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Bulletin December 2001 December 2001 Volume 86, Number 12 _________________________________________________________________ FEATURES Stephen J. Regnier Editor A review of the Presidential Address: Medicine, government, and capitalism 8 Linn Meyer Director of The ACS chapters: Where do we go from here? 10 Communications Robert M. Quinlan, MD, FACS Diane S. Schneidman Senior Editor Federal programs providing health insurance to children: A review 14 Erin LaFlair Tina Woelke Graphic Design Specialist Double-digit premium hikes: Alden H. Harken, The latest crisis in professional liability 19 MD, FACS Barry M. Manuel, MD, FACS Charles D. Mabry, MD, FACS Clinical Congress 2001: Highlights 21 Jack W. McAninch, MD, FACS Editorial Advisors Report of the Chair of the Board of Regents 30 C. James Carrico, MD, FACS Tina Woelke Front cover design Report of the Chair of the Board of Governors 32 Barbara L. Bass, MD, FACS Tina Woelke Back cover design Report of the Executive Director 34 Thomas R. Russell, MD, FACS About the cover... ACS Officers and Regents 35 This month’s cover depicts highlights of the 2001 Clinical Congress, including (clockwise from upper left): presentation of the Distinguished Service Award; the Presidential Address deliv- DEPARTMENTS ered by R. Scott Jones, MD, FACS; a special session on terror- ism; the presentation of the Na- From my perspective tional Safety Council’s Surgeons Editorial by Thomas R. Russell, MD, FACS, ACS Executive Director 3 Award for Service to Safety and the College’s Distinguished Phi- lanthropist Award; the carrying FYI: STAT 5 of the Great Mace during the Convocation; the dedication of the Owen H. Wangensteen Surgi- Dateline: Washington 6 cal Forum; and Dr. Jones’s instal- Division of Advocacy and Health Policy lation as President (center). De- tails about these and other events during the Clinical Congress are offered on page 21. (Photos by Chuck Giorno Photography.) Keeping current 39 Bulletin of the American What’s new in ACS Surgery: Principles and Practice? College of Surgeons (ISSN Richard Lindsey 0002-8045) is published monthly by the American Col- lege of Surgeons, 633 N. Saint Socioeconomic tips of the month 40 Clair St., Chicago, IL 60611. It Filing for Medicare services is distributed without charge to Fellows, to Associate Fellows, to participants in the Candi- The Journal page 58 date Group of the American Seymour I. Schwartz, MD, FACS College of Surgeons, and to medical libraries. Periodicals postage paid at Chicago, IL, and additional mailing offices. POSTMASTER: Send ad- dress changes to Bulletin of the NEWS American College of Surgeons, 633 N. Saint Clair St., Chicago, Dr. Collicott named to ACS executive staff 42 IL 60611-3211. The American College of Take a look at the activities of the ACS Insurance Program 43 Surgeons’ headquarters is lo- Gay L. Vincent, CPA cated at 633 N. Saint Clair St., Chicago, IL 60611-3211; tel. 312/202-5000, fax: 312/202- Working in the dark 45 5001; e-mail: postmaster@ Wu Shaotung facs.org; Web site: www.facs.org. Washington, DC, office is lo- cated at 1640 Wisconsin Ave., Clowes research award given 46 NW, Washington, DC 20007; tel. 202/337-2701, fax 202/ 337-4271. 2003 Travelling Fellowship available 46 Unless specifically stated otherwise, the opinions ex- pressed and statements Contributions to the 2002 Surgical Forum are requested 48 made in this publication re- flect the authors’ personal Scientific contributions sought for 2002 Clinical Congress 50 observations and do not im- ply endorsement by nor offi- cial policy of the American Fellows and facts 53 College of Surgeons. ©2001 by the American Col- Chapter news 54 lege of Surgeons, all rights re- Rhonda Peebles served. Contents may not be re- produced, stored in a retrieval system, or transmitted in any Bulletin index 59 form by any means without prior written permission of the publisher. Library of Congress number 45-49454. Printed in the USA. Publications Agreement No. 1564382. Officers and staff of the American College of Surgeons Steven W. Guyton, MD, FACS, Seattle, WA Officers Rene Lafreniere, MD, FACS, Calgary, AB Courtney M. Townsend, Jr., MD, FACS, Galveston, TX R. Scott Jones, MD, FACS, Charlottesville, VA President Kathryn D. Anderson, MD, FACS, Los Angeles, CA Advisory Council to the Board of Regents First Vice-President (Past-Presidents) Claude H. Organ, Jr., MD, FACS, Oakland, CA Second Vice-President W. Gerald Austen, MD, FACS, Boston, MA John O. Gage, MD, FACS, Pensacola, FL Henry T. Bahnson, MD, FACS, Pittsburgh, PA Secretary Oliver H. Beahrs, MD, FACS, Rochester, MN John L. Cameron, MD, FACS, Baltimore, MD John M. Beal, MD, FACS, Valdosta, GA Treasurer Harvey W. Bender, Jr., MD, FACS, Nashville, TN Thomas R. Russell, MD, FACS, Chicago, IL George R. Dunlop, MD, FACS, Worcester, MA Executive Director C. Rollins Hanlon, MD, FACS, Chicago,IL Gay L. Vincent, CPA, Chicago, IL James D. Hardy, MD, FACS, Madison, MS Comptroller M. J. Jurkiewicz, MD, FACS, Atlanta, GA LaSalle D. Leffall, Jr., MD, FACS, Washington, DC William P. Longmire, Jr., MD, FACS, Los Angeles, CA Officers-Elect (take