Bulletin November 2008

NOVEMER 2008 Volume 93, Number 11 FEATURES Stephen J. Regnier Editor Fahad’s journey 8 Linn Meyer Sylvia D. Campbell, MD, FACS Director of ACS Practice Patterns Survey, Part II: Communications Prescribing habits among surgical specialties 11 Karen Stein Charles M. Balch, MD, FACS; and Thomas R. Russell, MD, FACS Associate Editor Into the theater: Perspectives from a civilian trauma surgeon’s Diane S. Schneidman visit to the Combat Support Hospital in Balad, Iraq 16 Contributing Editor M. Margaret Knudson, MD, FACS Tina Woelke 2008 state legislative activity 26 Graphic Design Specialist Melinda Baker Alden H. Harken, MD, FACS Charles D. Mabry, DEPARTMENTS MD, FACS Jack W. McAninch, MD, FACS From my perspective 4 Editorial Advisors Editorial by Thomas R. Russell, MD, FACS, ACS Executive Director Tina Woelke Dateline: Washington 7 Front cover design Division of Advocacy and Health Policy Socioeconomic tips 31 Future meetings ACS Coding Hotline: Cholecystectomy questions Linda Barney, MD, FACS; Albert Bothe, Jr., MD, FACS; Clinical Congress and Debra Mariani, CPC 2009 Chicago, IL, October 11-15 2010 Washington, DC, October 3-7 2011 San Francisco, CA, October 23-27 Letters to the Editor should be sent with the writer’s name, address, e-mail address, and daytime tele- phone number via e-mail to [email protected], or via mail to Stephen J. Regnier, Editor, Bulletin, American College of Surgeons, 633 N. Saint Clair St., Chicago, IL 60611. Letters may be edited for length or On the cover: A Ugandan mother’s plea on behalf of her son, who suffered from clarity. Permission to publish letters is assumed unless the a heart complication, inspired dedicated surgeons and nonsurgeons in Tampa, author indicates otherwise. FL, to coordinate stateside care for the child (see article, page 8). NEWS Bulletin of the American College of Surgeons (ISSN 0002-8045) is published Dr. Cameron installed as 89th ACS President monthly by the American Col- 33 lege of Surgeons, 633 N. Saint Honorary Fellowships presented to five prominent surgeons 34 Clair St., Chicago, IL 60611. It is distributed without charge Citation for Prof. Jacques Brotchi 35 to Fellows, Associate Fellows, Fernando G. Diaz, MD, PhD Resident and Medical Student Members, Affiliate Members, Citation for Prof. Joaquim Gama-Rodrigues 36 and to medical libraries and allied health personnel. Periodi- Carlos A. Pellegrini, MD, FACS cals postage paid at Chicago, IL, and additional mailing Citation for Prof. Gerald C. O’Sullivan 37 offices. POSTMASTER: Send Tom R. DeMeester, MD, FACS address changes to Bulletin of the American College of Sur- Citation for Mr. Bernard Ribiero 38 geons, 633 N. Saint Clair St., George F. Sheldon, MD, FACS, FRCSEd(Hon), FRCSEng(Hon) Chicago, IL 60611-3211. Cana- dian Publications Mail Agree- Citation for Prof. Russell W. Strong 40 ment No. 40035010. Canada L. D. Britt, MD, FACS returns to: Station A, PO Box 54, Windsor, ON N9A 6J5. In memoriam: James C. Thompson, MD, FACS, 1928–2008 42 The American College of Marshall J. Orloff, MD, FACS Surgeons’ headquarters is located at 633 N. Saint Clair Germany Traveling Fellow selected for 2009 47 St., Chicago, IL 60611-3211; tel. 312/202-5000; toll-free: Dr. Eastman appointed to 800/621-4111; fax: 312/202- national injury prevention advisory board 47 5001; e-mail:postmaster@ facs.org; Web site: www.facs. Report of the 2008 American College of Surgeons org. Washington, DC, office is located at 1640 Wisconsin Japan Traveling Fellow 49 Ave., NW, Washington, DC Sam M. Wiseman, MD, FACS, FRCSC 20007; tel. 202/337-2701, fax 202/337-4271. A look at The Joint Commission: Unless specifically stated International focus on accreditation 55 otherwise, the opinions ex- pressed and statements made Trauma meetings calendar 55 in this publication reflect the authors’ personal observations ACOSOG news: “Such stuff as dreams are made on”: and do not imply endorsement Laparoscopic rectal cancer trial 56 by nor official policy of the David M. Ota, MD, FACS; and Heidi Nelson, MD, FACS American College of Surgeons. 2009 Oweida Scholarship availability announced 57 ©2008 by the American ® College of Surgeons, all rights NTDB data points: ATVs: “All-terrain victims” 59 reserved. Contents may not Richard J. Fantus, MD, FACS be reproduced, stored in a retrieval system, or transmit- ted in any form by any means without prior written permission of the publisher. Library of Congress number 45-49454. Printed in the USA. The American College of Surgeons is dedicated to improving the care of the sur- Publications Agreement No. gical patient and to safeguarding standards of care in an optimal and ethical 1564382. practice environment. From my perspective arlier this year, the American College of Surgeons announced the establishment of a new Health Policy and Research EInstitute, which is currently based at the University of North Carolina (UNC), Cha- pel Hill. Already this institute is enhancing the College’s capacity for analyzing issues and de- ’’ veloping thoughtful position statements, and we anticipate that it will assist this