Archive for May, 2013

Lessons Learned

Looking forward – May 2013

In his May column, Dr. Hoyt discusses a new ACS report titled Lessons Learned in the Pursuit of Quality Surgical Health Care, which highlights the key messages that the College’s leadership took home from their many stops on the Inspiring Quality tour.

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Insurance exchanges under the Affordable Care Act: How will they affect surgical care?

This article describes the potential advantages and consequences of ACA insurance exchanges and outlines the two types of exchanges established in the law: the American Health Benefits Exchange for individual purchasers and the Small Business Health Options Program for businesses with fewer than 100 employees.

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Surgical leadership in the era of quality-based payment

New payment models developed in the U.S. in recent years illustrate the challenges of identifying and rewarding quality, particularly in surgery. Payors are experimenting with a variety of approaches to quality-based payment, including tying payment to evidence-based care processes, penalizing errors and “never events,” penalizing readmissions, linking payment to patient satisfaction, providing opportunities for shared savings, and tying payment to clinical outcomes.

The 113th Congress: A look at the year ahead

This article is a prognostication of where the College’s legislative agenda is headed during the 113th U.S. Congress. Issues of greatest concerns include physician payment reform, medical liability, surgical workforce shortages and education, and funding for trauma system programs.

Industry-sponsored clinical trials: The problem of conflicts of interest

This article presents a case study involving an ethical dilemma in which a pharmaceutical company asks a physician to participate in a clinical trial and offers to pay the physician for enrolling patients in the study. The authors explore four options for resolving the dilemma: accept the offer and only reveal details relevant to informed consent, accept the offer and inform patients of the reimbursement arrangement, participate in the clinical trial without accepting reimbursement, and avoid participating in the clinical trial altogether.

Centennial reprint: 1952 Supreme Court decision prompts College action on fee splitting

To help commemorate the American College of Surgeons’ (ACS) 100th anniversary, the Bulletin of the American College of Surgeons is reprinting articles centered on the issues and developments that have defined the character and integrity of the organization throughout its history.

This month’s reprint centers on the College’s response to a March 1952 in which the U.S. Supreme Court ruled that the income tax deductions that two North Carolina opticians took for kickbacks to ophthalmologists on eyeglasses sold to their patients were ordinary and necessary expenses.

The Supreme Court’s decision prompted the ACS Board of Regents to study the intricacies of fee-splitting and to periodically issue statements defining and clarifying the College’s views on the matter. The first of these proclamations, “A Statement on Certain Unethical Practices in Surgery,” is reprinted in the May issue of the Bulletin. The statement is preceded by an article describing the court case and the ACS response. These materials were published in the July-August 1952 Bulletin.

Transitioning to ICD-10

Health care providers throughout the nation currently use International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). In 2009, the U.S. Department of Health and Human Services published a regulation requiring its replacement. The ACS encourages members to become familiar with the new code sets, understand the difference between ICD-9-CM and ICD-10, and prepare for how the change may affect their practices

Governors’ Committee on Physician Competency and Health

The latest report of the Board of Governors’ Committee on Physician Competency and Health provides updates on committee activities and highlights the recently released Being Well and Staying Competent: Challenges for the Surgeon, which is available on the ACS members-only portal at www.efacs.org.

Documentation of services provided in the postoperative global period

Over the last year, the U.S. Department of Health and Human Services (HHS) has gradually increased its analysis of the value of global surgical packages. In particular, HHS has focused on the evaluation and management (E/M) services provided within the postoperative period, which are included in the value of the global surgical package. This column offers suggestions on how ACS Fellows may document services provided during the global period and explains why HHS is interested in the measurement of postoperative work.

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Are older adults adequately represented in surgical oncology trials?

Older adults are projected to comprise a significant portion of a surgeon’s patient population. However, current surgical oncology trials are not designed to allow for widespread generalizability to their practice. This column features insights into the gap between cancer trials and the real world and the potential role of Z901101 in stimulating future studies and polices to broaden the accrual of older adults and their surgeons in new oncology trials.

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Hang ’em high

In order to examine the occurrence of hangman’s fractures in the National Trauma Data Bank® (NTDB®) research dataset for 2012, admissions medical records were searched using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). This column highlights these findings and provides a brief history for the term “hangman’s fracture.”

Study shows ACS NSQIP data more useful than administrative data in tracking readmissions

Hospitals participating in ACS NSQIP® may review clinical patient data and compare their outcomes with those at other hospitals in the database. In January 2011, ACS NSQIP began collecting key data on the frequency and causes of readmissions. A recently released study conducted by a research team at Northwestern Memorial Hospital, Chicago, IL, demonstrates that the information in ACS NSQIP accurately reflected patient medical records and how the information compared with administrative data.

ACS Division of Education presents new Transition to Practice Program

The ACS Division of Education has introduced the new ACS Transition to Practice Program in General Surgery. Details regarding this program, which assists residents in making the transition to independent practice, are highlighted in this news brief.

Dr. Stewart

ACS Board of Regents approves ACS Foundation Officers

The ACS Board of Regents has approved new officers of the ACS Foundation Board of Directors for three-year terms.

Mitchell C. Posner, MD, FACS, past-president of SSO (right), presents the Distinguished Service Award to Dr. Winchester.

Dr. David Winchester receives SSO Distinguished Service Award

David P. Winchester, MD, FACS, Medical Director of ACS Cancer Programs, received the first Distinguished Service Award from the Society of Surgical Oncology on March 8 during the organization’s 66th Annual Cancer Symposium at the Gaylord National Hotel in National Harbor, MD.

Clarification

Clarification is offered for a column titled “What surgeons should know about…The Physician Compare” website published in the February 2013 issue of the Bulletin.

Disciplinary actions taken

This news brief describes the disciplinary actions the ACS Board of Regents took at its February 8, 2013, meeting.

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John P. “Jack” Lynch, former Director of the ACS Organization Department

Longtime Director of the ACS Organization Department, John P. “Jack” Lynch, passed away March 5 at age 77.

Community Surgeons Travel Awards for 2014 now available

The ACS International Relations Committee announces two Community Surgeons Travel Awards for surgeons ages 30 to 50. These $4,000 awards allow international surgeons to participate in the annual ACS Clinical Congress; applications for these awards are due before July 1, 2013.

Apply by June 3 for 2013 Claude H. Organ, Jr., MD, FACS, Traveling Fellowship

The full requirements for the 2013 Claude H. Organ Jr., MD, FACS traveling fellowship are outlined in this news brief.

Contact

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Chicago, IL 60611