Dear Fellows,
Here is a way over-due report of some of the many activities going on in the College.
1. We are all invited to join the Los Angeles (Southern California) Chapter of the ACS at their annual meeting, January 16-18 in Santa Barbara, at the beautiful Four Seasons/Biltmore Resort. This is always an excellent meeting, with top-notch educational and social activities. Watch for mailings, or contact me and I'll forward your inquiries to the SCCACS. They have contractual arrangements in Santa Barbara through 2005, but would like to partner with us for a combined San Diego/Los Angeles Chapter meeting in January, 2006, in San Diego County. I think that would be a great idea, providing us with an opportunity to share some of their considerable resources, talent, and camaraderie. [PS: with outstanding vendor support and large attendance, their meetings have traditionally been money makers…which would be an added benefit for us.]
2. Governors' Survey Results...the major issues to surgeons in the U.S. today, as determined by Governor's surveying members (as we did earlier this year):
1. Professional Liability and Malpractice. Increasing premium rates (where coverage is even available) are forcing surgeons out of business or restricting practice, and restricting patient access to care (particularly emergency services). Frivolous lawsuits and "medical experts for hire" continue to be a problem.
2. Tort Reform. Trial lawyers continue to block meaningful legislation at State and National levels.
3. Physician Reimbursement. Last year's last minute reprieve with Medicare was not enough. Delays, denials and neglect of payment by private insurers has reached egregious levels. Surgeons can ill-afford to practice.
4. Graduate Medical Education. The 80 hour resident workweek and implications to future surgical practice are the big GME issues.
These were the most frequently named issues. Also mentioned were: Changes in Medicare and Medicaid, Workforce Issues, Impact of Healthcare Reform, Continuing Education, Trauma Care and Reimbursement, Credentialing and New Technology, Surgeon Competency (and measurement thereof).
3. The College has worked hard in all of the above areas to institute needed reforms, improve re-imbursement, and remedy workplace problems, and, in fact, was largely responsible for the rollback of the proposed 4.4% Medicare reimbursement cut in 2003 (replaced with a modest increase). In Chicago, we heard from Senate Majority Leader (and Cardiac Surgeon) Bill Frist, MD, on many of the bills (including Malpractice Caps and Tort Reform) that he and the College have partnered on, and it was good to know that we have a strong, intelligent and caring ally in such a powerful legislative position.
4. Big news in the past year is the start of the College's Political Action Committee (ACSPA/Surgeons PAC). Donations to the PAC have been incredible (in the several $100,000 range) in just the first year, but pale in comparison to many of our opponents' PAC's (the trial lawyers, for example). ACSPA funds support candidates who support us (and we met a few this week in Chicago…including surgeons running for local, state and national office). I hope you'll join me in contributing to the College's PAC when you renew your annual dues. I'm in the process of soliciting corporate donations to the Chapter, which we can then donate directly to the PAC, a tactic employed already by many of our fellow Chapters.
5. After many years of no Dues increases, the College has adopted a strategy of small incremental dues increases, tied to inflation, rather than periodic large increases. Although the college is fiscally sound (and did very well with investments over the past several years (I wish I had done as well!!!), we clearly need to increase our base of membership, not only for dues support, but so that we can truly say that we represent all of America's surgeons. The suggestion of the Board of Governor's is that you look around your hospitals, offices, clinics, O.R.'s and encourage surgeons who are not College members to join us so that we can provide a strong united front to the public and policy makers.
6. On another front, I was very impressed by the new Office of Evidence Based Surgery, which is an outgrowth of the recent Veterans Affairs/ACS prospective data base of operations performed in the V.A. medical centers looking for trends in adverse outcomes, as well as what works well. During the years of the survey, outcomes improved steadily (just as a result of participation, it seems). The College is setting up a surgical data base, not unlike the National Cancer Data Base and the National Trauma Data Base, in which we can all participate, and, I'm certain, improve outcomes. Given recent observations by the Institute of Medicine, and others, re: adverse outcomes, this has the potential to improve our quality of care. Watch for this to roll out.
7. Congratulations to all of our new fellows. The convocation ceremony this year, held at the start of the Clinical Congress (instead of the end), was very well attended, and we heard a very inspiring address from our new President, Dr. Claude Organ of Oakland, California. Dr. Organ is well known in the Bay area as an activist for many surgical and community issues, and I'm sure that the College will move forward under his leadership. And, of course, Dr. Tom Russell, of San Francisco, is the Executive Director, and is providing very strong leadership, as we anticipated he would.
I'll continue to update you with information, as it becomes available. As always, feel free to contact me with your concerns and suggestions.
Sincerely,
Jon M. Greif, DO, FACS
Governor, American College of Surgeons
Department of Surgery
Kaiser Permanente Medical Center
4647 Zion Avenue
San Diego, CA 92120
Office: 619-528-3754
FAX: 619-528-6911
Email: jon.m.greif@kp.org