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Highlights of the ACSPA Board of Directors and the ACS Board of Regents MeetingsFebruary 8-9, 2008
American College of Surgeons Professional Association (ACSPA) The ACSPA-SurgeonsPAC is doing well. It is now the fifth largest physicians’ PAC--up from the seventh. The PAC raised $639,000 in the 2006/2007 election cycle. Telephone solicitation continued to be a major component of the PAC’s fundraising efforts. Political disbursements were made to 129 candidates, leadership PACs, and party committees. Fifty percent of the ACS Governors in the US made contributions averaging $495. Eighty-five percent of the US ACS Regents made contributions averaging $912. The ACSPA-SurgeonsPAC will continue to support congressional leaders and other Members of Congress who support surgery’s legislative agenda. The PAC will be relied upon heavily as a tool for gaining access to legislators, and to ensure that a sustainable growth rate (SGR) fix is at the forefront of the legislative agenda. American College of Surgeons (ACS) The Board of Regents approved the following recommendations and requests from the Board of Governors. In order to improve relationships with international surgeons and increase international membership, the College should:
In light of heightened concern over surgical workforce and manpower issues, the College should:
Other recommendations/requests included:
The strategic planning process continued during the February 2008 meeting of the Board of Regents. The Strategic Planning Committee held its first telephone conference call meeting on January 15, 2008. The purpose of this meeting was to discuss the College’s action regarding socioeconomic issues and to formulate plans for future socioeconomic action. At the conclusion of the meeting, preliminary recommendations included:
The ACS Health Policy Institute became operational in January 2008. It is currently head-quartered at the Cecil G. Sheps Center for Health Policy Research at the University of North Carolina until the College’s Washington, DC, headquarters building is completed. At that time, it is anticipated that the Institute will relocate to Washington, DC. The Sheps Center is realigning personnel to obtain a quick start for research pertinent to surgical interests. One large review article and two submitted abstracts dealing with issues related to surgical workforce have already been completed. The article and abstracts will be credited jointly and, by agreement, co-branded with the American College of Surgeons. The College’s Division of Advocacy and Health Policy has been striving to improve communications with ACS leaders and the Fellowship. A new series of Web-based teleconferences has been initiated for ACS Governors and other leaders, a new electronic newsletter featuring ACS and ACSPA advocacy activities has been launched, Web-based educational teleconferences were organized to educate surgeons about quality reporting under Medicare, and discussion forums focusing on Medicare and other advocacy topics were created on the Web portal. The College continues to fill its role as a coalition builder. Advocacy efforts spearheaded by the College include extensive campaigns to generate support for a system of separate fee schedule spending targets and conversion factors under Medicare, reauthorization of trauma systems development legislation, and refinement of legislation to promote the implementation of health information technology. Physician Quality Reporting Initiative (PQRI) The Medicare PQRI program (initiated in 2007) will be continued in 2008. The program links a 1.5 percent Medicare physician payment bonus to the reporting of quality data on Medicare claims. This year, the program has 199 measures from which physicians can choose to report. Physicians who report on three or more performance measures for at least 80 percent of relevant procedures are eligible for the full 1.5 percent bonus payment. For physicians who report more than four performance measures, the Centers for Medicare & Medicaid Services (CMS) will choose the three measures with the highest reporting rate to calculate the bonus payment. Through its Division of Advocacy and Health Policy, the College hosted four Web-based teleconferences or “Webinars” in December to educate surgeons’ practices about participating in the PQRI program. Two of the Webinars were oriented to practices that had not previously participated, and two were focused on changes to the program in 2008 for those practices that were already participating in 2007. All of the PQRI-related materials developed by the College were updated on the Web site to reflect new measure specifications for 2008. On August 22, the U.S. District Court for the District of Columbia issued a decision that will make physician-identified Medicare claims data available for use by Consumers’ Checkbook / Center for the Study of Services, in order to assess health care quality. Specifically, the court decision requires the U.S. Department of Health and Human Services (HHS) to provide physician-specific Medicare claims data to Consumers’ Checkbook for