Young Surgeons Issues Committee
Wednesday, 5. December, 2001
The Italian Epicure Restaurant
Novi, Michigan

1. Call to Order:

Donald J. Scholten, MD, FACS, Chair, called the meeting to order at 5:37 PM

Present:

Donald J. Scholten, MD, FACS, Chair
Verne L. Hoshal, Jr. MD, FACS, President
Hugh J. Lindsey, MD, FACS
Brian L. Piazza, MD, FACS
James E. Reif, MD, FACS
Christopher P. Steffes, MD, FACS

Also Present: F. B. "Tom" Plasman, Chapter Administrator

Absent:

Farouck N. Obeid, MD, FACS, President-Elect
Cheryl A. Wesen, MD, FACS, Secretary-Treasurer
Anthony A. Holden, MD, FACS
Brian Ray Plaisier, MD, FACS
Jon C. Walsh, MD, MPH, FACS

2. Minutes:

The Minutes of the 17. October, 2001 meeting were reviewed. It was moved and seconded that these minutes be approved. This motion received unanimous approval.

3. Correspondence:

Doctor Scholten reported that items of correspondence from the American College of Surgeons have been entered into the Chapter Correspondence Notebook and will be available for review during the 6. March, 2002 Council Meeting.

4. Reports:

  1. CRNA Issue:

    Doctor Scholten called attention to the Health Legislation Analysis documents from the MSMS Government Relations Dept., Paul N. DeWeese, MD, R-67th District and submitted by Doctor Lindsey, included in the meeting packet.

    Discussion ensued pertaining to the matter of a CRNA being able to perform a service either with or without the supervision of a physician. The Committee observed that there is a loophole in the present law which allows the delegating physician to supervise surgical anesthesia over the phone, making it possible for that physician to supervise the procedure from another city. House Bill 4591 would change the law to require the delegating physician to (1) have anesthesia privileges at the health facility where the surgery is being performed and be physically available in the health facility when the surgeons being performed. Or (2) be performing the surgery.

    Discussion further identified the October 8, 2001 letter authored by Tom George, MD, R-61st District, where there was question as to the documentation which supported the first paragraph in his letter which states: "As a CRNA, I am sure you are already aware that Michigan law requires physician supervision when anesthesia is administered. This oversight requirement is met when you work with either the operating surgeon or an anesthesiologist.". There was general agreement that if the loophole could be corrected by House Bill 4591, the YSIC would be in favor of the bill. It was also pointed out that another loophole exists where CRNA services are performed when the lead health care professional is neither an MD or DO. Mr. Plasman was requested to learn from Doctor Tom George, the supporting documentation for the first paragraph in his letter for distribution to the Committee.

  2. Immunity from Liability for Uncompensated Care

    Doctor Scholten initiated discussion pertaining to the MSMS Government Relations Dept., Paul N. DeWeese, MD, R-67thDistrict and Doctor Lindsey's documents pertaining to this issue. A review of these documents indicated that supporters of Senate Bill 30-Substitute H-3, have successfully argued to the House and Senate that when care is provided to a patient free of charge, the patient should not be entitled to sue for economic ( i.e., out-or-pocket medical costs, lost wages, etc.) or non economic (i.e., pain and suffering) damages unless gross negligence, willful misconduct, or intentional harm are involved. It was pointed out that the Senate Bill has several stipulations the most concerning is that the care must be of a non emergency nature and must be provided in a health facility organized solely to deliver non emergency care without receiving compensation or in an entity that is not a health facility that provides non emergency health care to uninsured or underinsured individuals through the voluntary services of licensees or registrants who receive no compensation for providing the non emergency health care. There were several other stipulations considered by the Committee.

    Doctor Scholten pointed out that Governor John Engler had signed this bill into law on Friday , 30. November, 2001, to take effect 1. January 2002. It was the determination of the Committee to recommend to The Council that the appropriate Legislators be complemented for their diligent efforts for this bill to become Michigan Public Act No 172 of 2001.

    Discussion continued regarding the absence of consideration in the Act for Trauma and emergency care. It was determined that the Committee would develop a protocol for amending Act 172 of 2001 to include trauma and emergency care.

  3. State Trauma System Michigan Trauma Care Commission

    Doctor Scholten called attention to Meeting packet information which included a listing of Michigan Trauma Commission Members, the Schedule of Public Hearings on Trauma Care Delivery and information pertaining to presentation of testimony. The Committee members were requested to attend hearings in their area and to encourage other surgeons to also attend. Doctor Scholten stated he had attended three of the Public Hearings and that they have been well attended and the interests of Surgeons have been well represented and presented. Discussion ensued. It was the understanding of the Committee that the Purpose of the Commission is to establish a Trauma System in Michigan that is appropriately funded.

    There was the suggestion that the American College of Surgeons Trauma System Model be used by the Michigan Commission to implement a system. Information will be obtained to present to the Michigan Trauma Commission.

    5. Young Surgeons 2002 Forum: 2002 Young Surgeons Survey:

    It was determined to consider these two agenda items as one item. Doctor Scholten called attention to the Listing of New 2001 ACS Fellows and initiated discussion pertaining to the survey of these new Fellows with the results of this survey being incorporated into a program for the 2002 Forum. There was consensus that this be accomplished. Mr. Plasman was requested to prepare a draft Young Surgeons and New Fellows Survey for review and editing by the Committee.

    There was then discussion regarding the time and place for the 2002 Forum. Following consideration of several alternatives, it was determined that the most advantageous time and location would be to convene at the Friday, 10. May, 2002 MCACS Annual Meeting luncheon program where an ACS Officer will present, followed by a two hour program. Doctor Scholten requested the Committee members to be presenters on the subjects and activities they have researched and presented to the Committee. There will be significant time during the 6. March, 2002 YSIC devoted to the completion of an agenda so that information and registration can be initiated in Mid March 2002. It was also determined that as part of the survey, the announcement of the 2002 Young Surgeons and New Fellows Forum be made known.

    Discussion ensued pertaining to the utilization of the MCACS Web Site for this purpose and the posting of YSIC meeting Minutes. Further discussion resulted in the recommendation to The Council to assemble information and consider the implementation of an MCACS Email Server. Doctor Hoshal stated he would discuss this matter with John C. Eggenberger, MD, FACS, MCACS Web Master.

    6. 2002 Day in surgery Program:

    Doctor Hoshal reported for Anthony A. Holden, MD, FACS, stating that Doctor Holden has initiated contacts to learn the adjournment of the Michigan Legislative Session and identification of three to six Legislators, therefore, three to six cities, who would be interested in participating with their staff in the MCACS Day in surgery Program. The program could occur on the same day or during a week, in several cities where the program would include minimally five participants, these being the legislator, the surgeon, the media, a hospital representative and two or more surgeons' business office managers.

    The new ACS 2001 Fellows would be invited to participate as well as current MCACS members. Discussion ensued.. Doctor Reif stated that he would assist in organizing a 2002 MCACS Day in Surgery Program at the Midland Medical Center. It was determined to include this matter in the survey of Young Surgeons and New Fellows.

    7. Other Matters:

    The Chair determined to defer the Discussion pertaining to Hospital Trauma Verification Program to the next meeting.

    8. Adjournment:

    There being no further business to be considered by the Committee, Doctor Scholten adjourned the Committee at 8:37PM

    Respectfully Submitted,

    Donald J. Scholten, MD, FACS, Chair