NOVEMBER 2005 Volume 90, Number 11 FEATURES Stephen J. Regnier Editor Paying for quality: Making policy and practice work for patients 8 Shawn Friesen Linn Meyer Director of Surgical lifestyles: Communications Surgeon chronicles Native American history 14 Karen Sandrick Karen Stein Associate Editor Medical liability reform and state law: West Virginia 20 Daniel Foster, MD, FACS Diane S. Schneidman Statement on blunt suture needles 24 Contributing Editor Tina Woelke Graphic Design Specialist DEPARTMENTS Alden H. Harken, MD, FACS From my perspective 4 Charles D. Mabry, Editorial by Thomas R. Russell, MD, FACS, ACS Executive Director MD, FACS Dateline: Washington 6 Jack W. McAninch, MD, Division of Advocacy and Health Policy FACS Editorial Advisors In compliance... 25 with HIPAA’s NPI provisions—Part II Tina Woelke Division of Advocacy and Health Policy Front cover design Future meetings Clinical Congress 2006 Chicago, IL, October 8-12 2007 New Orleans, LA, October 7-11 2008 San Francisco October 12-16 Spring Meeting 2006 Dallas, TX, April 23-26 2007 Las Vegas, NV, April 21-24 2008 To be announced On the cover: Robert H. Ruby, MD, FACS (right), has spent many decades chronicling the histories of Native Americans (see page 14). NEWS Bulletin of the American College of Surgeons (ISSN 0002-8045) is published Kathryn D. Anderson installed as 86th ACS President monthly by the American Col- 28 lege of Surgeons, 633 N. Saint Donald D. Trunkey receives Distinguished Service Award 29 Clair St., Chicago, IL 60611. It is distributed without charge to College names three Honorary Fellows 32 Fellows, to Associate Fellows, to participants in the Candi- Citation for Prof. Bruce Neil Benjamin 32 date Group of the American Gerald B. Healy, MD, FACS College of Surgeons, and to medical libraries. Periodicals postage paid at Chicago, IL, Citation for Prof. Alfred Cuschieri 33 and additional mailing offices. Frederick L. Greene, MD, FACS POSTMASTER: Send address changes to Bulletin of the Citation for Prof. Sergio Pecorelli 34 American College of Surgeons, Karl C. Podratz, MD, FACS 633 N. Saint Clair St., Chicago, IL 60611-3211. Canadian Pub- Young Surgical Investigators lications Mail Agreement No. Conference to be held in March 2006 35 40035010. Canada returns to: Station A, PO Box 54, Windsor, Report of the 2005 ACS Traveling Fellowship to Germany 36 ON N9A 6J5. Joe Hines, MD The American College of Surgeons’ headquarters is ACS issues call for submissions located at 633 N. Saint Clair for 2006 Congress in Chicago 38 St., Chicago, IL 60611-3211; tel. 312/202-5000; toll-free: Disciplinary actions taken 39 800/621-4111; fax: 312/202- 5001; e-mail:postmaster@ Advances in Trauma seminar to be held in Kansas City 40 facs.org; Web site: www.facs. org. Washington, DC, office Trauma meetings calendar 40 is located at 1640 Wisconsin Ave., NW, Washington, DC ACOSOG news: Clinical trials update: 20007; tel. 202/337-2701, fax New trials highlight surgical innovations 41 202/337-4271. Unless specifically stated R. Scott Jones, MD, FACS otherwise, the opinions ex- pressed and statements made NTDB™ data points: in this publication reflect the A-hunting we will go 44 authors’ personal observations Richard J. Fantus, MD, FACS, and John Fildes, MD, FACS and do not imply endorse- ment by nor official policy of the American College of Sur- geons. ©2005 by the American College of Surgeons, all rights reserved. Contents may not be reproduced, stored in a retrieval system, or transmit- ted in any form by any means without prior written permis- sion 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. Space sold by Elsevier From my perspective ike the rest of the nation, we at the American College of Surgeons were deeply saddened by the human toll that Hurricane LKatrina wrought on New Orleans and the surrounding Gulf coast region this summer. In the wake of such enormous tragedy, we simply wouldn’t be human if we didn’t feel a tremendous sense of loss and vulnerability. These feelings of helplessness are particularly frustrating for members of the medical and surgical professions. We are trained to take control when catastrophe, natural or manmade, strikes. To the medical professionals We plunge into the maelstrom and try to salvage as many lives as possible. who fought to save lives under It’s not surprising, therefore, that so many “ physicians, residents, interns, nurses, and even the most grueling and primitive administrative staff stayed at their institutions throughout the hurricane and in its aftermath of circumstances, we extend our to ensure that patients were evacuated safely. I’ve heard several surgeons recount instances in thanks and admiration. which they or their residents dodged gunfire to get patients onto helicopters, worked handheld ventilators to keep children alive, and carried ’’ patients down darkened stairwells