June 1 issue of Spine.

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Can Weight-Loss Surgery Lower Cancer Risk for the Obese?

FRIDAY, June 13, 2014 (HealthDay News) -- Weight-loss surgery may do more than lower the risk of heart problems and improve type 2 diabetes in obese patients: A new review suggests it may also lower their chances of a cancer diagnosis. The report was published in the journal Obesity Surgery.

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HHS Inspector General Finds Big Problem With Medicare Coding

FRIDAY, June 13, 2014 (HealthDay News) -- Nearly 42 percent of Medicare claims for evaluation and management (E/M) services are incorrectly coded, according to an article published June 2 in Medical Economics.

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Obesity Explains More Rapid Growth Rate of Knee Replacement

FRIDAY, June 13, 2014 (HealthDay News) -- The differential increase in total knee arthroplasties over total hip arthroplasties is mainly due to more rapid growth in knee arthroplasties in adults with a body mass index of ≥ 25 kg/m², according to a study published in the June 4 issue of The Journal of Bone & Joint Surgery.

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Researchers Hesitant to Use Social Media to Show Findings

FRIDAY, June 13, 2014 (HealthDay News) -- Researchers remain uncertain about the use of social media to communicate their findings to policy makers, according to research published online June 6 in Health Affairs.

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Frailty Index Predicts Adverse Outcomes in Geriatric Trauma

FRIDAY, June 13, 2014 (HealthDay News) -- Frailty index is an independent predictor of in-hospital complications and adverse discharge disposition among geriatric trauma patients, according to a study published online June 11 in JAMA Surgery.

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U.K. Reports Risks for Use of Bone Cement in Hip Surgery

FRIDAY, June 13, 2014 (HealthDay News) -- Bone cement used in partial hip replacement for the treatment of fractured neck of femur is associated with rare but serious instances of perioperative death or severe harm consistent with bone cement implantation syndrome (BCIS), according to research published online June 12 in BMJ Open.

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Data From EHRs Should Be Used to Improve Patient Care

THURSDAY, June 12, 2014 (HealthDay News) -- The data from electronic health records (EHRs) should be utilized to improve the quality of patient care, according to an article published online June 10 in Medical Economics.

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Minimally Invasive Interbody Fusion Feasible in Obese

WEDNESDAY, June 11, 2014 (HealthDay News) -- Minimally invasive transforaminal lumbar interbody fusion (MiTLIF) is safe and produces satisfactory outcomes for treatment of overweight or obese patients, according to a study published in the June issue of the Journal of Spinal Disorders & Techniques.

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Bariatric Surgery Benefits Diabetes Over Long Term

TUESDAY, June 10, 2014 (HealthDay News) -- Long-term follow-up shows that, in patients with type 2 diabetes, bariatric surgery is associated with greater diabetes remission and fewer diabetes-related complications than usual care, according to a study published in the June 11 issue of the Journal of the American Medical Association, a theme issue on diabetes.

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Millions Will Not Have to Pay ACA Tax Penalties: Report

TUESDAY, June 10, 2014 (HealthDay News) -- Although an estimated 30 million people will still be uninsured in 2016, only four million are expected to pay penalties, according to the latest report from the nonpartisan Congressional Budget Office (CBO).

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Incentives May Lead to Greater Support for Practice Goals

MONDAY, June 9, 2014 (HealthDay News) -- Incentives may aid employees in meeting practice goals, according to an article published May 23 in Medical Economics.

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Needle Biopsy Underused in Patients With Breast Cancer

MONDAY, June 9, 2014 (HealthDay News) -- Needle biopsy appears to be underused in patients with breast cancer, according to a study published online June 9 in the Journal of Clinical Oncology.

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Veterans Affected by Scandal May Seek Private Care

FRIDAY, June 6, 2014 (HealthDay News) -- The recent scandal at the U.S. Department of Veterans Affairs (VA) may lead to more veteran visits to private physicians and community health centers, according to an article published June 2 in Medical Economics.

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Physician Political Contributions Are Increasing, Shifting

FRIDAY, June 6, 2014 (HealthDay News) -- The political alignment of physicians in the United States has shifted from predominantly Republican to predominantly Democrat, based in part on the larger number of women physicians and smaller percentage of physicians practicing solo or in small practices, according to research published online June 2 in JAMA Internal Medicine.

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Many 'Inconsistencies' in ACA Sign-Ups: Report

THURSDAY, June 5, 2014 (HealthDay News) -- A new government document finds that more than a quarter of the eight million people who signed up for coverage under the Obama Administration's new health care law have "inconsistencies" in the data they supplied.

Health Highlights: June 5, 2014

Gastric Bypass Sx May Be Best Strategy for Obese T2DM Patients

THURSDAY, June 5, 2014 (HealthDay News) -- Compared to diet and lifestyle changes, gastric bypass surgery appears to be the clear winner in helping obese people with type 2 diabetes lose weight and even rid themselves of the disease, according to a pair of studies published online June 4 in JAMA Surgery.

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Abstract - Halperin
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Claim Denials Expected to Increase

WEDNESDAY, June 4, 2014 (HealthDay News) -- Even with good office procedures, most practices are plagued by claim denials, a hassle that is expected to increase in the coming years, according to an article published May 8 in Medical Economics.

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Kineflex-L, CHARITE Artificial Discs Yield Similar Outcomes

WEDNESDAY, June 4, 2014 (HealthDay News) -- The Kineflex-L Disc and the CHARITE artificial disc produce similar outcomes in patients undergoing lumbar total disc replacement (TDR), according to a study published in the May 20 issue of Spine.

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Most Physicians Would Forgo Aggressive Treatment

WEDNESDAY, June 4, 2014 (HealthDay News) -- Although physicians regularly recommend high-intensity, aggressive, life-prolonging care for their terminally ill patients, the vast majority would choose to forgo such care for themselves at the end of life, according to a study published online May 28 in PLOS ONE.

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EHRs Can Be Used to Boost Practice Revenue

TUESDAY, June 3, 2014 (HealthDay News) -- Practices can achieve return on investment (ROI) for implementation of electronic health record (EHR) systems if they participate in alternative delivery models, according to an article published May 8 in Medical Economics.

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Outcomes of CABG Worse in Patients With Diabetes

TUESDAY, June 3, 2014 (HealthDay News) -- Coronary artery bypass graft surgery (CABG) is more expensive and the risk of long-term adverse outcomes is greater in patients with diabetes mellitus (DM), according to research published in the June issue of the Annals of Thoracic Surgery.

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FDA Approves Generic Version of Celebrex

MONDAY, June 2, 2014 (HealthDay News) -- The U.S. Food and Drug Administration on Friday gave its approval to the first generic version of the pain reliever Celebrex (celecoxib).

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Surgical Checklists Cut Post-Op Complications

MONDAY, June 2, 2014 (HealthDay News) -- Surgical checklists reduce postoperative complications but have no significant effect on mortality, according to a review published in the June issue of Anesthesiology.

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Physician's Briefing