New orthopaedic reimbursement ties compensation to number of times ‘that’s what she said.’

Inland Empire, CA – In addition to the new ICD-10 coding that will soon be transforming medical coding, Orthopedic RVU’s will now be based on a cases average ‘that’s what she saids’ or TWSS’s.  According to a recent American Association of Orthopedic Surgeon (AAOS) press release, the move came after months of private negotiations between surgeon groups, with the AAOS finally entered in the backdoor discussions last week, prompting today’s announcement.  Steve Remi, an AAOS representative offered a statement: “Heehee…entered in the backdoor…”

Michael Reiswig, one of the surgeons responsible for the historic change gave his take: “It really was pretty intuitive.  Carpal tunnel releases were averaging 30 minutes per case, and like 0.7 TWSS’s. I mean, what can you say during a carpal tunnel release, 'looking forward to doing some hand work'? On the other hand, tibial nailings were around 90 minutes and 4.3 TWSS’s per case.  ‘This rod’s too big.’ ‘It won’t fit in the canal.’ ‘Just pound on it a little harder.’ It only made sense that higher compensation should be linked to the cases with more double entendres.” 

The orthopedic oncologists were the one sub-specialty opposed to the move, stating simply that they were 'getting screwed’. 

I was told to start a case before the attending got in the room.  He looked at my work so far and before leaving to go scrub in...

Went to the hospital after studying at starbucks for a while.

Nurse A: 'mmm, you smell like coffee. Jennifer, come smell this guy!'
(get aggressively smelled by like 4 nurses)

thought A) this is weird
thought B) might be onto something here
thought C) why are they still smelling me. this is weird.

OR conversations:

(conversation about a paleo diet)
RN: "I basically don't eat anything with ingredients I can't pronounce. Like bananas."
Me: "Do you know how many complex sugars and compounds there are in bananas which we both can't pronounce?"
RN: "But I can pronounce banana."
Me: "And I can pronounce cheesypoof."

Dr. Simes demonstrating the proper technique of leaving the elbow free of webril during prophylactic splinting.

Junior orthopedic resident covers mistake by coining the phrase "prophylactic splinting"

RIVERSIDE, CA - Quick thinking second year junior orthopedic resident Mark Simes attempted to cover a mistake by convincing an attending of the utility of prophylactic splinting. At sign out, Dr. Simes presented the case of 38 year old Blake Sampson who presented acutely intoxicated to the ED with a left both bone forearm fracture. Dr. Simes then presented post reduction films of a splinted and seemingly uninjured right forearm.

When questioned about the apparent mistake, the rapidly adapting Dr. Simes stated: "We knew the left forearm was fractured, that much was clear. Would it displace?  Was it stable? I wanted to evaluate the full nature of injury, which I felt needed to be stressed under physiologic conditions to do so." When questioned about why a splint was placed on the uninjured arm, Simes stated: "In his state of intoxication, who knew what was going to happen to the right arm. I wasn't so much concerned with the fracture that was, I was concerned about the fracture that might be." The attending gave a long sigh and was heard mumbling something about "needing to get to private practice" while the OR control desk called for the patient for his prophylactic forearm ORIF.