Highlights of the ACSPA Board of Directors and ACS Board of Regents Meetings
June 9-10, 2006
From December 1, 2005 (the beginning of the current election cycle) to May 15, 2006, the ACSPA-SurgeonsPAC raised $760,181. Also, the telephone fundraising campaign continues to remain productive.
Of the 216
Contributions have been made to 123 candidate and leadership PAC committees. The ACSPA-SurgeonsPAC has organized 12 political fundraiser events.
The Executive Committee of the Board of Regents agreed to continue membership in Doctors for Medical Liability Reform (DMLR). The recent Senate debate on medical liability reform provided DMLR with an opportunity to further its objectives for 2006. Highlights of DMLR’s efforts include the following.
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Radio and print advertising – In an effort to support the Senate leadership, DMLR ran print and radio ads in target states. The ads ran during the April recess and highlighted access to care issues. Listeners and readers were directed to contact specific Senators to ask them to support medical liability reform.
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Forty-five million radio listeners heard DMLR’s messages – DMLR spokespersons participated in radio interview tours and/or recorded radio news releases that were broadcast 7,503 times on 5,613 stations nationally and in DMLR target states. The radio initiative resulted in approximately 45 million people who learned about the Senate vote, patient access to care problems, and the DMLR Protect Patients Now campaign.
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DMLR has built a grassroots network of 135,298 physicians, patients, and concerned citizens.
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Increased Web site traffic on the Protect Patients Now Web site in April and May resulted in 29,437 actions taken that were facilitated by DMLR’s
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DMLR Internet advertising resulted in 139,900 additional visits to the site.
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DMLR developed a petition to support comprehensive federal medical liability reform that has been signed by more than 37,708 physicians, patients, and concerned citizens. More than 21,000 of these petitions were signed since April 1.
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From April 1st through May 8th, 7,206 letters were sent to US Senators via the DMLR Web site.
Foundation Nomination
The Board of Regents approved the nomination of C. Rollins Hanlon, MD, FACS, of
American
ACS Institute for Health Policy Research
The Board of Regents approved a business plan to establish an ACS Institute for Health Policy Research. In its advocacy efforts, the College is frequently hampered by a lack of high-quality data on the health care system’s effects on surgical patients, as well as a lack of data on socio-economic issues and trends affecting surgeons. Policy research foundations and government agencies tend to focus their research efforts on primary care and epidemiological issues, and scant attention is devoted to surgery. The College’s Health Policy Steering Committee (HPSC) appointed a working group to investigate the concept of creating a health policy research institute for surgery. Upon the conclusion of the group’s investigation, the HPSC concluded that the College, its Fellows, and the surgical specialty societies would all benefit from establishing such an institute. The HPSC proposed that the College establish an
MedPAC. The appointment of a surgeon to the Medicare Payment Advisory Commission (MedPAC) has been a top priority for the
SQA. The Surgical Quality Alliance (SQA), formed by the College as a resource for all surgical specialties struggling with development and implementation of physician performance measurement systems, has made significant progress. A number of educational sessions have been held, and jointly-sponsored comment letters were submitted to various quality-related organizations, particularly with respect to inpatient care. Plans are underway to begin a comprehensive review of issues related to outpatient surgical procedures. The SQA continues to grow and now includes 16 surgical specialty societies.
Emergency care workforce issues. The Division of Advocacy and Health Policy worked with the Regental Task Force on Emergency Care Workforce Issues to develop a report outlining the emergency care workforce problem, its underlying causes, relevant efforts by the College, and potential legislative, regulatory, and private sector remedies. The paper was formally released on June 14 in conjunction with the
Bariatric surgery. The Centers for Medicare and Medicaid Services announced on February 21 that Medicare will cover bariatric procedures only when they are performed in facilities that are certified by the College or by the American Society for Bariatric Surgery.
Medicare physician payment. The estimated 2007 fee schedule update is -4.7 percent. Members of Congress have stated publicly that they expect to pass another one-year “fix” to provide relief for the problem, and there remains potential for combining the relief “fix” with some kind of pay-for-performance scheme.
Closed Claims Project. The Board of Regents reviewed the final report on the ACS Closed Claims Project. Forty surgeon-reviewers, five insurance companies, and eight site visits were required to complete reviews of 460 closed claims with indemnity or loss experience greater than $25,000. F.
National Approvals Program for Breast Care
The Board of Regents approved a business plan for a National Approvals Program for Breast Care. In 2005, a proposal was made to establish a multidisciplinary accreditation process for breast centers in the
The Program is a consortium of national, professional organizations dedicated to the improvement of the quality of care and outcomes of women with diseases of the breast. Meeting the goals of this mission will be pursued through standard-setting, scientific validation, and patient and professional education.