organization in our efforts to become an increasingly prominent presence in the policymaking arena. Establishment of the ACS Initial steps Start-up of this important branch of the College Health Policy and Research is being led under the careful guidance of George F. Sheldon, MD, FACS, Zack D. Owens Distin- Institute presents an guished Professor of Surgery at UNC’s School of Medicine. Dr. Sheldon, a Past-President of the opportunity for the American College, was selected for this position through a national search process. He is receiving adminis- College of Surgeons to play trative assistance from Thomas J. Ricketts, PhD, deputy director of the UNC Cecil G. Sheps Center a true leadership role in for Health Policy Research. The Cecil G. Sheps Center for Health Policy the health policy arena. Research is an institute within the UNC that reports to the vice-chancellor and collaborates with the schools of medicine, dentistry, public ’’ health, nursing, and allied health. The center has 140 full-time time researchers, numerous our efforts much more quickly than if we had graduate students, and substantial existing grant attempted to build an entirely new program support from the Health Resources and Services from scratch. Administration, the Agency for Healthcare Re- search and Quality, and the National Institutes Exploratory projects under way of Health. For its first project, the ACS Health Policy and This collaboration with an existing health Research Institute is studying surgeon work- policy research center is a new model that allows force issues. More specifically, the researchers at a professional organization, such as the College, the institute are attempting to answer questions to collaborate with demographers, statisticians, about how many surgeons will be needed to en- survey experts, and other experts in health ser- sure patient access to care in the future, which vices research. The collaboration between the specialties need to attract more trainees, and American College of Surgeons and UNC also the causes of geographic disparities in access to ensures that the ACS Health Policy and Re- surgical care. Dr. Sheldon and his team at UNC search Institute has access to the resources and have already conducted considerable research knowledge necessary to cultivate a nationally regarding the impending surgical workforce respected think tank. Drs. Sheldon and Ricketts crisis and have started to generate ideas about are both highly regarded authorities on health how the federal government can help to ensure care issues, and the Sheps Center has a long and that surgeons are accessible to the patients who distinguished record in conducting health policy need their services. research. Basing the institute at UNC during its Based on the institute’s research, the Col- early stages of growth has allowed us to initiate lege has arrived at some of the suggestions we 4 VOLUME 93, NUMBER 11, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS intend to offer to health policymakers to assist Strong, coordinated presence them in addressing the workforce issue. These Because the institute’s staff will be conducting recommendations include the following: (1) research and helping to write position statements encouraging a well-planned expansion of U.S. on issues affected by the federal government, the medical school graduates and residency train- program’s headquarters will ultimately relocate ing programs, (2) providing federal financial to the building that will house the College’s support for specialties with lengthy training new Washington Office, which is scheduled for requirements, (3) eliminating caps on the completion in 2010. Having the College’s advo- number of residents eligible for federal sup- cacy and institute staffs in the same location will port at each training institution, (4) expanding allow for the timely exchange of information and programs that give financial support to rural ensure that all of our policy-focused efforts are physicians to include surgical specialists, and well coordinated. (5) providing incentives for surgeons to take call Although the ACS Health Policy and Research in our nation’s trauma centers and emergency Institute will be headquartered in Washington, departments. the institute will maintain a relationship with We anticipate that the ACS Health Policy and UNC. The fact of the matter is that our Washing- Research Institute will continue to play an in- ton Office will not have nearly the same research strumental role in helping the College to develop capabilities or staff capacity as our collaboration specific, scholarly, well-conceived strategies that with the Sheps Center affords us. lawmakers can apply in reforming the nation’s Establishment of the ACS Health Policy and health care delivery system. For example, as Con- Research Institute presents an opportunity for gress and the Centers for Medicare & Medicaid the American College of Surgeons to play a true Services strive to create a value-based, patient- leadership role in the health policy arena.

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