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American College of Surgeons Professional Association (ACSPA)
The ACSPA Board of Directors approved the 2005 organizational membership dues payment for Doctors for Medical Liability Reform (DMLR). The Board of Directors voted to join DMLR in August of 2003. The ACSPA made a monetary commitment to the organization, which entitled it to a position on the DMLR's Steering Committee. Current first-tier members of the Steering Committee are the American Association of Orthopaedic Surgeons, the American College of Obstetricians and Gynecologists, the American College of Emergency Physicians, the Society of Thoracic Surgeons, and the ACSPA. The ACSPA is the largest organization in the coalition, and its representative, F. Dean Griffen, MD, FACS, holds office as secretary.
During 2004, the ACSPA-SurgeonsPAC raised $596,000 through its presence at the Clinical Congress and at chapter meetings, and through telephone calls and annual mailings. The PAC's telephone fund raising program began on April 28 and collected $350,000 in pledges. The ACSPA-SurgeonsPAC donated to over 112 candidates, party committees, and leadership PACs.
Three ACSPA members were successful last year in their first campaigns for Congress. On January 12, the ACSPA co-hosted a reception for these new representatives.
In 2005, the ACSPA-SurgeonsPAC will continue to support congressional leaders and other members of Congress who support surgery's legislative agenda. The first fundraising activity to be hosted by the ACSPA-SurgeonsPAC on behalf of the physician organizations was held on February 2.
American College of Surgeons (ACS)
ACS Statements
The Board of Regents approved a new statement developed by the Committee on Ethics. The new Statement of Principles of Palliative Care will be published in an upcoming edition of the Bulletin and then posted on the College's Web site. This statement replaces a previous statement titled Principles Guiding Care at the End of Life.
The Board of Regents approved a Statement on Service Volume and Quality. The statement was developed by the College's Health Policy Steering Committee, and will be published in a future edition of the Bulletin and subsequently posted on the College's Web site.
Board of Governors
The Board of Regents approved recommendations presented by the Board of Governors. At its meeting on October 10, 2004, the Board of Governors heard reports from the Governors committees. Several of the committees presented recommendations that were approved by the Board of Governors. In turn, the Board of Governors present1ed these recommendations to the Board of Regents for approval.
Scholarships
The Board of Regents approved a new health policy scholarship jointly sponsored with the American Academy of Otolaryngology-Head and Neck Surgery Foundation. The College awards approximately $1.5 million annually in scholarships.
ACS Bylaws
The Board of Regents approved a change to the College's Bylaws. Article VII, Section 1 (f), will be revised to read "Unprofessional conduct."
ACS Foundation
The Board of Regents approved the Bylaws for the American College of Surgeons Foundation, as well as the members of the Foundation's Board of Directors and its slate of Officers. At
its October meeting, the Board of Regents approved a business plan to establish an American College of Surgeons Foundation. The sole purpose of the Foundation is to raise money to sup-port the education, research, and patient safety programs of the College. Members of the Foundation's Board of Directors are as follows:
Oliver H. Beahrs, MD, FACS
John L. Cameron, MD, FACS
Edward R. Laws, MD, FACS
Richard B. Reiling, MD, FACS
Thomas R. Russell, MD, FACS
The following individuals are the Foundation's Officers:
President Edward R. Laws, MD, FACS Secretary Richard B. Reiling, MD, FACS Treasurer John L. Cameron, MD, FACS MD Director of Development Thomas R. Russell, MD, FACS
Comptroller Gay L. Vincent, CPA
Chief Development Officer Fred W. Holzrichter, CFRE
Development Office
During calendar year 2004, the College received gifts and pledges totaling $1,984,872. This total compares to the previous calendar year's gifts and pledges of $1,418,705. The Development Committee is working to increase awareness of the benefits of using planned gifts, and is also working closely with financial planning experts to provide personal planned giving counsel upon request. The Development Office continues to communicate regularly with pharmaceutical and medical device companies in an ongoing effort to explore opportunities for funding.