use in reporting to the public on the number and types of procedures each physician provides under Medicare and to somehow translate those data into an assessment of health care quality. In meetings with HHS officials, the College and other specialty organizations expressed appreciation for the intent behind the Consumers’ Checkbook lawsuit, but expressed skepticism about whether these Medicare data will improve the current lack of meaningful provider-specific data for consumers to use in making wise health care decisions. HHS has notified the court of its intention to appeal the decision, and the College is one of 17 medical and surgical specialty societies planning to file an amicus brief in support of the appeal. On December 18, the Senate passed the Medicare, Medicaid, and SCHIP Extension Act of 2007 (S. 2499) by unanimous consent. The bill included provisions to increase the Medicare fee schedule conversion factor by 0.5 percent for all physician services provided between January 1 and June 30, 2008. The House of Representatives passed S. 2499 on December 19, on a 411 to 3 vote, and the bill was signed into law on December 29. The Medicare fee schedule conversion factor was scheduled to be cut 10.1 percent on January 1 because of the SGR system used to determine Medicare payment updates. Without further congressional action, Medicare payments will be reduced 10.1 percent on July 1 or by 10.6 percent from the current payment level. The bill also included six-month extensions of other payment policies, particularly those that support payments in rural areas. CMS has announced that, because of the change in 2008 payment rates, it will reopen the period for physicians to make decisions about whether to sign Medicare participation agreements for 45 days. It is not known whether CMS will allow physicians to revisit their participation agreement status if and when payments are reduced mid-year. The House had passed a more comprehensive Medicare measure that included payment increases of 0.5 percent in 2008 and 2009, but the House and Senate could not reach agreement on all details of the package, particularly with respect to proposed payment cuts elsewhere in Medicare that would have been used to offset the increase in physician payments. The disagreements largely centered on payment rates to Medicare Advantage plans, which are Medicare plans administered by private health insurance companies. In early December, the College contacted Fellows on multiple occasions via email and asked them to telephone their Senators and Representatives to encourage support of Medicare payment increases. From responses received, it appears that approximately 3,000 Fellows made these contacts--the College’s most successful effort to generate such grassroots support. Advocacy efforts also included organizing opportunities for surgeons to meet with key Senators and Representatives. ACS multiple conversion factor proposal On August 1, the House passed the Children’s Health and Medicare Protection Act (HR 3162, or CHAMP Act) on a 225 to 204 vote. The bill, which included measures to reauthorize the State Children’s Health Insurance Program, also included provisions that would have provided two years of positive Medicare fee schedule updates of 0.5 percent in 2008 and 2009. Impor-tantly, the bill would have implemented more comprehensive Medicare payment reforms by establishing a system of six separate fee schedule updates and conversion factors based on service categories, including a separate category for major surgical procedures. These provisions were similar to those included in the College’s service category growth rate reform proposal, which was included in legislation HR 3038. In a letter dated December 8, a bipartisan coalition of 140 Representatives led by Reps. Lincoln Davis (D-TN) and Pete Sessions (RTX) sent a letter to House Speaker Nancy Pelosi (D-CA) and Republican Leader John Boehner (R-OH) expressing support for the Medicare reform measures included in the House-passed CHAMP Act. This letter was proposed and drafted by the College. By either voting for the CHAMP Act or signing the Davis-Sessions letter, 279 Representatives expressed support for separate service category targets. ACS efforts to promote separate targets In September, the College and 11 surgical specialty organizations sent letters to all 100 Senators expressing support for two years of fully funded positive fee schedule updates, as well as the CHAMP Act provisions pertaining to the multiple spending targets and conversion factors. This letter was organized and produced by the College. In addition, College staff visited with more than 80 Senate offices in the fall, in an effort to build awareness of and support for these provisions of the House CHAMP Act. In late October, the College led medical and surgical specialty organizations in advocating against a letter being circulated by Sen. Herb Kohl (D-WI) regarding imaging issues in the CHAMP Act. As originally drafted, the letter opposed the multiple targets included in the Act. Through these advocacy efforts, the offending language was removed from the final letter.
