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

Mentorship Program

The Society of Surgical Chairs held a meeting about their mentorship program on October 26 at the 2014 Clinical Congress in San Francisco, CA. Keep reading to find out the discussion highlights.

Discussion Highlights

Challenge of Interdisciplinary Centers

Extradepartmental, interdisciplinary, hospital-based clinical centers are on the rise and will likely be an upcoming challenge to department-centric activities. Understanding and being able to access funds-flow through these centers will be critical to department vitality. Department (chair) representation and involvement on center planning and governing boards will be critical to allowing departments to remain “in the game.” It was not clear how funds flow through such centers would be structured, but could ideally be aligned with cost and quality incentives.

The Return of Managed Care and the Quality Imperative

There was broad expectation that the return of capitation and managed care was imminent and unavoidable. In this scenario, surgery would likely become a cost center, and not a revenue resource. Improving surgeons’ quality performance was therefore critical, and case volume would become deprioritized. Intensive provider-specific outcomes reporting that is already available through Crimson, UnitedHealthcare, ACS National Surgical Quality Improvement Program, and other third-party databases was embraced. Quality improvement feedback to faculty including (blinded) comparisons to peer groups and length of stay and cost/resource utilization data was viewed as critical to achieving quality improvement.

It’s More than Being in the Operating Room

The imperative for chairs to figuratively and literally “be at the table” when key school or hospital meetings take place was strongly endorsed as “the most important part of the job.” Some viewed operating room (OR) obligations as an important and distinguishing counter to these demands, and chairs presence on the OR schedule to maintain their “finger on the pulse” was also emphasized. Because of these responsibilities, administrative effort take up at least half of the panelists’ time as chair.

An Alternative “Triple Threat” Model

The epitaph of the academic surgeon as a clinical, research, and education triple threat was recognized. Instead, it was felt that departments as an amalgam of individual faculty each with focused areas of excellence could represent a new vehicle for comprehensive academic excellence. Faculty recruitments consequently needed to reflect support for such an organizational mosaic.

Incentivizing Academic Productivity

It was felt to be important for chairs to develop bonus structures that supports academic productivity beyond clinical RVUs, in particular to develop the “departmental triple threat” noted above.

Know Your Boss—An End to the Autocratic Era

It was noted that it is now important for chairs to be responsive “above and below”—to both faculty and their own leadership, reflecting, and end to a prior era in which surgery chairs were dominant in such relationships. The importance of understanding and fostering reporting relationships to deans, CEOs, and hospital administration was emphasized.

Know Your Culture

Departments and institutions are not all the same, and it is critical to know what will and will not be effective in different organizations.  

Recruitment

In the context of the above considerations, it was voiced that recruitment of outstanding new faculty members was one of the most important aspect of the chair’s responsibilities.

Mentorship Meeting Agenda