member spotlight: larry lilly, md, facsohiofacs.org/wp-content/uploads/2016/09/2007_summer.pdf ·...
TRANSCRIPT
Member Spotlight:Larry Lilly, MD, FACS
Chapter NewsMember Spotlight: Larry Lilly, MD, FACS
2007 Annual Meeting Summary
Dr. Yowler Assumes OCOT Leadership Role
Ohio Chapter Fellows Rated Highly by Peers
Welcome 2007 Ohio Chapter Leadership
District UpdatesSouthwestern District
AdvocacyS-PAC Contributors
S-PAC Contribution Form
From the CollegeStay Up-To-Date, Earn CME Credit by Reading the Surgical Index Each Month
Dr. Reiling Elected President of ACCC
Midwest Surgical Association Annual Meeting
American College of Surgeons 93rd Annual Clinical Congress
Surgery NewsCommunity Colorectal Cancer Screening
Key to Improving Colorectal Cancer Screening: the Family Physician
Cleveland Clinic to Host 2007 Medical Innovation Summit Oct. 1-3
Pumps Someday May Allow Patients to Recover Their Own Hearts Be
a S-
PAC
Contri
buto
r
Editor’s Corner . . . . . . . . . . . . . . . . . . . . . . . 3
Past Presidents’ Listing . . . . . . . . . . . . . . . . . 3
Chapter NewsMember Spotlight: Larry Lilly, MD, FACS . . . . . . . . . . . . . . . . . 4
2007 Annual Meeting Summary . . . . . . . . . . . 5
2007 Membership Application . . . . . . . . . . . 7
Dr . Yowler Assumes OCOT Leadership Role . . . . . . . . . . . . . . . . 8
Ohio Chapter Fellows Rated Highly by Peers . . . . . . . . . . . . . . . . . 8
Welcome 2007 Ohio Chapter Leadership . . 8
District UpdatesSouthwestern District . . . . . . . . . . . . . . . . . . 9
AdvocacyIs Tort Reform Working? . . . . . . . . . . . . . . 10
S-PAC Contribution Form . . . . . . . . . . . . . 11
S-PAC Contributors . . . . . . . . . . . . . . . . . . 12
From the CollegeStay Up-To-Date, Earn CME Credit by Reading the Surgical Index Each Month . . 12
Dr . Reiling Elected President of ACCC . . . 12
Midwest Surgical Association Annual Meeting . . . . . . . . . . . . . . . . . . . . . 13
American College of Surgeons 93rd Annual Clinical Congress . . . . . . . . . . 13
Surgery NewsCommunity Colorectal Cancer Screening . . . . . . . . . . . . . . . . . . . . 13
Key to Improving Colorectal Cancer Screening: the Family Physician . . . . . . . . . 15
Cleveland Clinic to Host 2007 Medical Innovation Summit Oct . 1-3 . . . . . . . . . . . . 16
Pumps Someday May Allow Patients to Recover Their Own Hearts . . . . . . . . . . . . 17
Table of Contents
Ohio Chapter, American College of Surgeons2007-2008 Executive Committee
PresidentLinda M. Barney, MD, FACSWright State University(937) [email protected]
President-ElectChristopher R. McHenry, MD, FACSMetroHealth Medical Center(216) [email protected]
SecretaryW. Scott Melvin, MD, FACSThe Ohio State University(614) [email protected]
TreasurerJoseph James Sferra, MD, FACSToledo Surgical Specialists Inc(419) [email protected]
Immediate Past PresidentWilliam C. Sternfeld, MD, FACSToledo Clinic Inc(419) [email protected]
2007-2008 District Councilors
NortheastVictoria L. Van Fossen, MD, FACS(330) [email protected]
NortheastAnthony Stallion, MD, FACSCleveland Clinic Foundation(216) [email protected]
NorthwestMichael J. Bielefeld, MD, FACSMichael J Bielefeld MD LLC(419) [email protected]
NorthwestPeter F. Klein, MD, FACSTSSI(419) [email protected]
SoutheastJeffrey T. Innes, MD, FACSAdvanced Surgical Techniques(614) [email protected]
SoutheastJ. Allen McElroy, MD, FACSSurgical Associates of Marietta(740) 374-2252
SouthwestAkpofure P. Ekeh, MBBS, MPHMiami Valley Hospital(937) [email protected]
SouthwestCari Ann Ogg, MDThe Jewish Hospital(513) [email protected]
ACS Board of Governors: Ohio Members
Alice Ann Dachowski, MD, FACSHolzer Clinic(740) [email protected]
Robert E. Falcone, MD, FACSGrant Medical Center(614) [email protected]
David N. Linz, MD, FACSCanton General Surgery Associates(330) [email protected]
Michael S. Nussbaum, MD, FACSUniversity of Cincinnati Medical Center(513) [email protected]
Joseph James Sferra, MD, FACSToledo Surgical Specialists Inc(419) [email protected]
Michael E. Stark, MD, FACSToledo Surgical Specialists Inc(419) [email protected]
Ohio Chapter, American College of SurgeonsExecutive Office
Brad L. Feldman, MPAExecutive [email protected]
Pulse is the official publication of the Ohio Chapter, American College of Surgeons. It is published four times a year in Columbus, Ohio as a benefit of membership and circulated free of charge to Ohio Chapter members.
Information appearing in this publication is obtained from sources we believe to be reliable. The information may not be a complete statement of all available data and is guaranteed as such. Conclusions are based solely on editorial judgment and analysis of technical factors and surgical/medical industry information sources. Pulse is copyrighted and portions may be reprinted with the permission of the Ohio Chapter. Pulse is not responsible for the contents of its advertisements and advises all members to investigate claims before making any purchases.
Permission requests to reproduce written material should be sent to:Ohio Chapter, ACSP.O. Box 1715Columbus, OH 43216-1715(877) 677-3227
© Copyright 2007, Ohio Chapter, ACS. All rights reserved.
