Hi, its Duretti Fufa #jhsjc

Thank you for selecting our article to discuss and for your comments #jhsjc

I completely agree with you Jonathan regarding inability to categorize all patients. We excluded 25% for this reason. #jhsjc

I agree with the term guideline here but we admit it is difficult to apply to all patients. #jhsjc

As you could see, we excluded 25% of patients who underwent surgery in that period for that reason #jhsjc

Guidelines change behavior. That is to some degree irrespective of practice environment #jhsjc

I agree that the magnitude of impact will vary based on practice setting #jhsjc

I think its important to highlight that this was a first iteration of opioid education/guideline #jhsjc

As Jen Waljee pointed out at her AAHS talk, the process is iterative #jhsjc

If we believe that diversion has contributed, decreasing pills in circulation even to those not abusing will help #jhsjc

Exclusion was mainly for patients with preop opioid tolerance and those w/surgery not categorizable in the table of procedures #jhsjc

NY state has now mandated 3 hours of training for all prescribers. #jhsjc

It is an online module/certificate. I don't know if cost is to state or hospital #jhsjc

Agree with all points. NY has registry. This kind of guideline/education data must be combined with data on pill consumption #jhsjc

I'd liken variation to uncertainty (not innovation) with respect to this topic. #jhsjc

and even more interesting, if it correlates with patient outcome or satisfaction #jhsjc

We can link back to the discussion of guidelines...some patients will remain outliers even in CTS! #jhsjc

Agreed but treating the same disease in different patients often results in different outcomes so we need to address both sides #jhsjc

2019 Emerging Leaders Forum Chair Lisa A. Taitsman, MD, MPH, FAOA and Facilitator Peter Kim, PhD (center) with Emerging Leaders Forum attendees at #AOAmtg