Letter from the President
It is truly a great honor to have been elected to serve as the President of the New Jersey Orthopaedic Society for this year. During the last several years serving on the board of The New Jersey Orthopaedic Society and organizing two of our annual educational symposia, I have come to truly understand how crucially important the NJOS is to the practicing orthopaedic surgeon in New Jersey. With over 500 members we are fortunate to have one of the country’s largest and most active specialty societies. The NJOS serves the orthopaedic community through its missions of education and advocacy.
By way of introduction, I have been a practicing orthopaedic hand surgeon in Gloucester County since I completed my training at the Hospital of the University of Pennsylvania and the Indiana Hand Center in 1996. I have served in leadership positions at my two surgical centers and have been involved in the Medical Society of New Jersey having previously served on their Board of Trustees for over 10 years. I am currently Vice President of the Medical Staff at Inspira Medical Center in Woodbury, New Jersey.
Each spring, our annual educational symposium brings several nationally known thought leaders in for a Saturday morning session to share their insight on the cutting edge and controversial issues in orthopaedics. In addition, in the afternoon prior to the symposium, we sponsor Dr. Vincent McInerny’s annual residents’ research and complications conference. I believe this is unique to New Jersey in that it brings together orthopaedic residents from every single residency in the state to present their research or complicated case reports to each other, the state’s orthopaedic community, and the visiting professors in a very collegial forum. Most past faculty have shared with me how rare this experience is in comparison to what they see as they travel the country lecturing.
I am also pleased to announce that we are collaborating with The Eastern Orthopaedic Association for their upcoming annual meeting (October 19-22, 2016) in New Orleans. NJOS members will be able to attend the meeting at the EOA member rate. In addition, several members of NJOS will be moderating sessions and the NJOS has awarded two travelling fellowships to New Jersey resident physicians to presents their research papers. Finally, The Society has invited Dr. Thomas E. Price to speak. Dr. Price is a six term congressman from Georgia who was, for twenty years, a practicing orthopaedic surgeon. I look forward to hearing his perspective on the myriad of federal programs including the ACA and MACRA that impact our lives on a daily basis.
While most of us believe our residency and fellowship training prepared us for the clinical practice of orthopaedics, we soon realize that the practice of medicine is profoundly impacted by the business practices of hospital systems and the insurance industry as well the legislative and regulatory environments they are so good at influencing. We frequently may feel that our livelihoods and our ability to treat our patients are beyond our control. With active participation in the New Jersey Orthopaedic Society, however, I realize that you do have a voice to influence these decisions that are being made around you. Our advocacy team of lobbyists and legal counsel help to organize the orthopaedic opinion on the impact of many of the issues currently being debated in the New Jersey Legislature (Out of Network, Narrow Networks, Ambulatory Surgical Center Issues, Opioid legislation and regulation, Scope of Practice Issues). Through our purchasing Alliance that provides a significant discount for malpractice coverage with MD Advantage, we have been able to have significant visibility and clout in Trenton to help have our concerns heard.
The New Jersey Orthopedic Society Board and I value the perspective and experience of each of our members. We truly want to make sure that the society is focused on what the members need and want us to do. Please feel free to contact me at email@example.com with any questions or concerns.
Bruce Monaghan, MD
The State Board of Medical Examiners yesterday, March 2nd, adopted emergency regulations to implement the new opioid prescribing limitations law recently signed into law by Governor Christie immediately. Please note that you and your physician colleagues should immediately comply with these regulations. Please find the emergency regulations here: http://www.njconsumeraffairs.gov/bme/Documents/BME-Emergency-Adoption-and-Concurrent-Proposal.pdf. In addition, please find an update to the bulletin we recently provided below. Again, the law’s prescribing requirements are now in effect. These emergency rules are effective immediately and will remain in effect for 60 days, and are being concurrently proposed for re-adoption to permit the submission of comments concerning the rules and the intention of the Attorney General and Board to make these rules permanent. Comments may be submitted after March 20th when this rule is officially published. We will remind you when that date approaches. contact us with any questions.
NEW STATE OPIOID PRESCRIBING INFORMATION
Please review this entire bulletin and share it with your physician colleagues so they can comply with this new state law as soon as possible. Last month, Governor Chris Christie signed sweeping new legislation changing state law as to how and when opioid drugs may be prescribed. The law has now taken effect via emergency regulations. The bill was scheduled to take effect on May 16, 2017 but as we suspected the prescribing provisions are now in effect. Under the new law and according to the emergency regulations, a practitioner is not permitted to issue an initial prescription for an opioid drug in a quantity exceeding a five-day supply for treatment of acute pain. We advise members to amend their opioid prescribing practices to comply with the law as soon as possible.
Prior to issuing such an initial prescription, a practitioner shall:
Discuss with the patient the risks associated with the drug, including risks of addiction and overdose;
Explain the reasons why the prescription is necessary;
Set forth available alternative treatments;
Take and document the results of a thorough medical history;
Conduct, as appropriate, a physical examination;
Develop a treatment plan focused on the patient’s pain;
Access relevant information from the Prescription Monitoring Program.
On the fourth day of an initial prescription a practitioner may, after consultation with the patient, issue a subsequent prescription for the opioid drug. In order to do so, the practitioner must determine that the subsequent prescription is: (i) necessary and appropriate; and (ii) will not present an undue risk of abuse, addiction or diversion.
If a third prescription is issued to a patient for an opioid, the practitioner is required to enter into a pain management agreement with the patient. Finally, any health care professional authorized to prescribe an opioid shall take part in at least one educational credit (in each reporting period) related to prescribing opioid drugs.