On July 12, CMS published a proposed regulation outlining Medicare physician payment policy changes for 2008. At that time the Medicare fee schedule conversion factor was still slated for an estimated 9.9 percent reduction effective January 1, 2008. On November 1, CMS released the final rule on the fee schedule. Most of the provisions included in the proposed rule were retained. In addition, the final rule announced that a 10.1 percent across-the-board reduction in Medicare physician payments would be implemented unless Congress intervened by the end of the calendar year. Without congressional action, the fee schedule conversion factor was set to drop from $37.8975 to $34.0682. The College submitted an extensive comment letter on the proposed rule on August 31, and also submitted comments on provisions in the final rule that were open to public comment-- particularly interim relative value unit provisions that were detrimental to surgery. Ambulatory Surgery Centers (ASC) legislation Introduced by Sen. Mike Crapo (R-ID) in October 2007, S. 2250, the Ambulatory Surgical Center Payment Modernization Act of 2007, would provide a more equitable payment system for ASCs and follow a MedPAC recommendation to modify the ASC procedures list. S. 2250 would provide a more equitable payment rate of 75 percent of the Hospital Outpatient Prospective Payment System. In addition, the bill would allow payments to ASCs for any surgical service, except for those procedures where, 1) the HHS Secretary identifies a specific risk concerning a certain procedure being performed in an ambulatory surgery setting, or 2) an overnight stay is required. The College sent a letter to Sen. Crapo endorsing the bill and College staff has been meeting with numerous Senate office staffers in order to gain more support for the bill. Stereotactic breast biopsy regulatory proposal On November 5, the National Mammography Quality Assurance Advisory Committee (NMQAAC), which is an advisory committee of the Food and Drug Administration, held a hearing to discuss the possible modification of the definition of mammography under the Mammography Quality Standards Act (MQSA). This action would have the effect of regulating stereotactic breast biopsy procedures under MQSA. Thomas R. Russell, MD, FACS, and Shawna C. Willey, MD, FACS, presented testimony on behalf of the College on how stereotactic breast biopsy is an important diagnostic tool for surgeons and their patients. Dr. Russell testified that federal regulation of interventional medical procedures is inappropriate under MQSA, in the absence of a clinically significant mammography-related problem and MQSA standards that could address that specific problem. Dr. Willey, Director of the Betty Lou Ourisman Breast Health Center at Georgetown University Hospital, stated that the proposed regulatory changes could be detrimental to the interests of patients in need of breast biopsy and ultimately hurt patient access and patient care. In particular, the College’s witnesses emphasized that there should be no federal regulations to restrict certain physician specialties from providing specific services or procedures. The NMQAAC has not taken any further action on the proposal. Congress finished work on 11 FY 2008 appropriations bills, including the Bush-vetoed Labor-Health and Human Services-Education bill (L-HHS-E), by wrapping them together in an omnibus bill at the end of the year. However, to ensure the President would sign the enormous package, funding was cut to adhere to the spending levels proposed in his original budget request. During that process, $3 million for trauma systems development—which was won on the Senate floor when the L-HHS-E bill was considered separately in October and included in the final L-HHS-E bill that was passed by the House and Senate--was dropped from the bill. The trauma program is authorized for $10 million for FY 2009, and the College and its supporters are again working to secure its funding. The College and other key groups are working together to launch an initiative to formally establish in statute and provide significant federal funding for trauma-focused grants for the National Trauma Institute. Legislation has been introduced in the House (HR 3673) by Reps. Ciro Rodriguez (D-TX) and Charlie Gonzalez (D-TX), and the coalition is working to achieve the introduction of companion legislation in the Senate. Introduced in November 2007 by Sens. Patty Murray (D-WA), Johnny lsakson (R-GA), Jeff Bingaman (D-NM), and Kay Bailey Hutchison (R-TX), 3.2319, the National Trauma Stabilization Act of 2007, would provide critical funding to trauma centers that are at risk of closing due to the increased uncompensated and charity care costs they must absorb. Spearheaded by the National Foundation for Trauma Care, the bill language was taken from the original Trauma Systems legislation, Title XII of the Public Health Service Act, passed in 1990. It was modified to include all trauma centers and to include new language specifying that trauma centers must use ACS trauma registry guidelines and must participate in a trauma system to receive federal