New Oklahoma law makes contraception more convenient
OKLAHOMA CITY- A new law that gives women access to a six month prescription of birth control will make it easier to access pregnancy prevention medication, one health advocate said.
Maintaining access to contraceptives can be difficult for women who live in rural areas, have multiple jobs, children to care for and limited transportation.
Senate Bill 176 will require fewer trips to the pharmacy, said Laura Bellis executive director of the Take Control Initiative.
The new law, which takes effect Nov. 1, requires insurance companies that provide coverage for contraception to allow women to obtain six months of birth control at the same time after being prescribed a three month supply.
The Take Control Initiative, which is based in Tulsa County, has operated the nation's longest running birth control access program for 15 years. The program is focused on removing barriers while growing access to birth control.
Increasing access can also improve the effectiveness of contraception. Bellis said some methods of contraception require individuals to take it at the same time every day. Maintaining access to care aids in consistency.
Having access to contraception by age 20, reduces women's chances of living in poverty, according to the group's 2024 annual report.
Sen. Jo Anna Dossett, D-Tulsa, one of the authors of the legislation declined to comment. Rep. Cynthia Roe, R-Lindsay, did not return messages seeking comment.
Although contraception can be used to prevent pregnancy, 14% of women use it for non-contraceptive reasons. It can be used to treat acne, irregular periods, cramps, migraines and endometriosis.
'Hopefully this change in law will remove a barrier to these organizations that are truly trying to protect public health in Oklahoma,' said Mary Boren, D-Norman. She was one of 30 senators who voted in favor of it.
Gov. Kevin Stitt allowed the bill to become law without his signature.
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Forbes
5 hours ago
- Forbes
Ethiopia: Brutal Conflict-Related Sexual Violence Continues To This Day
A woman poses for a photograph in an undisclosed location on October 11, 2024. She told AFP that at the beginning of the conflict in Tigray in November 2020, she had been beaten, tortured and raped by seven men with different military uniforms, Ethiopian and two-year war in Ethiopia's Tigray region left hundreds of thousands people dead, more than one million still displaced and cost more than $20 billion in damage, until a peace deal in November 2022 ended the bloodshed. Among the many barbaric acts inflicted on civilians during the two-year conflict in Ethiopia's northernmost region of Tigray, rape and sexual violence were "systematic" and used as a weapon of war, according to a study published in 2023 by the scientific journal BMC Women's Health. Estimates of the number of rapes committed vary widely — up to as many as 120,000 — according to data compiled by the researchers, with many reluctant to report the attacks. The victims reported that most of the perpetrators were Ethiopian or Eritrean soldiers, but also militiamen from the neighbouring Amhara region. (Photo credit: MICHELE SPATARI/AFP via Getty Images) AFP via Getty Images On July 31, 2025, Physicians for Human Rights (PHR) and the Organization for Justice and Accountability in the Horn of Africa (OJAH), both non-governmental organizations, published the results of an investigation into conflict-related sexual and reproductive violence (CRSV) in Ethiopia, focusing on the Afar, Amhara, and Tigray regions. The new report, entitled ''You Will Never Be Able to Give Birth': Conflict-Related Sexual and Reproductive Violence in Ethiopia', is the first publication to comprehensively analyze patterns of perpetration of CRSV in the Tigray, Amhara, and Afar regions. The report shows widespread, systematic, and deliberate acts of CRSV which continue to this day. The report makes several concerning findings in relation to the nature and scale of the use of CRSV in Ethiopia. The report, based on 515 medical records of survivors of CRSV, 602 survey responses from health workers who have treated survivors of CRSV, and 39 in-depth interviews with health workers and four focus groups with professionals who provided care to survivors, found that: - 91% of surveyed health workers reported seeing patients who had experienced multiple perpetrator rape; medical records showed a median of three perpetrators per incident. - 90% of surveyed health workers saw at least a few patients with unwanted pregnancy from CRSV. - Medical records and interviews reveal that perpetrators inserted objects – stones, nails, hand-written letters with revenge plans citing previous wars – inside of survivors' vaginas. - 84% of health workers surveyed indicated survivors identified members of the Eritrean military as perpetrators. 