OhiO Chapter, ameriCan COllege Of SurgeOnS
www.ohiofacs.org
2
OhiO Chapter, aCS paSt preSidentS
Edwin Ellison, MD. . . . . . . . . . . . . . . . . . . . .1957Robert T. Allison, MD . . . . . . . . . . . . . . . . . .1958Byron G. Shaffer, MD . . . . . . . . . . . . . . . . . .1959Jack W. Cole, MD . . . . . . . . . . . . . . . . . . . . .1960Berton M. Hogle, MD . . . . . . . . . . . . . . . . . . .1961Franklin L. Shively, Jr, MD, FACS . . . . . . . . . .1962Stanley O. Hoerr, MD . . . . . . . . . . . . . . . . . . .1963Tom E. Lewis, MD, FACS . . . . . . . . . . . . . . . .1964Walter A. Hoyt, Jr, MD, FACS . . . . . . . . . . . . .1965Warren Wendell Green, MD . . . . . . . . . . . . . .1966Stephen Ondash, MD . . . . . . . . . . . . . . . . . .1967Richard Zollinger, MD . . . . . . . . . . . . . . . . . .1968Tom Morgan, MD. . . . . . . . . . . . . . . . . . . . . .1969C. William Loughry, MD . . . . . . . . . . . . . . . .1970Miles Flickenger, MD. . . . . . . . . . . . . . . . . . .1971Mary M. Martin, MD, FACS . . . . . . . . . . . . . .1972Charles Lovingood, MD . . . . . . . . . . . . . . . . .1973
P.J. Robechek, MD . . . . . . . . . . . . . . . . . . . . .1974Byers Shaw, MD . . . . . . . . . . . . . . . . . . . . . .1975William J. Flynn, MD . . . . . . . . . . . . . . . . . . .1976Tom Kelly, MD . . . . . . . . . . . . . . . . . . . . . . . .1977Robert P. Hummel, MD, FACS . . . . . . . . . . . .1978Robert E. Hermann, MD, FACS . . . . . . . . . . .1979Roland A. Gandy, Jr, MD, FACS . . . . . . . . . . .1980Robert K. Finley, Jr, MD, FACS . . . . . . . . . . . .1981Larry C. Carey, MD . . . . . . . . . . . . . . . . . . . .1982Robert M. Zollinger, Jr, MD, FACS . . . . . . . . .1983William V. Sharp, MD . . . . . . . . . . . . . 1983-1984Sterling W. Obenour, MD, FACS . . . . . . . . . . .1984Rex K. Whiteman, MD . . . . . . . . . . . . . 1985-1986Richard B. Reiling, MD, FACS . . . . . . . . . . . .1987John Peter Minton, MD, FACS, PhD . . . . . . . .1988Richard B. Fratianne, MD, FACS . . . . . . . . . .1989Lawrence H. Linder, MD, FACS . . . . . . . . . . .1990
Sidney F. Miller, MD, FACS . . . . . . . . . . . . . . .1991Josef E. Fischer, MD . . . . . . . . . . . . . . . . . . .1992Juan R. LaCerda, MD . . . . . . . . . . . . . . . . . .1993Dennis Ross Irons, MD, FACS . . . . . . . . . . . .1994Jeffrey L. Ponsky, MD, FACS . . . . . . . . . . . . .1995Ezra Steiger, MD, FACS . . . . . . . . . . . . . . . . .1996Michael A. Flynn, MD, FACS . . . . . . . . . . . . .1997G. William Parker, MD, FACS . . . . . . . . . . . . .1998Mark A. Malangoni, MD, FACS . . . . . . . . . . .1999Margaret M. Dunn, MD, FACS . . . . . . . . . . . .2000Michael S. Nussbaum, MD, FACS . . . . . . . . .2001Joseph P. Crowe, Jr, MD, FACS . . . . . . . . . . . .2002Robert E. Falcone, MD, FACS . . . . . . . . . . . .2003E. Christopher Ellison, MD, FACS . . . . . . . . .2004Michael E. Stark, MD, FACS . . . . . . . . . . . . .2005Gary B. Williams, MD, FACS . . . . . . . . . . . . .2006William C. Sternfeld, MD, FACS . . . . . . . . . .2007
Editor’s CornerBy Jeffrey S. Palmer, MD, FACS, FAAP
This issue of Pulse has several informative articles . In Chapter News, we report
on Dr . Larry Lilly, voted as a top-ranked breast cancer surgeon by central Ohio physicians . There is an announcement that Dr . Charles J . Yowler has assumed the chair of the Ohio Committee on Trauma (OCOT) . Furthermore, the Ohio chapter reports on four Fellows of the Ohio Chapter ranked highly by peers - Dr . Larry Lilly, Dr . William Wise, Dr . Steve Duff, and Dr . John Burgers .
Also included in this issue is a 2007 membership application . Membership to the Chapter is an essential component to the continued success of our society . We provide this application in order to simplify the renewal and recruitment process . In District Update, a report concerning
the aggressive expansion in the market of physician-owned ambulatory surgery centers in Southwestern District of Ohio .
In From the College, The Surgical Index (TSI) is discussed as a means of being an effective and efficient way to identify and stay up-to-date with the highest quality articles in the monthly journal literature and obtain continuing medical education credit . Also, implications of the Trauma Care Systems Planning & Development Act of 2007, H .R . 727 passing are reviewed . Furthermore, Dr . Richard B . Reiling was elected president of the Association of Community Cancer Centers (ACCC) .
Finally, I would like to thank the members of ACS for the positive feedback on the last edition of Pulse. Your comments are appreciated
and considered in order to provide our members with a newsletter that provides essential up-to-date information . Please do not hesitate to contact the Editorial Board of Pulse if you have any articles and/or any other recommendations .
SUMMER 2007 3
Chapter News
In a recent survey of central Ohio physicians conducted by the Columbus Dispatch and
Columbus station WBNS 10-TV, four Fellows of the Ohio Chapter, ACS appeared in a list of top doctors in their specialties . The most recent “Docs Rate Docs” mail survey was conducted from January 15 through February 5, 2007 .
Doctors were asked to whom they would likely refer family members for treatment . This month’s Member Spotlight, voted top-ranked breast cancer surgeon by central Ohio physicians, is Larry J . Lilly, MD, FACS, of Riverside Breast Specialists in Columbus .What is your educational background and experience? B .S ., Electrical Engineering, West Virginia; M .S ., Ohio State University; M .D ., Ohio State University .
Where did you start your career?I started my solo practice at Riverside Methodist Hospital (RMH) in 1980 . How did you become interested in your profession? In the course of my 20-plus years in surgery practice, my patients were more and more breast cancer patients, so I chose to exclusively take care of them .Who were your professional mentors? What did you learn from them?Dr . Bill Knorr, general surgeon at RMH demonstrated a caring attitude
and the amount of time it takes to do it right . Also, Dr . Ron Naille, plastic surgeon at RMH .How did you decide to join your practice? I started my own breast practice in August 2005, to be able to spend the time needed on each patient .What has been your greatest joy in your career? Greatest frustration?During the course of my education and life, God directed me into this path . I’m confident I’m doing what God wants, and with the love and support of my family, that’s my greatest joy . My greatest frustration is insurance companies . And of course, there are never enough hours in the day to accomplish what I want .What do you feel separates you from the “rest of the pack” of physicians or surgeon? In other words, what makes you unique?I do spend a lot of time talking to my patients, answering questions, calling each report and information to them personally . I am totally hands-on in their care, and I’m always learning new things to help my patients .If you were not a surgeon, what other career path(s) would you have taken?Electrical engineer or missionary .In your opinion, what are the biggest issues facing the surgical/medical industry in the next five years?The lack of ability to care for patients in a preferred and timely manner because of restrictions of insurance companies . It seems everything is a struggle dealing with most insurance companies .
What is the most exciting areas/most compelling advancements you’ve experienced within the surgical profession during your career?Electronic medical records! Internet availability to communicate and send answers to patients, technological advances and treatments .Why did you join the Ohio Chapter?To be supportive of my fellow surgeons .How have you applied your roles with the Ohio Chapter to community involvement?I’m involved with multiple committees, groups and boards in the medical community . Beside Ohio Chapter, I’m currently a member of the National Consortium of Breast Centers and of the American Society of Breast Surgeons .What can the Ohio Chapter do for young surgeons? Any advicefor surgeons just getting started?Help them realize the financial returns may not be what they expect, and they should be seriously into medicine to care for the patients .
SUMMER 2007 4
Member Spotlight: Larry Lilly, MD, FACS
SUMMER 2007 5
The Ohio Chapter, American College of Surgeons Annual Meeting, held May 11-12, 2007 at the Westin Great Southern Hotel in Columbus, was another successful event . Following are session summaries from the meeting .Friday, May 11Annual Meeting, Ohio Cancer Liaison Physicians Friday morning’s schedule commenced with the annual meeting of the Ohio Cancer Liaison Physicians, who first discussed the role of the cancer liaison physician in Ohio’s comprehensive cancer control plan . The session exposed fellows to Ohio’s comprehensive cancer control coalition and the coalition’s plan to reduce cancer incidence and mortality in Ohio by 2010 . Presented by Ann-Hilary Hanly, MPA, executive director for Ohio Partners for Cancer Control, Ohio’s comprehensive cancer control coalition .
Next on the schedule was “Improve the Quality of Cancer Patient Care: Are you e-QuIPed?” a session designed to provide clinicians and other healthcare professionals with an understanding of how Commission on Cancer initiatives and NCDB data can help registries evaluate the quality of cancer patient care at their facilities . Presented by Lina Patel-Parekh, MHA, CHE, a cancer quality indicator research analyst at the American College of Surgeons, Commission on Cancer .
