Post #1158: High-volume knee replacement surgeons in DC, MD, VA

 

If you’re thinking of having knee replacement surgery and live in DC, MD, or VA, you may want to download and have a look at this Excel (.xlsx) file:

High volume knee replacement surgeons DC-MD-VA
Size: 0,2 MB
38 Downloads

 

The workbook linked above contains a list of orthopedic surgeons in DC, MD, or VA who performed knee replacements on traditional Medicare enrollees in 2018.  It shows the volume of each surgeon’s Medicare-paid total knee replacements, partial replacements, and repairs (revisions) of replacements. A second sheet in the workbook provides counts of fee-for-service Medicare inpatient knee and hip replacements by hospital for the same three states.

Why should you care about how many knee replacements a surgeon has done?  In a phrase, practice makes perfect.  This is true of most complex surgical procedures such as joint replacements, and is particularly true of partial knee replacements.  To quote one carefully-done large scale study out of Great Britain:

Caseload had a profound effect on implant survival. Low-volume surgeons had a high revision rate ... and therefore should consider either stopping or doing more UKR procedures. High-volume surgeons ... demonstrated a 10-year survival rate of 97.5%, which was similar to that reported in registries for the best-performing TKRs.

(N.B., UKR = partial knee replacement, TKR = total knee replacement, revision = repair or replacement).

Why care about Medicare-paid surgeries?  Mainly, that’s the only data you can get that shows the number of procedures performed by individual surgeons.  The data and methods are public information (accessible at this link).  That raw information is impossible for most people to use, so I created the workbook above.  As importantly, Medicare is a big piece of this market.  In these three states, in 2018, the traditional (fee-for-service) Medicare program paid for roughly half of all knee replacement surgeries (documented below).  And so, while this Medicare-based workbook only shows part of each physician’s practice, in most cases it shows a large part of it.

Think of this as a place to start as you decide upon a surgeon and hospital for your knee replacement.  Volume of surgery alone is not a direct measure of a physician’s quality or competence.  But if you’re going to have a knee joint replaced, you probably want a surgeon who replaces a lot of them.   You’ll obviously want to look at more than just surgical volume before choosing a surgeon.  But surgical volume is one reasonable criterion.  This is one of the few places were you can find orthopedic surgeons known to do a high volume of knee replacement surgery.

For now, you only need to know a few things to use the data. 

  • There are no warranties or guaranties about the accuracy of this information.  Use it at your own risk.
  • This is a snapshot of 2018.  Things change, people move around.
  • These are based on claims (bills) submitted by these surgeons and paid by Medicare.  There may be occasional errors, such as the inclusion of a mix of surgery and assistant-at-surgery services for an individual surgeon.
  • This is restricted to self-designated orthopedic surgeons.  This may omit the occasional legitimate knee surgeon who (e.g.) self-designates as a sports medicine physician or other sub-specialty.
  • An orthopedic surgeon had to be paid for at least eleven knee surgeries of a given type in order to be listed.  (A “type” in this case is an AMA Current Procedural Terminology (r) code.)  A blank entry in this file should best be interpreted as “fewer than eleven surgeries”.
  • An orthopedic surgeon practicing in this geographic area might have been correctly omitted from this file because a) they moved here after 2018, or b) the address of their main practice is listed as being in some other state, or c) they did fewer than eleven of every type of knee surgery on traditional Medicare enrollees in 2018.

This workbook also contains a crude ZIP-code based distance measure.  You can use a standard Excel method (“filtering”) to find orthopedic surgeons near you.  For example, you can easily reduce the list to orthopedic surgeons within 30 miles of a given ZIP code, who did at least 100 Medicare-paid knee replacements in 2018.  The README sheet in the workbook briefly explains how to filter the data.

Absolutely nothing about this file is perfect.  The counts are incomplete, the distance measure is crude, and so on.  But for most users, it’s probably good enough to be useful.   If you’ve ever tried to find a specialist, used an on-line website, and been faced with a list of hundreds of names, you’ll understand the utility of having some systematic approach to whittling down the choices.  At the very least, if you’ve gotten recommendations for a surgeon, you can now look them up and see whether or not they appear to do a lot of knee replacements.  And, as discussed below, you can often use the Medicare Compare website to identify hospitals to which that surgeon admits patients.

The rest of this post talks a bit more about the underlying data source, documents the estimate of traditional Medicare’s share of the market in these three states, and rambles a bit about about why I put this together.

 


The data, and fee-for-service Medicare’s share of the local knee replacement market.

The Excel workbook above is based on Medicare claims (medical bill) data.  In this section, I describe the relevant parts of the Medicare program, and show that for the three states in question (DC, MD, VA), in total, traditional fee-for-service Medicare paid for about half of all knee replacements in 2018.  Throughout, I ignore Medicare Part D (drug) coverage.

