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

The Communication Pulse: Leadership and Member Perspectives

100 Words

Do you ever stop to reflect on where you are in your career? While it is helpful to look back, it is intriguing to ask yourself: What will the practice of surgery look like in the future? What will evolve that will make surgery safer or procedures once considered impossible, possible? In 1882, William Halsted performed one of the first gallbladder operations on his mother on her kitchen table at 2:00 am using candlelight. Imagine that time. Today, modern anesthesia and physiologic monitoring, laparoscopic procedures, robotic surgery, and operating microscopes are standard technologies that we often take for granted. What amazing progress!

— Beth H. Sutton, MD, FACS, Chair, American College of Surgeons Board of Regents

— L. Scott Levin, MD, FACS, Vice-Chair, American College of Surgeons Board of Regents

Surgeon Voices

In this issue, ACS Regent Steven D. Wexner, MD, FACS, FRCSEng, FRCSEd, FRCSI(Hon), FRCSGlasg(Hon), Director, Digestive Disease Center at Cleveland Clinic Florida in Weston, FL, interviews:

Anthony Atala, MD, FACS, urological surgeon, director, Wake Forest Institute for Regenerative Medicine and ACS Regent, who discusses his work in engineering tissues for patients, as well as how his work could have an impact on COVID-19 medications. Dr. Atala, who recently had his work on bioprinting highlighted in the New York Times, speaks on the use of implanted cells to aid wound healing; the impact of 3-D printing on scaled-up tissue generation; and the generation of miniaturized tissue and organs to test drug effectiveness and toxicity, including the body-on-a-chip system that is being used to test COVID-19 medications.


Henri R. Ford, MD, MHA, FACS, FAAP, FRCSEng(Hon), dean, Leonard M. Miller School of Medicine, University of Miami, FL; ACS Regent; and Program Chair for the ACS Clinical Congress, who discusses how Clinical Congress takes shape each year, as well as the different circumstances surrounding this year’s virtual conference. Dr. Ford speaks on the Program Committee’s abstract review process, which entails reviewing hundreds of abstracts to choose the best, most balanced conference program possible. He also discusses the process and learning experience in organizing this year’s event, which required regular meetings and making rapid decisions on how to maximize the new virtual format.

Anna M. Ledgerwood, MD, FACS, professor of surgery, Wayne State University School of Medicine, Detroit, and director, trauma services, Detroit Receiving Hospital, MI, and Charles E. Lucas, MD, FACS, professor of surgery, Wayne State University School of Medicine, who discuss their experience with participating in the first hospital virtual site visit for the ACS Trauma Verification Program. Interestingly, Detroit Receiving Hospital was the first hospital in the U.S. to be verified by the American College of Surgeons in 1988. Dr. Ledgerwood and Dr. Lucas speak on the complications with privacy and accessibility during their virtual visit, including navigating the hospital to show the site surveyors the facility's resources and sharing patient files without violating confidentiality requirements. 

How to Assess Your Hospital's Financial Health

Patrick V. Bailey, MD, MLS, FACS, Medical Director, ACS Advocacy, interviews Julie Conyers, MD, MBA, FACS, a rural general surgeon in Ketchikan, AK, about assessing your hospital’s financial health. Dr. Conyers explains how the Affordable Care Act has affected whether health care is recession-proof; identifies indicators that your hospital might be struggling financially, especially in the difficult COVID-19 era; and speaks on related topics in this informative discussion.

John A. Wilson, MD, FACS, Speaks Out in Opposition to Proposed Medicare Payment Cuts

In an op-ed published August 7 in the Winston-Salem Journal, John A. Wilson, MD, FACS, vice-chair of neurosurgery, Wake Forest Baptist Health, Winston-Salem, NC, and president, American Association of Neurological Surgeons, voices the surgical community’s serious concerns about the proposed rule on the 2021 Medicare Physician Fee Schedule. Dr. Wilson notes that the Centers for Medicare & Medicaid Services proposed rule, released the evening of August 3, would cut Medicare payments for surgical practices by as much as 9 percent. “A cut of this magnitude in normal times would be a shock to our health care system. But to make these cuts in the middle of this pandemic is devastating and represents public health malpractice,” Dr. Wilson wrote.

This op-ed and several others are part of a larger effort by the American College of Surgeons and other surgical groups through the Surgical Care Coalition to get the word out about how devastating the proposed Medicare cuts will be to patient access to surgical care. Read more about these initiatives in this Thursday’s Advocacy Brief.

Telemedicine Benefits Neurosurgery Patients and Providers

by William C. Welch, MD, FACS, FAANS, FICS, FANOS, Chair, American College of Surgeons Advisory Council for Neurological Surgery

Neurosurgeons have used telemedicine sporadically in the past, mostly in the context of evaluation for potential stroke therapies. In an intensive care unit or emergency department setting and with highly qualified specialist assistance, the evaluator is able to get a clearer picture of the patient’s neurological status to determine the appropriateness of further highly specialized interventions. This expensive and labor-intensive process has, at least in the outpatient setting, been replaced with readily available commercial telecommunications platforms.

The 30 patients I evaluated recently in the office via telemedicine were in the comfort of their homes, usually accompanied by their spouse, and not terribly angry with my tardiness. They came from five different states and were thrilled to be able to receive an evaluation without the inconvenience of intra- and interstate travel. The history and radiographic reviews that I obtained were similar to what I collect during in-person visits. The physical examination was slightly more limited than an in-person consultation.

Overall, neurosurgeons and their patients have had positive experiences with telemedicine. The consults save the patient time, inconvenience, money and the need to make transportation arrangements. The system allows patients to receive highly specialized evaluations in a convenient fashion. The ACS Advisory Council for Neurosurgery strongly supports the continued option for patients to have access to telemedicine consultations with their specialists of choice and supports the College’s efforts to this effect.