The third session of the cancer liaison meeting, “Community Colorectal Cancer Screening: Conception, Implementation and Preliminary Results,” focused on discussion of the formation of a Community Colorectal Taskforce
in a small community with limited resources that have made an immediate and significant impact on colorectal cancer diagnosis in the community . Michael D . Sarap, MD, FACS, general surgeon in private group practice in Cambridge, Ohio for 20 years and an ATLS provider and instructor, presented the session .
The final presentation discussed cancer quality indicators, pay for performance and United Healthcare’s vision for assuring the quality of cancer care . The session, “Cancer Quality Indicators, Pay for Performance and United Healthcare’s Vision,” was presented by Lee Newcomer, MD, director of Oncology Services at United Healthcare Insurance . Ohio Committee on Trauma Meeting
The Ohio Committee on Trauma Meeting covered the following topics: recent political activity; future organization of Ohio COT; a financial report; state Trauma Coordinator update; ATLS statewide report; report on State Trauma Registry; region reports; Level III issues; the Trauma Resident Essay Contest, and website issues . The session was presented by OCOT chair Charles J . Yowler, MD, FACS, FCCM, associate professor of surgery at Case Western Reserve University and Director of the Division of Trauma, Critical Care, Burns and Metro Life Flight, Program Director for the Surgical Critical Care Fellowship and Director of the Comprehensive Burn Care Center at the MetroHealth Medical Center Campus of CWRU .
Resident’s ProgramThe afternoon program for
residents started by covering
the “Transition from Training to Practice .” The session provided a general overview of some major business issues faced upon entering practice after residency or fellowship, including discussing the merits of different practice settings that may be of interest to residents and fellows transitioning to practice . The session also provided some insight into areas that the resident or fellow contemplating entry into practice may want to study in the final months of residency . The session also provided a forum for answering business questions related to starting or joining various practice settings . Presenter was Frederick Cason, MD, an associate professor and residency program director of the Department of Surgery at University of Toledo Medical School .
Next, registered investment advisor James Bailey and financial advisor Randall S . Keller covered “Is There Wealth at the End of the Rainbow?” - a discussion of how medical practice economics are trending toward making life more difficult .
“Resident Education - the Next Generation” was the topic for Richard H . Bell Jr, MD, the assistant executive director of the American Board of Surgery . He discussed how resident education in surgery has come under pressure for a number of reasons within the past five years .Annual Resident Research Forum & Poster Session
The top two finalists in basic and clinical science categories and the recipients of the trauma and cancer awards presented their work during this session . The clinical science winner received the Stanley O . Hoerr Award and the best abstract
Chapter News
2007 Annual Meeting Summary
Continued on page 6
SUMMER 2007 6
on oncology received the John P . Minton Award .
The following are winners for the Resident Essay Contest 2007:
Basic Science, First Prize-Ryan Thomas, MD“RON Receptor Signaling
in Pancreatic Cancer Cells Promotes VEGF Production and is Proangiogenic”
Basic Science, Second Prize-Mubeen Jafri, MD“MAPK Signaling Pathways
Contribute to Rotaviral Induced Cholangiocytic Injury and Viral Replication”
Clinical Science, First Prize-Mubeen Jafri, MD“Procurement Flush with Lactated
Ringer’s Solution Improves Outcomes and Decreases Cost in Adult Ortotopic Liver Transplant”
Clinical Science, Second Prize-Roy Phitayakorn, MD“Incidence of Thyroid Carcinoma
in Patients with Graves’ Disease”Oncology Award-Ryan Thomas, MD“COX-2 Inhibition Reduces
Pancreatic Intraductal Neoplasia in Pdx-Cre/LSL-KRas Mice”General Session: Perspective from the ACS The work day ended with the general session on “Pay for Performance and NSQIP,” presented by Frank George Opelka, MD, FACS, the American College of Surgeons perspective on pay-for-performanc, as well as an update on the quality improvement programs at the College (National Surgical Quality Improvement Program) .Evening with The Rick Brunetta Big Band Ohio Chapter fellows and their guests enjoyed socializing, networking, dinner and entertainment in the ballroom of The Westin Hotel with the Rick Brunetto
Big Band, a popular central Ohio 17-piece orchestra that features the music of the 30’s and 40’s Big Band era on up through the present .
Saturday, May 12Starting the day concurrently
were the Association of Women Surgeons Breakfast and the keynote breakfast presentation .
Keynote Breakfast Presentation“Damage Control Resuscitation:
Directly Addressing the Early Coagulopathy of Trauma,” discussed rapid progress in trauma care made during times of conflict that yield advances in trauma care that translate to civilian practice . This breakfast presentation was sponsored by the Ohio Committee on Trauma, and presented by Colonel John Holcomb, MD . Holcomb has an extensive background in military service as a surgeon, and is currently commander of the US Army Institute of Surgical Research (USAISR) and chief of the Trauma Division at Brook Army Medical Center, San Antonio, TX . Holcomb covered current resuscitation practices and future resuscitation products .Saturday Morning General Session
“The Surgical Management of Obesity” provided a comprehensive review of bariatric surgery, including the unique pre-operative evaluation of the obese patient for surgery and the procedures that are being performed today including traditional and minimally invasive approaches . The session also discussed the unique complications seen after bariatric surgery, outcomes related to weight loss and resolution of co-morbidities, and future treatments . Presented by Bradley Needleman, MD, director of the Bariatric Surgery Program at Ohio State University Hospitals, which evaluates and follows patients through medical and surgical weight loss options .
“Thrombosis Prophylaoxie in Surgical Patients,” a discussion of the incidence, presenting patterns of venous thromboembolism, was presented by Joseph A . Caprini, MD, professor of surgery at the Feinberg School of Medicine, Northwestern University, in Chicago, Illinois . He discussed the many clinical presentations of the disease and the national initiatives such as SCIP and NQF safe practices, and described a risk assessment system for surgical patients .Ohio Chapter Annual Business Meeting During the 52nd Annual Meeting, the new Ohio Chapter officers were installed for the coming year . Congratulations to this year’s officers:President: Linda M . Barney, MD, FACSPresident Elect: Christopher R . McHenry, MD, FACSTreasurer: Joseph J . Sferra, MD, FACSSecretary:W . Scott Melvin, MD, FACSImmediate Past President: William C . Sternfeld, MD, FACSOhio Oration: Medicare and Medicaid Policies, Problems, Changes and the Future This final session focused on Medicare and Medicaid cost containment policies at a time of cutbacks in employer-sponsored health insurance coverage for current employees and retirees . The impacts of the Medicare Modernization Act of 2003 and the Deficit Reduction Act of 2005 were explored, the session discussed the likely future challenges of the Medicare and Medicaid programs . Presented by Sunday E . Ubokudom, MD, associate professor in the Department of Political Science & Public Administration at the University of Toledo .
