Orthopaedic Surgeon Shortage Predicted-Due to Soaring Joint Replacement Procedures

Two studies find patient demand will soon surpass the number of orthopaedic surgeons available

In the near future, there may not be enough orthopaedic surgeons to provide joint replacements to all who need them. According to two new studies presented at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), the number of patients requiring hip or knee replacement surgery is likely to soon outpace the number of surgeons who can perform the procedure.

According to a study co-authored by Thomas K. Fehring, M.D., if the number of orthopaedic surgeons able to perform total joint replacements continues at its current rate:

In 2016, 46 percent of needed hip replacements and 72 percent of needed knee replacements will not be able to be completed.

“I was somewhat shocked at the shortfall that we predicted,” says Dr. Fehring, an orthopaedic surgeon at OrthoCarolina Hip and Knee Center in Charlotte. “This is life-changing surgery, offering patients the chance to be mobile, and a very high percentage of patients may not be able to receive it.”

Joint replacement, also known as arthroplasty, is considered by many to be one of the most successful medical innovations of the 20th century. Total joint replacement is a surgical procedure in which the patient’s natural joint is replaced with an artificial one.

More than 700,000 primary total hip and knee replacements are performed each year in the United States, and demand for the surgery is expected to double in the next 10 years.

A second study co-authored by Steven M. Kurtz, Ph.D., found that a major reason for the growth in patient demand for joint replacement is the increase in younger patients.


Projections show that by 2011, more than 50 percent of patients requiring hip replacements will be under the age of 65; the knee-replacement patient population will reach that threshold by 2016.


For primary total knee replacement, the fastest growing group of patients is in the 45-54 age category; the number of procedures performed in this age group is projected to grow from 59,077 in 2006 to 994,104 (an increase of 17 times) by 2030.

“Joint replacement is generally thought of as a procedure for older people, over 65,” says Dr. Kurtz, corporate vice president and office director at Exponent, Inc., in Philadelphia. “Our projections show that younger people make up a big piece of the pie, and that is only going to increase if historical trends continue.”

Both researchers believe that the key to stemming this supply-side crisis is for policymakers to reconsider the rates at which total joint replacements are reimbursed. The reimbursement rates have consistently gone down over the years, even as the costs of providing health care have gone up.

However, Dr. Kurtz notes that the possibility of new technologies may offer a glimmer of hope. “It’s hard to predict what changes will come about in the next 20 years,” he says. “Hopefully, we will have some new tools in the future to help address this problem, which could be of epidemic proportions.”

Disclosure: Dr. Fehring and Dr. Kurtz and their co-authors received no compensation for this study.

National Office of Urban Affairs

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The U.S. Conference of Mayors meeting held this week in Washington D.C. was highlighted by a meeting with the President and Vice President of the United States on Friday, February 20 inside the White House East Room.

President Obama announced that he signed February 19, an executive order establishing the White House Office of Urban Affairs, where former New York City Bronx Borough President Adolfo Carrion will head up the agency. The office was created to, ”provide leadership for and coordinate the development of the policy agenda for urban America across executive departments and agencies;
(b) to coordinate all aspects of urban policy;
(c) to work with executive departments and agencies to ensure that appropriate consideration is given by such departments and agencies to the potential impact of their actions on urban areas;
(d) to work with executive departments and agencies, including the Office of Management and Budget, to ensure that Federal Government dollars targeted to urban areas are effectively spent on the highest-impact programs; and
(e) to engage in outreach and work closely with State and local officials, with nonprofit organizations, and with the private sector, both in seeking input regarding the development of a comprehensive urban policy and in ensuring that the implementation of Federal programs advances the objectives of that policy.”

In short, the office will coordinate all federal urban programs. The President said he is getting letters from constituents across the country about the problems they are facing. He acknowledged that mayors cannot deficit spend and that is why the recovery plan will create 3.5 million jobs and aid state and local governments to stem municipal cutbacks. He reiterated that 18 million will get health insurance and seven million taxpayers will receive financial help to get insurance after job loss.

“What makes this recovery plan so important we are putting America to work in what needs done in critical areas…it lays a new foundation,” the President said.

He said 400,000 people will be put to work across the country in infrastructure improvement based jobs. Infrastructure improvements include roads and highways, bridges, high speed rail, early childhood education, modernization of medical records and laying broadband lines

“We’ve done more in 30 days to advance health care reform than has occurred in a decade,” he said. He also said, what is required in returned is unprecedented accountability and responsibility to the taxpayer.

“They expect to see their money spent in its intended purposes without waste or fraud,” President Obama said.
He said this means he will hold both federal and local municipalities responsible for its use.
“We will use the new tools to watch the taxpayers money with more rigor and transparency than ever. If a federal agency proposes something that will waste money I will put them on notice,” President Obama said.

He said the same goes for local municipalities.
“I will call them out on it.” No compromise or shortcuts, he said.
He said the stimulus plan does not mark the end but the beginning of what he plans to do to attack urban challenges.
The President said he thinks about his start into politics when speaking with mayors--community outreach. He said citizens frequently look to local municipalities in times of financial trouble.

Reporters speaking with the mayors during an impromptu news conference on the white house driveway, after the meeting, asked about this accountability.
The mayors collectively said they welcome having their feet being held to the fire because it is what they have been going through everyday anyway. New Orleans mayor, Ray Nagen, said the money the cities will receive will go through the states to be disbursed. He said it took about three years to get hurricane victim monies. He said the legislature of each state can vote whether to take the money or not.

