Verne L. Hoshal, Jr. MD, FACS, Pres.-Elect
Farouck N. Obeid, MD, FACS, Secretary,
and guest of the Chapter,
Jon H. Sutton, MBA,
State Affairs Associate,
Health Policy and Advocacy Department, ACS.

Doctor Saxe, then initiated an introduction of the Young Surgeons:

A. Young Surgeons Representation on Council.

Dr. Saxe suggested that the Chapter revise its method of representing young surgeons at the Council. In place of the Council appointing two young surgeons, the Council would welcome the young surgeons electing their own representatives. It was decided to defer selecting those representatives until later in the meeting.

B. Activities for Young Surgeons.

1. Mechanisms were discussed to continue communication among the young surgeons to facilitate their participation in activities and to bring "grass roots" young surgeons' interests to the Council. It was proposed that an email list-server be developed and supplemented by faxing communications.

2. Projects / areas for activity.
Doctor Saxe stated that another goal of this Forum is to identify projects of interest to the young surgeons and to develop strategies for bringing those interests to fruition.

a. One of the activities he proposed was becoming involved in the legislative arena. Examples of that type of activity include the Key Contact Program, establishment of a Chapter legislative committee, sponsoring a Day in Surgery program for state legislators, and direct contact with state legislators. Doctor Saxe felt that in past years neither he nor the Chapter had recognized the importance of a Chapter presence with respect to legislative matters. Recently a letter from Thomas M. George, MD, State Representative, 6lst District stated:

"As a new member of the legislature, I can authoritatively tell you that when constituents speak to their elected officials regarding an issue, one of the most common responses will be, "Well, what's your association's position on this?' If the legislator learns that the constituent is not a member of the association, or that the constituent and the association have differing positions, then both are undermined in the eyes of the legislator".

The position of the Chapter on legislative matters peculiar to the practice of surgery is important.

Doctor Saxe introduced Jon H. Sutton who briefed the Forum regarding the activities of the College in Washington DC. Several issues receiving ACS attention are the Patient Bill of Rights legislation, Medicare and Medicaid reimbursement, collective negotiations with State health plans, and the need for greater spending for education.

Mr. Sutton described several advocacy opportunities, e.g., the Key Contract Program coupled with a Legislative Alert Program, the importance of Coalition Building among specialty societies and the various educational resources available to young surgeons.

Doctor Saxe gave as an example of an issue of particular interest to surgeons the Blue Cross Blue Shield - Michigan implementation of the InterQual Guidelines and the secrecy surrounding the existence and availability of these guidelines to practicing surgeons.

Doctor Saxe described the Chapters initiation of efforts to conduct a Michigan Legislative "Day in Surgery Program, outlining the efforts to date.

Doctor Obeid emphasized the importance of Chapter members in educating the legislature regarding the importance of a trauma system in Michigan. Doctor Obeid reported that without the efforts of Michigan Chapter members there would not have been Legislative approval for the establishment of a Commission on Trauma and the 2002 implementation of trauma guidelines in Michigan.

b. Surgical Education
Dr. Saxe suggested that young surgeons, as recent residency graduates, might wish to meet with residency program directors to assist in developing curricula, to give oral exams, and to critique Board Exam review courses.

c. Annual Scientific Meeting
There was information presented regarding the opportunity for young surgeons to participate in the October 31 - November 2, 2001 MSMS Annual Scientific Meeting by organizing and presenting a course in surgery for surgeons and non-surgeons.

d. Socioeconomic Issues
Discussion ensued regarding a Chapter role in assisting with billing, coding and answers to legal questions. Doctor Brian L. Piazza, Port Huron, noted to absence of networking to discuss reimbursement policies established by various health organizations and suggested establishing a directory. Doctor Hoshal commented that the Chapter has a web site and professional positions listing and could add a membership directory. Doctor James E. Reif commented regarding the disputed Certificate of Need Process and the various positions of specialty societies pertaining to this matter. He suggested also there was a need to more clearly define the issues related to evidence based medicine on a national basis. Doctor Obeid suggested the opportunity to join forces with MSMS in various lobbying efforts as was done with the trauma legislation. Doctor Jerome I. Finkelstein stated his concern with care guidelines being developed by insurance companies and not by surgeons. He also indicated his concern with possible ethical issues and the erosion of surgeon professionalism by the general public.

A. After dinner the Forum formed three discussion groups: Group One...Identify and articulate Issues in which the Chapter should be involved. Group Two...Discuss implementing the Day In surgery Program. Group Three...Identify methods by which issues can be addressed via the legislative process.

B. Following group discussion the Forum reassembled to receive the reports of the discussion groups.

Group One, Doctor Hugh J. Lindsey, reported the key interests are, Access to Care, Quality of Care, Timely Payment, Collective Bargaining, and the need to be knowledgeable regarding health legislation.

Group Two, Doctor Anthony A. Holden reported the Day in Surgery program should be expanded to achieve maximum exposure, i.e., to be conduced simultaneously in more than one city with the legislator meeting with the community surgeons who have served the legislator's family and friends and to conduct it in the legislator's community hospital. The group suggested that media representatives should be participants, which may influence the legislator to participate in not only the trauma and surgical portion of the program, but also the office visit where timely payment challenges can be specifically addressed. Doctor Holden stated the "constituency factor" is important to the success of the program.

Group Three, Doctor Jerome I. Finkelstein reported regarding the venues for framing issues to the Michigan legislature. E-mail of letters of support to legislators from young surgeons is the most effective non-personal program. The Capitol Check-UP program in which a large number of physicians meet with legislators is known to be effective. There was discussion regarding the importance of authoring the content of emails and letters to bring about the desired effect.

Respectfully Submitted,