Archive for November, 2012

Looking forward – November 2012

On Christmas Day 2008, John Pryor, MD, FACS, was killed by mortar shrapnel while serving as a combat surgeon in Mosul, Iraq. A dedicated trauma and military surgeon, Dr. Pryor devoted much of his career after the September 11, 2001, attacks on the U.S. to serving his country. Many stories have been written about Dr. Pryor since his death, but perhaps no one is better able to tell his story than Dr. Pryor himself, and his brother Richard J. Pryor, MD, a retired emergency physician, has enabled him to do just that in a new book titled Alright, Let’s Call It a Draw: The Life of John Pryor. To write this unique book, Dr. Richard Pryor compiled his brother’s journal entries, his own memories, correspondence, and interviews to allow John Pryor to tell his own life’s story.

Prior book cover001

Guest Column: Alright, Let’s Call It a Draw: The Life of John Pryor, by John and Richard Pryor

I write this as a review of a book that touched me in many ways, but also as an editorial on the evolution of surgical education and practice and the impact this career choice can have on family and friends. Indeed, this review serves as a call for all health care professionals to analyze how […]

Stakeholders invested in GME

The critical state of graduate medical education funding

The recession and deficit have compelled federal and state governments to begin withdrawing longstanding support for residents and teaching hospitals while, simultaneously, predictions about the health care workforce suggest that more physicians will need to be trained than the current system allows. This article offers recommendations for moving toward a rational, multi-stakeholder solution to the graduate medical education (GME) funding crisis.

RAS Issues Symposium: Surgery at the end of life: For love or money?

To operate, or not to operate—that is the question. Data show that in 2008, among Medicare beneficiaries in the final year of life, nearly one in three underwent a surgical procedure. Nearly one in five had surgery in the last month of life, and nearly one in 10 had surgery in the last week of life. Why do we operate on these patients? Does the availability of hospital beds influence surgeons to operate more frequently? Perhaps—but the reasons surgeons operate are more complicated than these data would suggest.

RAS Issues Symposium: Reining in the scalpel

Recent articles in the mainstream press indicate a growing public awareness that end-of-life procedures are overused. As surgeons, we know that the decision to perform surgery at the end of life is difficult, and there is no shortage of manuscripts delving into this complex topic. From this author’s perspective, end-of-life operations, specifically in the elderly, are overused and do little to lengthen or improve quality of life and, indeed, often cause more harm than good.

RAS Issues Symposium: An argument against heroic intervention

Recent articles in the mainstream press indicate a growing public awareness that end-of-life procedures are overused. As surgeons, we know that the decision to perform surgery at the end of life is difficult, and there is no shortage of manuscripts delving into this complex topic. From this author’s perspective, end-of-life operations, specifically in the elderly, are overused and do little to lengthen or improve quality of life and, indeed, often cause more harm than good.

Enhancing surgical advocacy at the state level: The Day at the State Capitol grant program in action

In 2012, the second year of the Day at the State Capitol grant program, the level of participation grew to include 16 states and 17 ACS chapters. The following is a summary of the state lobby day programs held in 2012, including the various approaches for hosting lobby day events, and highlights of some of the important legislation discussed with state legislators.

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Progress report: Northern California Chapter’s legislative activities

The Northern California Chapter sponsored its second Day at the State Capitol on April 17, which was held in conjunction with the California Medical Association (CMA) Legislative Day. This article highlights both the successes and the lessons learned from these unified advocacy efforts and emphasizes key goals for the future.

Performing exploratory laparotomy.

Short-term surgical missions make a difference: A life-changing case in Ibi, Nigeria

Short-term surgical missions clearly are not the long-term solution for sustainable health care in the developing world, even as the need for basic surgical care in resource-poor countries remains significant. This article illustrates how these missions can have a positive impact on both patients and physicians, especially when partnering with an established host organization.

The S.S. Vandyck steaming into the Havana, Cuba, harbor.

Cruise to South America: The College’s first international outreach effort

On February 10, 1923, the S.S. Vandyck set sail from New York Harbor for a cruise to Central and South America. This voyage represented the culmination of the College’s early efforts to reach out to the international community and expand its influence beyond North America’s borders. The September 1923 issue of the Bulletin recounts this experience, and The Foreword and Supplementary Foreword to the issue are republished here as part of the Bulletin’s Centennial series.