73% of health workers surveyed indicated survivors identified members of the Ethiopian military as perpetrators; 51% indicated Amhara militias and Fano. The report is the first to identify the use of the crime of forced pregnancy while in captivity, with survivors held in captivity by their perpetrators until giving birth. The report is further the most comprehensive documentation of the intent of perpetrators behind the atrocities in Tigray – the first time evidence of intent has been triangulated between medical records, health worker surveys, and interviews. According to this in-depth study, perpetrators expressed intent to prevent future Tigrayan births and exterminate the ethnic group. Many of the perpetrators were quoted to say: 'Tigrayans have to be eradicated' as they were committing CRSV. The report is also the first to capture data on CRSV in Amhara and Afar, including a temporal analysis showing how the lack of atrocity prevention in Tigray led to the spread of CRSV in other parts of the country. The report documents several heartbreaking testimonies. As a coordinator for a women's group in Tigray was quoted in the report: 'There are women here who have scars left on their bodies. There are those who have given birth unexpectedly. There are those who got pregnant unexpectedly. There was a woman whose husband [a former soldier] was not present during the war, the perpetrator, an Ethiopian soldier who knew her husband, came to her house and forced her into marriage and even had their picture taken together and hung it in her house. He got her pregnant during that time and gave her his address [so that] his unborn child could find him when he left. So, this is something that the war has brought.' The findings of this report should trigger responses from the international community. However, as it stands, the situation is rarely making the headlines as the world is focused elsewhere. This is despite the fact that the situation in the region is deteriorating and raising concerns about a re-escalation of conflict in northern Ethiopia and surging geopolitical tensions between Ethiopia and Eritrea. The situation is further exacerbated by the drastic foreign aid cuts, which have shuttered health clinics and led to preventable deaths in Ethiopia. As the dire situation continues, victims/survivors must be put first. This means assistance to all those suffering from the consequences of the horrific CRSV perpetrated over recent years. This means investigating and prosecuting all those responsible for the crimes. This also means investing in prevention, as no money in the world can comprehensively address CRSV once perpetrated.
Yahoo
21 hours ago
- Yahoo
Syncing With Your Chronotype Can Maximize Sleep and Productivity
zeljkosantrac/Getty Images Most people acknowledge that there are two types of sleepers in the world—early birds and night owls—but research has shown that there are actually four or more sleep-wake cycles. The time you naturally open your eyes in the morning and doze off in the evening is the individual expression of your circadian rhythm, a.k.a. your chronotype, which also drives when you feel most alert or sleepy throughout the day. Your chronotype is based on natural daily fluctuations in your body temperature and hormones. Generally, body temp rises as daylight increases. Alertness-boosting cortisol also notches upward in the morning, and then levels off and dips as daylight fades, coinciding with your level of mental awareness. As the sun sets, the sleepiness-promoting hormone melatonin replaces cortisol. The exact cadence of this flux varies based on genetics, Jennifer Martin, PhD, spokesperson for the American Academy of Sleep Medicine and professor of medicine at the David Geffen School of Medicine at University of California Los Angeles, tells SELF. The morning larks among us have a faster-ticking body clock, so this whole schedule kicks off earlier, she explains, while the night owls have a slower clock, pushing the pattern later. Most people fall somewhere in the middle. If you sync up your everyday schedule with your chronotype, you could find it easier to get quality sleep and also get things done. Read on to find expert advice for determining your chronotype and using this intel to align your activities with your body's innate rhythm. 3 ways to figure out your chronotype There's debate among researchers about exactly how many chronotypes there are, but Dr. Martin says it's helpful to think of these schedules as a continuum spanning from the earliest-rising larks to the latest-sleeping night owls. You might intuitively know if you have a strong inclination toward one extreme or the other, but sometimes the requirements of work and other daily obligations can overshadow our true preferences. So Dr. Martin suggests thinking about how you act on vacation (when you're not jetlagged). 