Editor's Note The Centers for Medicare & Medicaid Services (CMS) on October 9 announced proposed changes to how it enforces the Physician Self-Referral Law (ie, Stark Law), which penalizes physicians and other healthcare providers for referring patients to outside services they could stand to benefit from financially. The proposed rule…

Read More

Editor's Note This survey of Harvard Medical School students’ perceptions of barriers to a career in surgery found high rates of verbal discouragement and concerns about family aspirations. Of 729 medical students surveyed, 261 completed the questionnaire (58.6% women, 41% men, 0.4% transgender). Results showed: no significant gender difference in…

Read More

Editor's Note In this study of patients with left main coronary disease, there was no significant difference in outcomes at 5 years between treatment with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Researchers randomly assigned 1,905 patients with left main coronary artery disease of low or intermediate…

Read More

Editor's Note In this study of patients with displaced femoral neck fractures, the incidence of secondary procedures did not differ significantly between patients who had total hip arthroplasty (THA) and those who had hemiarthroplasty. THA was associated with modestly better function over 2 years but with a slightly higher incidence…

Read More

Editor's Note This national survey of surgical residents found that needlesticks occur frequently, many events are not reported, and numerous reporting barriers exist. Of 7,395 respondents from all 260 general surgery residency programs, 27.7% noted experiencing a needlestick in the last 6 months. Most events occurred in the OR (77.5%)…

Read More

Editor's Note In a proposed rule, the Centers for Medicare & Medicaid Services (CMS) is considering whether to reimburse for percutaneous coronary interventions (PCIs) at ambulatory surgical centers (ASCs), the September 20 tctMD reports. As of May 1, 2019, approximately 22 states allowed for coronary interventions to be done outside…

Read More

Editor's Note This study found that surgical site infections (SSIs) occurred most commonly after total joint replacement revision procedures and were related to many patient comorbidities, which were significantly associated with a higher risk of SSIs. In this analysis of 335,134 total knee replacements (TKRs) and 163,547 total hip replacements…

Read More

Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…

Read More

Editor's Note Though recent guidelines mandating additional barrier attire for all scrubbed and unscrubbed OR personnel from the Agency for Healthcare Research and Quality (AHRQ) and Joint Commission, which include bouffant caps covering all hair and long-sleeved surgical attire covering all exposed skin, this study finds that this mandate does…

Read More

Editor's Note Overlapping, nonconcurrent surgery was not associated with an increase in serious unanticipated events in this study. Of 61,525 surgical procedures performed over 1 year at a large academic medical center, a total of 8,391 patients had any overlap (beginning or end) and were matched on 11 variables. Compared…

Read More