Medicare and Medicaid audits

Health care fraud is a persistent and costly problem both for commercial and government payors. The Centers for Medicare & Medicaid Services (CMS) estimates that a significant amount of fee-for-service payments are misspent on improper payments every year. To address health care fraud, Congress and the CMS have developed a variety of approaches over the past several years to audit Medicare and Medicaid claims. This article is intended to present a high-level summary of these seven common audits.

Malignant pleural effusion research provides insights to improve surgical study design

Our research shows tunneled pleural catheters are reliable methods to control malignant pleural effusion and may be optimal if full lung expansion is uncertain. This experience also suggested that a phased data gathering approach to better launch complex surgical trials and the selective use of alternative trial designs would enhance such future endeavors. This column highlights important lessons for future study.

Surgical care measures show significant progress

Beginning in 2012, all Joint Commission-accredited hospitals must meet a performance improvement standard that establishes an 85 percent composite compliance target on all of the hospital’s selected accountability measures. This column highlights these measures, which include surgical care, heart attack, heart failure, pneumonia, and children’s asthma care core measure sets.

Figure 1. Hospital discharge status

Gunned down

This column highlights the increasing trend of multiple-victim shootings in the U.S. To examine the occurrence of firearm-related assaults in the National Trauma Data Bank® (NTDB®) research dataset for 2010, admissions medical records were searched using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).

Dr. Eastman

A. Brent Eastman, MD, FACS, installed as 93rd ACS President

A. Brent Eastman, MD, FACS, a general, vascular, and trauma surgeon from San Diego, CA, was installed as the 93rd President of the American College of Surgeons during Convocation ceremonies on September 30. Two Vice-Presidents also took office during the Convocation: R. Phillip Burns, MD, FACS, of Chattanooga, TN, as First Vice-President and John M. Daly, MD, FACS, of Philadelphia, PA, as Second Vice-President.

2012 HFE Matsuno Photo

Citation for Prof. Seiki Matsuno, MD, FACS

Honorary Fellowship in the American College of Surgeons (ACS) was awarded to five prominent surgeons from Japan, the Philippines, Mexico, England, and Belgium during the September 30 Convocation ceremonies that preceded the official opening of the 2012 Annual Clinical Congress in Chicago, IL.

2012 HFE Ona Photo

Citation for Prof. Enrique T. Ona, MD, FACS, FPCS

Honorary Fellowship in the American College of Surgeons (ACS) was awarded to five prominent surgeons from Japan, the Philippines, Mexico, England, and Belgium during the September 30 Convocation ceremonies that preceded the official opening of the 2012 Annual Clinical Congress in Chicago, IL.

2012 HFE Orozco color

Citation for Prof. Emeritus Hector Orozco, MD, FACS

Honorary Fellowship in the American College of Surgeons (ACS) was awarded to five prominent surgeons from Japan, the Philippines, Mexico, England, and Belgium during the September 30 Convocation ceremonies that preceded the official opening of the 2012 Annual Clinical Congress in Chicago, IL.

Dr. Sheldon (left), receives the Lifetime Achievement Award from then-ACS President Patricia J. Numann, MD, FACS, FRCS.

Dr. Sheldon honored with Lifetime Achievement Award

The second Lifetime Achievement Award of the American College of Surgeons (ACS) was presented to George F. Sheldon, MD, FACS, during the Convocation ceremonies on at the 2012 Clinical Congress. Dr. Sheldon is the Zack D. Owens Distinguished Professor of Surgery at the University of North Carolina (UNC) at Chapel Hill School of Medicine and a Past-President of the ACS.

Minister of stae for health visit to RCS 17-04-07

Citation for Prof. Lewis Spitz, MB, BCh, PhD, FRCS, FRCS(Ed)

Honorary Fellowship in the American College of Surgeons (ACS) was awarded to five prominent surgeons from Japan, the Philippines, Mexico, England, and Belgium during the September 30 Convocation ceremonies that preceded the official opening of the 2012 Annual Clinical Congress in Chicago, IL.

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