Looking forward – October 2015

David B. Hoyt

David B. Hoyt, MD, FACS

The practice of surgery grows ever more complex, with greater demands for health care professionals to accept accountability for patient outcomes, the development of new code sets and payment formulas, and the need to be responsive and provide quality care to an aging population. As surgeons seek to comply with new regulatory and legislative mandates and develop the skills necessary to provide coordinated, team-based patient care, the American College of Surgeons (ACS) staff and volunteers are continually working to provide our Fellows with the resources, services, and educational opportunities they need to thrive.

In fact, I would argue the need for professional societies like the ACS has never been greater. In times of uncertainty, professional societies have the intellectual property, if you will, that members need to cope with the challenges of modern-day practice. We have the authority to influence and manage change and to serve as trusted collaborators with other groups and government agencies that are committed to finding solutions to the health care-related problems facing the nation.

ACS intellectual property

Some examples of the College’s intellectual property include our advocacy, quality improvement, and educational programs.

Our team in the Division of Advocacy and Health Policy (DAHP) analyzes bills, regulations, and proposed policies to determine how they will affect surgeons and their patients. Likewise, they work with lawmakers and rule-makers to help them better understand the impact of their decisions. They provide ACS members with the tools and resources they need to influence public policy, such as the ACS Professional Association’s SurgeonsVoice program. They also disseminate valuable information to members on how to comply with policy demands and still grow a thriving practice in an era of value-based purchasing with the following tools and resources:

  • A monthly e-newsletter, The ACS Advocate
  • E-mail alerts
  • Regular articles and columns in the Bulletin
  • Primers on medical liability, hospital employment, and practice management issues
  • Coding workshops

In addition, the DAHP works with the Division of Member Services to present the Annual Leadership & Advocacy Summit, which comprises a range of presentations on effective surgical advocacy and opportunities for surgeons to meet with members of Congress and their staffs on Capitol Hill.

The Division of Research and Optimal Patient Care offers the ACS National Surgical Quality Improvement Program to hospitals seeking to benchmark and improve outcomes. This area of the College has developed quality improvement programs that are specific to certain specialties or disciplines of surgery, including the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, the Trauma Quality Improvement Program, pediatric quality improvement programs, cancer programs, and many more. Furthermore, this division is developing a quality manual for surgical quality officers to use in their efforts to lead departments of surgery to new levels of high reliability. Additionally, the Committee on Trauma and Commission on Cancer, which fall under the aegis of this division, run programs that verify that trauma and cancer centers are meeting the College’s standards.

Our Division of Education offers programs that allow surgeons to experience the joy of lifelong learning and comply with the surgical boards’ standards for Maintenance of Certification. The most high-profile example would be this month’s Clinical Congress. However, the College also offers programs that enable surgeons to learn about leading surgical teams, such as the Surgeons as Leaders: From Operating Room to Boardroom and the Residents as Teachers and Leaders courses. Furthermore, the Division of Education provides members with opportunities to review clinical guidelines for care through the Evidence-Based Decisions in Surgery program and to sharpen their skills and knowledge through the Surgical Education and Self-Assessment Program. Moreover, in the face of concerns that surgical trainees have expressed about their confidence in entering surgical practice after residency, the College has developed a Transition to Practice in General Surgery program. This College offering allows individuals who have completed their training to work under the supervision of experienced surgeons for a period of time before they enter practice.

Collaboration

Furthermore, the College collaborates with other organizations and stakeholders so that we can pool our resources and talent to improve patient care. For example, at last year’s Clinical Congress, Jonathan Woodson, MD, FACS, Assistant Secretary of Defense for Health Affairs, and I signed an agreement to form the Military Health System (MHS) Strategic Partnership with the American College of Surgeons. As a result, the MHS and the ACS are working together to ensure that surgeons are better prepared to provide services often learned on the battlefield, sharing educational opportunities and developing systems-based approaches to care and practice guidelines.

One project that the MHS and the College have worked on together, along with law enforcement, emergency medical services, and public health agencies and organizations, is the development of the Hartford Consensus. The Hartford Consensus statements on improving survival from active shooter and mass casualty events were generated by a joint committee convened by ACS Regent Lenworth M. Jacobs, Jr., MD, MPH, FACS. The committee’s years of work culminated in the following:

Another collaborative effort that should benefit many patients is being led by ACS Past-President L.D. Britt, MD, MPH, DSc(Hon), FACS, FCCM, FRCSEng(Hon), FRCSEd(Hon), FWACS(Hon), FRCSI(Hon), FCS(SA)(Hon), FRCSGlasg(Hon). Dr. Britt has worked to establish a partnership with the National Institute on Minority Health and Health Disparities (NIMHD) to improve access to surgical care for all Americans, regardless of race, ethnicity, age, socioeconomic status, and other demographic factors. Given the College’s history with quality improvement programs and the NIMHD’s considerable research and scientific resources, this partnership has the potential to expand access to surgical care for all Americans. As a first step in developing a research agenda for eliminating variations in patient care, the ACS and the NIMHD convened a highly successful meeting this past summer. The work has just begun but promises to open the door to care for many underserved Americans.

The next 100 years

The efforts described here ensure that our members have the knowledge and resources they need to ensure that their patients receive the appropriate surgical care. And whereas these programs and collaborative efforts signal the College’s commitment to advocacy, education, and quality improvement, your membership in the ACS and use of the FACS insignia demonstrate to the public that you are committed to upholding our shared values.

To continue to thrive in the next 100 years, the College’s leadership recognizes that we cannot rest on our laurels. To remain relevant to the next generation of surgeons we must continue to provide clarity in increasingly complex times. We must invest in a resilient, well-informed, talented staff and focus on the practical needs of our members. We must embrace new member communication channels and collaborate with other committed stakeholders. We must be the essential force driving quality improvement and be the trusted source of meaningful clinical solutions. We must be the organization that unites, builds consensus, and cuts through uncertainty. The ACS leadership and staff are committed to achieving these objectives and to proving that now, more than ever, membership in the College has real value.


If you have comments or suggestions about this or other issues, please send them to Dr. Hoyt at lookingforward@facs.org.

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