'If you love staying up late and sleeping in until 10 or 11:00 a.m., you probably have night-owl tendencies,' she says. Whereas, 'if you go on vacation, and you're super excited about a 6:00 a.m. tee time, for example, you're likely a morning person.' To get more precise, you can also take a chronotype questionnaire. The Morningness Eveningness Questionnaire (MEQ) includes 19 questions—about when you'd ideally choose to wake up, do physically or mentally tough work, and go to sleep—and categorizes you as one of five types based on your score: definitely morning, moderately morning, neither type, moderately evening, and definitely evening. Michael Breus, PhD, a clinical psychologist and sleep medicine specialist, also created the popular ChronoQuiz, which assesses both your habits around and feelings about sleep—and groups people into four camps, each named after an animal with similar behaviors: the lions (which are the morning people), the wolves (a.k.a. the night folks), the bears (who fall in between), and the dolphins, who Dr. Breus explains have some 'genetic irregularity' and an erratic sleep pattern that doesn't fit neatly into the other camps. How to optimize your schedule based on your chronotype Sleep within your ideal window. Since chronotype is based on genetics, morning people can't typically sleep in to make up for late nights, and night people can't generally doze off sooner to account for earlier rise times, Dr. Martin points out. So, if your eyes usually open around dawn, do your best to turn in early enough to still clock the recommended seven-ish hours of sleep; and if you tend to stay awake until the wee hours, aim to sleep in late enough to hit that number. This way, you can get ahead of sleep deprivation and the full slate of health detriments that comes along with it. Of course, aligning your sleep schedule with your chronotype can be a struggle with life obligations—especially for the night owls, whose schedules conflict with societal norms around workday start times. In this scenario, do what you can to slide back your wakeup time and minimize the need for brain power before work: prep breakfast, lay out clothes, get a jump on other morning admin in the evenings. For the early birds (and neutral folks), standard work schedules tend to fit more easily. If you find that social and home tasks are creeping into your evenings and nudging your bedtime back, see how you can spread out plans (so you aren't hit with late nights back-to-back) and reallocate to-dos for before-work time. Do mentally challenging tasks during energy 'on' times. If you're a morning type, you don't just rise with the sun—your body's arousal level also peaks early, between 7 and 10 a.m.; whereas, nighttime types hit max alertness around 7 to 10 p.m., Cindi May, PhD, a professor of psychology at College of Charleston who studies chronotypes, tells SELF. Her research suggests your brain is also primed to do its best work during your respective 'on' period, particularly if you have a strong chronotype. That doesn't apply to every task. 'If you're using a highly practiced skill or rote responses, then you're probably going to be fine whenever,' she says. 'But if you are engaged in a task that requires analytic thinking or attention to detail, that demands that you filter out distraction in order to pay attention, then you'll likely perform best during your optimal zone.' These include activities like making a decision or having a tough conversation, recalling things, reasoning through a complex problem, or weighing the pros and cons of an idea. Practically, it can help to think of the day in two chunks: Morning types tend to experience their most productive hours in the first half of the day, and nighttime types, in the back half, Dr. Martin says. Neutral types can flex a bit in either direction. That said, there's generally an 'off' time for everyone, Dr. Martin says, which tends to fall around 2 to 4 p.m. All chronotypes may lose some alertness in this window, triggering difficulties with creativity and concentration. It's an ideal time for a nap or lower-lift tasks. Eat on a consistent schedule. The optimal timing of meals and snacks depends on your lifestyle and energy needs—but sticking to the same pattern each day (whatever it may be) is a boon for your circadian rhythm, Dr. Breus says. It's more important to eat your first meal of the day at a consistent time that aligns with your internal clock, say, shortly after you wake up, rather than at a specific hour on the wall clock, Dr. Martin says. Also, aim to wrap up eating a couple hours before your bedtime, Dr. Breus adds, as the workings of digestion could interfere with sleep efficiency and quality. Can you change your chronotype? Experts say it's not possible to switch your chronotype. Your genes are your genes, after all. But while your underlying tendency is set, there are things that can shift your sleep-wake schedule a bit on a given day. If you're a night owl and want to wake up and feel alert sooner, bathing your eyes in light first-thing can help get your daytime hormones flowing, and limiting light in the evening can kickstart the nighttime ones, Dr. Martin says. Vice versa if you're an early bird who wants to push your rhythm back: Avoid light for the first couple hours of your day, and get lots of it later on. Another potential chronotype-adjuster is exercise. Research suggests a dose of physical activity in the