Advocacy and Health Policy
The Board of Regents approved funds to complete an analysis of closed malpractice claims to generate data that will help guide relevant ACS educational efforts and the development of resource material for ACS members. The ACS Patient Safety and Professional Liability Committee is conducting a pilot project to analyze closed claims to see if the surgical profession can replicate the success realized by the anesthesiologists, whose claims-review process has resulted in programs that have reduced the number and severity of lawsuits for their specialty. The committee was intrigued with implementing a similar program because there is potential for reducing patient injuries and improving patient care, as well as stabilizing the liability premiums paid by surgeons. The process could be used to identify and prioritize patient safety issues. Such a program would demonstrate that the profession of surgery is doing what it can to prevent those maloccurrences that are, in fact, preventable. At the conclusion of the project, the committee believes it will be able to report on the most common events leading to malpractice claims, as well as the causes of the most severe injuries.
In comments submitted to the Centers for Medicare & Medicaid Services (CMS), the College focused on the need for CMS to adopt a new methodology and better data collection for calculating malpractice relative value units (RVUs) that would more fairly compensate high-risk surgical specialties. The College submitted codes that it considers undervalued for consideration during the five-year review of RVUs. The review will take place in 2005, and any resulting changes to the value of these codes will become effective in 2007. The College also called into question the issue of parity with regard to newly established Medicare payment for drug administration codes.
In December, Frank Opelka, MD, FACS, represented the College at a meeting in Iowa to discuss the geographic adjustments that are made to Medicare physician payments in rural areas. The meeting was hosted by the Urban Institute, which was operating under contract to CMS to complete a congressionally mandated study of the adequacy of Medicare payments to rural physicians. Dr. Opelka suggested that add-on adjustments to rural payments and improved administration of "bonus" programs are the preferred means of addressing rural area concerns.
CMS published a new proposed list of procedures it will cover in ambulatory surgical centers (ASCs). CMS proposed to add 25 procedures and delete 100. The College submitted its comments on the proposed list. In addition to commenting on specific procedures included and excluded from the list, the College urged CMS to reevaluate it methods for approving procedures for Medicare reimbursement in ASC settings and for establishing payment rates for individual procedures.
In a release that was effective June 1, CMS set new associated principles for informed consents and operative notes. Paul Friedmann, MD, FACS, and ACS staff met with CMS officials on December 13 to review the informed consent guidelines and discuss their implication for teaching programs. Agency representatives agreed to review suggested changes in the guideline language.
The Senate and the House passed two patient safety bills in 2003 and 2004, but they were unable to negotiate the differences between the bills before adjourning last year. As an active member of the Patient Safety Coalition, the College will continue to work with congressional staff and other health care organizations to promote passage of patient safety legislation in 2005.
Talks are underway with key legislators on the reintroduction of legislation to reauthorize the Trauma-EMS Program. The College is collaborating with other specialty societies in an effort to find compromise language for another reauthorization bill in 2005.
The College has also collaborated with other surgical specialty societies to update the 2002 study, Physicians as Assistants at Surgery. The fifth edition should be published early this spring.
The 2005 series of basic and advanced CPT and ICD-9-CM coding workshops has been scheduled for May, July, and September in Baltimore, Chicago, and Dallas, respectively. The 2005 practice management course, "Charting a Sound Course for Surgical Practices," will only be provided at the Spring Meeting and the Clinical Congress.
Certification/Accreditation
The Board of Regents approved funding for the infrastructure to support verification, certification, and accreditation activities within the Division of Education. National trends impacting surgical practice and surgical education include intense focus on surgical competence, surgical outcomes, and patient safety. The need to verify, certify, and accredit individuals, educational programs, and educational systems is an integral component of these trends.
Initial planning for an ACS Accreditation Center is under way. Noting that this is one of the College's major priorities, the Executive Committee of the Board of Regents discussed and approved the formation of a task force to review the creation of an ACS Accreditation Process.
E-learning
The Board of Regents approved funding for a demonstration project involving development of an e-learning module to support practice-based learning and improvement. The purpose of the project will be to define the characteristics and standards in e-learning important for authoring modules, to evaluate the educational impact and use of the module, and to create a framework for designing multiple e-learning modules and integrating them with other e-learning resources.
Education
A new interactive CD-ROM, Personal Financial Planning and Management for Residents and Young Surgeons, was released during the 2004 Clinical Congress. A set of two CD-ROMs, Practice Management Course for Residents and Young Surgeons, should be ready for release in early 2005.
Three sessions from the 2004 Spring Meeting are available as Web casts on the Internet and offer opportunities to earn online Category 1 CME credits. Nine sessions from the Clinical Congress will be available in early 2005.
