Surgery News - August 2007 - (Page 1)

VOL. 3 • NO. 8 • AUGUST 2007 SURGERY NEWS THE OFFICIAL NEWSPAPER OF THE AMERICAN COLLEGE OF SURGEONS VIVIAN E. LEE/ELSEVIER GLOBAL MEDICAL NEWS Fatalism Impedes Surgery for Early Pancreatic Cancer Missed opportunities for resection. BY DIANA MAHONEY INSIDE Drug Developments Breast Test A new lab assay detects breast cancer that has metastasized to nearby lymph nodes. • 8 News From the College Else vier Global Medical Ne ws The time-bound milestones required of a surgical resident make family planning “a tough nut to crack,” said Dr. Patricia Turner. Women Across Cultures Share Career Obstacles B Y M I C H E L E G. S U L L I VA N Else vier Global Medical Ne ws lthough women surgeons in different parts of the world are influenced by their unique cultures, they share the drive to take on challenges and overcome anything that might impede their success. Interviews with women surgeons from Germany, Italy, Kuwait, and the United States revealed that despite differences in culture, age, training, and specialties, they have experienced many of the same kinds of biases throughout their careers. All of the demands for respect that have marked her 42-year career have been worth it, said Dr. Liselotte Mettler, who trained at A the University of Kiel (Germany), under the auspices of Dr. Kurt Semm, the father of modern laparoscopic surgery. “There have been many stones in my path, but every extra fight to become better than others improved my own ability and capacity,” said Dr. Mettler, professor of obstetrics and gynecology at Kiel. “To achieve my position as professor, I had to work twice as hard as any of my male colleagues.” Dr. Mettler not only learned pioneering laparoscopic techniques, but outperformed some of her male colleagues and raised three children. Those were not easy years, she recalled. “Just to be able to do surgery in those See Obstacles • page 14 pervading sense of pessimism about pancreatic cancer and its treatment may partly explain new data showing that more than half of eligible patients with operable, early-stage pancreatic adenocarcinoma do not undergo surgical resection, even though such treatment is the only opportunity for cure, according to investigators. Of 9,559 patients with potentially resectable clinical stage I pancreatic tumors identified through the American College of Surgeons National Cancer Data Base (NCDB) between 1995 and 2004, approximately 71% did not undergo pancreatectomy, including 54% for whom there was no documented or identifiable reason for not having the surgery, wrote Dr. Karl Y. Bilimoria of Northwestern University, Chicago, and his colleagues in an ahead-of-print Annals of A Surgery article released online in June. Referring to the findings as evidence of a “striking underuse” of potentially life-extending surgery, the authors blamed the deficit primarily on “nihilistic attitudes toward the disease” among patients, referring physicians, and some surgeons. While a clear reason for not pursuing surgery was noted for approximately 19% of the patients, 38% of the remaining patients with potentially resectable tumors “were simply not offered surgery,” and no reason was given for the other 14% of patients, the authors wrote. In the 19% of patients for whom a clear reason was noted for not doing surgery, 9% were excluded because of age, 4% refused the surgery, and 6% were excluded because of comorbidities. Among the nearly 29% of patients in the study who did undergo pancreatectomy, the See Pancreatic Cancer • page 4 Workforce Shortage The Board of Regents has issued a statement about the erosion of surgical care. • 1 0 Thoracic Surgery Survival Strategy Consider ventricular status, not just symptoms, in managing aortic stenosis. • 1 6 Head & Neck Surgery Cautious Optimism Minimally invasive thyroidectomy may become more widely adopted. • 1 8 Coverage of ASC Procedures to Expand B Y A L I C I A A U LT Else vier Global Medical Ne ws VITAL SIGNS next year, health cover Starting programs willfederal any procedure performed at an ambulatory surgery center, with few but defined exclusions, according to final regulations recently released by the Centers for Medicare and Medicaid Services. The payment formula for such procedures, to be phased in over 4 years, was also set by the regulations. Previously, CMS covered approximately 2,600 procedures when they were performed at an ASC; now, an additional 790 procedures will be eligible in 2008. According to Dr. Charles Mabry, as new procedures receive CPT codes, they, too will Female Surgeons Paid Less Than Male Counterparts Women (n = 118) Men (n = 957) $249,676 General surgery $307,456 ELSEVIER GLOBAL MEDICAL NEWS be covered, unless they are specifically excluded. Dr. Mabry is chairman of the American College of Surgeons’ health policy steering committee and a member of the general surgery coding and reimbursement committee. CMS will not pay for a procedure if it falls within the following exclusion criteria: It poses a significant safety risk to the beneficiary. SURGERY NEWS It would result in the patient’s requiring active monitoring or an overnight stay. It directly involves major blood vessels. It requires major or prolonged invasion of body cavities. It results in extensive blood loss. It is emergent or life threatening. See ASC Procedures • page 2 Presorted Standard U.S. Postage PAID Permit No. 384 Lebanon Jct. KY 60 Columbia Rd, Bldg B Morristown, NJ 07960 CHANGE SERVICE REQUESTED $238,357 Vascular surgery $331,834 Source: 2005 data, Medical Group Management Association

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Contents Drug Developments News From the College Thoracic Surgery Head & Neck Surgery

Surgery News - August 2007

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