morning or afternoon can move your schedule up—so if you're a night owl, working out in the first part of the day could help you conk out earlier. By contrast, doing some movement in the back half of the day may delay your circadian rhythm a bit, which could benefit early birds who are looking to stay awake later into the night. If you're thinking, Doesn't caffeine have this effect, too?, you should know: It mostly masks sleepiness or grogginess, which may temporarily improve your focus, memory, and physical performance when you're running low on sleep, Dr. May says. But there's no evidence to suggest consuming it in the morning could move your circadian rhythm up. If anything, it's been shown to delay that schedule, which could make it even tougher for caffeine-gulping night owls to fall asleep at a reasonable hour. More broadly, caffeine can tamper with the quality of your sleep and make it less restorative, so relying on it to wake up earlier or stay up later than your norm isn't a great long-term strategy. Ultimately, unlocking an ideal schedule comes down to respecting your personal energetic cadence, Dr. Martin says. But for some people—like those with extreme chronotypes or ones that clash with their obligations—it can be super tough to get on track. If that's you, she says, it's best to reach out to a sleep specialist, who can offer targeted therapies to help match your sleep-wake pattern to the structure of your life (or the other way around). Related: 3 Things to Do When You're So, So Tired But Sleeping More Isn't an Option I Have ADHD. Here Are 9 Productivity Tips That Really Help Me 17 Energizing Afternoon Habits for When You Need a Pick-Me-Up Get more of SELF's great service journalism delivered right to your inbox. Originally Appeared on Self
Newsweek
a day ago
- Newsweek
The Country's Leading Doctors Focus on Personalized, Less-Invasive Care
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Choosing the right doctor matters—especially when you or a loved one is facing complex or life-saving surgery. Specialists go beyond the common diagnoses and care from general practitioners to offer advanced expertise to treat specific conditions with focus and precision. In addition to the specific training and certifications required to advance in their fields, these physicians also share a similar passion and metric for success when providing top-tier care to patients. For the first time, Newsweek and Statista compiled a ranking of America's Leading Doctors 2025, which highlights more than 2,800 doctors from 15 medical specialties in hospital systems around the country. Previously, the partners published top rankings for vascular and spine surgeons; this is the first comprehensive ranking to be published. "High-quality specialist care is crucial for long-term health," Statista told Newsweek in a statement. "With this new resource, Statista and Newsweek continue to expand their portfolio of high-quality health care rankings, committed to empowering patients with trusted, data-driven guidance for some of life's most important health decisions." Each specialty highlights 175 to 200 doctors, with the top 30 ranked numerically, and the rest listed alphabetically by last name. The specialties include: Cardiothoracic Surgery – Top 200 Cataract Surgery – Top 200 Colorectal Surgery – Top 185 Foot and Ankle Surgery – Top 200 Glaucoma Surgery – Top 200 Hand Surgery – Top 200 Hip Surgery – Top 200 Knee Surgery – Top 200 Mohs Surgery – Top 100 Pain Management – Top 200 Retina Surgery – Top 200 Shoulder Surgery – Top 200 Spine Surgery – Top 200 Sports Medicine – Top 175 Vascular Surgery – Top 185 Ranked doctors have up to three affiliated hospitals, which are determined by patient volume and desk research. Doctors with no hospital affiliations listed may work in private practices or at an institute. Being a top specialist requires not only years of training but deep commitment and the mindset that the job is tough and inconvenient. Dr. Leonard Girardi, the top cardiothoracic surgeon on the breakout ranking, is a professor and chief of cardiothoracic surgery at NewYork-Presbyterian / Weill Cornell Medical Center. "Today's faculty member has to understand that it is not a job, it is a career, it is a commitment, it is a passion, and you have to be willing to make a lot of sacrifices so that you can be available and deliver the best care to your patients who are under your care," he told Newsweek. "And that may be inconvenient, but 24/7 is the business, at least of cardiothoracic surgery. You can't flip a switch and turn it off." Photo-illustration by Newsweek/Getty Doctors were evaluated based on four main data sources. The first was doctor performance data from Medicare Fee-for-Service claims and CareJourney, a health care analytics platform that offers insights to optimize care and costs and was acquired by Arcadia in 2024. Doctors were measured based on 2022 and 2023 "episode of care data," meaning the set of services provided by the doctors to treat a procedure or condition in their specialty, like heart