May Round Up

The round up is going to occur every so often-basically when I feel there is enough quality information to pass onto you and will include a brief summary and hopefully some insights.

Truth Telling MD Debunks Knee Replacement Surgical Claims on the Net

The first sentence of this next article starts out “Total knee replacements are one of the most successful procedures in all of medicine.” Over 6,000 websites contain this exact sentence.” Actually google searching in NY yields over 9,000 results of pages that use this exact phrase. Much of what passes as information today is swiped from one or two places and repeated over and over again.  Oh snap now my article will come up in the results as well for this phrase.

I work really hard to avoid passing on what I think is meaningless information or outright marketing hype. I want to highlighted this next article because it was written by an MD who chronicles his forthright comments as he searches the google search engine results for knee replacement + New Orleans. He is reading between the lines of the slick advertising and so should you. Enjoy.

Knee Replacements – New Orleans Magazine – May 2015 – New Orleans, LA “Total knee replacements are one of the most successful procedures in all of medicine.” Over 6,000 websites contain this exact sentence.

A Google search linking knee replacement and New Orleans returned 244,000 hits one day and 246,000 the next. The first site to pop up, fueled no doubt by some payment to Google, promises an “advanced technology and technique” yielding better clinical outcomes, quicker recovery time, reduced pain, highly accurate placement of knee implants and shorter hospital stays.

Checking a Medicare website, I was unable to verify the claim of shorter hospital stays, but this hospital’s complication rate after knee replacements was “no different than the national rate.” Looking at other measures this hospital reported fewer intravenous line infections but more surgical site infections after colon surgery. And the amount of time patients were kept in their emergency room before admission was almost twice the Louisiana average.

The second hit took me to a company website promoting a replacement joint “lab-tested to simulate the number of steps the average person takes in 30 years.” Insert your location in their Find a Physician box ,and up pop names of select orthopedic surgeons who use their “exclusive technology.” There were eight surgeons certified to use their specific device on the Northshore but only four in Jefferson and Orleans parishes. Scrolling down to technical notes,  I read, “The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people.”

The third hit was a Northshore orthopedic surgeon who believes in “the body’s natural ability to heal itself.” Another local practice site describes in laymen language what knee replacement involves both during and after surgery. I searched some text from this local website online and found huge hunks of identical wordage online from Mayo Clinic.

Angie’s List popped up part way down the first page of hits. It promised to name 12 knee replacement surgeons to avoid and 35 top-rated ones. When they asked for my credit card number to collect a monthly fee, I moved on, knowing that office staff and PR firms can outdo even former Assistant Federal Attorneys in their posting abilities.

Another link was to an archived local television news segment reporting how “a local surgeon has created a way for knee replacement patients to go home the same day and heal faster.” Turns out the Rapid Recovery Knee Replacement this team “created” is a an off-the-shelf program sold to hospitals and physicians to market and streamline joint replacement surgeries with an eye for higher revenue returns.

 

OutPatient Knee Replacement:The Next Big Thing

There is a big push to lower the cost of knee replacements as large volumes of surgeries are helping to accelerate healthcare  costs.  In the first article, Brobson Lutz, MD. talked about an ” off-the-shelf program sold to hospitals and physicians to market and streamline joint replacement surgeries with an eye for higher revenue returns.”  There are pros and cons for outpatient surgery and I’ll be doing a full  article soon but keep in mind this revolution is not patient centric. You will see plenty of articles similar to the one below. Beware. Mostly these are glorified press releases promoting the strategy  as part of an advertising campaign by the hospital…My advice at this point is to avoid right now until more data comes in.

Cabell Huntington Hospital performs outpatient knee replacement

Although total knee replacements are more or less common these days, Cabell Huntington Hospital reports performing something new — a total knee replacement done on an outpatient basis.

“Still, even today, only about 1 percent of total joint replacements in this country are done on an outpatient basis, and I’m delighted to report that we have the framework and ability to do this in Huntington.” Cabell Huntington Hospital performs outpatient knee replacement – Business, Government Legal News from throughout WV

More Reasons To Avoid Low Volume Hospitals

And if you needed more reasons to pick a high volume hospital read this really informative piece. Thde bottom line is if you live someplace rural SERIOUSLY consider having the surgery somewhere else even if that means you have to travel and stay with a family member or friend for awhile before heading home.

Risks Are High at Low-Volume Hospitals

Risks Are High at Low-Volume Hospitals – US News As many as 11,000 deaths may have been prevented between 2010 and 2012 if patients who went to the lowest-volume fifth of the hospitals had gone to the highest-volume fifth.

Like other hospitals in thinly populated areas, Sterling Regional Medical Center does a bit of everything. The 25-bed Colorado hospital has its own heliport, delivers about 200 babies a year and admits more than 1,200 patients for a variety of conditions and procedures. Replacing worn and painful hips and knees is among them. To patients, the surgery may seem perfectly routine.

These large numbers of low-volume hospitals, the analysis found, continue to put patients at higher risk even after three decades of published research have demonstrated that patients are more likely to die or suffer complications when treated by doctors who only occasionally see similar patients rather than by experienced teams at hospitals with more patients and established protocols.

“You can save your life by picking the right place,” says Leah Binder, director of the Leapfrog Group, a consortium of major employers that emphasizes safety in measuring hospital performance.