Chapter News Continued from page 5, Annual Meeting
Please send your completed form to: Ohio Chapter Payment Processing Center P.O. Box 71-3055 Columbus, Ohio 43271-3055 Or fax to (614) 221-2335 The mission of the Ohio Chapter of the American College of Surgeons is to educate its membersand the public about surgical care within the state of Ohio, and to support the mission and goals ofthe American College of Surgeons. Payment of dues or other contributions to the Chapter are not tax deductible as charitablecontributions for income tax purposes. They may, however, be tax deductible as ordinary andnecessary expenses to the extent not allocated to lobbying expenses. The OCACS estimates thatthe non-deductible portion of your dues is 15%. The Ohio Chapter of the American College of Surgeons (OCACS) collects credit card information tomake it easier for you to register for seminars and events online, as well as paying for otherservices. OCACS does not use or share credit card information for any other purpose. We retainsuch information as is needed for standard accounting record keeping requirements. Every step istaken to protect the loss, misuse, and alteration of the information under our control. If you prefer,please use a check or money order to make any necessary payments. Thank you. Taxpayer ID # for Voucher Use Only: 23-7039480 source:op0107
Ohio Chapter, American College of Surgeons 22000077 MMeemmbbeerrsshhiipp AApppplliiccaattiioonn
JJaannuuaarryy 11 –– DDeecceemmbbeerr 3311,, 22000077Telephone: (614) 221-9814
Toll Free: (877) 677-3227Fax: (614) 221-2335
GENERAL INFORMATION (Please print or type) GENERAL INFORMATION (Please print or type)
Name: ________________________________________ Name: ________________________________________
Employer: _____________________________________ Employer: _____________________________________
Work Address: _________________________________ Work Address: _________________________________
City: _________________ State: _______ Zip: ________ City: _________________ State: _______ Zip: ________
Work Phone: _______________ Fax*: _______________ Work Phone: _______________ Fax*: _______________
Web Address: ___________________________________ Web Address: ___________________________________
Preferred Email*: ________________________________ Preferred Email*: ________________________________
ADDITIONAL CONTACT PERSON ADDITIONAL CONTACT PERSON If you have a support person who the Chapter may contact when you are in surgery, please provide his/her information: If you have a support person who the Chapter may contact when you are in surgery, please provide his/her information:
Office Contact: __________________________________ Office Contact: __________________________________
Phone: ________________________________________ Phone: ________________________________________
Gender: Male Female Year Born: ______________ Gender:
Year you became FACS, or Associate Fellow: __________ Year you became FACS, or Associate Fellow: __________
Home Address: __________________________________ Home Address: __________________________________
City: _________________ State: ________ Zip: ________ City: _________________ State: ________ Zip: ________
Home Phone: _______________ Fax*: _______________ Home Phone: _______________ Fax*: _______________
Preferred Mailing Address: Home Work Preferred Mailing Address:
*Fax and/or email will be used for member communications. *Fax and/or email will be used for member communications.
PRACTICE INFORMATION PRACTICE INFORMATION
Primary Practice Type: ___________________________ Primary Practice Type: ___________________________
Primary Practice Specialty: ________________________ Primary Practice Specialty: ________________________
Primary geographic area of Practice: Urban RuralPrimary geographic area of Practice: Urban Rural
TYPE OF MEMBERSHIP
TYPE OF MEMBERSHIP $ 245 Fellow - Must have met all of the requirements and been formally admitted into Fellowship of the ACS.
$ 115 Asso $ 115 Asso
ciate Fellow - Must be recognized by the ACS as an Associate Fellow.
$ 25 Retired - Must have been granted retired status by the ACS.
$ 0 Resident – Residents enrolled in approved surgical residency programs, and surgeons in a surgical research or fellowship program.
METHOD OF PAYMENT METHOD OF PAYMENT
Check # _____________ enclosed (Make checks payable to OCACS.) (Make checks payable to OCACS.)
Please charge my credit card.
____________________________________________ ____________________________________________ Account Number Account Number ____________________________________________ ____________________________________________ Name of Cardholder Name of Cardholder ____________________________________________ ____________________________________________ Authorized Signature Authorized Signature
________/__________ _______________________ ________/__________ _______________________ Expiration date Pin/3-4 digit security code Expiration date Pin/3-4 digit security code
(Located on back of card.) (Located on back of card.)
Address that credit card is issued to: Address that credit card is issued to:
Home Work Other
Other: ________________________________________________________________________________ www.ohiofacs.org Other: ________________________________________________________________________________ www.ohiofacs.org
Male Female Year Born: ______________
Home Work
$ 245 Fellow - Must have met all of the requirements and been formally admitted into Fellowship of the ACS.
ciate Fellow - Must be recognized by the ACS as an Associate Fellow.
$ 25 Retired - Must have been granted retired status by the ACS.
$ 0 Resident – Residents enrolled in approved surgical residency programs, and surgeons in a surgical research or fellowship program.
Check # _____________ enclosed
Please charge my credit card.
Home Work Other
SUMMER 2007 8
Chapter News
Dr. Yowler Assumes OCOT Leadership RoleEffective January 1, 2007,
Charles J . Yowler, MD, FACS, of MetroHealth Medical Center in Cleveland assumed the chair of the Ohio Committee on Trauma (OCOT) . Dr . Yowler was welcomed by previous chair, Jay A . Johannigman, MD, FACS, of Cincinnati at the November 11, 2006 business meeting of the OCOT .
Purpose of the OCOT is to improve all phases of management of the injured patient and to prevent injuries in the home, industry, on the highway, and during participation in sports . Visit the OCOT website at www.traumasystems.org.
The Ohio Committee on Trauma is active in promoting trauma education, advocacy, promotes
trauma research by sponsoring an annual trauma resident research competition, and continues to host ATLS courses . The Ohio COT will continue to play an active role in the development of the trauma system .
The next OCOT meeting is scheduled for October 25-26, 2007 in Akron, Ohio .
In a recent survey of central Ohio physicians conducted by the Columbus Dispatch and Columbus station WBNS 10-TV, four Fellows of the Ohio Chapter, ACS appeared in a list of top doctors in their specialties .
Doctors were asked to whom they would likely refer family members for treatment . Each of the surgeons listed were ranked first in their specialty by fellow physicians:
Specialty Top-Rated Physician . . . . . . . . . . . . . . . . . . . . . . . . . . . . Practice
Breast Cancer Larry Lilly, MD, FACS . . . . . . . . . . . . . . . . . . . . . . . . . . . . Riverside Breast Specialists Colon Cancer William Wise, MD, FACS . . . . . . . . . . . . . . . . . . . . . . Colon & Rectal Surgical Assoc . Lung Cancer Steve Duff, MD, FACS . . . . . . . . . . . . . . . . . . . . . . . . . . . Cardiothoracic & Vascular Surgical Specialists Prostate Cancer John Burgers, MD, FACS . . . . . . . . . . . . . . . . . . . . . . . . Urology Surgeons
The most recent “Docs Rate Docs” mail survey was conducted from Jan . 15 through Feb . 5, 2007 .
Ohio Chapter Fellows Rated Highly by PeersCompiled by Ohio Chapter, ACS Staff
Welcome, Ohio Chapter 2007-2008 LeadershipDuring the 52nd Annual Meeting,
the new Ohio Chapter officers were installed for the coming year . Congratulations to this year’s officers:
President Linda M. Barney, MD, FACS
Dr . Barney is associate professor of general surgery, Division Chief at Wright State University Department of Surgery . She previously served as 2006 president-elect for the Ohio Chapter, and represented Ohio as an alternate on the ACS Board of Governors from 2002-2003 .
President Elect Christopher R. McHenry, MD, FACS
Dr . McHenry is vice chairman of surgery at MetroHealth Medical Center and professor of surgery at Case Western Reserve University . He served as treasurer for Ohio Chapter last year, and was district councilor for the Northeast District from 2002 to 2006 .
Treasurer Joseph J. Sferra, MD, FACS
Dr . Sferra is Assistant Professor at the Medical College of Ohio in Toledo . He represented Ohio on the ACS Board of Governors from 2003 to the present . He served as Northwest District Councilor from 1998 to 2006 .
Continued on page 9
SUMMER 2007 9
District Updates
The Southwestern District of Ohio has been marked by aggressive expansion in the market of physician-owned Ambulatory Surgery Centers (ASC) some with single-specialty others with multiple-specialties . This has significantly impacted operative volumes in traditional hospital settings with attendant results on financial capabilities at these institutions . Some hospital administrations have found ways to partner with the ASCs, others have been outright hostile towards their formation .
The hospitals themselves are also expanding physical plants, service-
offerings and outpatient catchments . It remains to be seen whether the physician and support services exist to staff these expansion efforts .
