STATEMENT ON GOVERNOR HOCHUL’S 2022 STATE OF THE STATE ADDRESS
By John DiPreta, MD, President, New York State Society of Orthopaedic Surgeons
“Governor Hochul’s State of the State address was a thoughtful and hopeful articulation of the opportunities that abound in New York State when our government acts not as a barrier to progress, but as a partner in achieving it.
“The Governor made clear that health care is among her top priorities in the new year. Many challenges await her within that arena, as do many perspectives. We are hopeful that her policy and budget priorities will be founded on demonstrable, evidence-based approaches to care provision that will best ensure New Yorkers have access to the highest quality care delivered by the most qualified professionals.
“The New York State Society of Orthopaedic Surgeons will remain committed to being a productive partner and technical resource to the Governor and her team as, together, we address the challenges before us.”
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STATEMENT ON STATE’S ORDER TO DELAY “ELECTIVE” SURGICAL PROCEDURES THAT TAKES EFFECT TODAY
“Governor Hochul’s order to begin limiting certain surgical procedures is well-intended policy that unfortunately may do more to increase the suffering of New York’s patient population. The intent of the order is to reserve hospital capacity for potential COVID patient surges. However, as a blanket policy, it fails to consider and incorporate several critical factors.
“Primarily, it’s important to challenge the notion that certain procedures are ‘elective’ — a term that often is misunderstood to indicate that such procedures are ‘optional’ and therefore not critically important to a patient’s health and well being. For many patients, orthopaedic surgical procedures are essential interventions that resolve profound pain and debilitation that undermine both the physical and mental health of those who suffer.
“Unfortunately, due to policies earlier in the pandemic that prohibited ‘elective surgeries,’ and despite enhanced safety protocols and progress in the fight against COVID-19, thousands of patients in New York State with debilitating pain were not allowed to receive treatment, and were also hesitant to engage or re-engage with the healthcare system resulting in delays to care. These delays in surgeries and procedures ultimately resulted in prolonged pain and suffering, significant medical deterioration, and materially impacted patients’ prognoses, morbidity and/or treatment plans. It is important the Legislature, the Executive and regulatory partners understand how detrimental framing ‘elective surgeries’ as optional interventions has become for patients.
“Secondarily, the order unintentionally sends an erroneous signal that accessing healthcare of any kind presents a danger to the patient. Providers have instituted broad and effective COVID-19 protocols that have resulted in demonstrably safe access to care. Nevertheless, we saw volumes across many service lines, including primary care and chronic disease management, fall off significantly as the pandemic evolved. Thousands of seriously and chronically ill patients stopped or limited their pursuit of care vital to their lives and livelihoods. That cost has yet to be fully measured or understood, and should not be exacerbated.
“Lastly, as a blanket state policy the order is generally unnecessary. Providers and hospitals are most knowledgeable about their patients’ needs and their communities’ status and needs, including relative to COVID-19. They should be the ultimate decision makers regarding the appropriate site of service for their patients, keeping in mind quality, safety, and associated risks. With state guidance and coordination, hospitals and ambulatory surgical facilities can best determine the appropriate level of elective cases that can be performed while also maintaining pandemic response readiness.”
RECENT PUBLIC HEALTH STUDY PRESENTED AT NYSSOS ANNUAL MEETING FINDS LINK BETWEEN CHRONIC CANNABIS USE AND UNFAVORABLE JOINT REPLACEMENT SURGERY OUTCOMES
Albany, New York — A new study by researchers at the Maimonides Medical Center found a significant association between cannabis use disorder and unfavorable outcomes following total knee replacement. The study’s preliminary findings were unveiled at the New York State Society of Orthopaedic Surgeon’s (NYSSOS) annual meeting and symposium on October 22 by Dr. Miriam D. Weisberg, an orthopedic resident at the Maimonides Department of Orthopaedic Surgery, who was part of a team of researchers led by Maimonides’ research fellow Dr. Rushabh M. Vakharia.
The researchers collected data on more than 50,000 patients who had undergone total knee replacement surgeries, known as total knee arthroplasty, or TKA. Almost 10,000 of these patients had a clinical diagnosis of cannabis use disorder (CUD), which is generally defined as the persistent use of cannabis leading to impairment and social hinderance. The aim of the study was to determine whether cannabis use disorder patients undergoing primary TKA have higher rates of in-hospital lengths of stay, complications and increased healthcare costs.
The study concluded that:
- The majority of patients undergoing TKA with cannabis use disorder are between 45-65 years old.
- CUD patients were found to have nearly twice as long of an in-hospital length of stay following surgery (about 4-days compared to 2-days). This was also found to be increasing over the 8-year study period.