on their backs. Such heroics warrant our most profound respect and deepest thanks. We will highlight some of these stories in an upcoming issue of the Bulletin. Despite these individuals’ best efforts, some ripping though the plains) turns into a calamity, patients perished. The September 14 New York people are driven to point fingers and try to find Times reported that staff at Memorial Medical some rational explanation for how the situation Center in New Orleans, where 45 bodies were became uncontrollable. Many of the physicians discovered earlier that week, said they could do who were on site in New Orleans report that little more than comfort patients. Charity and their hospitals were prepared to make it through University Hospitals, both part of the Louisiana a typical hurricane, stocked with enough extra State University system, reportedly did not food, generators, and supplies to last at least have the money to hire helicopter companies to a week. What they weren’t prepared for was evacuate patients. Hence, they were among the the levees breaking and Lake Pontchartrain last to be evacuated and were forced to rely almost overflowing into the city. Moreover, the response exclusively on the military and federal agencies for from federal, local, and state relief agencies rescue activities. The two facilities were unable to was clearly inadequate and too slow. As Simon evacuate their 28 infant patients (18 in intensive Winchester noted in the September 8 New York care) until the morning of the Friday after Katrina Times, “The last time a great American city was hit and the levees broke. A total of 20 bodies were destroyed by a violent caprice of nature, the left behind at the two facilities; 12 of the patients response was shockingly different....” Referring had died before the storm. to the earthquake that upended San Francisco in 1906, killing 3,000 people and leaving 225,000 What went wrong? homeless, Mr. Winchester noted that the entire Whenever an inevitability (such as a hurricane nation responded to the disaster with speed and slamming into the southeast portion of the determination. Troops were quickly dispatched country, an earthquake in California, a tornado into the city to control looters and blast through 4 VOLUME 90, NUMBER 11, BULLETIN OF THE AMERICAN COLLEGE OF SURGEONS some of the wreckage. The mayor requisitioned for cataclysmic events. In addition, our Advanced boats to the Oakland telegraph office to inform Trauma Life Support® course trains health care the country that San Francisco was in ruins and professionals in providing prompt and effective needed help. Relief trains began arriving that care for individuals who are injured or otherwise same night. Congress convened and quickly passed in need of emergency care. legislation to pay all bills. Finally, I am proud to say that the College still At the time of the San Francisco earthquake, plans to hold its 2007 Clinical Congress in New no government-run agencies, such as the Federal Orleans. Many of you have fond memories of the Emergency Management Agency, were in place city, and we have always had a good experience to declare when disaster had struck and how to dealing with the convention center and hotels. By respond. The people of San Francisco reported bringing our meeting there, we will be doing our their dire situation, and the state and federal gov- part to help the city of New Orleans rebuild. ernment heard their plea and acted accordingly. To those individuals who lost family, friends, It was that simple. homes, and livelihoods to Hurricane Katrina, we offer our condolences and solemn wishes for Emerging from the flood better days ahead. To the medical professionals Despite the cripplingly slow pace of relief efforts who fought to save lives under the most grueling in New Orleans, I believe that this historically and primitive of circumstances, we extend our significant and unique city will eventually emerge thanks and admiration. All of you exemplify from this tragedy with the same grace as San that a disaster may demolish buildings and Francisco did nearly 100 years ago. To help the infrastructures but not the human spirit. hurricane survivors—patients and surgeons—the College has been working at several levels. First, Operation Giving Back was in regular contact with the major federal agencies that co- ordinated the response and through an electronic alert to our members provided surgeons with regular updates on how they could offer their Thomas R. Russell, MD, FACS services. Many of you volunteered your time and skills. The College applauds your generosity and compassion. In addition, our Job Bank is helping displaced surgeons find positions elsewhere. Equally as important, the surgical boards’ residency review committees are assisting trainees who need to be placed, at least temporarily, in other programs.