Roughly 60 million Americans are insured via Medicare, our federal health insurance for the aged and disabled. You can find a concise summary of enrollment statistics at this link.

Of those, just over one-third are actually enrolled in private health care plans, termed “Medicare Advantage” or “Medicare Part C” plans.  For those beneficiaries, Medicare simply pays monthly premiums to those plans, just like any other health insurance coverage.  With limited exceptions, the Medicare program itself never sees bills (claims) for services provided to those individuals.  They are (almost by definition) excluded from the counts in the Excel workbook provided here.

Roughly two-thirds remain in the traditional “fee-for-service” Medicare program.  For those individuals, Medicare hires contractors to process and pay their covered health care bills.  For those individuals, the Medicare program gets an electronic copy of every bill that was paid.  One way or the other, each bill shows what service was provided, and how much Medicare paid for it. Those are the counts that make up the data for the workbook above.

There is a small factor that also must be considered, which is that Medicare covers inpatient facility care (Part A) separately from payment for professional and outpatient services, such as payment to a surgeon (Part B).   An increasingly large share of enrollees in traditional Medicare have Part A coverage (which is free) but not Part B coverage (which is merely heavily subsidized, not completely free).  (This does not happen in Medicare Advantage, because (with rare exception) you must have both Part A and Part B coverage to be able to enroll in a Medicare Advantage plan.) Working from these enrollment statistics, about five million Medicare beneficiaries have Part A but not Part B.  Because these are by definition concentrated solely in the fee-for-service portion of Medicare, this means that currently about 12.5 percent of Medicare fee-for-service beneficiaries have Part A (hospital inpatient bill) coverage, but not Part B (surgeon’s bills) coverage.  These individuals tend to be relatively low users of care.  But to the extent that such an individual would get an inpatient knee replacement, Medicare would see a bill from the hospital, but not from the surgeon.

For the U.S. as a whole, we can use a reference inpatient database (the AHRQ HCUP database) to estimate the fraction of all inpatient knee replacements paid by any part of Medicare.  This will include both traditional fee-for-service Medicare and Medicare Advantage plans.  As of 2018, Medicare paid for 57% of all inpatient knee replacements.

But that would include not only traditional Medicare, but Medicare Advantage as well.  To parse those apart, I relied on an old analysis that I had done for clients back when I worked in this area.  (That analysis required separating out Medicare fee-for-service discharges from records for Medicare Advantage discharges.)  Based on that analysis, for knee surgery, for DC+MD+VA combined, traditional Medicare accounted for 90 percent of inpatient knee replacements in 2017.  (For the U.S. as a whole, it was more like 70%).

So fee-for-service (traditional) Medicare’s share of inpatient knee replacements, for DC+MD+VA, would amount to 90% of 57%, or 51%.

Finally, I have to guess what fraction of those with Medicare fee-for-service inpatient knee replacement had Part A but not Part B.  This is a lot harder, because those without Part B tend to have a much lower rate of service use for elective surgery such as knee replacement.  As a reasonable guess, based on years of looking at this question for other procedures, I’d guess that 6 percent of those knee replacement patients had Part A but not Part B.

So fee-for-service (traditional) Medicare’s share of surgeon’s bills, for knee replacements, for DC+MD+VA, would amount to 94% of 51%, or 48%.

The upshot of all of that is that, if I’m looking at fee-for-service knee replacement claims paid by Medicare Part B, in DC+MD+VA, in 2018, I’m looking at just under half of all knee replacements done in this geographic area.

The actual public-use data file is Medicare’s summary of the individual claims (bills).  Medicare summarized the file by physician identifier, place of service (inpatient or outpatient), and procedure (AMA Common Procedural Terminology (r) Code).  As a privacy protection measure, Medicare blanks the data any time that leads to a count of fewer than 11 total services.

Because of that summary-and-redaction process, I will lose some counts of knee replacements every time a surgeon does fewer than 11 of any one particular type of knee surgery.  But that factor is more-or-less irrelevant if the task is to find high-volume surgeons.  It might might drop a lot of volume out of the file in total, but it should leave the counts for high-volume surgeons more-or-less unaffected.

I did considerable post-processing of the Medicare file, to achieve two things.  First, I edited out aberrant-looking lines, mostly trying to get rid of claims for assistance-at-surgery.  (Assistance-at-surgery is exactly what it sounds like — it’s the service of assisting the main surgeon who performs the surgery.  Unfortunately, assistance-at-surgery is billed using the same codes as the surgery itself, with a separate “modifier” indicating assistance.  Medicare just summarizes all the bills, regardless of modifier.)  Second, I added the counts for the range of surgical codes to generate the categories you see labeled on the spreadsheet.

As a validation, I found that after all my edits, and all the CMS redactions of cells with fewer than 11 surgeries, I ended up with 93% of the “benchmark” count of U.S. total knee replacements.  (The benchmark is based on the Medicare Part B National Summary file, excluding assistance-at-surgery (80s) claims.)