In Cincinnati the largest hospital consortium, The Health Alliance, is currently engaged in court proceedings that will determine the make-up of the hospital group . Two hospitals have sued the Health Alliance to be allowed to leave the consortium . The typical issues of control and destiny setting are at the heart of the matter . The results will have significant impact on the surgeons, and public in the Greater Cincinnati area .
Robotic surgery is gaining ground in the Southwestern District with many of the larger hospitals installing Da Vinci systems, with some installing several . Prostatectomy, off-pump CABG are the major cases being performed but laparoscopic hysterectomy is increasing .
Other economic concerns are relatively calm at this time, though all are bracing for the inevitable response to the past several years double-digit inflation in health care costs .
Southwestern DistrictBy Elliott Fegelman, MD, FACS, District Councilor
Chapter News Continued Continued from page 8, Welcome
Secretary W. Scott Melvin, MD, FACS
Dr . Melvin is professor of surgery at Ohio State University Medical Center . He served as chair of the Medical Education/Program Committee from 2003 to 2006 .
Immediate Past President William C. Sternfeld, MD, FACS
Dr . Sternfeld has a general surgery practice in Toledo, served as Ohio Chapter president last year, and represented Ohio on the ACS Board of Governors from 2001 to 2004 .
SUMMER 2007 10
Advocacy
On The Ohio Chapter of the American College of Surgeons diligently worked to help enact tort reform in Ohio . The Ohio General Assembly passed significant legal changes almost four years ago . In the past, the Ohio Supreme Court has overturned tort reform laws . The current Ohio Supreme Court has yet to be asked to review the current law . However, the makeup of the current bench seems to take an interpretive view of the law as opposed to a legislative view as the previous court .
Have these new laws had an effect on medical liability in Ohio? The Toledo Bar Association and St . Luke’s Hospital in Maumee recently sponsored a joint meeting to address this question . Speakers included several attorneys from the Toledo area including one who served on the nine-member Ohio Medical Malpractice Commission . Two representatives from the Liability Insurance Industry spoke . Andrew Thomas, MD, MBA, Assistant Dean for GME at Ohio State University also spoke on Disclosure of Adverse Outcomes . Maureen Motter of the Ohio Department of Insurance presented data based on the 2005 closed claims data reported to Ohio Department of Insurance as now required by law .
In Lucas County, medical malpractice case filings have dropped from 190 in 2003 to 85 in 2006 . As of April 30,2007 there were 33 cases filed, a 56 percent decrease in filings since tort reform was enacted . Of the 553 cases filed between 2003 and
2006, 82 .8 percent have been closed; 33 (6 percent of cases filed) went to trial with a verdict for the plaintiff 7 times (21 .2 percent) . The jury awards were from about $290,000 to $10,000,000; 101 cases (21 .2 percent) were settled before going to trial, 324 (58 .6 percent) were dismissed with no payment .
Cases filed in Lucas County between 2003 and 2006 resulted in 63 .3 percent that were closed with no payment to the plaintiff so far . For 2003, of the 190 cases filed, 189 are closed with no payment in 74 percent . So far for 2006, of 85 cases filed, only 32 are closed with no payment in 84 percent . The data of closed claims for all Ohio in 2005 can be found on the Ohio Department of Insurance web site (www.ohioinsurance.gov g Medical Malpractice) .
The plaintiff’s attorney who was on the commission said it is much harder to take medical liability cases . He stated that the number of claims that come to attorneys have not decreased . However, the number filed has decreased because of the new laws . Smaller claims are more costly to pursue and the requirement for an Affidavit of Merit makes filing more difficult . Of course, this was the intent of the law, to keep cases with no merit out of the court system . Legal firms have redirected resources to other areas of law, away from medical liability cases .
So has tort reform accomplished its goal? From the data, it appears to
be a resounding YES . However, the book is not closed on this matter . The laws of 2003 have yet to be court challenged . The makeup of the Ohio General Assembly can always change . The legal profession continues to lobby to overturn the laws . This is why the Ohio Chapter needs to continue to be involved in the process . We need to continue our close relationship with our elected officials . We need to continue to support our political action committee, our S-PAC (see page 11 for an S-PAC contribution form) . We need to be involved in our legislative activities and visits to the State House . 2008 is a general election year and the Ohio Chapter and surgeons of Ohio need everyone to be involved .
The Chapter’s Advocacy and Health Policy continues to monitor and weigh in on current legislation . Our advocate consultants, Capitol Consulting with Dan and Belinda Jones are working hard for our and our patients’ benefits . To become more involved, please contact the Ohio Chapter by phone at (877) 677-3227, or by email at [email protected].
Michael E. Stark, MD, FACS, is currently chair of Ohio Chapter’s Advocacy and Health Policy Committee, served as chapter president in 2004-2005 and represents Ohio Chapter on the ACS Board of Governors.
Is Tort Reform Working?By Michael E. Stark, MD, FACS
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Name:
Employer
Home Address*:
City/State/Zip:
Daytime Telephone #:
Email:
* State law requires a home address. Post office boxes are not permitted.
Please check yourmethod of payment:
□
□Make PERSONAL check payable to
Ohio Chapter S-PAC.
Credit card information below.
Personal Check
Credit Card
Complete form and return to:Ohio Chapter S-PAC, CP1152
P.O. Box 1715Columbus, OH 43216-1715
Important tax information: S-PAC contributions may not be deducted as business or personal deductions for income tax purposes.
If paying by credit card, pleasecomplete all information and sign authorization statement before returning.
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Account Number:
Expiration Date:
Billing Street Address & Zip:
Security Code (3 digits on back of card):
Name on Card:
Credit Card Payment Method(personal credit cards only):
□□□□
VISA
MasterCard
American Express
Discover
When paying with a PERSONAL credit card, the following paragraph must be read and a signature is required or the registration will not be accepted.By submitting this contribution form, I hereby direct and authorize the Ohio Chapter, ACS to charge my S-PAC contribution to my personal credit card as directed above and hereby declare that the credit card used for this transaction is a personal credit card and not a corporate credit card.
Credit Card Information
_______________________________________________________________
_______________________________________________________________ _______________________________
Monthly/Quarterly Contribution
Personal Information
When paying with a personal credit card, you have the option to make a regular contribution to Ohio Chapter S-PAC, either monthly or quarterly. Please select the appropriate box below and write in the amount you would like to have deducted. In addition, you must read and sign the agreement below, authorizing Ohio Chapter, ACS to process your payment as indicated. Please note that all regularly processed contributions will be handled at the beginning of each month. If your personal credit card information should change at any time, please notify Ohio Chapter S-PAC at (877) 677-3227.
I would like to contribute $___________ to the Ohio Chapter S-PAC on a: □ monthly basis □ quarterly basis
When making regular contributions, the following paragraph must be read and a signature is required or the registration will not be accepted.By signing below, I authorize the Ohio Chapter S-PAC to process the credit card information given below for the amount and time intervals indicated above. I understand that I must provide Ohio Chapter, ACS with written notice to cancel any regular contributions, and that Ohio Chapter S-PAC will immediately place a stop on my regular contributions before the next contribution interval.
_______________________________________________________________ _______________________________Signature: Date:
Print Name:
Signature: Date:
The Ohio Chapter, ACS collects credit card information to make it easier for you to register for seminars and events online, as well as paying for other services. The Ohio Chapter, ACS does not use or share credit card information for any other purpose. We retain such information as is needed for standard accounting record keeping requirements. Every step is taken to protect the loss, misuse, and alteration of the information under our control. If you are uncomfortable or wary, please use a check or money order to make any necessary payments. Thank you.
YES! I want to contribute to the Ohio Chapter Political Action Committee Fund.
