American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Videos from Wednesday's Editions

Minorities more likely to linger on high-risk inactive status on kidney transplant waitlist

Sanjay Kulkarni, MD, FACS
New Haven, CT

Minority access to kidney transplant has improved—but perhaps not as much as we thought, said Dr. Sanjay Kulkarni, a kidney transplant surgeon. His review of organ waitlists found underserved groups over represented on “inactive” parts of waitlists for health reasons. His suggestion: a value-based payment marker to incent transplant and dialysis centers to erase their wait list disparities.

View the abstract online.


Going into surgical practice: The things you weren’t taught

Shuhbada Dhage MD, FACS
New York, NY

A panel explored the realm of the unknown—at least from the perspective of the newly minted general surgeon. Dr. Shuhbada Dhage recalled being unexpectedly required to manage a new team formed to carry out a research grant in her first year of practice. All new to her, she said.


Community risk factors for mass shootings include shortage of mental health care, poor socialization and socioeconomic inequality

Stephen K. Markowiak, MD
Toledo, OH

A review of 155 U.S. mass shooting events (four or more killed) between 2005-18 found identifiable social determinants of health that put communities at risk for these shootings. Dr. Stephen Markowiak, lead author, said prevention-minded communities should focus on access to mental health care, healthy/safe places to socialize and addressing socioeconomic inequality. He also lamented federal and state laws blocking release of mass shooting data to researchers.

View the abstract online.


Microbiome science emerging as surgical ‘friend,’ no longer foe

Susannah E. Nicholson, MD, FACS, MSCI
San Antonio, TX

While a great effort is made to kill or contain microbes in and around surgery, understanding of the salutary impact of microbiome science on surgical outcomes is growing, as a panel explored Tuesday. Dr. Nicholson discusses her own work, in which major adverse change in gut microbiome was found within 30 minutes of trauma, with implications for timing of blood transfusion.


Creating a risk-adjusted scale for weighing laparoscopic cholecystectomy performance

Tarik Madni, MD
Dallas, TX

General surgeons and their institutions need a better, risk-adjusted scale to stratify severity of cholecystitis in order for laparoscopic surgical outcomes to be weighed on an apples-to-apples basis, said Dr. Tarik Madni. He and colleagues found their own institution’s grading scale predicatively superior to a severity score system developed by the American Association for the Surgery of Trauma.

View the abstract online.


ACS Clinical Congress 2018 draws over 13,000, sees major uptick in research submissions

Henri R. Ford, MD, FACS, MHA, FAAP
Los Angeles, CA

Clinical Congress 2018 was a resounding success, said Dr. Henri R. Ford, Program Chairman.

He predicted participation, including registered attendance and local surgical training program involvement, will top 13,000, the highest in recent years. Clinical submissions were up 40 percent and enthusiasm in the Boston Convention & Exhibition Center bubbled over, with numerous SRO turnouts for presentations and panels.

“We’re extremely excited about the turnout for Clinical Congress 2018,” said Dr. Ford, MD, FCAS, MHA, FAAP. “First of all, interest in clinical programming is clearly there. Our membership is pretty excited about the opportunity to come and learn. So for us it means our educational mission is right on track. We must be meeting the needs of our Fellows, which is what we really hope to do.”

He noted the excitement over the introduction this year of late-breaking session, at which presentations were made highlighting discoveries in major clinical trial results as of August, instead of a deadline many months earlier.

“This year was a classic,” he said. “Several late entries turned out to be game-changers. Attendance at those was superb.”

A highlight for Dr. Ford personally was hosting the John J. Conley Ethics and Philosophy Lecture, “Value-Based Health Care Delivery: The Strategic Agenda,” by Harvard Business School professor and author Michael E. Porter. Dr. Ford called Porter, co-author of “Redefining Health Care: Creating Value-based Competition on Results,” a visionary thinker on value-based care. Porter’s address, scheduled for 45 minutes, ran nearly two hours to a packed house as of questions poured forth from the audience.

“His message was impactful, it was engaging and it really set the course for what the challenges are and what the American College of surgeons should be focusing on moving forward,” Ford said. ”In addition to inspiring quality, we need to inspire value.”


New graduate residents: Get thee to a contract lawyer

Tim Pritts, MD, FACS
Cincinnati, OH

Among the things surgical residents don't learn is how to read an employment contract, said Dr. Tim Pritts, member of a panel on that topic. He urged new graduates to protect their interests by engaging a lawyer familiar with law in the state where they'll practice.


Mastery in General Surgery program fills confidence, competence gap

David Richardson MD, FACS
Louisville, KY

Roughly 25 percent of newly graduating general surgery residents don’t feel prepared or confident enough to begin independent practice, said J. David Richardson, MD, FACS, and panel member on the Mastery in General Surgery Program, a mentoring effort designed to address the need. Fellowships, which attract 80 percent of graduates, don’t solve the problem, he added.


Lively panel explores shape, even need for fourth year of medical school

Nancy Gantt, MD, FACS
Youngstown, OH

The fourth-year medical school debate is about more than time, it’s about the changing learning styles and skills needed to be a doctor, and how med students are selected in the first place, said Dr. Nancy Gantt, part of a lively panel on the topic Wednesday. Historically, candidates who could memorize were advantaged and four years seemed needed. Today, with instant handheld access to data, as well as skyrocketing student debt, four years may not be the gold standard for all primary care and specialty fields, she said.