funding. There is $100 million authorized for the program in FY 2009 and such sums as necessary for FYs 2010-2014. Grants would be for three years and may be extended for an additional year as long as qualifying conditions are met. Individual grants may not exceed $2,000,000 nor exceed the level of uncompensated care provided in a facility’s emergency department. On October 30, the College and other surgical societies met with officials at the Department of Homeland Security (DHS) to lay the foundation for cooperation in the development of contingency plans for meeting national and local health care needs in the event of a national disaster. The surgical groups explained how trauma systems provide a model for coordinating the necessary resources beyond those typically involved in meeting public health requirements. DHS plans to organize a national conference to lay the groundwork for developing such plans. The College, along with the American Association of Neurological Surgeons and the American Academy of Orthopaedic Surgeons, developed a legislative agenda to address the ongoing surgical workforce crisis in emergency departments across the country. The following priority issues were identified: liability protections, reimbursement for treatment of the uninsured, loan deferment extension, and the regionalization of emergency care. Next steps included approaching other surgical specialty groups for support and enlisting a Member of Congress to sponsor this agenda in the second session of the 110th Congress. In June 2007, Rep. Tom Price, MD, FACS (R-GA), introduced HR 2626, the Comprehensive HealthCARE (Coverage and Reform Enhancement) Act of 2007. Soon after the bill was introduced, the College sent a letter to Rep. Price supporting this bill. This legislation includes several provisions that are consistent with longstanding College policy:
The College is working with six surgical specialty societies--American Academy of Otolaryngology-Head and Neck Surgery, American Association of Neurological Surgeons / Congress of Neurological Surgeons, American College of Osteopathic Surgeons, Society of Gastrointestinal Endoscopic Surgeons, and the Society of Thoracic Surgeons--to sponsor a Joint Surgical Advocacy Conference in Washington, DC, March 9-11. Other specialty societies plan to send delegations to the event, as well. The conference, which is open to all Fellows as well as to members of the other participating organizations, will feature briefings and visits with legislators on Capitol Hill. If the event proves successful, there are plans to make it an annual event. Loan initiatives for residents Medical school graduates are now finding they owe an average of $130,000 when their educational bills come due. The College supports HR 1407, the “Higher Education Affordability and Equity Act” sponsored by Rep. Phil English (R-PA), which would remove the limits on tax deductions for student loan interest. The College also supports S. 1066, the “Medical Education Affordability Act,” introduced by Sen. Chris Dodd (D-CT), which would provide relief by allowing young surgeons who qualify for the Economic Hardship Deferment to use this option beyond the current limit of three years into residency, assuring they will not have to begin repaying their loans or put their loans into forbearance during residency. On September 4, the College joined other national organizations in urging the U.S. Secretary of Education to increase the aggregate combined Stafford loan limit for health profession students from $189,125 to $223,793, arguing that the current limit has remained stagnant for over a decade and does not account for recent increases in annual unsubsidized Stafford loan limits or reflect programs of different duration. College opposes optometric equity Introduced by Rep. Janice Schakowsky, (D-IL), HR 1983, the Optometric Equity in Medicaid Act of 2007, would inappropriately expand the scope of practice for optometrists treating Medicaid beneficiaries. The College sent a letter to Rep. Schakowsky opposing this bill. HR 1983 would require Medicaid coverage of “medical and surgical services furnished by an optometrist to the extent such services may be performed under State law.” While optometrists have failed to gain surgical privileges in 17 states since its success in Oklahoma in 1998, they continue to press for licensure expansions. Health Information Technology (HIT) Congress has produced near-misses in the area of HIT legislation in each of the previous two years and the issue has been placed high on the health care agenda for 2008. At the request of congressional leaders, the College took the lead in negotiations on HIT legislation known as the "Wired for Health Care Quality Act” (S. 1418). An identical bill titled the “Promoting Health Information Technology Act” (HR 3800) was introduced in the House. This legislation, which would provide $278 million in grant funding for physicians to adopt HIT and create a permanent federal office for standards development, promises to be the primary legislative vehicle for HIT again this year. Attempts to “hotline” (passing by unanimous consent