ACS NewsScope
A Weekly News Update from the American College of Surgeons
April 11, 2008
Highlights for the week:
Hard Work Pays Off in Georgia
After years of grassroots advocacy on the legislative, regulatory, and judicial fronts, Georgia surgeons who fought to have general surgery defined as a single specialty finally achieved victory in the General Assembly. S.B. 433, a certificate-of-need (CON) reform bill, contains language that recognizes general surgery as a single specialty eligible for the exemption from the CON process for ambulatory surgery centers. The Georgia House passed the bill 138-17, and the Senate quickly followed suit with a 44-7 vote on April 5, the last day of the state’s 2008 legislative session. Gov. Sonny Perdue (R) signed the bill into law on April 9. For more information about this legislation, go to http://www.legis.ga.gov/legis/2007_08/sum/sb433.htm .
Highlights
VMS and ACS Launch Web site Dedicated to Medical Simulation
Eastern Virginia Medical School (EVMS), in conjunction with the American College of Surgeons (ACS), has developed a comprehensive database aimed at increasing collaboration among product developers, medical professionals, and researchers, as well as general awareness of the emerging field of medical modeling and simulation (MMS). The database, publicly available at www.medicalmodsim.com , includes more than 200,000 resources covering all aspects of the field of medical modeling and simulation that previously existed only in a diffuse network of information sources.
“The goal is to increase the use and quality of medical modeling and simulation,” C. Donald Combs, PhD, associate dean for planning and health professions at EVMS, said. MMS encompasses three main elements: the creation of models that with reasonable accuracy mirror reality, the analysis of such models, and the creation of simulators based on those models. It brings virtual reality from the realm of science fiction to the medical classroom and the operating room, and as the field has gained attention, the volume of research and development activity has gone up exponentially.
L. D. Britt, MD, FACS, chair of the EVMS Department of Surgery and Vice-Chair of the Board of Regents of the American College of Surgeons, helped facilitate the partnership, a move that fits with the College’s national leadership in promoting the use of MMS as a training tool to improve surgical practice. The driving principle behind the database’s development is to provide a central jumping-off point for new partnerships in MMS.
The database can be searched using any of nine browse folders, including two that list articles preselected by health care profession or surgical specialty. Additional browse folders will be added as new areas and demand are identified. For details on the medical simulation database, visit www.medicalmodsim.com.
Highlights
General Surgeons Needed for CAHPS Survey
The American College of Surgeons is sponsoring the development of a cross-specialty version of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for surgical patients. CAHPS has set the national standard as an instrument for evaluating patients’ health care experiences. It is used for public reporting of quality and performance improvement efforts within hospitals and health plans, and has been endorsed by the American Board of Medical Specialties for maintenance of certification purposes.
The College has contracted with American Institutes for Research and Westat to develop and pilot test the surgical CAHPS survey. The instrument currently is being field-tested, and the College is recruiting general surgeons to participate in this project. Participating practices will need to submit a list of eligible patients to Westat. All information collected will remain confidential and no identifying information about the patient or the practice will be linked to the results. Patient information will be collected in a manner that meets institutional review board and Health Insurance Portability and Accountability Act privacy standards. Upon completion of the study, interested participating practices will receive a brief report and comparative data, so they can see how they rate. For more information about the surgical CAHPS survey or to participate, contact cburley@facs.org or call 202-672-1517.
Highlights
Surgery News Article Presents Controversial Findings on Melanoma
Only half of approximately 3,000 patients with a positive sentinel lymph node biopsy underwent a completion lymph node dissection in a controversial retrospective analysis of 47,643 patients with invasive melanoma---a finding that suggests common practice is falling far short of guidelines. Even more surprising, 64 percent of positive patients at National Comprehensive Cancer Network (NCCN)/National Cancer Institute (NCI) centers did not undergo a completion lymph node dissection (CLND), according to a report in the April issue of Surgery News, the official newspaper of the American College of Surgeons, on findings presented at a symposium sponsored by the Society of Surgical Oncology. Patients were significantly less likely to undergo CLND if they were older than 75 years (odds ratio 0.56), had lower extremity melanomas (OR 0.63), had lesions 1.0 mm or less in thickness (OR 0.80), or underwent surgery at low-volume, community, or academic hospitals compared with high-volume or NCCN/NCI centers (P less than .0001), lead investigator Dr. Karl Y. Bilimoria reported.
The presentation stirred a great debate, as many audience members questioned the accuracy of the data captured from 2004 to 2005 by the National Cancer Data Base, a national oncology outcomes database run by the Commission on Cancer and the American Cancer Society. Critics did not believe that CLND could have been done in only 1,470 of 2,942 patients with a positive sentinel lymph node biopsy (SLNB), or that CLND rates were even lower at NCCN/NCI centers. The findings are provocative because current NCCN guidelines recommend that a CLND be performed for sentinel lymph node-positive melanoma, and that the CLND and SLNB should generally be performed in separate operations to allow for detailed histologic examination.
For details about the discussion that took place during the symposium, read the April issue of Surgery News at http://www.facs.org/surgerynews/index.html. In addition, don’t miss news reports on resternotomy and perioperative risks, pancreatic cancer survival, and the relationship between gastric bypass and hypertension, available exclusively in the Online Only edition of Surgery News.
Highlights
College Helps Surgeons Resolve Practice Management and Coding Issues
The American College of Surgeons will sponsor the following practice management Webinars in the coming weeks:
- Effective Governance and Management of Your Practice, April 23
- Benchmarking Practice Productivity and Profitability, May 7
- Developing a Practical Compliance Plan, May 23
Each Webinar will take place at 1 p.m. Eastern, noon Central, 11 a.m. Mountain, and 10 a.m. Pacific time and will last 60 to 90 minutes. For more information or to register, go to http://www.facs.org/ahp/workshops/teleconferences.html .
In addition, practices that have coding questions are encouraged to go to the ACS Coding Hotline Web site at http://www.facs.org/ahp/coding/secoding.html to learn about their eligibility for 10 free consultations annually.
Highlights
NewsScope
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The American College of Surgeons is a not-for-profit, tax-exempt organization dedicated to the study, training, and practice of surgery. ACS NewsScope is a weekly news service for Fellows of the American College of Surgeons and other interested individuals provided by the ACS Communications staff.
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by the American College of Surgeons, Chicago, IL 60611-3211
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