□ Gold Level PAC Contributor - $1,000 □ Silver Level PAC Contributor - $500 □ Bronze Level PAC Contributor - $250
□ General PAC Contributor - $125 □ Monthly/Quarterly Contribution (See below) □ Other PAC Contribution Amount: $__________
SUMMER 2007 12
Advocacy
From the College
Stay Up-To-Date, Earn CME Credit by Reading The Surgical Index Each Month
The Surgical Index (TSI) is dedicated to providing surgeons with an effective and efficient way to identify and stay up-to-date with the highest quality articles in the monthly journal literature, particularly those items that are most relevant to their practices and clinical learning needs . Surgeons are able to scan the monthly selected titles, identify relevant topics, review the abstracts, and decide whether to consult the full text articles for additional reading and possible application to practice . Monthly use of TSI and the associated links helps surgeons maintain a broad base of current knowledge in general surgery .
Surgeons who use TSI may obtain continuing medical education (CME) credit each month by reading the abstracts that are identified as carrying credit, achieving a score of 100 percent (with unlimited attempts) on a short post-test, completing a brief evaluation form, and submitting the results online . The American College of Surgeons
is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians and designates this educational activity for a maximum of 0 .5 AMA PRA Category 1 Credits(tm) (per abstract) . Details on the CME program for The Surgical Index can be found at http://www.facs.org/tsi/cme.html.
Dr. Reiling Elected President of ACCC
Richard B . Reiling, MD, FACS, was elected president of the Association of Community Cancer Centers (ACCC) during the organization’s annual meeting on March 30 . A cancer survivor himself, Dr . Reiling intends to make survivorship the central issue of his ACCC presidency . He also plans to assist community cancer programs and oncology practices in meeting the challenges of ensuring access to comprehensive cancer care for patients and engaging in outcomes analysis .
Dr . Reiling is the medical director of the Cancer Center at Presbyterian Hospital, Novant Health, in Charlotte, NC, and is active surgical
staff at Presbyterian Hospital and Presbyterian Matthews . He has served as a leader on a number of committees of the American College of Surgeons and has been accorded the College’s highest honor - its Distinguished Service Award . Dr . Reiling has also been a surveyor and a member of the College’s Commission on Cancer and a member of the Commission’s Standards Development Subcommittee . He is a former ACS Governor, representing Ohio, and is a Past-President of the Ohio Chapter . Dr . Reiling currently chairs the College’s Committee on Development .
Continued on page 13
On behalf of the Ohio Chapter, thank you to all members who have contributed to S-PAC in the past twelve months .
Gold Level ($1,000 +)
Silver Level ($500 - $999)Margaret M . Dunn, MD, FACSWilliam C . Sternfeld, MD, FACSGary B . Williams, MD, FACS
Bronze Level ($250 - $499)Michael J . Bielefeld, MD, FACS
Richard A . Falcone, MD, FACSRobert E . Falcone, MD, FACSRandall W . Franz, MD, FACSChristopher A . Grove, MD, FACSJay A . Johannigman, MD, FACSJames Merlino, MDPeter Muscarella II, MD, FACSMunier Nazzal, MD, FACSMichael S . Nussbaum, MD, FACSAmy B . Reed, MD, FACS
General Level (Under $250)Linda M . Barney, MD, FACS
Alice Ann Dachowski, MD, FACSChristopher A . Grove, MD, FACSJohn A . Howington, MD, FACSPeter F . Klein, MD, FACSHoward S . Madigan, MD, FACSMark A . Malangoni, MD, FACSChristopher R . McHenry, MD, FACSW . Scott Melvin, MD, FACSMichael Duke Sarap, MD, FACSJohn H . Raaf, MD, FACSBethanne Snodgrass, MD, FACSMichael James Walker, MD, FACS
Thank You S-PAC Contributors
SUMMER 2007 13
From the College Continued from page 12
Midwest Surgical Association Annual Meeting
The Midwest Surgical Association Annual Meeting will be held August 5-8, 2007 at the Nemacolin Woodlands Resort & Spa, Farmington, Pennsylvania . For more information regarding the Midwest Surgical Association, visit www.midwestsurg.org.
American College of Surgeons 93rd Annual Clinical Congress - October 7-11
American College of Surgeons will present its 93rd Annual Clinical Congress, October 7-11, 2007, at the Ernest N . Morial Convention Center, New Orleans, LA . Registration is scheduled to open in mid-June .
Registration and course fees will be available at that time . For more information, visit the website, www.facs.org/clincon2007/index.html.
Surgery News
Screening tests for colorectal cancer have been clearly proven to decrease the incidence of
the disease and also facilitate the diagnosis at earlier stages . It is also well documented that the rates of screening in the appropriate at-risk population remain below expected levels . Only 20 states mandate that insurance companies cover the cost of screening colonoscopies . Even those individuals whose insurance will cover the testing fail to take advantage of these potentially life-saving exams .
The Ohio Cancer Incidence Surveillance System administered by the Ohio Department of Health identified several counties in Ohio that showed higher percentages of late stage diagnosis of colon and rectal cancer from data collected during 1999-2003 . The ODH and the American Cancer Society met with taskforces from each of these 23 counties in early 2005 to investigate techniques that might increase
screening and earlier diagnoses in their communities . Each county taskforce would then go on to
address the problem in the most efficient manner for their individual communities . See figure 1.
The Guernsey County Colorectal Taskforce was formed and began work early in 2006 . The mission was to raise awareness of the significance of colorectal cancer and to enhance early detection by disseminating information and mobilizing community resources . The vision was to decrease colorectal cancer incidence and mortality in
Southeastern Ohio and improve the quality of life for all colorectal cancer survivors . A slogan was developed entitled “Face the Bear Facts: Colon Screenings Save Lives” . Team members included the Cancer Registrar and Cancer Program Administrator, nurses from various hospital departments, representatives from the American Cancer Society and local Health Department, local physicians and surgeons, a marketing department specialist and a cancer survivor . The taskforce included the CEO and the VP of Medical Affairs of the local hospital, Southeastern Med, signifying the importance placed on the initiative by local health care providers . Two representatives of National City Bank served on the taskforce for community support .
Guernsey County geographically sits on the edge of Appalachia . Six of the counties in our region have no hospitals . Southeastern Med has 90 acute care beds, 75 physicians on staff and has strived to be a regional center in this very rural area . Our Cancer Program has been accredited
figure 1. Cancer of the Colon & Rectum Diagnosed at Late Stage in Ohio
Community Colorectal Cancer ScreeningBy Michael D. Sarap MD, FACS, and Becky Wheeler CTR
Continued on page 14
since 1991 and we are an ACS verified Level III Trauma Center . Three general surgeons cover
the trauma, oncology, vascular and thoracic services and also provide all endoscopic support for the hospital . See figure 2.
The colorectal initiative received excellent community support in the form of various grants and donated time and services . Grants and donations were obtained from the American Cancer Society, Wal-Mart, the Kiwanis Foundation, National City Bank, Ohio Department of Health and The OSU Department of Pathology . Multiple physicians donated time and services . A private video company produced an award winning educational video at no cost to the taskforce .
The taskforce concentrated its efforts in three general areas . These were physician education, community education and concerted efforts to provide screening tests to the public in the form of free Hemawipe tests and reduced cost and no cost colonoscopies to those patients with financial difficulties . Primary care offices were visited and ACS screening guidelines were made available, posters and pamphlets were offered and the Blue Sticky Note Project (ODH involvement) was instituted to encourage conversation about screening tests between
physicians and patients . Community education efforts included four billboards, radio spots, direct postcard mailings to 10,500 households in five counties, and newspaper articles . The previously mentioned video documented the hospital CEO undergoing an actual colonoscopy . National City Bank allowed displays in their bank lobbies, presentations were made to all local service clubs, brochures were sent with the Senior Citizen Center Meals on Wheels and a Theater ad reached 130,000 patrons in 12 months .