in the Senate without formal floor debate) this HIT legislation in November were stymied after concerns were raised by the College and other physician groups over a provision that would have undermined years of progress on the development of risk-adjusted quality measures by calling for the public release of raw Medicare claims data. Negotiations were successful and resulted in significant concessions by the sponsors including major qualifications on the release of this data. While lesser concerns with this bill remained regarding the lack of privacy provisions and the inadequacy of grant funding, ultimately the decision by Congress to pass a trimmed-down Medicare vehicle did not leave room for the inclusion of this HIT bill. College continues support for increased cancer research funding The College continues to be an active member of the One Voice Against Cancer (OVAC) coalition and will continue to lobby Congress for adequate levels of funding for cancer programs and research in 2008. In 2007, Congress enacted small increases in funding from the previous year for the National Institutes of Health (NIH), which translated into slight increases at NIH cancer programs including a 0.25 percent increase for the National Cancer Institute and a 0.2 percent increase for the National Center on Minority Health and Health Disparities. CDC’s Cancer Programs saw a 2.7 percent increase from the previous year with relatively large shift funding towards programs targeting cervical cancer. The CDC’s Ovarian Cancer Awareness program saw an 18.7 percent increase and the National Breast and the Cervical Cancer Early Detection Program saw a 1.2 percent increase, while the remaining seven cancer programs at CDC saw decreases of 1.7 percent. ACS Health Policy Steering Committee (HPSC) The HPSC has been considering a proposal to develop a risk management course that could be offered at chapter meetings in partnership with liability insurance carriers. The plan is either to develop an ACS program or to cosponsor programs developed by liability insurers that would confer premium discounts on Fellows who participate. Background research was conducted by staff and shared with the committee, and F. Dean Griffen, MD, FACS, was asked to spearhead the effort. Letters about the proposal were sent to 15 carriers. Dr. Griffen will be making personal contacts with both the carrier representatives and the College’s chapters to facilitate this collaboration. The committee suggested that an article be published in the Bulletin informing Fellows of the many types of risk management education and premium discount programs already sponsored by liability insurance carriers, and plans are under way to develop resource material on this issue for the College’s Web site. The HPSC reviewed a request from Ethicon to participate in an effort to remove overly broad legislative language in the Farm Bill that banned the use of live animals in marketing medical devices. The concern was that the proposal would interfere with manufacturers’ activities in training surgeons on the use of medical devices. At the committee’s request, the Washington office collaborated with Ethicon and other organizations in an advocacy effort and the problematic language was eliminated. ACS General Surgery Coding and Reimbursement Committee (GSCRC) The GSCRC reviewed seven separate sets of Correct Coding Initiative edits. For three sets of edits, the GSCRS did not agree with the proposed edits. Clinical rationales describing concerns with these edits were sent to the Medicare contractor charged with developing and maintaining the Medicare edit files. CMS accepted the rationales and will not implement the proposed edits for those codes. Medically unlikely edits are Medicare edits that limit the number of times a procedure may be performed and billed in a single day. A set of 1,377 proposed edits was reviewed by the GSCRC, and comments for 153 general surgery codes were submitted. CMS accepted all the requested changes. ACS Patient Safety and Quality Improvement Committee The committee reviewed its Patient Safety Course presented at the Clinical Congress. The course was well received, and there is interest in expanding it. The syllabus contained basic principles such as high reliability, systems approach, teamwork, communication, leadership, and distribution of the workload. Evaluations received revealed that those attending the course would take the information back to their institutions where it can be used as a resource. Because the course was relatively small there was a great deal of engagement. The committee would like to allow the course to mature into a safety certification course that the ACS would convene, similar to what it does for the ATLS® course. This would include not only didactic sessions but also simulation-based training. Coding workshops scheduled for 2008 The College has again contracted with Karen Zupko and Associates to provide a series of CPT and ICD-9-CM coding workshops during 2008. These one-day workshops are intended for all general surgeons, closely related specialties, and their staffs. The course “Introduction to CPT, ICD-9-CM, and Evaluation and Management Coding” will introduce participants to the key principles of ICD-9-CM and CPT coding. 