Why did I put this together.

I worked more than 30 years as a health economist, and spent most of that time analyzing Medicare claims data.  After three decades, I was both good and quick at doing that sort of analysis.

During my career, I was repeated floored by how hard it was for the lay person to get an answer to even the simplest questions about health care, based on Medicare’s experience.  If somebody in the Medicare program had not tabulated exactly what you wanted, just by chance, then you were out of luck.  In most cases, for most questions, my sole option was to work up an analysis, from scratch, directly from the large public-use or limited versions of the Medicare claims and enrollment data files.

Absent that data access and analytical firepower, I could not get answers to obvious and simple questions.  And it wasn’t so much that Medicare didn’t occasionally try to provide summary data that could answer some questions.  It’s more that most questions you’d like to see answered require just a little bit of analysis that is specific to that question.

And so it is with these counts of surgeries.  Medicare makes the raw summary file available, and even has an interactive on-line query system.  And even with that, I’d bet that the average American would find it impossible to use that system to produce any sort of meaningful information.  You have to know just a little bit — about the codes used to represent the surgeries, about assistance-at-surgery claims — to convert the raw data to a useful listing.

And, since I spent 30 years developing those skills, I figured I should put them to some use.

This is actually the second time I’ve done this analysis.  The first time was years ago, when a friend’s wife was facing a replacement of a failing partial (unicoldylar) knee.  Her knee was not done correctly the first time, it had worn prematurely, and replacements are much harder than initial implants.  She really wanted to find the best of the best for her surgery.  And so I did essentially this analysis, and in fact came across the surgeon who literally wrote the textbook on revisions of uni knees.

That story then had a happy ending.  But without access to information like this, it’s hard to pick a surgeon.  You are reduced to asking friends for suggestions, or soliciting suggestions from social media.  Both of which can work, but neither of which is very systematic.

The second time I did this analysis was two weeks ago, when a question about surgery for a uni knee revision was posted on NextDoor.  I figured, I might as well dust off the old analysis and see what it said now.  And it actually turned up the same national expert on uni knees, at the top of the listing.

Otherwise, finding and choosing a surgery is just a hard task.  You scrape together whatever information you can find from various sources.  Maybe you solicit recommendations from your family physician, friends, or via social media.  And you try to synthesize all of that.

What I have found is that on-line physician finder sites give you an overwhelming number of choices.  And when it comes to surgeons, it seems like all of them get top ratings.  They are great for showing you all of your options.  They are not much good when it comes to narrowing your options.

And that’s why I like practice-makes-perfect as a guide.  It’s not merely that you should avoid surgeons with low volumes of the particular surgery you need.  It’s that you will find that, particularly with anything out-of-the-ordinary, surgeons with high volumes got that way because they had a reputation for being the local expert.  A surgeon doesn’t get to do (say) 80 partial knee revisions per year unless that surgeon has the reputation as the go-to person for that particular surgery.

So there you have it.  It’s not perfect, slick, or pretty, but it makes that Medicare data available to people who might want to use it.  Now that I’ve worked out the kinks for doing this from public-use data, there’s no barrier to doing a national version of this file, and there are only small barriers to doing this for other common surgeries where the practice-makes-perfect effect is known to be important.  As a final note, Medicare updates the underlying data annually in November, so if I’m still in this business at that time, I should be able to update this using newer data then.

Post #1153: The dance of data destruction

For about 20 years, I was self-employed as a health economist.  In the course of that, I used terabytes of “sensitive data” in the form of health care claims (bills), all of which, at some point, had to be destroyed.

I started in the era of reel-to-reel magnetic tape.  You’ll still see those big reel-to-reel tape drives in the backround of cheesy science-fiction movies.  At some point, those open reels morphed into tape cartridges, the same magnetic medium in a more convenient and higher-storage-density package.

In either case, destroying data on magnetic tape was easy.  All you had to do was pass a big purpose-made electromagnet over the tapes, and they were rendered unreadable.  Bulk tape erasers were cheap, fast, and effective.

Then, for a while, I got most of my data on optical media such as DVDs.  Those actually had some entertainment value when they were due to be discarded.  I’d toss them on the gravel pad in my back yard and invite my kids to stomp on them.   They seemed to have a good time, and I guarantee the results made the discs unreadable.  It was an occasional family ritual we referred to as the dance of data destruction.

But what I mostly have now are disk drives.  Boxes and boxes of high-capacity disk drives.

As my career progressed, drive manufacturers were great about increasing drive capacity.  I started out using 30 and 60 megabyte drives.  (Yes, megabyte).  Large files had to be split across multiple drives.  But as time went on, files that I used to have to split across multiple drives now easily fit on modern multi-terabyte drives.  The sizes of the files that were made available for distribution increased accordingly.

