Orthopaedic Resident Practice Management and Health Policy Education: Evaluation of Experience and Expectations

Abstract

IntroductionPractice management and health policy have generally not been considered integral to orthopaedic resident education. Our objective was to evaluate residents’ current experience and knowledge, formal training, and desire for further education in practice management and health policy.MethodsWe developed a 29-question survey that was divided into three sections: practice management, initial employment opportunity, and health policy. Within each section, questions were directed at a resident’s current experience and knowledge, formal training, and interest in further education. The survey was distributed at the end of the academic year through an Internet-based survey tool (www.surveymonkey.com) to orthopaedic residents representing multiple programs and all postgraduate years.ResultsThe survey was distributed to 121 residents representing eight residency programs. Of those, 87 residents responded, resulting in a 72% response rate. All postgraduate years were represented. Regarding practice management, 66% had “no confidence” or “some confidence” in coding clinical encounters. When asked if practice models, finance management, and coding should be taught in residency, 95%, 93%, and 97% responded “yes,” respectively. When evaluating first employment opportunities, the three most important factors were location, operating room block time, and call. Regarding health policy, 28% were “moderately familiar” or “very familiar” with the Physician Payments Sunshine Act, and 72% were “not familiar” or “somewhat familiar” with bundled payments for arthroplasty. Finally, when asked if yearly lectures in political activities would enhance resident education, 90% responded “yes.”Discussion and conclusionRegarding practice management, the survey suggests that current orthopaedic residents are not familiar with basic topics, do not receive formal training, and want further education. The survey suggests that residents also receive minimal training in health policy. Residents feel that health policy will be important in their careers, and they would benefit from formal training in residency.

Coding Practices in Hand Surgery and Their Relationship to Surgeon Compensation Structure

“…Although resources have improved over the years, there is still a gap in understanding medical coding and billing. 3 , 16 , 17 , 18 , 19 The ASSH offers a free webinar on practice management, which has included topics on reimbursement and coding. 20 Formal education programs have shown significant improvement in residents’ knowledge and ability to identify fraud.…”

“…Recent literature has shown that these educational problems still persist. 3 , 16 , 17 , 18 , 19 The ASSH Coding Corner newsletter is an effort to distribute coding knowledge and updates across the ASSH membership. 20 Improved communication and education regarding appropriate coding practices as well as easily accessible reference materials may assist in minimizing coding discrepancies for surgical hand procedures.…”

The Transition to Practice from Residency and Fellowship

“…Regardless of the practice setup (i.e., academics, private practice, or hospital-employed), knowing how to appropriately code and bill for services is critical. In a recent survey study by Stautberg et al, >90% of the responding orthopaedic residents agreed that training in coding and billing during residency is “essential” and their training would be more complete with formal education on these topics 8 . Only 13% of those respondents stated that they would be confident enough to code for provided services if they were in independent practice the next day 8 .…”

Engaging in advocacy during medical training: assessing the impact of a virtual COVID-19-focused state advocacy day

“…However, health policy and advocacy education have traditionally been lacking within US graduate medical education, with most non-medical educational efforts focusing on business preparedness and practice management among residents and recent graduates across many medical specialties. [1][2][3][4] These gaps in health policy and advocacy education can leave trainees feeling frustrated and paralysed; while trainees feel it is essential for physicians to participate in advocacy efforts to shape health policy, their perceived ability to do so is curtailed by a lack of knowledge surrounding these areas. 5 6 Further, lack of health policy and advocacy awareness can also be detrimental to the quality and equity of patient care provided, prompting calls to address this critical training gap.…”