office October 2002) Lloyd D. MacLean, MD, FACS, Montreal, PQ William H. Muller, Jr., MD, FACS, Charlottesville, VA C. James Carrico, MD, FACS, Dallas, TX David G. Murray, MD, FACS, Syracuse, NY President Jonathan E. Rhoads, MD, FACS, Philadelphia, PA Richard R. Sabo, MD, FACS, Bozeman, MT David C. Sabiston, Jr., MD, FACS, Durham, NC First Vice-President Seymour I. Schwartz, MD, FACS, Rochester, NY Amilu S. Rothhammer, MD, FACS, Colorado Springs, CO George F. Sheldon, MD, FACS, Chapel Hill, NC Second Vice-President G. Tom Shires, MD, FACS, Las Vegas, NV Frank C. Spencer, MD, FACS, New York, NY Board of Regents Ralph A. Straffon, MD, FACS, Shaker Heights, OH James C. Thompson, MD, FACS, Galveston, TX Edward R. Laws, Jr., MD, FACS, Charlottesville, VA Chair* Executive Staff Jonathan L. Meakins, MD, FACS, Montreal, PQ Vice-Chair* Executive Director: Thomas R. Russell, MD, FACS Barbara L. Bass, MD, FACS, Baltimore, MD Division of Advocacy and Health Policy: L. D. Britt, MD, FACS, Norfolk, VA Cynthia A. Brown, Director William H. Coles, MD, FACS, New Orleans, LA American College of Surgeons Oncology Group: Paul E. Collicott, MD, FACS, Chicago, IL Samuel A. Wells, Jr., MD, FACS, Group Chair Edward M. Copeland III, MD, FACS, Gainesville, FL Communications: Linn Meyer, Director A. Brent Eastman, MD, FACS, La Jolla, CA Division of Education: Richard J. Finley, MD, FACS, Vancouver, BC Ajit K. Sachdeva, MD, FACS, FRCSC, Director Josef E. Fischer, MD, FACS, Boston, MA Executive Services: Barbara L. Dean, Director Alden H. Harken, MD, FACS, Denver, CO* Finance and Facilities: Gay L. Vincent, CPA, Director Gerald B. Healy, MD, FACS, Boston, MA* Human Resources: Jean DeYoung, Director R. Scott Jones, MD, FACS, Charlottesville, VA* Information Services: Howard Tanzman, Director Margaret F. Longo, MD, FACS, Hot Springs, AR Journal of the American College of Surgeons: Jack W. McAninch, MD, FACS, San Francisco, CA* Wendy Cowles Husser, Executive Editor Mary H. McGrath, MD, FACS, Maywood, IL Division of Member Services: John T. Preskitt, MD, FACS, Dallas, TX Paul E. Collicott, MD, FACS, Director Ronald E. Rosenthal, MD, FACS, Wayland, MA Organization: John P. Lynch, Director Maurice J. Webb, MD, FACS, Rochester, MN Division of Research and Optimal Patient Care: *Executive Committee Cancer: David P. Winchester, MD, FACS, Medical Director Board of Governors/Executive Committee JoAnne Sylvester, Associate Director Office of Evidence-Based Surgery: J. Patrick O’Leary, MD, FACS, New Orleans, LA Margaret Mooney, MD, Interim Director Chair Trauma: Sylvia D. Campbell, MD, FACS, Tampa, FL Gerald O. Strauch, MD, FACS, Director Vice-Chair Executive Consultants: Timothy C. Fabian, MD, FACS, Memphis, TN C. Rollins Hanlon, MD, FACS Secretary Olga Jonasson, MD, FACS 2 Julie A. Freischlag, MD, FACS, Los Angeles, CA VOLUME 86, NUMBER 12, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS From my perspective n October 23, I met with Tom Scully in his offices at the U.S. Department of Health and Human Services. As you Oprobably know, Mr. Scully is the new Administrator of the Centers for Medicare & Med- icaid Services (CMS), previously known as the Health Care Financing Administration. With me was Cindy Brown, Director of the College’s Division of Advo- cacy and Health Policy. Ken Simon, MD, FACS, a general surgeon who works for the CMS, was also in attendance. Our conversation centered largely on the steep reductions in Medicare payment all physicians are likely to face in January 2002 and on the regulatory burdens they are dealing with. The College has joined a I found Mr. Scully to be very knowledgeable with coalition of more than 50 respect to the controversies surrounding the issue ‘‘ of physician reimbursement. He clearly under- stands the overriding problem, which is a flaw in medical organizations to the law that established the current basis for set- ting the conversion factor that determines Medi- vehemently protest the care payment. We noted that these Medicare reductions are oc- reduction in a conversion curring at the same time that surgeons and other physicians are encountering heightened regulatory factor that is based on and legal burdens. We explained to Mr. Scully that new laws and rules dealing with compliance, emer- unsound legislation... gency room coverage, and so on, place increasing pressures on a surgeon’s practice and responsibil- ’’ ity. Rising liability costs add further financial ing the work values for more than 240 surgical strains. These factors, coupled with falling reim- services. This effort would have culminated in sig- bursement, are simply making practice untenable nificant increases in reimbursement for many pro- for many surgeons and other physicians. Mr. Scully cedures. Unfortunately, much of their achievement recognizes that our concerns are very real, having will be undone by CMS’s recent announcement witnessed the experience of a close friend who is a that there will be a 5.4 percent reduction in the fee surgeon and who retired from practice at age 51 schedule conversion factor for 2002, bringing pay- for all of these reasons.
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