Archive for November, 2013

Looking forward – November 2013

In this month’s column, Dr. Hoyt provides an update on the ACS’ strategic plan to meet the challenges of a rapidly evolving health care environment. The goal of this plan—which is centered on four pillars: quality, education, advocacy, and member services—is to help surgeons cope with and influence many of these changes.

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Applying surgical apps: Smartphone and tablet apps prove useful in clinical practice

This article explores the apps that surgeons are using more commonly in clinical practice, for research, and for education and discusses concerns regarding the expanding use of apps in surgical practice. The authors also address apps for patient use and how this technology is changing the delivery of surgical care.

RAS-ACS Symposium essays: Residents debate pros and cons of online patient rankings

Each year, the Resident and Associate Society of the American College of Surgeons (RAS-ACS) hosts a symposium at the Clinical Congress featuring a debate on a timely issue in surgical training or practice. In addition to the symposium debate, the RAS-ACS Issues Committee coordinates an essay competition open to all RAS members. The topic for this year’s symposium and essay competition was Patient Rankings: Should Patient Feedback Affect Our Pay and Delivery of Care? The top “pro” and “con” essayists are invited to serve as panelists at the symposium, and the second-place pro and con essays are featured in the Bulletin.

Choosing a physician in the Yelp era

Although physician review website (PRW) metrics are less than comprehensive and may be inaccurate measures of physician skill, these sites have successfully accomplished what government agencies and professional organizations have been unable to do—broadly disseminate user-friendly, search engine-optimized information on physician performance. The merits of these sites may be debatable, but as more patients are drawn to PRWs, physicians and professional organizations will be challenged to eventually accept them or provide an alternative that is just as accessible, understandable, and applicable to all physicians.

Patient rankings: Why patient feedback should affect our delivery of care but not our pay

Closer inspection reveals that medical and surgical practice and education within the U.S. are similar fields. Both involve a special relationship between an educator (physician/teacher) and a learner (patient/student). Importantly, both continue to face challenges regarding cost-effectiveness and performance evaluation. The crux of the issue lies in the idea that the learner has the ability to provide critical feedback that may enhance educator performance. This suggests that the learner and educator can switch roles—an idea not often acknowledged in either field. This article addresses how patient feedback should be incorporated into the delivery of quality health care and how education reform is helping to set a preliminary example for medicine to follow.

Patient feedback makes us better surgeons

Today, patients have a voice through publicly reported surveys and unregulated social media (Facebook, Twitter, HealthGrades.com, and others), which allow users to compare and evaluate surgeons in a Web-based setting. In the near future, patient feedback may be used as a measure of health care quality, which will affect physician reimbursement and quite possibly the sustainability and viability of surgical practices. However, scorn and resistance to patient feedback systems are strong and many physicians believe that the process is flawed.

Legislated mints on the pillow

Altering pay based on subjective surveys will increase costs to the medical system with no evidence that these surveys will improve the quality of care. “For government to legislate exactly what factors lead to that immeasurable connection [between patient and physician] taints the relationship with impersonal checkboxes, while adding costs to an already expensive and complex medical system with no evidence that it will increase value in American health care,” the author writes.

The ACS Inspiring Quality timeline

The ACS NSQIP® Quality In-Training Initiative: Educating residents to ensure the future of optimal surgical care

This article describes the ACS NSQIP® Quality In-Training Initiative and its three objectives: adaptation of ACS NSQIP data for use in graduate surgical education, development of a national quality improvement curriculum, and the creation of a culture in surgical education that emphasizes quality conscientiousness.

Dr. De Long

IM nailing makes basketball player’s recovery a snap

An update on the effects of surgical care provided to Kevin Ware—the University of Louisville, KY, basketball player who suffered an open wound when he broke his right tibia in the NCAA Tournament—is provided in this article.

Medicine still a noble calling, despite outside interference

In this month’s column, the author explains why he considers surgical practice an enduring and worthy profession.

TJC screen capture

Implementation guide offers effective strategies to combat SSIs

This month’s column provides an overview of The Joint Commission’s Implementation Guide for NPSG.07.05.01 on Surgical Site Infections: The SSI Change Project. This new guide is designed to help health care professionals reduce surgical site infections by providing effective practices for implementing National Patient Safety Goal (NPSG) 07.05.01.

Emergency department disposition

What’s on TV

This month’s column examines the occurrence of pediatric injuries resulting from falling Televisions. The information presented is drawn from the National Trauma Data Bank research dataset for 2012.

Dr. Pellegrini

Carlos A. Pellegrini, MD, FACS, FRCS(I)(Hon), installed as 94th President of the ACS

Carlos Pellegrini, MD, FCS, FRCS(I)(Hon), installed as President; ACS Vice-Presidents were also installed at 2013 Clinical Congress.

Six prominent surgeons accorded Honorary Fellowship in the ACS

Honorary Fellowship in the ACS was awarded to six prominent surgeons from Germany, England, Mexico, Thailand, and Malaysia during the Convocation ceremonies that preceded the official opening of the 99th Annual Clinical Congress in Washington, DC.

Professor Büchler

Citation for Prof. Markus W. Büchler

Prof. Markus Büchler of Heidelberg, Germany, is presented for Honorary Fellowship in the ACS by Andrew L. Warshaw, MD, FACS.

Professor Heald

Citation for Prof. R.J. Heald, CBE, MChir, FRCS(Ed)(Eng)

Prof. R.J. (Bill) Heald, CBE, MChir, FRCS(Ed)(Eng), of Basingstoke, Hampshire, England, is presented for Honorary Fellowship in the ACS by John K. MacFarlane, MDCM, FACS, FRCS(C).

Professor Ruiz

Citation for Prof. J. Octavio Ruiz Speare, MD, FACS

Prof. J. Octavio Ruiz Speare, MD, FACS, of Mexico City, Mexico, is presented for Honorary Fellowship in the ACS by Lenworth M. Jacobs, Jr., MD, FACS.

Professor Prinya

Citation for Prof. Prinya Sakiyalak, MD, FACS

Prof. Prinya Sakiyalak, MD, FACS, of Bangkok, Thailand, is presented for Honorary Fellowship in the ACS by Patricia J. Numann, MD, FACS, FRCS(Ed)(Hon), FRCS(Glas)(Hon).

Professor Williams

Citation for Prof. Norman S. Williams, MS, FMedSci, FRCS(Eng)

Prof. Norman Stanley Williams, MS, FMedSci, FRCS(Eng), of London, England, is presented for Honorary Fellowship in the ACS by Murray F. Brennan, MD, FACS, FRCS(I)(Hon), FRCPS(C)(Hon). FRCS(Ed)(Hon), FRCS(Eng)(Hon), FRCS(Glas)(Hon), FRACS(Hon).

Professor Yip

Citation for Prof. Cheng-Har Yip, MB, BS, FRCS(Edin)(Glas)

Prof. Cheng-Har Yip, MB,BS, FRCS(Edin)(Glas), of Kuala Lumpur, Malaysia, is presented for Honorary Fellowship in the ACS by Benjamin O. Anderson, MD, FACS.

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