The Program will recognize certain levels of breast centers eligible for participation, although there is considerable overlap in the levels for many breast centers in the
Rural Trauma Team Development Course
The Board of Regents approved a business plan for a Rural Trauma Team Development Course. The Rural Trauma Subcommittee of the Committee on Trauma identified a need for education of trauma personnel in rural areas of the
Business Plan Update on the
The Board of Regents reviewed an updated business plan for ACS NSQIP. The ACS NSQIP roll out to private sector hospitals began in the fall of 2004. The overall goal of ACS NSQIP is to improve the surgical care of patients throughout the
ACS NSQIP has been working closely with the Centers for Medicare and Medicaid Services on the Surgical Care Improvement Project (SCIP), and is planning to release a SCIP data collection module this summer. The module will be released to ACS NSQIP participants free of charge and will allow hospitals the ability to enter both sets of data in one location. A few of the new objectives for the program over the next two years are:
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To develop additional ACS NSQIP modules, in a cost-effective manner, that meet market needs.
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To train and support surgical clinical nurse reviewers at each of the participating institutions.
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To provide data analysis and feedback to the participating hospitals.
The Board of Regents approved the dissolution of the Communications Committee of the Board of Regents and the Public Profile and Visibility Steering Committee, and approved the establishment of the Public Profile and Communications Steering Committee (PPCSC). Initially, the PPCSC will focus on the mid-June IOM press conference at which A. Brent Eastman, MD, FACS, will be a major presentor, identifying himself with the College and presenting the College’s views on emergency and trauma care in the
The College has contracted with a public relations/communications management firm that is working with College staff to use the IOM press conference as a platform to bring attention to the issues related to emergency and trauma care. The desired outcome is to achieve solid, broad-based system reform that corrects payment, liability, and reimbursement disincentives that currently penalize surgeons for participating in emergency, hospital, and uninsured care and increasingly inhibits surgeons’ participation in that care.
The short-term objectives of the College’s efforts are to:
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Increase public awareness of patient safety risk when trauma centers and emergency departments are inadequately staffed.
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Increase public understanding of the
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Introduce the larger problem of surgeon shortage by focusing on trauma centers and emergency departments.
The key messages for the short-term objectives are:
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Our nation’s trauma system – the best hope for anyone who is seriously injured or who experiences an acute life-threatening event – is in serious jeopardy.
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The alarming news is that patients are increasingly at risk because the current health care system discourages surgeon participation in trauma centers and emergency departments.
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Policymakers must correct the inequities in the system to encourage surgeon participation in trauma centers and to ensure that vitally important trauma patient services are not lost.
Statement on Insurance, Alcohol-related Injuries and
The Board of Regents approved a Statement on Insurance, Alcohol-related Injuries and
In a majority of states, however, it is legal for an insurer to withhold payment to a treating physician or hospital if information demonstrates that the patient was intoxicated or under the influence of any narcotic, unless administered on the advice of a physician. The National Association of Insurance Commissioners (NAIC) developed the payment withholding Uniform Accident and Sickness Policy Provision Law (UPPL) in 1950. In 2001, the NAIC voted unanimously to correct the law in favor of providing payment to a treating physician or hospital, irrespective of drug or alcohol involvement. Such legislative change, however, must be accomplished at the state level. To date, only eight states have enacted the 2001 amendment.
The Statement emphasizes the College’s strong support of the new 2001 NAIC law and encourages adoption of this legislation in all states. Doing so will enable trauma centers to fulfill their obligation to provide alcohol screening and intervention for problem drinkers as part of their program to prevent injuries.
Statement on Principles of Patient Education
The Board of Regents approved a Statement on Principles of Patient Education. Developed by the Patient Education Advisory Committee, the statement summarizes the critical role of patients and their significant others as integral members of the surgical team and as being essential to delivering optimum and safe surgical care. Active involvement of patients as partners in care can increase compliance and decrease complications through early identification of risks. Patients need to possess the requisite knowledge and skills to contribute effectively to their own care, and patient education is key in this regard.
Clinical Congress. The major theme of the Clinical Congress is "Working Together Toward Humanitarian Ideals." This year’s meeting is designed to address contemporary topics in surgery related to the core competencies, patient safety, new procedures, emerging technologies, and non-clinical topics relating to the practice of surgery. The Program includes 112 general sessions, 13 didactic postgraduate courses, and 21 skills-oriented postgraduate courses.