The multiple initiatives prompted nearly 300 calls to our cancer
program administrator for more information, to acquire Hemawipes or to arrange an interview with our financial counselors for the reduced cost or free colonoscopy . Fifty colonoscopies were carried out with most being totally free, including the physician, hospital and pathology fees .
The taskforce efforts resulted in a modest 5% increase in colonoscopies for 2006 but polyp detection increased by 25% . The total number of cases of colorectal cancer diagnosed rose 50% (2005-27 cases, 2006-40 cases) since the formation of the taskforce and its initiatives!! More than double the number of Stage I cases were found (5 to 11) in the same time period . See figures 3 and 4.
During the first four months of 2007 the initiatives have continued . The taskforce has just received notice of additional grant money and has decided to use part of the funds to include informational brochures in the local newspapers of Guernsey and several surrounding counties . Colonoscopy numbers continue to trend upward as do the numbers of polyps being removed in comparison to 2005 and before the colorectal cancer taskforce began its work . If the pace continues, 2007 will show colonoscopies up 10% and polypectomy cases up 40% . More importantly, of the nine cases of colorectal cancer diagnosed in 2007, only one patient has been found at surgery to have positive lymph nodes . Two patients with rectal cancer are receiving neoadjuvant chemotherapy and radiation prior to planned surgery and pathologic staging .
Clearly, in our small community there has been a definite improvement in awareness of colorectal cancer
SUMMER 2007 14
Surgery NewsContinued from page 13, Community
figure 2. Ohio EMS/Trauma map
The Bottom Line Colon cancer diagnosis by year at Southeastern med:
Year Total Number 2003 30 2004 27 2005 27 2006 40
The total number of cases of colorectal cancer diagnosed has risen about 50 percent since the formation of the taskforce and its initiatives.figure 3. The Bottom Line
stage 2005 2006 no. % no. % 0 4 14.8% 2 5.0% I 5 18.5% 11 27.5% II 7 25.9% 9 22.5% III 9 33.3% 12 30.0% IV 2 7.4% 6 15.0%
figure 4. Stage at Diagnosis
Continued on page 15
screening and real progress in decreasing late stage diagnoses .
Michael D. Sarap, MD, FACS, is a general surgeon in private group practice in Cambridge, Ohio for 20 years doing general, vascular, trauma, and oncologic surgery and
endoscopy. He is also an ATLS provider and instructor, chairman of Southeastern Medical Trauma and Cancer Committees and serves on Board of Trustees. He serves on Ohio ACS Trauma, Community Hospital and Applicant Committees.
Becky Wheeler, CTR, is a Certified Cancer Registrar who collects cancer management data and annually follows every living patient in the cancer data center for Southeastern Ohio Regional Medical Center.
Surgery NewsContinued from page 14, Community
SUMMER 2007 15
I am active in the Ohio Colorectal Cancer Coalition as a member of the executive committee and as chairman of the Literacy/Disparities Taskforce . The Literacy/Disparities Taskforce after research and discussion felt that the key to improving colorectal cancer screening is the family physician .
The barriers that the family physician faces in this endeavor break out into the following array: •Patientsusuallypresentwith acute problems not for colorectal screening . So how do you broach the subject of colorectal cancer screening? How is the problem of competing priorities to be addressed? •Howdoyousetupoffice protocols and charting to identify patients that should have colorectal cancer screening (anyone over age 50) and alert the physician to address colorectal cancer screening? This needs to be done simply, efficiently and with minimal demand on physician/staff time and resources . •Howdoyouaddresscolorectal cancer screening in a comprehensible and acceptable manner to the patient? •Whatcolorectalcancerscreening methods should you offer the patient, since there is an
array of screening modalities with variable sensitivities, specificities, inconveniences, compliance barriers, reimbursement barriers, access barriers, etc .? •Howdoyouincorporateallthis into the time constraints of an office visit?
The Literacy/ Disparities Taskforce using Ohio Department of Health, American Cancer Society and other resources simplified protocols to essential elements and designed materials for the physician, office staff and patient with an emphasis on colonoscopy (not excluding other screening modalities) . The Literacy/Disparities Taskforce then designed a research project to evaluate the protocol with Michelle Shipp, MD, Department of Epidemiology, Ohio State University . An earnest attempt was made to recruit family physicians to participate in this colorectal screening project . Physician comments as to the utility of the protocol were as follows: •Physicianshaveelectronic medical records with prompts to address screening •Physicianhavenoelectronic medical records but always address colorectal cancer screening
A small informal study was conducted at my facility to gain an understanding of the process . Physicians felt they were addressing all colorectal cancer screening at a rate of 100 percent . Hospital employees in my community are cared for by local physicians and reported that any cancer screening offering was 25-40 percent . Colorectal cancer screening in Ohio according to the Behavioral Risk Factor Surveillance System 2004 is 25 percent FOBT and 53 percent sigmoidoscopy/colonoscopy . But the proof of effective colorectal cancer screening is in the outcomes of screening i .e . there should be a preponderance of Stage 0 and Stage I colorectal cancer in our treatment data . Ohio’s data from the National Cancer Data Base 2000-2004 shows that Stage O and Stage I cases make up eight percent and 19 percent, respectively, of the Stage distribution for 50-59 year old colorectal cancer patients, which are the prime screening group .
The best state data comes from Connecticut, 14 percent are Stage O and 20 percent are Stage I . From this data it appeared to me that Connecticut had an effective colorectal cancer screening program . I contacted the Connecticut Department of Health requesting
Key to Improving Colorectal Cancer Screening: the Family PhysicianBy Valeriy Moysaenko, MD, FACS
Continued on page 16
SUMMER 2007 16
Surgery NewsContinued from page 15, Key to Improving
Cleveland Clinic will host its annual Medical Innovation Summit, an international gathering of health care, business and media leaders to examine trends in medical innovation and cardiovascular technologies, Oct . 1-3 . The 2007 Medical Innovation Summit will offer unparalleled insight into the driving forces in the world of medical innovation .
The 2007 Medical Innovation Summit will feature:
Nationally Recognized Speakers and Panelists Confirmed speakers include: • KerryClark,CEO& President, Cardinal Health •StephenHemsley, President & CEO, United HealthCare Group •SidneyTaurel,Chairman& CEO, Eli Lilly and Company •TonyZook,ExecutiveVice President North America, and President & CEO, AstraZenecaUS •ChristineA.Poon,Vice Chairman, Worldwide Chairman, Medicines & Nutritionals, Johnson & Johnson
•BillCook,Founder, Cook Medical •JohnCapek,Ph.D.,Senior Vice President, Abbott Vascular •TimJohnson,M.D., ABC News •BarnabyFeder, New York Times •JoanneSilberner,NPR •SteveSternberg,USAToday •MichaelMcCurry,Partner, Public Strategies Washington •RichFerrari,Managing Director, De Novo Ventures •EdKania,ManagingPartner and Chairman, Flagship Ventures •HarryRein,GeneralPartner, Foundation Medical Partners •WaleedHassanein,M.D., Founder, President & CEO, TransMedics •MikeBerman, Berman Medical •SidneyCohen,M.D.,Ph.D., Cordis Corporation •FredMoll,M.D.,Founder& CEO, Hansen Medical •GaryBecker,Ph.D.,Nobel Laureate, University of Chicago
•MichaelMussallem,Chair- elect, Adva Med; CEO, Edwards LifeSciences •ElizabethNabel,M.D., Director, NHLBI/NIH •BarryColler,M.D., Vice President, Medical Affairs, Rockefeller University •JudahFolkman,M.D., Director, Vascular Biology, Children’s Hospital Boston •BillHawkins,CEO, Medtronic •BillHarrington,Partner, Three Arch Ventures •BonnieLabosky,CEO, Cardiac Concepts •C.RandallMills,CEO,Osiris •GeorgeBuckley, CEO & President, 3M
A complete list of speakers is available online at www.clevelandclinic.org/innovations/summit/. •“Top10”HealthCare Innovations Cleveland Clinic experts will announce and discuss their second annual selection of
Cleveland Clinic to Host 2007 Medical Innovation Summit Oct. 1-3From the Cleveland Clinic
information on their colorectal cancer screening program . I was informed that Connecticut physicians had made a commitment and set up programs to provide colorectal cancer screening to all citizens regardless of reimbursement status .