valve surgery for cardiothoracic surgeons or hip replacements for hip surgeons. Both episode volume and outcomes, including average days of long-term stay, mortality rates, complications, unplanned readmissions and average payment, were factored into the score. Doctors who treated a high volume of patients in 2023 received a separate "High Performance" demarcation in the form of one, two or three ribbons. Establishing trust with patients is critical, especially when patients are facing serious, life-threatening procedures. Even with the success rate of open heart surgery near 98 percent, Girardi understands that his patients who are referred to him by their primary care physician might be anxious. "It's really important to be able to take complex situations and put it into layperson terms," he said. "You have to instill confidence in that and in them, so that they feel that OK in a one-hour conversation ... and that's something that I think you need to always keep in the back of your mind because that's a very humbling thing." The second data source was peer recommendations. Thousands of medical experts participated in an online survey from March to May 2025 to recommend doctors in their specialty either in or out of their respective states. Recommendations were weighed based on the order of preference indicated, the reason for recommendation and the professional experience of the survey participant. Survey participants had expertise in one or more of the 15 specialties included on the ranking across the 20 states with the highest number of specialists in the country. Those states include Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia and Washington. All doctors in these states were eligible for consideration as long as they performed a minimum number of relevant episodes for each specialty. The top states vary slightly between the specialties. "Having the confidence of your peers and the respect of your peers is certainly something that is incredibly rewarding and valuable," Girardi said. "If you're doing decent work over a long period of time, hopefully that respect and that confidence in your work will follow. And I'm very grateful, and I think that's the foundation to ultimately having the same confidence coming from patients." On the recommendations, participants were also asked to assess the quality of care for each doctor, including treatment, follow-up care and use of the most up-to-date equipment, as well as the professional expertise of the doctor. Doctors were rated by peers on a scale of one (poor) to 10 (excellent). These three data points as well as each doctor's certifications for their specialty from American medical and surgical certification boards contributed to each doctor's final score. Doctor performance data made up 60 percent, peer recommendations accounted for 27.5 percent and quality assessment and certifications made up 7.5 percent and 5 percent, respectively. The methodology for the America's Leading Doctors 2025 ranking from Newsweek and Statista. The methodology for the America's Leading Doctors 2025 ranking from Newsweek and Statista. Statista For the doctors on the list, being a leading doctor in their respective specialty requires more than these data points. As these fields evolve through research and technological advancements, physicians are able to provide better care—meaning using less invasive procedures and offering personalized care to each patient. Dr. Joseph Ricotta is the national medical director for Vascular Surgery and Endovascular Therapy for Tenet Healthcare and chairman of the Department of Surgery at Delray Medical Center. He ranked No. 2 on the vascular surgery specialty list. He told Newsweek that his field has advanced with the help of new technology to offer minimally invasive procedures, surgical robots to simplify complex procedures with more stability and accuracy and AI tools to more quickly predict conditions like aortic aneurysms and pulmonary embolisms based on CAT scan results. These tools allow doctors to provide more comprehensive and tailored treatments to patients, Ricotta said. "At the end of the day, it's all about quality and patient outcomes," he said. "Providing that individualized approach to each patient and being able to pull from the big tool kit we have as vascular surgeons allows us to provide the best care for patients." Advances like minimally invasive surgery and other new treatments are improving the quality of care across several specialties. But they are also helping patient outcomes for years after they leave the operating room. Dr. Martin Weiser is a surgical oncologist specializing in colon cancer, rectal cancer, small bowel cancer, appendiceal cancer and anal cancer at Memorial Sloan Kettering Cancer Center. He is the top-ranked colorectal surgeon on Newsweek's list. In recent years, there has been an alarming spike in colorectal cancer in young people, prompting experts to lower the recommended screening age to 45. Early diagnosis is critical for the survival of young patients in their 20s and 30s, and