Implementation of a five-level program for verification of knowledge and skills of individuals following participation in educational programs of the College is underway. Each of the didactic and skills-oriented postgraduate courses to be offered during the 2006 Clinical Congress has been reviewed and assigned a verification level.
A new course on ultrasound for surgical residents is being developed by the National Ultrasound Faculty. The course will be offered during the 2006 Clinical Congress.
DVD on Surgical Errors. Disclosing Surgical Error: Vignettes for Discussion, was recently released. The vignettes demonstrate two approaches used by a surgeon to disclose to a patient’s family a major technical error that occurred in the operating room. The vignettes demonstrate a number of effective disclosure techniques, along with certain approaches that need improvement. The vignettes may be used as free-standing trigger tapes for small group discussions between surgeons, surgical residents, and medical students; or they may be incorporated into a comprehensive curriculum on communication skills.
Accreditation. The Model for Accreditation of Education Institutes by the College was formally approved by the Board of Regents in June 2005. It involves two levels of accreditation: Level I, Comprehensive and Level II, Basic, both of which are based on three Standards: Learners; Curriculum; and Technical Support and Resources. The program was formally launched in October 2005.
The Board of Regents granted conditional approval of a request for a new shared faculty career development award. The award is to be jointly sponsored with the Neurosurgery Research and Education Foundation (NREF) of the American Association of Neurological Surgeons. Regental approval is contingent upon equal funding by the NREF and the College. The two-year award is given to assist a surgeon in the establishment of a new and independent research program in an area of neurological surgery.
Committee on Diversity Issues – Revised
The Board of Regents approved a revised mission statement for the College’s Committee on Diversity Issues. The mission statement reads as follows:
“The primary mission of the Committee on Diversity Issues is to study the educational and professional needs of minority surgeons, including minority groups defined by race or gender, in an effort to optimize the opportunities for these surgeons to achieve professional success and satisfaction.
Secondly, the mission of the Committee is to study the impact of diversity on delivery of surgical care and to work to optimize equitable delivery of surgical care to all population groups.”
The following CoC activities have taken place or have been initiated since the February 2006 Board of Regents meeting.
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The CoC continues to support the
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The Board of Regents approved a request for funds to support a national marketing campaign designed to increase the public’s awareness of the importance of being treated at a CoC-approved cancer program.
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The CoC hosted two Survey Savvy workshops targeted to cancer program staff in
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The Cancer Program Standards 2004, Revised Edition was released in March.
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A Survey Savvy workshop to address the pediatric standards has been scheduled for early 2007.
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The
Continuous Quality Improvement (CQI)
Major activities in the area of Continuous Quality Improvement are:
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Grant Activities: the Patient Safety in Surgery Study and the ACS/Anesthesia Patient Safety Foundation Proposal.
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Education Activities: the Young Surgical Investigators Conference, the Outcomes Research Course, and the Clinical Trials Methodology Course.
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Other Activities: the Surgical Research Committee, the Committee on Perioperative Care, and various accreditation efforts.
e-FACS.org, the ACS Web Portal
Since the College’s Web portal e-FACS.org was launched in January 2006, new content and resources have been added, and existing features have been made more robust and easier to use. During the first four months of operation, more than 3,000 members of the College have visited e-FACS.org, generating over 70,000 hits.
George F. Sheldon, MD, FACS, Editor-in-Chief, continues to develop the Editorial Board for e-FACS.org. There are now 16 at-large members, 45 community editors, 154 associate community editors, and 40 communities of which 12 are specialty communities and nine are subspecialty communities under the category “general surgery.” The remaining communities are special interest communities.
Dr. Sheldon sent letters to all general surgery department heads asking them to consider putting a link to the College’s portal on their home page. He will also send letters to the heads of departments for all of the surgical specialties in the
The ACS Web Portal provides a highly effective mechanism for disseminating and enhancing access to educational programs and products, offering individually tailored education, and providing opportunities to earn Category 1 CME credits and maintain a record of credits.
Journal of the
The Journal turns 101 years old in July 2006. Statistics for 2006 online usage show total monthly downloads of 54,940 versus 38,333 for the same time period in 2005, a 30 percent increase. As of May 15, JACS provided 84,788 CME-1 credits to Fellows of the College, at no cost.
JACS has taken on a new program. One of the important functions of the College's Committee on Trauma (COT) is to support and develop interest in trauma care among residents. The committee sponsors an annual resident paper competition and receives some outstanding papers. At the COT Executive Committee meeting, discussion centered on the possibility of publishing the winning Basic Science and the winning Clinical Paper in JACS. JACS is very pleased to welcome this addition.