Drive manufacturers did a great job of increasing capacity, but speed of access did not increase in proportion.  As a result, it takes hours upon hours to overwrite the data on a modern multi-terabyte drive.  I even bought a device dedicated to erasing drives.  This device absolutely works at as fast a rate as the drive can handle.  And for multi-terabyte drives, it takes the better part of a day to do even one pass over the entire drive surface.

And so, as much as I hate to do it, I’ve decided to destroy the drive hardware rather than just wiping the drives and giving them away.  Once you figure out how to get into the drives and extract the platters (disks), this is orders-of-magnitude faster than overwriting the data and keeping the drive intact.

This bothers me, because these drives still work.  But it only bothers me a little.   Disk drives with rotating magnetic media are dinosaurs, being replaced by solid-state drives in just about every conceivable situation.

So my lovely multi-terabyte hard drives are, in a sense, just the reel-to-reel tapes of the 2020s.  They work, but they are in the process of becoming obsolete.

I found several YouTube videos on how to take apart hard drives, but none of them seemed particularly good.  So I made my own.  If you’ve ever wondered what the inside of a hard drive looks like, check out my three-minute YouTube video on how to disassemble a hard drive and extract the platters.

Post #676: I paid my taxes yesterday

Which would not ordinarily be a thing to blog about.  So it’s an odd commentary on the times when doing my taxes was a pleasant change in routine.

I owed a bunch of money to the Commonwealth this year.  I figured that the Governor would appreciate receiving it in a timely fashion, all things considered.  So I did my taxes yesterday.

The deadline for Virginia is June 1 this year.  The Commonwealth says that if you pay by June 1, no penalties or interest are due.  (My tax software said differently, so I’m not sure what the deal is.)

The Federal deadline, by contrast, is July 15.

So this year your Virginia income tax is due before your Federal.  But you have to fill out your Federal forms first, anyway, in order to do the Virginia form.  In terms of the time and hassle cost, tax day here in the Commonwealth is effectively June 1, no matter what the Feds say.

This was my first tax year in pure retiree mode, and boy was it an eye-opener. 

I ran my own little business here in Vienna until August 2018.  And I paid full freight, tax-wise.  As a self-employed person, you start off by paying both halves of Social Security and Medicare.  So that’s about 16% off the top.  (You get a bit of that back, as a deduction.)  And then you pay the rest.  The Town got its slice (Gross Receipts tax), then the Commonwealth, then the Feds.

To a pretty close approximation, my combined marginal tax rate used to be above 50%, and my average tax rate was about 33%.  That’s with stuffing as much as I legally could in an SEP-IRA.

To which my daughter would say, first-world problem.  Because it meant that I had a good job and my business wasn’t going bust.

But now?  No wage income means no social security.  Investment income means many of those lovely tax dodges set up for rich people now apply to me.  Add in some reduction in income, toss with progressive tax rates.  And voila:  I ended paying an average Federal rate of about 9%, and a marginal rate just slightly higher than that.

Which is, oddly enough, how I ended up owing so much to the state.  Back in the day (meaning, when I was working), Virginia taxes weren’t exactly rounding error, but compared to the Federal bite, they looked pretty darned reasonable.

And so, when I figured total taxes for withholding, I did my Federal, and used a rule-of-thumb for State.  Which is now wrong, because I now get all the geezer-related tax breaks from the Feds, but nothing like that from the Commonwealth.

Weirdly, the Commonwealth’s tax bite is the same as it always ways.  But now that my Federal rate is so ludicrously low, I’m kind of resenting the Virginia rate.

In the end, good sense prevails.  I’ve always thought I got excellent value for my Virginia tax dollar.  I’m not going to change my mind on that, now that I’m retired.  As stated, I suspect that the Commonwealth needs my money right about now.  So I got ’em done.

 

Post #614: The sky is blue

 

White Clouds in Blue Sky ca. 1996

Source:  Clipart-library.com

No, really.  Stick with me here.  What I mean is, have you noticed that the sky is unnaturally blue.

This is Virginia, for crying out loud.  The spring/summer sky should be, at best, pale blue, edging toward fish-belly white.  But day after day, it’s like we’re living at high altitude in the Rockies.  Perfect beautiful blue sky.

Did you know that if we shut down all industrial activity and fossil-fuel use, the impact would be to raise the earth’s temperature significantly?  In the short run.  And only in the short run.  True fact.  That’s because we release both C02 and particulates/aerosols.  C02 warms the earth, but aerosols cool it.  The C02 is very stable, remains in the air for a enormously long time.  Most particulates and aerosols would rain out/fall out in a matter of weeks to months.

Basically, the longer the shutdown, the better the sky should look.

But apparently this is perception of better air in the DC area is purely in my head.  Because empirically, somehow, the air quality index for DC is … no different than it normally is.  Per this web page.

