Convention issue:
International Hernia Congress ®
GeneralsurGerynews.Com
The Independent Monthly Newspaper for the General Surgeon J anuary 2012 • V olume 39 • n umber 1
opinion
Spam in a Can b y D aViD C ossman, mD
ACOs: The Latest Experiment In Health Care Delivery First Accountable Care Organizations To Be Unveiled Soon; The Theory: Cost Savings by Pooled Patient Risk, Coordinated Care
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while back, I joined in on a conference call between the American College of Surgeons (ACS) and heads of the surgical specialty societies, including orthopedics, neurosurgery, ENT, vascular and thoracic. On this call (which was open to surgeons of the societies), I could listen but could not speak—a communication format family and friends have recommended I use more often. But nobody said I couldn’t write, so here goes. To my surprise, the atmosphere on the call that night seemed tense. Accountable care organizations (ACOs) and private contracting and balance billing were on the table. The ACS supported the former and opposed the latter, whereas the subspecialty societies lined up unanimously on the opposite side. When it was asked if there was any representative from the specialty societies who supported the ACS’s positions on these issues, the silence, in my opinion, felt long, awkward and deeply meaningful. If nothing else, it begged the question: Why would any surgeon be a member of both a specialty surgery association and the ACS? For those of you who have been
b y G abriel m iller
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pam in a
see aCCountable Care page 7
AMA Delegates Balk at ICD-10 Implementation Docs Voice Frustration: “Burdensome,” “Expensive,” “Worthless”
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EXTENDED HERNIA COVERAGE Pullout Section Page 15
San FranciSco—One in every six American surgeons meets the criteria for alcohol abuse or dependence, according to a new study presented at the 2011 Clinical Congress of the American College of Surgeons (ACS). Of 7,164 surgeons surveyed, 1,112 (15.5%) had scores consistent with alcohol abuse or alcohol dependence. Among women, excess alcohol consumption was even higher: 25.6% of female surgeons screened positive for alcohol abuse or dependence compared with 13.9% of male surgeons. “The results are very compelling; these are high numbers and I would suggest that they are very accurate,” said lead author Michael Oreskovich, MD, clinical professor of psychiatry at the University of Washington, Seattle, and see alCohol abuSe page 11
New Product
b y C aroline h elwiCk
new orleanS—At its 2011 Interim Meeting held in November, the House of Delegates of the American Medical Association (AMA) approved a number of resolutions its members felt would affect patient access to care and the organization’s
Higher Than General Population; Researchers Find Predictors b y C hristina F ranGou
or physicians, one of the most talked about phrases to come out of the Affordable Care Act two years ago has been “accountable care organization” (ACO). As a concept, ACOs represent a change far broader than many other aspects of the health care reform bill, promising to change health care delivery on a systemwide scale. And yet,
EXTENDED see HERNIA COVERAGE S C page 42
Alcohol Abuse High Among Surgeons
own financial bottom line. Delegates voted to “work vigorously” to stop the implementation of ICD-10 diagnostic coding system. The International Classification of Diseases and Related see iCD-10 page 41
ExparEl™ from pacira pharmaceuticals, Inc.
see insert at page 24 and announcement at page 33
exPert APProAches Novel Breakthroughs in Hernia repair see page 18
INSIDE In the News
Surgeons’ Lounge
Torso Gunshot Victims Require at Least 24 Hours of Observation. ................... 6
Case Study of a Difficult Hernia. ....................... 35 Hernia........................
see ”Gut reaction” page 24