Questions then centered around making sure that the cities could receive the economic stimulus if the money was voted approved by each state and how they would like to see it spent.
After hearing from Democratic mayors, reporters on hand called to hear from Republican mayors.

A Republican mayor from Minnesota said, “one of the things we are now recognizing are the tools being put on the table to put our people back to work. The reinvestment act makes sure people are back to work and infrastructure is repaired and amenities offered, enriching the lives of each city’s citizens.
Another Republican South Carolina mayor said he was against the stimulus package at first but now that the recovery bill is law, he thinks, “we need to put as much of the money in long term projects as possible.”
It was apparent that the mayors who attended the meeting were on board with the President's plans.

Vice-President Joe Biden reminded all in attendance about the web site that could help shed light on how the recovery money is spent.

“Only after one month, laws have been signed to strengthen the American people. The results are clear and ready for the people to see it involves patient outreach," Vice President Joe Biden said, during an introduction of President Barack Obama.
“There is so much more to do,” he said.

Biden spoke of how for years America’s cities have been neglected and the concerns of its mayors unheard.
“We know how important cities are. Seven out of ten jobs are in (our nation’s) cities.” They haven’t been paid much attention to thus far.

He said the recovery package signed into law will provide “unprecedented investment in American cities."
“We have to make this work for our people,“ Biden said.
He acknowledged that taxpayers are trusting the government to spend the money in a way that it was intended. He said taxpayers can go to Recovery.gov to see how the money is being spent and make their concerns known.

He asked the mayors to highlight projects that need private investment and growth.
“The world is watching to see how well this will work.” Biden said.


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Media Seen as the Primary Cause of the Depth and Length of the Global Recession, According to New Research From Frost & Sullivan

Companies Must Ignore Fear, Make Smart Moves to Emerge Stronger

In a recent survey conducted by Frost & Sullivan, the Growth Partnership Company, 91% of CEOs blame the breadth and depth of the current economic situation on the media.

"The media's manipulation of statistics, negativity, exaggeration, and doomsday forecasts have driven fear and panic among consumers and businesses alike," says David Frigstad, Chairman of Frost & Sullivan.

Economic statistics are often twisted and exaggerated. The fear of total economic collapse is perpetuated in the media to grab attention and sell more copies or attract more viewers or listeners. Because of this, consumers and business have frozen spending, canceled projects, sold investments, and laid off workers. This has caused a downward spiral in demand and pricing that has now caused about 20 trillion dollars of damage globally.

"As the media continues to perpetuate fear, uncertainty and doubt, there is a growing chance that it will result in a self-fulfilling prophecy," adds Frost & Sullivan Economist Sandeep Maheshwari.

What clearly started out with financial mismanagement and fraud on Wall Street has now escalated into a major global recession exacerbated by the media. According to Frost & Sullivan's research, CEOs cite how the media has continued to drive fear through efforts to gain more readers, viewers, and listeners. The ironic turn is that the media is also being victimized by the current recession, with declining audiences and falling ad revenues.

In the responses portion of the study, CEOs made several interesting comments:

-- "Several newspapers have compared the overall job losses to the Great Depression without taking into account the huge increase in U.S. population since that time. These comparisons only generate more fear and are counter-productive."

-- "Economists miss every turn in the economy. Why do we rely on their forecasts today when they are so unreliable? They move like a herd of antelope -- their current forecasts all fit nicely into a pack."

-- "I recently read a headline that said Microsoft will lay off 5,000 workers. At the end of the piece it mentioned it would be over a three year period. Compared to the overall size of Microsoft, this is not newsworthy."

We are now at a turning point. An unprecedented global stimulus plan and guaranteed programs are now in place. More than 8 trillion dollars globally is being pumped into the economy, along with trillions of dollars in guarantees. Retail sales, housing prices, existing home sales, and used car sales are all showing signs of strength. Interest rates are at historical lows and mortgage relief is in sight.

"All of these trends could signal the turning point if we change our outlook. The media, economists, politicians, bankers, and business executives could collectively turn the economy around by working simultaneously to restore confidence back into the system -- in turn, calming the public. It's time for us to give up on the doom and gloom," concludes Frigstad.

America's Emptiest Cities

Vacancy rates in these spots spell lots of empty neighborhoods.
Call it a modern-day tale of two cities.
For decades, Las Vegas, ripe with new construction and economic development, burgeoned into a shimmering urban carnival. Detroit, once the fulcrum of American industry, sagged and rusted under its own weight.

Jeff Howe and Crowdsourcing

Riot

...But when a riot breaks out and the prisoners take him hostage, a lifer (played by Nicolas Cage) is forced to help the young man out. xXx director Rob Cohen was originally attached to the project when it was set-up at New Line.

First Look: Nic Cage in Matthew Vaughn's Kick-Ass

September 10, 2008
Source: TheBadandUgly.com, Millarworld.tv
by Alex Billington

"If I absolutely have to go to jail for a comic-book movie then I accept no substitutes. This is the one. I hereby declare Kick-Ass as the greatest movie of 2009." That's how author Mark Millar starts out his blog on the production of Kick-Ass, the comic book adaptation directed by Matthew Vaughn that's currently shooting in London.