So I’m a little perplexed.  You’d think, from the traffic reduction alone, you’d see better air quality.  But … no.  I think I’ll keep looking around to see if anyone can explain this.  Or maybe the Air Quality Index doesn’t quite measure what I think it measures.

Post #606: US Census: If you’ve gotten “the postcard”, you’re being unhelpful

Look familiar?  If so, you’re being a bad person.

We have all gotten our notices in the mail by now requesting that we get on-line and fill in the US Census.  I’ve neglected mine.  Which is kind of horrifying, considering that I’ve actually done a bit of survey work professionally. And used the Census data professionally.

When I finally got “the postcard”, I knew I was being a bad actor.  Assuming that Census does this in a standard manner, getting “the postcard” is a mark of shame.  So it was time to fill in the Census.  Which I have now done.

I timed it.  It took me 10 minutes, for the four people in my household.  Which is typical.  But I messed something up, so I thought I might mention that.

The plain language of the Census form says to count all individuals who were staying in your house on April 1.  But that’s not correct.  If you have a child who was supposed to be away at college on April 1, you are NOT supposed to report them as living in your household in April 1.  Even though they were.  They will be counted as they usually are, in their respective college towns.

Here’s a link go the US Census page on that.

Unsurprisingly, the last question specifically addresses that.  Census gives you the opportunity to flag that college student, so that Census can (somehow) identify them based on some college reporting them.  Presumably, because Census will find a person with my daughter’s exact name and date of birth, at some college near to my home, they’ll take her off of the count for my household, and retain it on the count for the college.

Now let me explain the postcard of shame.  I’m assuming Census uses standard survey protocols.  Typically, in a mail survey, you’ll get a first notice in the form of a full letter.  If you don’t fill it in, there will be a followup in the form of a short letter, saying, in effect, please read the prior letter.

But only the truly uncooperative get the postcard.  The postcard is typically used for the second followup.  The practical reason for using a postcard for second followup is that, by that time, you’re not worth the price of a first-class stamp.  If you’ve been enough of a jerk as to ignore the first and second notices to do what you are legally obligated to do, chances are you aren’t going to cooperate no matter what.

In other words, by the time you get to second followup, the likely yield is so low that you’re practically just not worth bothering with.  But it’s still cheaper than having to send out the paper-copy Census form.

And vastly cheaper than having in-person followup, which I’m not even sure they are going to be able to do this time.  Census taker was always a somewhat hazardous occupation.  Now, it’s not even clear they are or should send people door-to-door, to deal with the least-cooperative people among us.

The upshot is that the US Census is among the many things that COVID-19 has scrambled.  It’s a pretty good guess that a lot of people are not going to be counted.  Do your part to fix that.  Get on line and fill out your Census form today.

Getting our fair share of Federal, state, and local government money — not to mention our seats in the U.S. House of Representatives — all depend on that Census count.  The information they ask for is minimal.  Name, date of birth, sex and race/national origin for every person in the household.  And do you own or rent the place where you live.  That’s it.  Get it done.

 

Post #541: A couple of corrections: Beulah Road Park; $9M parking garage.

Here are a couple of non-correction corrections.  The first is fact, the second is speculation/reason/guesswork.

Fact is that the Town referred to its 8-acre Beulah Road property as a park for decades before it decided to use it for mulching (Post #526).   The documentary evidence for that is overwhelming (see first section below).

Speculation/reason/guesswork is that the town roughly doubled the estimated cost of the Patrick Henry Parking Garage, out of nowhere (Post #531), as a ploy to get somebody else to pay the full cost of the garage.  Funding agencies will want to see the Town pay half the cost.  But the Town wants somebody else to pay for all of it.  So, just claim that it costs twice as much as it actually does.  That’s a fraud, but so is the claim that this garage will serve large numbers of Vienna Metro commuters, which is how the Town justifies asking for regional traffic congestion relief funds for this.

Continue reading Post #541: A couple of corrections: Beulah Road Park; $9M parking garage.

Post #538: Maple Avenue streetlights

Image Source:  Linked from the Dominion Power outdoor lighting website.

This is a brief followup to Post #503.

At the time I wrote that post, roughly one streetlight in seven along Maple was burnt out.  My contention was that … well, nobody cared.  Nobody noticed, and nobody really had to care about it.  Just looked a little sloppy is all.

As I was driving down Maple last night, something seemed different.  I’ll have to double-check this, but I believe that a) all the burnt-out bulbs have now been replaced and b) some of the poles themselves seem to be undergoing repairs.  I’m pretty sure I saw at least one with wires sticking out where the “acorn” light globe should have been.

Edit:  Drove down there by the light of day this afternoon and, sure enough,  there are headless light poles scattered along much of the length of Maple.  So some sort of maintenance operation appears to be underway.