doctors are thinking about how to personalize the care to ensure they can maintain healthy lives after treatment. He told Newsweek that listening to the patient and seeing what they need is the first step in being a great doctor in any specialty. "There's a standard of care that's in a textbook that experts say is the best way to treat patients, and that's how we treat most patients," he said. "But there's always exceptions and certain specific patient needs that we should consider, and [we] take the time to listen to the patients to see what they need [and] help explain to them the use of alternative treatments." Focusing on long-term survival means developing treatment beyond radiation to preserve patient fertility and using chemotherapy and radiation to avoid surgery or colostomy bags that can lead to poor bowel function. "These are even more important when we have younger patients that would potentially live for 40 years after their treatment, because the majority of people with colorectal cancer are cured," he said. "So it's all about maintaining the highest quality of life while we provide a cure whenever possible." Weiser said he has dedicated his life to studying cancer, from the biology to the treatment, and it is the patient's recovery and return to normal or near-normal that drive him every day. That is why he is dedicated to doing research to advance the field for the broader community to reduce treatment toxicity while maintaining good, quality outcomes and continuing to learn along the way. "I think certain medicine and surgery is a humbling field because complications and bad outcomes occur all the time, and you have to accept that, learn from it whenever you can and move forward," he said. "In the back of my mind, I carry the memory of a lot of patients that may not have done as well as I had hoped, to try to remember: Is there something we can learn? I think that's what drives our research, and it gets you up every day to do a better and better job." Below outlines the episodes performed, certifications and states taken into account for doctor scores in each specialty. The 20 states listed are the ones with the highest number of doctors per specialty. Episodes per specialty: Physicians who treated a high number of patients in 2023 received a separate "High Performance" demarcation in the form of ribbons. Doctors in the 75th percentile received one ribbon, the 85th percentile received two and the 95th percentile received three. These ribbons do not directly impact a doctor's ranking. Peers' choice: Survey participants were also able to specify a "peers' choice" standout treatment for each recommended doctor. A peers' choice standout treatment was selected only when more than 10 doctors received multiple recommendations for that episode. Cardiothoracic Surgery Episodes Heart valve surgery (30% weighting toward episode score) Coronary artery bypass graft surgery (30% weighting toward episode score) Heart device and aorta surgeries (20% weighting toward episode score) Surgical removal of lung (20% weighting toward episode score) Board Certification American Board of Surgery – General Surgery Peer Choice Coronary artery bypass graft surgery States Included Arizona, California, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington, Wisconsin Cataract Surgery Episodes Cataract (20% weighting toward episode score) Secondary membranous cataract surgery (40% weighting toward episode score) Cataract surgery with lens implant (40% weighting toward episode score) Board Certification American Board of Ophthalmology States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington, Wisconsin Colorectal Surgery Episodes Acute hemorrhoids (25% weighting toward episode score) Blockage of the digestive tract (10% weighting toward episode score) Colonoscopy (25% weighting toward episode score) Surgical removal of colon (40% weighting toward episode score) Board Certifications American Board of Surgery – General Surgery American Board of Colon and Rectal Surgery Peer Choice Surgical removal of colon States Included Arizona, California, Connecticut, Florida, Georgia, Illinois, Indiana, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, Ohio, Pennsylvania, Texas, Virginia, Washington Foot and Ankle Surgery Episodes Broken or dislocated ankle/foot (40% weighting toward episode score) Surgery to replace ankle joint (20% weighting toward episode score) Fracture/dislocation treatment lower leg/ankle/foot (40% weighting toward episode score) Board Certifications American Board of Orthopaedic Surgery States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington Glaucoma Surgery Episodes Glaucoma (30% weighting toward episode score) Glaucoma surgery (70% weighting toward episode score) Standout Treatments Surgeries that improve fluid drainage Surgeries that decease fluid production Incision of eye and revision of iris General eye pressure relief procedures Board Certification American Board of Ophthalmology Sates Included Arizona, California, Colorado, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington, Wisconsin