American College of Surgeons Professional Association (ACSPA)

As of August 23, the ACSPA-SurgeonsPAC raised $421,000 toward its $500,000 goal for the 2005 fund raising year, which ends on November 30. As of August 15, $213,000 had been pledged to the PAC via the telephone fundraising campaign.

Of 215 US members of the Board of Governors, 104 (48 percent) contributed to the PAC for an average contribution of $376. The contributions represent a 15 percent increase over the June report.

So far in 2005, the ACSPA-SurgeonsPAC has organized eight political fundraiser events. Three additional events will be hosted.

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American College of Surgeons (ACS)

Statements
The Board of Regents approved the recommendation of its Committee on Ethics to withdraw ST-7 Statement on Ethics in Patient Referrals to Ancillary Services. The statement was published in 1989 in response to the Stark legislation, which attempted to define the circumstances under which it was appropriate for a physician to refer patients to ancillary health service facilities in which the physician had a financial interest. The statement has become outdated due in part to revisions to the legislation over the past 15 years.

The Board of Regents approved a Statement in Support of Legislation Regarding Fire Safe Cigarettes. Recognizing that cigarette smoking is a major health hazard, the College supports aggressive efforts to educate the public on the dangers of using tobacco products and the subsequent high costs of this serious but preventable problem. Fires caused by cigarettes can cause serious burn injuries and deaths, and the College supports efforts and legislation aimed at preventing burn injuries associated with cigarettes. The Statement was developed by the Committee on Trauma (COT) Subcommittee on Injury Prevention and Control, and will be posted on the College’s Web site once it has been published in the Bulletin.

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Finance Committee
Upon the recommendation of the Finance Committee, the Board of Regents approved a business plan and start-up funding for a proprietary mutual fund benefit. The fund would be designed to serve as one component of a surgeon’s investment program and could be used for retirement and nonretirement savings. It is anticipated that the fund will debut at the 2006 Clinical Congress.

The Board of Regents also approved the Finance Committee’s recommendation to provide $1.7 million for 2007 scholarship funding. The Board also approved the recommendation that the Scholarships Committee work with the ACS Foundation to develop a process to expand opportunities.

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ACS Foundation
On September 1, 2005, the Internal Revenue Service (IRS) approved the ACS Foundation’s application for tax-exempt status under section 501(c)(3) of the Internal Revenue Code. Contributions directed to the ACS Foundation are now officially tax deductible.

As of September 14, 2005, gifts and pledges in the amount of $262,772 had been received. This amount represented an increase of $128,551 over the same period last year.

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Selected Readings in General Surgery
The Board of Regents accepted the gift of Selected Readings in General Surgery (SRGS) from Robert N. McClelland, MD, FACS, founder and editor-in-chief. Under the College, this outstanding resource would be taken to the next level through integration and linking with existing educational programs. Educational guidance and advice would be provided to further enhance the product and create new programs based on SRGS. In addition, SRGS would be linked to the Surgical Education Self-Assessment Program, integrated into the Fundamentals of Surgery Resident Curriculum, used in practice-based learning and improvement activities, and promoted as a special resource to meet Maintenance of Certification requirements.

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ACS Iran Chapter
The Board of Regents approved the formation of an ACS Chapter in Iran. The ACS Iran Chapter is the College’s 33^rd International Chapter.

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Advocacy
Efforts to develop physician pay-for-performance (P4P) programs both for Medicare and in the private sector have intensified tremendously in recent months, catching many specialties unprepared. The College worked with the surgical specialty societies to draft a framework for developing P4P systems for surgery. This document has served as the basis for joint responses to P4P proposals developed on Capitol Hill and by Medicare. In addition, the College joined the steering committee of the Ambulatory Quality Alliance, a group of payors, patients, employers, federal officials, and medical and surgical organizations that is addressing P4P implementation issues.

The College continues to support advocacy efforts of particular interest to the surgical specialties on both the state and federal levels. Additionally, many resources have been devoted to the Five-Year Review of work under the Medicare Physician Fee Schedule.

In a letter to Representative Nancy Johnson, Chair of the Ways and Means Subcommittee on Health, the College has stated its support of H.R. 3617. H.R. 3617 is focused solely on establishing a P4P model for Medicare physician payments. H.R. 3617 would provide a payment increase of 1.5 percent for Medicare physician payments in 2006 and repeal the SGR and replace it with payment updates based on the Medicare Economic Index in 2007 and all future years. As a result, H.R. 3617 would guarantee payment increases for all physicians in 2006,  and in future years, most likely guarantee increases even for physicians who fail to meet their quality measures.