I’m not sure whether to thank the Town, or VEPCO, no Virginia Power, no Dominion Resources, nope maybe it’s Dominion Power?  I have the vague feeling that all the streetlights belong to Dominion?

You can get part of the story on streetlights and streetlight outages on this Town of Vienna web page.  Briefly, we pay a streetlight maintenance fee to Fairfax County, which in turn pays that fee to Dominion, which owns and services the streetlights.

That’s why streetlight outages are be reported to Dominion, not to the Town.

Unfortunately, the links to Fairfax and Dominion websites on that TOV web page are broken.  The County’s explanation of streetlights is given on this page of the Fairfax County websiteThe Fairfax County instructions for reporting a streetlight outage are given on this page, which in turn links to an interactive map.  (FWIW, the interactive map totally and completely failed to work for me.)

Post #534: Sell the Robinson property; use the money to build sidewalks

The title of this post is somewhat more than just a cheap attention-getting trick.  But you’ll have to skip to the end to get to that.  Possibly, this post will explain why I found the discussion of sidewalks at the last Town Council meeting so irritating.

In logical order, then: Continue reading Post #534: Sell the Robinson property; use the money to build sidewalks

Post #527: W&OD bridge?

Two of the W&OD road crossings in the Town of Vienna will be updated, based on suggestions in the Town’s Maple Avenue Multimodal etc. study.  The W&OD road crossings at Park Street and Church Street will get raised crosswalks, turning them more-or-less into speed humps.  And they’ll get new signs.

It’s tough to say why, of all the things in that study, the Town decided that those two W&OD road crossings were a priority.  For sure, there was no formal cost-benefit or risk analysis done.  I think they just sort of liked the idea, and it was cheap to do.  So they’re going to do that, and that’ll be the tangible outcome of that study, along with filling in a right-turn lane where Mill and Church intersect.

This seems to have stirred up some interest in a W&OD bridge for the Mape Avenue/W&OD crossing in the Town of Vienna.  To be clear, we’re not getting a bridge there, and nobody is talking about paying for a bridge.  And in this post, I’m briefly going to explain why that is — why this was ignored in the Town’s Multimodal study, and will it will likely remain a low-priority issue.  My conclusion is that the stoplight we have now for the W&OD Maple Avenue crossing is probably good enough, given the size and cost of a bridge.

 


But other crossings have bridges …

Sure, but those crossings tended to be ones with significant problems and traffic, often where a new traffic light would not work, or where there are problems, despite a light, due to heavy traffic.

The closest large dedicated bridge on the W&OD is the Citizens’ Bridge in the People’s Republic of Falls Church.  This is where the W&OD trail crosses Route 7/Broad Street.  This bridge dates to 1992 or so.  Falls Church citizens agitated for a bridge because bicyclists and pedestrians were crossing Broad Street there, rather than walk/bike to the stoplight-controlled intersection at West Street.

That bridge is an object lesson in the nature of bicycle and pedestrian traffic.  At the time, the bridge was lauded as an example of effective small-town government.  But one could just as easily say it’s there because various bicyclist and pedestrian scofflaws routinely jaywalked rather than walk an extra 200 feet to cross with the light (while getting their exercise along the W&OD trail.)

More recently, the influx of new tax and toll monies means that all kinds of marginal and low-value projects are now being funded, as long as they plausibly help people get around without a car.  This includes a spate of new bridges for the W&OD.  These tend to be for intersections where the road crossings were an annoyance to bicyclists and/or motor vehicles, though not particularly dangerous (at least in my opinion).

There’s a bridge going up for the Route 29 crossing just east of Falls Church, and a bridge is planned for where the W&OD crosses Wiehle Avenue in Reston.  Neither of these is a particularly difficult crossing now, although Weihle is awkward because it’s so close to a stoplight with no place to stop in the median.  Both of these crossings, though, apparently have fairly high automobile accident rates, as cars stopping for bicyclists get rear-ended with some frequency.

Above:  Route 29 W&OD crossing just east of Falls Church, and Weihle Road crossing in Reston.

In essence, right now, these are just crosswalks used by a lot of bikes.  Not unlike the W&OD crossings in Vienna.  But soon those simple crosswalks will be replaced by some fairly large and obtrusive bridge structures.  Here’s a “before and after” view of Weihle Avenue where it crosses the W&OD trail.

Above:  Wiehle Road crossing now, and Wiehle Road showing artist’s conception of bridge.  (Orient by trees in background).  Source for Weihle bridge:  FCDOT via restonnow.com


So why not Maple Avenue in Vienna?