Again this year, the Journal is pleased to publish the abstracts from the Surgical Forum presentations held during the Clinical Congress. On Monday, October 9, the Surgical Forum will announce its dedicatee, and present awards to the outstanding abstract authors. This year, 241 abstracts are contained in the Supplement. Of these, 11 will receive awards for excellence.
Name mentions for the College and its programs continue to appear in national and community publications and on various Web sites. Topics covered most frequently in recent weeks were the Cancer Approvals Program, various issues related to Medicare coverage for surgical services, and issues related to trauma centers and trauma systems.
A newspaper-based print advertising campaign was developed in an effort to highlight the Commission on Cancer’s (CoC) approvals program. The intent of the campaign is to help consumers find a CoC approved program, which “provides the best in cancer care close to home.”
Lazar J. Greenfield, MD, FACS and the editorial staffs of the International Medical News Group and the College continue to focus on the main goal of providing useful and current information to Surgery News readers. A recent readership survey indicates that this newspaper is very well received by the surgical community.
The Governors’ Committee on Socioeconomic Issues solicited the ACS membership for nominations for the 2006 ACS/PMHI Surgical Volunteerism Award in association with the Pfizer Medical Humanities Initiative. The award is offered annually in recognition of individuals who make significant contributions to surgical care through organized volunteer activities. The committee reviewed all of the nominations that were submitted, and selected John L. Tarpley, MD, FACS, of
At its February 2006 meeting, the Board of Regents deferred action on a proposed Statement on Sharps Safety that was developed by the Committee on Perioperative Care (CPC). The Board of Regents requested that this statement be reviewed by members of the Board of Governors. The proposed statement was reviewed by the Governors' Committee on Blood-borne Infection and Environmental Risk. Minor changes were suggested and these suggestions were forwarded back to the CPC, after they were reviewed and discussed by the Executive Committee of the Board of Governors. Mark A. Malangoni, MD, FACS, Chair of the Board of Governors, relayed this information to the Board of Regents during its June meeting.
The database of volunteer opportunities within the
Ongoing efforts continue to be devoted to expanding the database of international volunteer opportunities. As of May 15, 18 agencies were represented on the OGB Web site translating to 40 opportunities for surgical volunteers. An additional 39 volunteer agencies had been contacted and were in the process of being incorporated into the OGB database, and twelve agencies had been added to the database.
Also as of May 15, hits to the OGB Web site exceeded 850,000 since its launch on September 1, 2005. Ongoing efforts include:
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Collaborative discussions regarding an appropriate mechanism for the College to respond to disasters.
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The 2006 volunteerism panel at the Clinical Congress will include residents' perspectives on volunteerism and international surgical care.
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The 2006 ACS/PMHI surgical volunteerism award winner will be highlighted during the Volunteerism panel.
Standard items for review, discussion, and action by all of the College’s Advisory Councils included the College’s Web portal, ACS public profile and visibility, Continuous Quality Improvement, and recommendations for the Jacobson Innovation Award, Sheen Award, and Honorary Fellowship. Other projects included:
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Spring Meeting
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Clinical Congress
The Advisory Council for General Surgery, chaired by Mark A. Malangoni, MD , FACS, presented a proposed position statement on acute care surgery to the Board of Regents for approval. The Board did not approve the proposed statement, but requested that it be reviewed by all of the Advisory Councils for further development and refinement. Marshall Z. Schwartz, MD, FACS, Chair of the Advisory Councils' Chairs, will facilitate this request.
The 2006 Leadership Conference was held at the
Resident and Associate Society (RAS)
The Resident and Associate Society recognizes its position as an organization of the future Fellows of the College, and continues to work to ensure that it represents the voices, views, and concerns of the young surgeons to the leaders of the College. The following activities are just a few of the ongoing efforts of RAS.
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The Communications Committee continues to publish the bimonthly RAS-ACS Newsletter.
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The Issues Committee has put together a panel discussion for the annual symposium during the Clinical Congress.
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The Education Committee is developing Web-based guides for a career in academic surgery and applying for fellowships in subspecialties of surgery.
Last year, a new RAS-ACS Leadership Scholarship was introduced, and three recipients were awarded paid travel and expenses for ACS educational courses. RAS-ACS petitioned for – and received – additional funding in order to offer the scholarship program on an annual basis.
As of May 15, there were 668 active jobs listed on the site with 62 posted resumes. The site receives approximately 100 hits per day.
Plans are underway for providing tours of the College’s Archives Room, as well as the College’s headquarters building during the upcoming Clinical Congress. Tours of the J.B. Murphy Memorial Auditorium are also planned.
The 2006 Convocation will be held at the Hilton Chicago hotel rather than the
Revised September 12, 2006