Audio recordings of sessions from the 2004 Spring Meeting and Clinical Congress are available on CD-ROM. In addition, these sessions are also offered in MP3 format.
SESAP 12 was released at the Clinical Congress. The initial sales have been brisk. The program includes new features: content categories were changed to make them congruent with the con-tent categories of the Recertification Examination of the American Board of Surgery, the CME verification process was streamlined, and an audio companion was added. A SESAP Sampler will be launched in the spring.
An Editorial Board has been appointed to review the tapes housed in the ACS Video Library. The Board will review and arrange the tapes thematically in order to produce new video-based education products.
The first Resident Award for Exemplary Teaching was presented at the 2004 Annual Meeting of Fellows. The award recognizes excellence in teaching by a resident and highlights the importance of teaching in the daily lives of residents.
The one-day program for surgical residents, "Life After Residency," will be presented on Friday, April 15, 2005, just prior to the start of the Spring Meeting. Three special sessions for residents are being planned in collaboration with the Resident and Associate Society of the College. They will be held on Sunday, April 17, 2005. The sessions include, "Spectacular Cases for Residents," "Surgical Jeopardy," and a new clinical abstract presentation session.
Journal of the American College of Surgeons (JACS)
JACS began its celebration in honor of the 100th anniversary of publication. Each issue of JACS during 2005 will contain a retrospective editorial about a specific topic from early issues of JACS. January 2005 marked another milestone, as JACS and the Bulletin will be packaged together for mailing through Elsevier.
As of December 2004, the JACS Online CME-1 Program had logged 59,600 CME-1 credits at no cost to Fellows of the College. At all times, JACS Online maintains two full years of material, or 48 possible credits.
Communications
Members of the Public Profile and Visibility Steering Committee initiated the final recruitment and selection process for the members of the College's Public Outreach Television Team. Letters, along with a videotape explaining the concept of the program, were sent to individual Fellows who had expressed an interest in the project. The response to that letter and a letter that Dr. Russell had sent resulted in a total slate of 25 candidates for review and consideration. Ten of those candidates accepted and will attend a training session, which is intended to introduce the team members to all of the players at television stations and to provide in-depth insight into how the business works, how to establish a working relationship with a TV station, and how surgeons can optimize their interactions with their local stations.
The ACS Web portal prototype that was demonstrated last October has been transferred into a full production level software and hardware environment, and the graphic design is being revised to improve ease-of-use for members of the College. Dialog continues with parties that are interested in partnering with the College to fund the portal project. A media kit that outlines the purpose and intended content of the portal has been prepared for distribution to a large number of companies representing various commercial activities.
Continuous Quality Improvement (CQI)
CQI, formerly the Office of Evidence-Based Surgery, held a new course, "Outcomes Research." The course focused on designing observational studies, assessing validity, working with large databases, conducting basic statistical analysis, and adjusting for risk. Feedback from faculty and participants was very positive, and the multi-day course will be offered again in 2006.
Work continues on the Web site for the ACS National Surgical Quality Improvement Program (ACS NSQIP). The Web site will be a primary source of information regarding the program. A PowerPoint presentation about the ACS NSQIP is now available for downloading.
Cancer
As of December 31, 2004, almost 1,270 Commission on Cancer (CoC)-approved cancer program registries had responded to the National Cancer Data Base (NCDB) request for case submissions. Approximately 92 percent of CoC-approved cancer programs have submitted data in response to the 2003 Call for Data.
The American Cancer Society has recruited Intel Solution Services to conduct an assessment of the NCDB. The goal of which is to position the NCDB to better support cancer prevention, early detection, and quality of care initiatives.
Trauma
The following is an update on Trauma activities.
Member Services
The Board of Regents approved waiving the application fee, or first year's dues, for all PGY-1 surgical residents. In subsequent years, they will be billed at the dues rate relative to their category of membership.
The Rural Surgeons Subcommittee of the Advisory Council for General Surgery continues to meet regularly. In addition to a third Rural Surgery Forum, a general session is planned for the 2005 Clinical Congress.
As of January 11, 2005, the Job Bank had 488 positions listed, and 57 job seekers and their resumes. The site averaged 500 hits/week.
Representatives of the ACS Committee on Young Surgeons asked the Board of Regents to consider, as one of its future Policy and Planning initiatives, providing childcare for those who attend the ACS meetings. The Board suggested that the Convention and Meetings division explore the possibility of providing such services.
Revised April 23, 2007