It boils down to need, cost, and size.  And all of these argue against a similar structure at the W&OD crossing on Maple Avenue.
First, the existing light-controlled crossing works well.  We have the occasional bicycle scofflaw crossing against the light.  But in my experience, those are few and far between.   And that’s because that current path is in fact the shortest distance.  So we do not have the problem that Falls Church had, with a constant stream of jaywalkers who were unwilling to walk to the nearest light-controlled intersection.
Second, a bridge there would necessarily be fairly large.  And it’s not that you need a massive structure to move the bicycles.  It’s that VDOT requires a minimum 17.5′ clearance (I just looked that up), and bike paths are never supposed to have more than a 5% slope if that can be avoided.  When you combine those two (17.5′ tall, 5′ slope) you realize the bridge would have to span Maple Avenue and 350′ on either side of Maple.
The upshot is that the entire bridge structure (including earthworks at either end) would have to span about 750′ (350′ + 350′ plus the width of Maple).  No coincidence, this is roughly the length of the Citizens’ Bridge in Falls Church.  So, if you look at that (above), that’s more-or-less the minimum size of structure that you can get away with.  Not due to the load of the bicycles, but due to the combination of clearance and slope limits on the structure.
So the very smallest it could be, built to those standards, would be a span from almost Church Street at one end, to almost the end of the Whole Foods market at the other.   This would cut Maple Street off from the trail and make trail access difficult.  (In fact, some of the opposition to the Falls Church Citizens’ Bridge came from local merchants who saw the bridge as discouraging bicyclists from stopping (and spending money) in Falls Church.  See the newspaper article cited above.)
It will also cost somewhere in the neighborhood of $6M to $12M.  Or so.
 
A internet search shows the cost of steel pedestrian bridges runs about $2000/linear foot for a prefab steel footbridge such as the Falls Church one. Of the 700′ length, the Falls Church Citizen’s Bridge is roughly 400′ of steel bridge, and the rest earthworks.  At that price, the steel bridge alone would cost about $8M.   So call it $10M or so, based on that.  
A second data point comes from the bridge slated for Weihle Avenue in Reston, which has a preliminary cost estimate of $11.4M, per the newspaper article cited above. 
 
A third data point is a reported cost of about $6M for what looks like a roughly-similarly-sized intersection (W&OD crossing four lanes of traffic).
Caveat:  The reported cost of the Falls Church Citizens’ Bridge, just under $1M, is vastly less than $10M after accounting for inflation.  Adjusting that circa-1992 cost for the Consumer Price Index change to 2020 yields about $2M in today’s money.  On the other hand, that initial cost estimate may have been in error, as the $11.4M Weihle Avenue bridge was originally supposed to cost under $3M.
So, maybe not exactly $10M, but somewhere in that ballpark seems likely.
In summary:  The current Maple Avenue W&OD crossing appears safe, appears to have relatively few bicyclist scofflaws, and in general provides easy on/off access to the W&OD in the heart of Vienna.  Any bridge there would necessarily be large and fairly expensive.  It’s easy enough to see why other intersections have gotten bridges before anyone would think of funding a bridge for the Maple Avenue W&OD crossing.

Post #526: Our assets become our liabilities, part 4: Beulah Road Park Industrial Zone

File this one under “aren’t you glad you don’t live there”.  Or maybe under “don’t get in the way of the Town bureaucracy.”  But certainly under “nobody else does this, and hey, I bet there’s a reason for that.”


First, walk a mile in their shoes.

Suppose you’d lived in a home in Vienna since the 1960s.  Or bought one of our many ’60’s-era houses.  Like the one pictured above.  It’s in a nice, quiet neighborhood with mature shade trees.  And all the land for half-a-mile in every direction is zone RS-12.5, for single-family houses on modest lots.

But there’s a problem.  There’s a large piece of vacant property abutting your back yard.  Historically, some Town of Vienna documents marked that tract as park land.  So you may have been foolish enough to consider that vacant land a real asset in your neighborhood.

Then, surprise:  An industrial waste processing facility moves in and takes over that lot.  This facility runs noisy machinery for hours a day.  At various time of the year, streams of diesel dump trucks move onto and off of the property, unloading and loading the materials to be recycled.  In years past, the property was littered with construction debris, until you complained to the Town about it.  And the recycling operation generates large mounds of pungent rotting organic matter.

Well, complain to the Town, you might say.  Nobody has the right to operate an industrial facility in the middle of a residential neighborhood.

Nice thought.  Except that it’s the Town’s industrial facility.  Welcome to what the Town of Vienna refers to as the Beulah Road Mulch Yard.

While it’s (almost) inconceivable that the Town would grant someone else the right to use property in that location that way, the Town granted itself a conditional use permit for that mulching operation back in 2004.  You can read some of the contemporary press coverage in this link, or this link, and by following the links at the bottom of those stories.

Member of the Northeast Vienna Citizens’ Association (NEVCA) did their research on this when the issue first came up in 2003.  That’s the year the Town bought a large (and loud) tub grinder for grinding up leaves, and roughly the time the Town moved mulching operations to the current site.  Here’s their timeline for how that property was classified and used by the Town of Vienna, from the November 2003 NEVCA Notes:

Source:  NEVCA Notes, November 2003.