2008 practice management Web casts The College has once again joined with Economedix to present a series of practice management Web casts in 2008. The program consists of 24 live distance-learning courses dealing with critical aspects of practice management and is designed to help surgeons maintain productive, efficient, and profitable practices in today’s challenging environment. The Wednesday Web casts are followed by on-demand audio casts for surgeons and their staff in the event they miss the live session. For more extensive information on the efforts of the College’s Division of Advocacy and Health Policy, please visit the Advocacy Web page at: http://www.facs.org/ahp/index.html. The Board of Regents approved the recommendations presented by the ACS Program Committee for the reorganization of the Clinical Congress educational format. A concise summary of the changes will be published in the Bulletin and Surgery News. Journal of the Online and fax submissions to JACS CME-1 Online Program currently exceed 179,000 cumulative credits, provided as a member benefit. In 2007, 540 new users earned 7,969 credits. Total credits provided in 2007 equaled 43, 576 (a 25 percent increase over 2006). This program would be beneficial for all ACS chapters. Work continues on international promulgation of ATLS in Pakistan, Poland, and India. ATLS courses are now conducted in 49 countries. The Rural Trauma Committee is developing an instructor course for the Rural Trauma Team Development Course. The committee is also studying communication between Level III/IV hospitals and Level I/II hospitals regarding transfers. The CoC will host a national conference, Coming Together 2008: A National Forum on Cancer Care in the United States, July 14-15, 2008, in Baltimore, MD. National leaders and advocacy experts will discuss legislative and regulatory issues that will affect the future of cancer patient care. Participants will learn which new directions national organizations such as the National Cancer Institute, Food and Drug Administration, Centers for Disease Control and Prevention, and others are taking to improve cancer patient care. Presentations will address how the health care environment can be changed to improve quality and eliminate disparities in care and how the leading advocacy organizations are making an impact on national policy. The CoC is offering a new Web conference series with one-hour programs to support the educational needs of cancer program team members in CoC-accredited cancer programs. Eight conferences have been developed and scheduled to date. Each Web conference is presented live on the date scheduled and includes a Q&A session with the presenter. Following the original presentation, the program will be available via streaming video (with audio) for 90 days to registrants. Registration is required to participate in the 2008 Web conference series. CME/CE hours are provided. The Bariatric Database of the ACS BSCN Accreditation Program became fully operational in February 2008. The submission of outcomes data on all bariatric operations performed at both provisionally and fully approved centers is required for centers to obtain and maintain accreditation. The data will be reviewed on an annual basis. Bariatric data collectors at Level A accredited centers were invited to attend the first ACS Bariatric Database training on February 26-27, 2008. A second training is scheduled for March 25-26, 2008, for bariatric data collectors at Level B accredited centers. After training of the current ACS BSCN sites is complete, future training for newly enrolled sites will be Web-based. Partnership efforts with the Joint Commission (JC) have resulted in JC recognition of the ACS BSCN Accreditation Program. Accredited ACS BSCN centers will be acknowledged with a Merit Badge on the JC’s Quality Check Web site. This Web site allows visitors to search through roughly 15,000 commission-accredited health care organizations and learn about a facility’s accreditations, services provided, and special quality achievements. ACS National Surgical Quality Improvement Program (ACS-NSQIP) The ACS NSQIP is being modified to improve upon a number of issues encountered by the enrolled private sector hospitals. A sample of the changes includes: decreasing the amount of data collected per case, changing the sampling frame to collect more of the important and clinically meaningful cases, providing surgeon specific outcomes, and providing more instruction to hospitals on how to improve their outcomes. There are a number of working groups that are developing ways to enhance ACS NSQIP, e.g. the development of pediatric and gynecology modules. Meetings have been set with both the Society for Thoracic Surgery and the Society for Vascular Surgery to discuss possible areas for collaboration around data collection and feedback. The Geriatric Surgery Task Force is identifying potential “geriatric specific” variables for potential collection in ACS NSQIP in order to help measure and