Hand Surgery Episodes Joint or tendon inflammation of the finger/wrist/hand (15% weighting toward episode score) Joint cyst (15% weighting toward episode score) Inflammation or injury of the tendons or ligaments in the arm (15% weighting toward episode score) Fracture/dislocation treatment arm/wrist/hand (40% weighting toward episode score) Carpal tunnel and related syndromes (15% weighting toward episode score) Board Certifications American Board of Orthopaedic Surgery American Board of Orthopaedic Surgery – Subspecialty Hand States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington Hip Surgery Episodes Repeat hip or knee replacement surgery (30% weighting toward episode score) Hip replacement (40% weighting toward episode score) Fracture/dislocation treatment pelvis/hip/femur (30% weighting toward episode score) Board Certifications American Board of Orthopaedic Surgery States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington Knee Surgery Episodes Knee arthroscopy (20% weighting toward episode score) Knee joint injury treatment (20% weighting toward episode score) Knee replacement (30% weighting toward episode score) Knee fracture/dislocation treatment (10% weighting toward episode score) Treatment of inflammation/injury of the tendons/ligaments in the leg (20% weighting toward episode score) Board Certifications American Board of Orthopaedic Surgery States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington Mohs Surgery Episodes Removal of cancerous skin growth (100% weighting toward episode score) Board Certifications American College of Mohs Surgeons (ACMS) Member American Board of Dermatology – MDS (Micrographic Dermatologic Surgery) States Included Alabama, Arizona, California, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin Pain Management Episodes Disorders of the thoracic spine (8% weighting toward episode score) Injection for back pain (28% weighting toward episode score) Lower back pain (28% weighting toward episode score) Neck pain and spine problems (28% weighting toward episode score) Spinal stenosis post laminectomy (8% weighting toward episode score) Board Certifications American Board of Physical Medicine and Rehabilitation American Board of Anesthesiology American Board of Pain Medicine States Included Arizona, California, Florida, Georgia, Illinois, Indiana, Kentucky, Maryland, Michigan, Missouri, Nevada, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Wisconsin Retina Surgery Episodes Age-related macular degeneration (15% weighting toward episode score) Blockage of vein or artery in the retina (eye) (15% weighting toward episode score) Destruction of retinal or choroid lesions by laser or other (15% weighting toward episode score) Retinal detachment (15% weighting toward episode score) Surgical retina and vitreous procedures (40% weighting toward episode score) Board Certifications American Board of Ophthalmology States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington, Wisconsin Shoulder Surgery Episodes Shoulder arthroscopy/rotator cuff repair (40% weighting toward episode score) Total shoulder replacement (60% weighting toward episode score) Board Certifications American Board of Orthopaedic Surgery Peer Choice Total shoulder replacement States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington Spine Surgery Episodes Spinal fusion (34% weighting toward episode score) Disorders of the thoracic spine (14% weighting toward episode score) Spinal deformity or curvature (5% weighting toward episode score) Spinal stenosis post-laminectomy (5% weighting toward episode score) Back and neck pain treatment without fusion (14% weighting toward episode score) Lower back pain (14% weighting toward episode score) Neck pain and spine problems (14% weighting toward episode score) Board Certifications American Board of Orthopaedic Surgery American Board of Spine Surgery (ABSS) Peer Choice Spinal fusion States Included Alabama, Arizona, California, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington Sports Medicine Episodes Pain in Joint (45% weighting toward episode score) Arthritis (45% weighting toward episode score) Carpal tunnel and related syndromes (10% weighting toward episode score) Board Certifications American Board of Orthopaedic Surgery American Board of Orthopaedic Surgery – Sports Medicine Subspecialty Certification American Board of Physical Medicine and Rehabilitation (Sports Medicine) States Included Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia, Washington Vascular Surgery Episodes Creation or repair of blood vessel access for dialysis (28% weighting toward episode score) Surgery to improve blood flow in carotid arteries (28% weighting toward episode score) Surgery to restore blood flow to the leg (28% weighting toward episode score) Varicose vein treatments (8% weighting toward episode score) Peripheral vascular disease treatment (8% weighting toward episode score) Board Certifications American Board of Surgery – General Surgery American Board of Surgery – Vascular Surgery States Included