- CUD patients were 1.5 times more likely to have a medical complication, such as pneumonia, respiratory failure or heart attack, within 90-days following surgery.
- CUD patients were found to be up to 56 percent more likely to experience prostheses-related complications, such as loosening or infection, compared to their counterparts, within two years of their knee replacement.
- Day of surgery costs and total global 90-day episode of care costs were found to be nearly 20 percent higher in the CUD group compared to the case-matched cohort.
NYSSOS President Dr. John DiPreta said: “The study strongly suggests that all of the impacts of broader cannabis use are not yet fully understood, and that more research and diligent impact analysis is necessary as we move forward. We are hopeful that the state’s cannabis policy makers and regulators move cautiously, and more importantly, reflect on the health of all New Yorkers as they implement New York’s legalized cannabis program to ensure that any potential unanticipated consequences of increased cannabis use are effectively addressed and, if possible, mitigated. To that end, we stand ready to provide any assistance possible as it relates to the musculoskeletal health of New Yorkers and these consequences of cannabis use.”
The Maimonides research was one of several studies presented at the NYSSOS annual meeting and symposium. The full Maimonides study has been submitted for publication to the Journal of the American Academy of Orthopaedic Surgeons and is currently under review.
NYSSOS TO CONVENE NOVEMBER 9TH MULTIDISCIPLINARY WEB CONFERENCE TO ADDRESS CONCUSSION MANAGEMENT
Experts to Share Strategies on Recognizing Concussions and Providing Proper Treatment, Especially Among School Aged Children
Virtual Program Provided in Conjunction With the Brain Injury Association of New York State, Sports Medicine Concepts and Syracuse Orthopedic Specialists Will Provide Critical Guidance to a Wide Range of Education, Athletics and Medical Professions
Albany, New York — The New York State Society of Orthopaedic Surgeons today announced plans to convene a multidisciplinary virtual conference on November 9th to share evidenced-based approaches to recognizing concussions and providing proper treatment, especially among school-aged children.
The webinar event, which is also sponsored by the Brain Injury Association of New York State (BIANYS), Sports Medicine Concepts, and Syracuse Orthopedic Specialists, is targeted to a wide variety of education, athletics and medical professions, including: athletic trainers; athletic directors; school nurses, counselors, psychologists, social workers, and medical directors; teachers; primary care physicians; concussion clinics; physical therapists; speech and language therapists; pediatricians; occupational therapists and orthopaedists, among others.
Child and adolescent head injuries are far more common than previously thought. According to the federal Centers for Disease Control and Prevention, 11.7 percent of children aged 15 to 17 have experienced a serious head injury, creating a clear and emergent call to action.
The primary goal of the November 9th virtual conference is to provide each professional discipline with an understanding of its shared role in the concussion management care circle, and to actively apply concepts learned from the day's event.
NYSSOS President Dr. John DiPreta said: “Orthopaedists are focused on the health of the entire musculoskeletal system, including the head, spine and associated nervous system. The focus in recent years on concussion injuries at the professional athletics level has generated a far broader realization that athletes at every age and level must be protected from concussion injuries, and just as importantly, that the education, athletic and medical professionals who respond to and/or treat concussions are fully up to date on the most effective concussion recognition and treatment strategies available.”
Program elements of the conference include:
• Initial Assessment, Acute Management and Typical versus Prolonged Recovery, including: recognizing signs and symptoms of concussion; selecting and utilizing appropriate sideline assessment tools; identifying appropriate care and red flags for immediate referral/emergency transport; identifying “typical” recovery times/stages; and selecting appropriate referrals and rehabilitation tools to manage prolonged recovery.
• The Concussion Management Care Circle, with learning objectives that include: defining components of multidisciplinary concussion management teams; identifying rolls and responsibilities of each profession within the care circle; creating interdisciplinary communication plans; creating a concussion protocol that can address different severities of concussion; identifying strategies to manage patient expectations; and patient-provider communication.
• Navigating New York State Legislation and Regulations, with learning objectives that include: demonstrating understanding of the differences between state legislation, local guidelines, and specific organization policies; creating a concussion protocol that adheres to local and state regulations for your profession and patient population; and demonstrating understanding of pending legislation.
A full program agenda including faculty and eligibility for continuing education credits can be found at https://nyssos.org/concussion/
STATEMENT ON THE APPOINTMENT OF DR. MARY T. BASSETT AS NEW YORK STATE COMMISSIONER OF HEALTH
By NYSSOS President John DiPreta, M.D.
“The orthopaedic community welcomes the appointment of Dr. Mary T. Bassett as New York State’s new Commissioner of Health. Muscloskeletal health and the associated quality of life issues central to orthopaedic care are critical elements of a comprehensive and accessible health care system.
