Bulletin August 2004

AUGUST 2004 Volume 89, Number 8 _________________________________________________________________ FEATURES Stephen J. Regnier Editor Laparoscopy at sea: Overcoming unique challenges 12 Linn Meyer Lt. Cdr. David S. Thoman, MD, FACS Director of Communications Surgical lifestyles: Fellow fully realizes the art of surgery 18 Karen Sandrick Diane S. Schneidman Senior Editor Securing the future of general surgery: Tina Woelke A rural surgeon’s perspective 21 Graphic Design Specialist Richard A. Armstrong, MD, FACS Alden H. Harken, The Governors’ Committee MD, FACS on Physician Competency and Health 26 Charles D. Mabry, Lynn H. Harrison, Jr., MD, FACS MD, FACS Jack W. McAninch, The gloves are off: MD, FACS The Aetna and CIGNA settlements: Part II 29 Editorial Advisors Irene Dworakowski Tina Woelke Front cover design Back cover design DEPARTMENTS About the cover... From my perspective Editorial by Thomas R. Russell, MD, FACS, ACS Executive Director 3 Rough oceanic waters add challenges for U.S. Navy surgeons attempting to perform Dateline: Washington 6 the intricate laparoscopic Division of Advocacy and Health Policy procedures that allow sol- diers to return to duty safely and quickly. In his article on What surgeons should know about... 8 page 12, Lt. Cdr. David S. ...the next step for quality measurement: Paying for it! Thoman, MD, FACS, de- Jean A. Harris and Barbara Cebuhar scribes his experiences aboard the USS Tarawa during four months of its 2003 Pacific de- ployment, including partici- pation in Operation South- ern Watch and Operation Iraqi Freedom. Cover photos: sea photo © Corbis/Punchstock; laparo- scope photo courtesy of the Laparoscopy Hospital. 04AUGBULLinsidecover.pmd 2 8/5/2004, 3:07 PM NEWS Bulletin of the American College of Surgeons (ISSN Chapter leaders learn about politics and advocacy 33 0002-8045) is published Diane S. Schneidman monthly by the American Col- lege of Surgeons, 633 N. Saint Clair St., Chicago, IL 60611. The young surgeon advocate experience 38 It is distributed without Laurel Soot, MD, FACS, and Scott Soot, MD, FACS charge to Fellows, to Associate Fellows, to participants in the Candidate Group of the Dr. Britt receives distinguished educator award 43 American College of Surgeons, and to medical libraries. Peri- odicals postage paid at Chi- Report of the 2004 Australia cago, IL, and additional mail- and New Zealand Travelling Fellow 44 ing offices. POSTMASTER: Joseph J. Cullen, MD, FACS Send address changes to Bul- letin of the American College of Surgeons, 633 N. Saint Clair St., ACS/STS 2003 Health Policy Scholar reports on activities 47 Chicago, IL 60611-3211. Cana- dian Publications Mail Agree- James S. Allan, MD, FACS ment No. 40035010. Canada re- turns to: Station A, PO Box 54, Windsor, ON N9A 6J5. Dr. Schultz to head FDA’s Center The American College of for Devices and Radiological Health 49 Surgeons’ headquarters is located at 633 N. Saint Clair St., Chicago, IL 60611-3211; tel. ACS Scholars to present at the Surgical Forum 49 312/202-5000; toll-free: 800/ 621-4111; fax: 312/202-5001; e-mail:postmaster@ Fellows in the news 51 facs.org; Web site: www.facs. org. Washington, DC, office is located at 1640 Wisconsin NTDB™ data points: “Water and alcohol don’t mix” 53 Ave., NW, Washington, DC by Richard J. Fantus, MD, FACS, and John Fildes, MD, FACS 20007; tel. 202/337-2701, fax 202/337-4271. Unless specifically stated Chapter news 54 otherwise, the opinions ex- Rhonda Peebles pressed and statements made in this publication reflect the authors’ personal observations Education activities strengthen surgery in the Dakotas 55 and do not imply endorsement by Mark O. Jensen, MD, FACS by nor official policy of the American College of Surgeons. ©2004 by the American College of Surgeons, all rights reserved. Contents may not be reproduced, stored in a re- trieval system, or transmitted in any form by any means without prior written permis- sion of the publisher. Library of Congress number 45-49454. Printed in the USA. Publications Agreement The American College of Surgeons is dedicated to improving the care of the No. 1564382. surgical patient and to safeguarding standards of care in an optimal and ethical practice environment. Officers and staff of the American College of Surgeons Rene Lafreniere, MD, FACS, Calgary, AB Officers Vice-Chair Julie A. Freischlag, MD, FACS, Baltimore, MD Claude H. Organ, Jr., MD, FACS, Oakland, CA* Secretary President Donald E. Fry, MD, FACS, Albuquerque, NM Anna M. Ledgerwood, MD, FACS, Detroit, MI Mary Margaret Kemeny, MD, FACS, Jamaica, NY First Vice-President Mark A. Malangoni, MD, FACS, Cleveland, OH Murray F. Brennan, MD, FACS, New York, NY Valerie W. Rusch, MD, FACS, New York, NY Second Vice-President John O. Gage, MD, FACS, Pensacola, FL Secretary Advisory Council to the Board of Regents John L. Cameron, MD, FACS, Baltimore, MD (Past-Presidents) Treasurer Thomas R. Russell, MD, FACS, Chicago, IL W. Gerald Austen, MD, FACS, Boston, MA