improve care to geriatric surgery patients. A number of hospitals internationally have requested to participate in ACS NSQIP. Work is under way to develop an International ACS NSQIP. There are a number of issues currently being addressed including criteria, feasibility, data definitions, and auditing. A working plan is being developed to begin piloting ACS NSQIP in three to six international hospitals. Since initiating the program three years ago, ACS NSQIP has been recognized by the Joint Commission, Centers for Medicare & Medicaid Services, Leapfrog, and specific payors such as Blue Cross. The ACS NSQIP Surgical Care Improvement Project (SCIP) has been developed and success-fully tested with CMS, and several sites are currently evaluating the use of this module for the submission of their SCIP data. The JC module will also be available to sites wishing to use the tool to submit their data to the JC. The American Board of Surgery now recognizes the ACS NSQIP as an acceptable program in meeting the Evaluation of Performance in Practice requirement for Maintenance of Certification. With increasing formal recognition and endorsement, ACS NSQIP is becoming the acknowledged standard for surgical quality of care measurement and improvement. Public Profile and Communications Update In early December, work was completed on the College’s book for surgical patients. The book I Need an Operation... Now What? is listed on Amazon.com, Borders.com, and Barnes&Noble.com. A special page has also been created for the book on both the College’s Web portal and public Web site. Work has begun on redesigning the Communities and Specialties area of the College’s Web portal, e-FACS.org. Beginning with the General Surgery Community, the design changes will eventually be made across all areas of the portal. The next communities to be updated with the redesigned format will be the general surgery subspecialty communities and the Residents/ Associate Fellows community. The ACS Communications staff has been working with Paul F. Nora, MD, FACS, and staff of the Division of Advocacy and Health Policy on the development for the College’s new Nora Institute for Surgical Patient Safety. The Nora Institute Web site is scheduled to launch by mid-June. Although the Institute Web site will be visible through the College’s public Web site, it will also have a major presence on e-FACS.org. Surgery News is now in its fourth year of publication and progressed in 2007 with a number three ranking in terms of overall readership. “The 20/20 Vision,” a section launched last September, has enhanced the newspaper’s socioeconomic coverage with invited commentaries from experts addressing topics such as State Children’s Health Insurance Program funding, health policy changes, medical tourism, and the future of this country’s health care system. Articles on surgical innovation, the on-call crisis, and the emerging acute care specialty have been featured along with an overview of the health care proposals being put forth by several Presidential candidates. Resident and Associate Society (RAS) Ted A. James, MD, RAS Chair, gave an update on the projects and goals of RAS. Dr. James stressed the importance of involving RAS members in the activities of the College. It was recommended by a member of the Board of Regents that each Governor bring a resident to the annual Clinical Congress meeting. The Committee on Young Surgeons (CYS) will present two education programs during the 2008 Clinical Congress, one in conjunction with RAS. The 2008 Initiates Program will focus on personal financial planning, and the other session will examine strategies to combat stress and improve health and wellness. A major priority for CYS in 2008 will be to identify programs and activities that can be undertaken by the chapters to enhance young surgeons’ participation and representation at the local level. Significant personnel resources continue to be devoted to the upkeep and further development of the OGB Web site. Since the last report, partnerships with the following nonprofits have been established: Friends of Good Samaritan, International Surgical Missions, Remote Area Medical, SMART Teams, CRUDEM, Surgical Volunteers International, Solidarity Bridge, and Mission Cataract. Total domestic partner agencies equal 39, and total international agencies equal 48. Traffic to the OGB Web site has exceeded 3.2 million hits since its inception. Profiles have been completed by over 900 surgeon volunteers. A productive inaugural meeting of the OGB Advisory Council was held on September 25, 2007, in Chicago. The Advisory Council was presided over by its Chair, Bruce D. Browner, MD, FACS, and Vice-Chair Andrew L. Warshaw, MD, FACS. Other members of the Advisory Council are: Benjamin Aune; William A. Bernie, MD, FACS; Sylvia D. Campbell, MD, FACS; Julie A. Freischlag, MD, FACS; Sen. William H. Frist, MD, FACS; Edward R. Laws, MD, FACS; West Livaudais, Jr., MD, FACS; Anathea Carlson Powell, MD; Randolph Sherman, MD, FACS; John L. Tarpley, MD, FACS; and Michael C. Magee, MD, FACS. The group undertook a thorough review of existing programs and future goals. Short term (one year) goals established include:
Progress to date includes:
The annual Association of Program Directors in Surgery meeting to be held in April 2008 in Toronto will feature a panel discussion on international surgical experiences for surgery residents. As a gesture of contributing to the recovery of the New Orleans health care infrastructure in the continuing aftermath of Hurricane Katrina, Project New Orleans was planned in partnership with New Orleans Habitat for Humanity and the Daughters of Charity Health Care Clinics. During Clinical Congress 2007, 180 volunteersCsurgeons, family members, residents, exhibitors, and othersCdonated 720 service hours and demolished 24,000 square feet in a former school building slated to become a medical clinic in the Ninth Ward. This work was estimated to save the Daughters of Charity approximately $60,000 in construction costs. Additional contributions of over $22,000 were made to both organizations. A drive was also coordinated to recover surplus materials from Clinical Congress exhibitors that could be utilized by area schools. Enough school supplies were donated to fill thirteen pallets requiring an 18-wheeler to transport them. Ten Louisiana elementary schools benefited from donations of over 3,500 pens, 3,700 notepads, and 3,500 tote bags in addition to other supplies. These efforts generated considerable positive press for the College in local and national news venuesCboth television and print. Participants reported extremely high satisfaction with the projects and expressed interest in future opportunities of a similar nature.
The Surgical Volunteerism plenary session featuring presentations by the three surgical volunteerism award winners was very well attended and was capped off by a lively Q&A session from an engaged audience. Final comments were made by Edward M. Copeland, III, MD, FACS, who expressed his strong support of the programs and resources that the College has invested in to facilitate and encourage volunteer outreach.
The Surgical Volunteer Networking Reception was very well attended and was a wonderful informal forum for interaction with the 2007 Volunteerism Award winners and other members of the College who were interested and involved in volunteerism. Attendees included the senior leadership of the Pfizer Medical Humanities Initiative and a number of medical students interested in a career in surgery. ACS Advisory Councils for the Surgical Specialties Each of the College’s 12 Advisory Councils meets twice a year--in the spring and during the Clinical Congress. Items of common interest and concern are discussed throughout the year. All Advisory Councils routinely discuss the Jacobson Innovation Award, Sheen Award, and Honorary Fellowship, and forward nominations to the ACS Honors Committee for its consideration. In an effort to increase ACS membership, several Advisory Councils will conduct mailings to residency program directors highlighting the membership benefits available to Resident members and encouraging 100 percent participation from all programs, as well as the residents in each program. Advisory Council members are encouraged to communicate ACS membership benefits to their specialty organizations. The Advisory Councils continue to develop specialty-sponsored programming presented at the Clinical Congress. Beginning in 2008, the resident-geared sessions and Churchill Lecture previously presented at the Spring Meeting will now be presented at the Clinical Congress. As of mid-January there were 1,057 active jobs listed on the Web site with 302 posted résumés. This is a valuable service for all of our members. The service is complimentary to our Resident members. ACS Surgeons Diversified Investment Fund Drops Expense Ratio to Just Over 1 Percent Recognizing the goal of offering members of the American College of Surgeons and affiliated organizations a reasonably priced investment product, the expense ratio of the College’s Surgeons Diversified Investment Fund (SDIF) has been lowered to just over 1 percent. The lower expense ratio will have an immediate positive impact on our current shareholders, and, over time, will positively impact the performance returns for prospective and current shareholders. The new expense ratio, including ETF costs, is 1.08 percent. Moving forward, all current and prospective investors will have the ability to invest at a lower cost in a no-load, open-end, diversified, actively managed mutual fund broadly modeled after the ACS’s endowment utilizing its same investing principles of asset allocation, diversification, and rebalancing. For more information, please download a copy of the prospectus at http://www.surgeonsfund.com/ or call 1-800-208-6070 and a copy will be mailed to you. An investor should consider the charges, risks, expenses and investment objective carefully before investing. Read the prospectus carefully before you invest or send money. SDIF is distributed by Ultimus Fund Distributors, LLC, 225 Pictoria Dr., Suite 450, Cincinnati, OH 45246. Their phone number is 513-587-3400.
Online April 1, 2008
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