FOS

ACOEM releases guidelines on disorders of the hip and groin

The American College of Occupational and Environmental Medicine (ACOEM) has published new medical treatment guidelines for providing care to workers with injuries and disorders of the hip and groin. The guidelines include more than 200 recommendations covering prevention of venous thromboembolic disease, hip arthroplasty, pre- and postoperative rehabilitation, and overviews of each treatment option, indicating the existence or lack of evidence, cost, and side effects. The guidelines are now available online through ACOEM's APG-I web application and will be published in the third edition of "Occupational Medicine Practice Guidelines" later this year. AAOS has not endorsed the guidelines and is relaying the announcement for informational purposes only.
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Cultural background can be a barrier in physician/patient relationship.

A column published in the New York Times looks at the issue of culturally competent care. According to the article, studies have shown that adherence to a medication or a treatment regimen is often lower than 50 percent—a figure that can drop further when there are cultural variations between physician and patient. Arthur Kleinman, MD, professor of medical anthropology and psychiatry at Harvard Medical School warns that even the term "cultural competency" can be restrictive in that it suggests that culture is not fluid and is only important for patients. Physicians themselves bring a "culture of biomedicine" that can result in misunderstandings. "What you don’t want," says Dr. Kleinman, "is doctors carrying around plastic cards listing the five things you need to think about when you see, for example, an Asian-American patient. What you want is the ability to inquire, to ask questions."

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Access the AAOS culturally competent care educational resources...

Osteoporosis-related fractures add billions to healthcare costs.

A recent study from the federal Agency for Health Quality and Research (AHRQ) finds that the hospitalization rate for patients admitted with osteoporatic-linked fractures increased by 55 percent between 1996 and 2005. Of the more than 1 million hospitalizations in 2006 that had a diagnosis of osteoporosis, more than one-quarter also involved a fracture. The study also included the following findings:

• Osteoporotic fractures cost hospitals $2.4 billion in 2006.

• Women were 6 times more likely to be hospitalized with an osteoporotic fracture than men.
• Two thirds of patients with an osteoporotic fracture were admitted through the emergency room.
• More than half of the patients were more likely to be released to a nursing home or rehabilitation center, compared to just 16 percent of patients requiring hospitalization for any reason.

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Steep rise in knee replacements projected.

According to a report in the November issue of the Mayo Clinic Women’s HealthSource, the number of knee replacements is expected to increase 525 percent by 2030. The following reasons are among those given for the increase:

• People are living longer and, to remain active, want the procedure done sooner rather than later.

• An increasing number of people have advanced arthritis, which could be related to ever-rising rates of obesity.
• The designs of artificial knees have been improved so that they can be adapted to the patient's needs and size.
• Minimally invasive knee replacement allows for smaller incisions and may facilitate faster recovery times.
• Studies show that many people who have total knee replacement achieve significant pain relief, improved mobility, and better overall quality of life.

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AAMC sees increase in medical school enrollees, minority applicants.

According to data released by the Association of American Medical Colleges (AAMC), the 2007 entering class is the largest ever, with nearly 17,800 first-year enrollees—a 2.3 percent increase over the previous year. Additionally, 11 of the 126 medical schools in the United States boosted their entering class size by more than 10 percent this year. The applicant pool also included more individuals from racial and ethnic minorities, with the number of black male applicants and Hispanic male applicants both increasing by 9.2 percent. The number of black males who accepted and enrolled in medical school this fall increased by 5.3 percent—a rate nearly double that of the first-year entrant increase overall. Hispanic male first-year enrollees remained at the same level as 2006. For more information:

http://www.aamc.org/newsroom/pressrel/2007/071016.htm