“We look forward to working with Dr. Bassett to continue our efforts to address disparities in care that undermine the muscloskeletal health of many underserved communities. Many complex and fundamental issues impact these matters, including insurance company practices that restrict care, and proposed policy changes that create barriers for orthopaedic physicians. We hope to work with DOH and the Legislature to address these concerns in the coming year.
“In addition, building on the work of NYSSOS and that of our national group, the American Academy of Orthopaedic Surgeons, we are eager to work with Dr. Bassett to build more diversity among the orthopaedic physician ranks to better address the needs of all communities.
“Governor Hochul has pledged to rely on health experts to advise her in making appropriate, evidence-based decisions for all New Yorkers. We believe such a foundation is essential for crafting effective health policy, and we are committed to helping her fulfill that pledge.”
Learn more
The New York State Society of Orthopaedic Surgeons (NYSSOS) is pleased to announce it has selected Altfest Personal Wealth Management as the preferred wealth management education provider for its members.
NYSSOS is the premier organization representing the orthopaedic community in New York. The Society serves orthopaedic specialists, subspecialists, fellows, residents and their patients by helping to create an optimal practice environment in which to provide quality and efficacious orthopaedic care.
“Our relationship with Altfest demonstrates further NYSSOS’ commitment to deliver value to its members throughout their professional lifecycle and beyond,” said NYSSOS’ president, Dr. John DiPreta. “Our partnership with Altfest enables members to receive custom tailored financial planning and investment management education as well as complimentary consultations. As the professional and personal demands on our members increase, we find it important to provide needed support and services to promote their education, resilience, and well-being. Our relationship with Altfest underscores this commitment to our members.”
Andrew Altfest, CFP®, President of Altfest Personal Wealth Management, said, “We are honored to have been selected by NYSSOS. Since its founding in 1983, Altfest has served the distinct financial planning and investment management needs of physicians. As NYSSOS’ partner, we will offer members timely, helpful, and usable financial planning information through a variety of means, including webinars, and email communications. We encourage members to take advantage of our educational content, which includes topics such as creditor and asset protection, student debt management, and tax reduction strategies, as well as our complimentary consultations.” “Given our many years of service to doctors,” Altfest continued, “we well understand the crucial part financial planning education plays in promoting their personal wellness. Altfest is gratified to have been chosen for this important role.”
To learn more about NYSSOS, including its benefits for orthopaedic surgeons, please visit www.nyssos.org. To learn more about Altfest, including its educational webinars, other informative content, and complimentary consultations for orthopaedic surgeons, please visit www.altfest.com/physicians or contact Jesse Frehling at jfrehling@altfest.com.
Governor Andrew M. Cuomo today announced that New York will end the state disaster emergency declared on March 7, 2020 to fight COVID-19. Given New York's dramatic progress against COVID-19, with the vaccination rates, and declining hospitalization and positivity statewide the state of emergency will expire after Thursday, June 24.
Federal CDC guidance will remain in effect, which includes masks for unvaccinated individuals, as well as all riders on public transit and in certain settings, such as health care, nursing homes, correctional facilities, and homeless shelters.
State and local government health departments will still be able to ensure mask rules and other health precautions are adhered to in those settings.
We will keep you abreast of any guidance coming out of the New York State Department of Health.
NYS Department of Health Commissioner Dr. Howard Zucker released the following statement regarding the Johnson & Johnson vaccine: "Today the CDC and FDA issued a statement recommending a pause in the use of the Johnson & Johnson vaccine out of an abundance of caution. New York State will follow the CDC and FDA recommendation and pause the use of the Johnson & Johnson vaccine statewide immediately today while these health and safety agencies evaluate next steps. All appointments for Johnson & Johnson vaccines today at New York State mass vaccination sites will be honored with the Pfizer vaccine. "As the CDC and FDA have said, any adverse events related to the Johnson & Johnson vaccine 'appear to be extremely rare' and, 'People who have received the J&J vaccine who develop severe headache, abdominal pain, leg pain, or shortness of breath within three weeks after vaccination should contact their health care provider.' "I am in constant contact with the federal government and we will update New Yorkers as more information becomes available."
OrthoInfo, the AAOS patient education website, is a free member resource that provides orthopaedic surgeons and patients with authoritative, in-depth information about musculoskeletal health.
The website features more than 400 articles, videos, and animations on common orthopaedic problems, surgical procedures, nonsurgical treatments, injury prevention, and healthy living.
All content is developed and peer reviewed by AAOS members. Written in simple language, OrthoInfo articles can help your patients be better informed and participate more fully in their care and recovery.
Access the site
Advocating for the orthopaedic surgeon, patients and musculoskeletal health in New York.
info@nyssos.org 1-518-439-0000 Address: PO Box 38004, Albany, NY 12203