Executive Director Oliver H. Beahrs, MD, FACS, Rochester, MN Gay L. Vincent, CPA, Chicago, IL John M. Beal, MD, FACS, Valdosta, GA Comptroller Harvey W. Bender, Jr., MD, FACS, Nashville, TN George R. Dunlop, MD, FACS, Worcester, MA C. Rollins Hanlon, MD, FACS, Chicago,IL Officers-Elect (take office October 2004) R. Scott Jones, MD, FACS, Charlottesville, VA M. J. Jurkiewicz, MD, FACS, Atlanta, GA Edward R. Laws, MD, FACS, Charlottesville, VA* LaSalle D. Leffall, Jr., MD, FACS, Washington, DC President-Elect Lloyd D. MacLean, MD, FACS, Montreal, QC Andrew L. Warshaw, MD, FACS, Boston, MA William H. Muller, Jr., MD, FACS, Charlottesville, VA First Vice-President-Elect David G. Murray, MD, FACS, Syracuse, NY Henry L. Laws, MD, FACS, Birmingham, AL David C. Sabiston, Jr., MD, FACS, Durham, NC Second Vice-President-Elect Richard R. Sabo, MD, FACS, Bozeman, MT Seymour I. Schwartz, MD, FACS, Rochester, NY Board of Regents George F. Sheldon, MD, FACS, Chapel Hill, NC G. Tom Shires, MD, FACS, Las Vegas, NV Edward M. Copeland III, MD, FACS, Gainesville, FL* Frank C. Spencer, MD, FACS, New York, NY Chair James C. Thompson, MD, FACS, Galveston, TX Gerald B. Healy, MD, FACS, Boston, MA* Vice-Chair Executive Staff H. Randolph Bailey, MD, FACS, Houston, TX Barbara L. Bass, MD, FACS, Baltimore, MD* Executive Director: Thomas R. Russell, MD, FACS L. D. Britt, MD, FACS, Norfolk, VA Division of Advocacy and Health Policy: Bruce D. Browner, MD, FACS, Farmington, CT Cynthia A. Brown, Director Martin B. Camins, MD, FACS, New York, NY American College of Surgeons Oncology Group: William H. Coles, MD, FACS, Chapel Hill, NC Samuel A. Wells, Jr., MD, FACS, Group Chair A. Brent Eastman, MD, FACS, San Diego, CA Communications: Linn Meyer, Director Richard J. Finley, MD, FACS, Vancouver, BC Division of Education: Josef E. Fischer, MD, FACS, Boston, MA Ajit K. Sachdeva, MD, FACS, FRCSC, Director Alden H. Harken, MD, FACS, Oakland, CA Executive Services: Barbara L. Dean, Director Charles D. Mabry, MD, FACS, Pine Bluff, AR Finance and Facilities: Gay L. Vincent, CPA, Director Jack W. McAninch, MD, FACS, San Francisco, CA Human Resources: Jean DeYoung, Director Mary H. McGrath, MD, FACS, San Francisco, CA* Information Technology: Howard Tanzman, Director Robin S. McLeod, MD, FACS, Toronto, ON* Journal of the American College of Surgeons: Claude H. Organ, Jr., MD, FACS, Oakland, CA Wendy Cowles Husser, Executive Editor Carlos A. Pellegrini, MD, FACS, Seattle, WA Division of Member Services: Karl C. Podratz, MD, FACS, Rochester, MN Paul E. Collicott, MD, FACS, Director John T. Preskitt, MD, FACS, Dallas, TX Division of Research and Optimal Patient Care: J. David Richardson, MD, FACS, Louisville, KY R. Scott Jones, MD, FACS, Director Thomas V. Whalen, MD, FACS, New Brunswick, NJ Cancer: *Executive Committee David P. Winchester, MD, FACS, Medical Director Trauma: David B. Hoyt, MD, FACS, Medical Director Board of Governors/Executive Committee Executive Consultant: C. Rollins Hanlon, MD, FACS Courtney M. Townsend, Jr., MD, FACS, Galveston, TX 2 Chair VOLUME 89, NUMBER 8, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS From my perspective little more than two years ago, the American College of Surgeons established an affiliate organization with a more flex- A ible 501(c)6 tax-exempt status—the American College of Surgeons Professional Asso- ciation (ACSPA). This group’s first and most sig- nificant initiative to date has been the creation of a political action committee (PAC), ACSPA- SurgeonsPAC. This seems like a good time for an update on this restructuring and its achievements. Why was the PAC formed? The impetus for establishing the ACSPA- SurgeonsPAC was a proposal from the Board of Much of what we need to do Governors’ Socioeconomic Affairs Committee. The today and in the future members of this committee believed that surgery needed a representative PAC to strengthen the profession’s grassroots advocacy efforts and to revolves around influencing bring it in sync with other medical organizations that are attempting to influence health policy. the political climate and Over the course of several years, the Governors’ committee had attempted to encourage the Board creating the will to change. of Regents to form a PAC. During the course of the debate, it became increasingly apparent that surgical practice was becoming more entrenched in politics and that the vast majority of health policy decision makers and advisors were from outside of the surgical community. Hence in 2001, must be able to support political candidates who the Regents acknowledged that we needed to make have a health policy agenda consistent with what the changes that were necessary to establish a PAC we believe is necessary to care for the surgical to represent the surgical perspective. patient. A PAC is one of the most valuable tools Because of its restrictive tax-exempt status as available to accomplish these goals.

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