It seems that a commitment to address colorectal cancer screening effectively and to provide colorectal cancer screening regardless of
reimbursement status should at least raise our rate of Stage O colorectal cancer from eight percent to Connecticut’s level of 14 percent . This would also greatly reduce the morbidity and mortality of colorectal cancer in our state . Effective colorectal cancer screening programs would also reduce the incidence of colorectal cancer through the removal of colonic polyps .
Are Ohio physicians capable of this type of commitment?
Valeriy Moysaenko, MD, FACS is a general surgeon and a Fellow of the American College of Surgeons, and an associate clinical professor of surgery at Wright State University.
Continued on page 17
Surgery NewsContinued from page 16, Cleveland Clinic
the “Top 10” medical innovations they expect to have a significant impact in 2008 . •LiveSurgeries Two live, interactive surgeries will illustrate what is at stake for those affected by cardiovascular disease . Surgeries will be broadcast in the MBNA Conference Center of the InterContinental Hotel Cleveland each morning at 7:30 a .m .
This marks the fifth year Cleveland Clinic has hosted this international gathering of industry decision-makers to dissect advances revolutionizing health care and accelerate the application of life-saving cardiovascular technologies . The 2007 Medical Innovation Summit will draw 900 industry executives, entrepreneurs, venture capitalists and clinicians who will focus on the medical, technological and economic trends . Also featured will be the Cleveland Clinic’s annual
selection of the “Top 10” health care innovations, live, interactive surgeries and in-depth debates on industry challenges .
The Summit opens Monday, Oct . 1 at 3 p .m . with remarks by Delos M . “Toby” Cosgrove, M .D ., CEO and President of Cleveland Clinic . The world-renowned Cleveland Orchestra, led by Franz Welser-Mˆst, will perform at the opening night gala .
CCF Innovations, the commercialization and innovation arm of Cleveland Clinic, organizes the Medical Innovation Summit, promotes innovation and is responsible for commercialization of all Cleveland Clinic technologies . CCF Innovations advances product-oriented innovation and transforms promising therapies, devices and diagnostics into beneficial medical products, via spin-off companies, licensees and equity partnerships .
Cleveland Clinic, located in Cleveland, Ohio, is a not-for-profit multispecialty academic medical center that integrates clinical and hospital care with research and
education . Cleveland Clinic was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation . U .S . News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey . Approximately 1,800 full-time salaried physicians and researchers at Cleveland Clinic and Cleveland Clinic Florida represent more than 100 medical specialties and subspecialties . In 2006, there were 3 .1 million outpatient visits to Cleveland Clinic . Patients came for treatment from every state and from more than 80 countries . There were more than 53,000 hospital admissions to Cleveland Clinic in 2006 . Cleveland Clinic’s Web site address is www.clevelandclinic.org.
For more information on the Medical Innovation Summit, including the agenda, please visit http://www.clevelandclinic.org/innovations/summit/.
SUMMER 2007 17
An injured athlete can rest on the couch to recover before returning to sports, but an injured heart doesn’t have the same luxury - at least not yet .
One Ohio State University Medical Center surgeon predicts that within 10 years, mechanical support devices for the heart will be put to use temporarily to allow a damaged heart to rest and recover itself . Right now, such heart pumps,
known commonly as ventricular assist devices, or VADs, are typically used as bridges to transplant and in some cases as long-term therapies for chronically ill patients .
“I see this as a huge potential therapy for many heart failure patients who will have the opportunity 10 years from now to recover their own hearts,” says Dr . Benjamin Sun, chief of cardiothoracic surgery at Ohio
State’s Medical Center and director of cardiac transplantation and mechanical support .
Why is he so confident? Because he and other physicians have seen the kind of heart healing a VAD can provide . Functioning essentially as surrogate pumps for the heart, the devices have been used for years to help patients who are poor candidates for transplantation regain enough physical and nutritional
Pumps Someday May Allow Patients to Recover Their Own HeartsReprint From The Ohio State University Hospitals Division of Cardiothoracic Surgery
Continued on page 18
Surgery NewsContinued from page 17, Pumps Someday
health to make them strong and successful transplant recipients .
These early patients’ experiences demonstrated that for some, the pumps could be better therapy than a transplant, Sun said . “This became the jumping-off point for patients who were not good candidates for transplantation . Some people now can go home with these pumps for years and live a very good quality of life . And they can be walking around in public without anyone knowing they have a pump .”
Ohio State’s Medical Center has one of the largest and most successful cardiac mechanical support programs in the country, currently managing patients with 10 different types of mechanical support devices (including a total artificial heart), and slated to participate in a worldwide study of a new, apricot-sized investigational device in early 2007 .
The devices differ in size and portability - some patients on VADs must remain hospitalized while others are able to live at home with the implanted devices and an accompanying power pack . Why so many? “We don’t have the perfect pump for every indication now . We use a variety of pumps for very different diagnoses,” Sun says .
The pumps’ functions also differ, depending on patient need . Some provide volume displacement, meaning they squeeze blood out of the heart chambers; others operate on a high-speed rotor to provide a continuous flow of blood . The latest generation of VADs operate with magnetic levitation bearings to move blood, meaning the parts never touch each other, which results in a potentially lower risk for clots and less wear on the device itself .
The Ohio State program’s strength and size is largely attributable to its status as an academic medical center .
“As an academic institution we are not married to a single manufacturing company or a single device . We have a strong desire to participate in the future of the field . We analyze the devices and compare them in an unbiased environment,” Sun said .
In animal studies, researchers at Ohio State are using the devices to exercise the heart to see if recovery can be achieved in a chronically ill heart . “For people after an acute attack, we definitely can use devices on them and see recovery . But for people with multiple heart attacks, cardiomyopathy or chronic heart failure, we are still trying to determine whether we can mechanically support them, and
recover the heart after the pump gives their heart a rest,” Sun said . “We do see people’s hearts getting stronger with these pumps, but so far they’re not strong enough to come off the pump .”
Researchers also are exploring whether the devices could be combined with stem cell transplants or gene therapy . And there is still a lot to learn about the heart function itself .
“We understand the damage that occurs to the heart during and after a heart attack . But with other causes of damage, such as chemotherapy and some viruses, we don’t know how to stop or reverse that damage, or even what molecular or cellular mechanism caused the damage in the first place,” Sun said . “We’re hoping we’ll reach a point where mechanical support can rest the heart while we learn what’s going on and can intervene to make the heart better . We could then take all the hardware out, letting the patient walk away from this with their heart truly ‘recovered .’”
Reprinted with permission from the Ohio State University College of Medicine Division of Cardiothoracic Surgery website. For more information, visit http://surgery .osu .edu/cardiothoracic/index .cfm
SUMMER 2007 18
NEW! Ohio Chapter Discussion ListsThe Ohio Chapter Executive Office staff has been working behind the scenes to implement online Discussion Lists as an additional member benefit . A ‘Listserv’ is an online forum that allows you to communicate interactively with other Ohio Chapter fellows via email or through a web page . The Executive Office is currently conducting testing of the
new Listservs and will launch this new service very soon .
Lists Available on the New Ohio Chapter Listserv include:
Young Surgeons • General Discussion
Watch for a special E-News, on www.ohiofacs.org and in an upcoming issue of Pulse for complete details on how to access and use the new Listservs .