In July, the Senate Appropriations Committee approved its funding legislation for the Departments of Health & Human Services, Labor, and Education for fiscal year 2006. In response to a College-initiated coalition letter of support for the Health Resources & Services Administration’s (HRSA) Trauma-EMS Program, which garnered signatures from 23 other organizations, included in this bill is $3.4 million for the HRSA Trauma-EMS program, as well as $20 million for Emergency Medical Services for Children (EMSC). The companion House bill does not contain any funding for trauma, but does provide $19 million for EMSC.

Also in July, the College, along with 32 other organizations, signed a letter in strong support of S. 760, the Wakefield Act. This bill would reauthorize the EMSC program for an additional five years with an annual funding level of $23 million.

College and American Trauma Society representatives met in August. The purpose of the meeting was to urge the Bush Administration to include the Trauma-EMS Program in its FY 2007 budget, due in February 2006.

The EMTALA Technical Advisory Group (TAG), composed of 19 members including four ACS Fellows, met June 15-17, 2005. TAG was created to provide advice and recommendations to CMS concerning regulations related to EMTALA and their application to hospitals and physicians. In comments submitted to TAG, the College strongly urged the advisory committee to reject any legislative or regulatory efforts to require surgeons to take call as a condition of Medicare participation or as a stipulation to obtain hospital privileges. TAG voted to recommend that CMS not require physicians to serve on-call as a condition of Medicare participation. During its next meeting, TAG will consider additional proposals to address the shortage of on-call specialists and will continue to examine other EMTALA-related issues.

For a second time, the College partnered with 11 other medical organizations to participate in an exhibit at the National Conference of State Legislatures Annual Meeting. With over 5,000 state legislators government officials, and other policymakers in attendance, the meeting provides a “one-stop” grassroots advocacy forum on a wide range of issues with the dominant theme being medical liability reform.

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Education
The 2006 Spring Meeting will be held in Dallas, TX, April 23-26. The program is being planned by the Advisory Council for General Surgery in collaboration with the Division of Education and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). The College’s Spring Meeting will precede SAGES meeting. The Excelsior Surgical Society/Edward D. Churchill Lecture will be delivered on Monday, April 24. Two special joint programs co-sponsored by the College and SAGES will be presented on Wednesday, April 26. A number of sessions specifically directed at surgical residents will be presented in collaboration with the Resident and Associate Society of the American College of Surgeons.

The first year of collaboration between the College and SAGES on the Fundamentals of Laparoscopic Surgery Program has been very successful. Jointly launched in April 2005, sales of the program have been brisk.

The Task Force on Surgical Palliative Care has been very successful in developing and implementing state-of-the-art educational programs to enhance palliative care in surgery. A one-day seminar was held in May 2005. The seminar was well received, and a follow up seminar is planned 2006. 

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Journal of the American College of Surgeons (JACS)
JACS Online CME-1 Program continues to provide CME-1 credits at no cost. To date, the program has provided more than 72,000 credits.

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Surgery News
Feedback from members of the College who are receiving Surgery News continues to be very positive. A PDF version of the newspaper is available via the College’s Web site. If the news-paper reaches the break-even point, it will be possible to expand the print circulation in the future to include all members of the College.

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Operation Giving Back (OGB)
Operation Giving Back was officially introduced at the 2004 Clinical Congress, and has had a busy and exciting year. Relationships have been established on the domestic and international fronts, volunteer resources have been researched and compiled, the online Web resource has been revised and expanded, and work has been initiated with the ACS Committee on Resident Education toward the creation of volunteer opportunities for residents.

In response to the ravages of Mother Nature, the program was extended well beyond its primary mission when it mobilized surgeons in response to two major natural disasters. The Web site was quickly utilized to serve as a means of conveying timely and pertinent information on every-thing from points of contact for responding, to continuity of care for affected patients. The immediate and overwhelming response of ACS members is clear and compelling evidence of the need for information on how to assist in such situations. Equally compelling were the difficulties experienced by some volunteers and the barriers they encountered, which negatively impacted the delivery of care. It is hoped that issues such as the portability of medical licenses over state lines, credentialing of volunteers, and the provision of tort liability coverage to medical volunteers will be examined in a new light and with renewed importance in the aftermath of these disasters.

There remains much to be done. Operation Giving Back will continue to adhere to its mission of facilitating volunteerism on both the domestic and international fronts.

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