Why bring this up now?

OK, so that neighborhood took a beating in 2004, and has been taking that beating ever since.  Why bring that old news up now?

You may or may not recall that the Town bought a house on Beulah Road, back in 2018.  The house was directly adjacent to the Town’s Beulah Road property.  And, at the time, the official line of the Town government was that they bought it with no purpose in mind.  Even at the time, that was pretty clearly a prevarication.  That was almost surely bought with the construction of the new police station in mind, as I documented in this post, with a link to a news article by Brian Trompeter.

The Town just recently moved to reclassify that small parcel of land on which that house sites as land for “government use”, in the Town’s Comprehensive Plan.  That zoning — for government use — is not something you can see on the Town’s zoning map.  (We don’t have a zone for that.)  It’s only something that exists as a land use category in the Town’s strategic plan.

But apparently that doesn’t quite tell the whole story.  Exactly what the whole story is, it’s kind of hard to tell.  But that building and the Beulah Road property will now be used as part of the building of the new police station.  As I understand it, the Town needs somewhere to park the fleet of 20-some police vehicles, and apparently that unimproved Beulah Road property is the place they’ve chosen to do that?  Tough to say, as all I am running on at this point is rumors.

The point is, this has opened up an old wound for residents of this neighborhood.  It’s not enough to have the Town’s leaf mulching facility in their back yards.  Now, in addition, that’s going to become parking for the police fleet? which I would guess entails some use of sirens at some point?  And so, graveling or paving enough of that lot to allow for such parking?  And, maybe, as in the past, storage of the odd bit of construction debris and such, as the Town apparently did when it redid the sidewalks along Maple?

Who knows?  And that’s pretty much the point.  At one point, the Town apparently considered that to be a neighborhood park.  But over the  years, they have slowly peeled back part of the tree cover as they turned it to various other uses.  The Town turned a deaf ear to the residents of that neighborhood when it decided to use as more-or-less an industrial site, mulching all of Vienna’s fall leaf litter there.  And now, in addition, it’s to become a police vehicle parking lot, and it’s not clear what else.

If I lived there, given the history, I’d be a little worried too.  Makes my problem with cut-through traffic from 444 Maple West seem like small potatoes.


Does anyone else do this?

This, being, get their fall leaf litter converted to mulch or otherwise disposed of?  This turns out to be a fairly difficult question to answer.  But near as I can tell, nobody in this area runs an industrial-scale leaf mulching operation in the middle of a residential area.  Except the Town of Vienna.

City of Alexandria.  They maintain a leaf mulch site at 4215 Eisenhower Avenue.  This is in an industrial area, adjacent to (e.g.) self-storage facilities, ball fields, and similar.

Fairfax County:  From the look of it, my guess is that Fairfax does its mulching (for this part of the county) at the Ox Road solid waste transfer facility.  That’s in the heart of a large industrial/governmental use area.  But I could not find documentation to prove that.

Town of Herndon.  Some earlier work by NEVCA suggests that Herndon does not perform these operations within its Town limits, but I could not verify that (on-line) using current information.  (Historically, they filled roll-off containers with leaves, then trucked those out for composting.)  Herndon also does not appear to offer free mulch to residents (as Vienna does).  Presumably, Herndon residents would have to rely on Fairfax County free mulch.

City of Fairfax:  Fairfax City directs residents to the County’s free mulch, which suggests (but does not prove) that Fairfax City doesn’t do its own mulching.

City of Falls Church.  They offer residents free locally-produced leaf mulch, but provide no clue on their website as to where they produce that mulch.

 


Is this a good use of scarce land?

Fairfax County currently values that 8-acre tract at about $2.5M, but it’s not clear what, exactly, that valuation reflects.  Certainly not the value of the land for use as housing.  But that’s roughly the same value that Fairfax puts on the 11-acre Glyndon Street park.

Putting aside the impact on the neighbors, it seems to me like running a mulch pile is a fairly low-valued use of a scarce resource such as Town of Vienna land.  You have to wonder if this practice started back in the days before Fairfax County itself became so invested in recycling.  I can’t help but wonder what it would cost the Town to turn that tract of land into another useful Town park, instead of using it for what amounts to refuse collection (and, going forward, vehicle parking).

Finally, I should make it clear that a) as a homeowner, you don’t have to participate in the Town’s leaf mulching operation and b) current environmental thinking actually discourages you from doing that.  The point being that the heat generated by mulching on an industrial scale kills off eggs of beneficial insects that might otherwise overwinter on your leaf mulch, such as various species of butterflies.  If you have the room and the inclination, mulching your own leaves probably makes more environmental sense than having the Town mulch them for you.