Surgery News - October 2008 - (Page 5)

OCTOBER 2008 • SURGERY NEWS NEWS 5 New ACS Institute Looks Into Future of Surgery BY JANE ANDERSON Else vier Global Medical Ne ws orkforce issues head the list of research projects planned for the American College of Surgeons’ new Health Policy and Research Institute, along with the evolution of surgical practice over time, according to the institute’s leaders, Dr. George F. Sheldon and Thomas J. Ricketts, Ph.D. The institute, housed at the University of North Carolina’s Cecil G. Sheps Center for Health Policy Research, was established earlier this year in an effort to provide solid data on which to base ACS policy, said Dr. Sheldon, an ACS Fellow and director of the institute. “One of the key questions in health care today is, What services do people provide?” Dr. Sheldon said. “Certainly in surgery, interchangeability is much less— you can’t have a brain surgeon and a urologist covering for each other.” The institute’s initial work involves “getting a grasp on how many surgeons there are, how many are in training, and what we’re doing and what we need to be doing in terms of payment and disease burden,” said Dr. Ricketts, deputy director of the UNC health policy research center and administrative director for the ACS institute. “We’re looking through our existing files to make sure we have a sense of who really is doing surgery. It’s a lot harder than you’d think to actually follow these folks as their practice careers change. We’re interested in seeing how their careers change over the long haul,” he explained. Refinement of the available national databases is the first task, he said. Next, the ACS institute intends to investigate how, exactly, surgeons are practicing. “In North Carolina, we have data on all physicians in the state. We can merge that into data on inpatient and ambulatory procedures,” Dr. Ricketts said. The data then can be used to determine what general surgeons actually are doing, and information also can be teased out on differences that arise between surgeons of different sexes and ages, groups vs. solo practitioners, and small vs. large hospitals, he said. “We’ll get a sense of what they’re doing and how that changes over time,” Dr. Ricketts said. This type of baseline work— which is expected to take about 2 years to complete—will allow ACS policy makers to make educated guesses about future workforce levels, he said. In addition, “as we go along, we’ll be able to answer some specific questions that arise,” Dr. Ricketts said. For example, there has been a rapid rise in orthopedic procedures, and “we’re looking at procedures trying to see if this is a real dramatic uptick or if it has moved up steadily with the population,” he said. “We hope to get some preliminary answers soon.” Another project for the new institute is developing an index of surgical underservice, Dr. Sheldon said. The institute also will be looking at progressive subspecialization in surgery. “Seventy-nine percent of every 1,000 people who finish general surgical training take additional training,” he said. In addition, the ACS institute intends to W be very involved in crafting health care reforms on a national level—an endeavor Dr. Sheldon hopes will move to the forefront in the spring of 2009. The ACS decided to work with the UNC center after considering other ways to create the new institute, including building it in-house. By collaborating with UNC researchers, “we have access to an incredible amount of expertise,” said Dr. Sheldon. In addition, the UNC center already has infrastructure in place: a data system that will allow research to proceed more quickly, he said. The institute is working with two surgeons who are resident fellows at UNC, and three other fellows pursuing UNC doctoral degrees in public health. As one of six federally designated regional workforce analysis centers in the United States, the UNC center is wellequipped to help tackle questions about the surgeon workforce, Dr. Sheldon noted. Although federal funding for the center’s health workforce research was discontinued in 2006, UNC continues to be active in such work. Over the next few years, the ACS institute hopes to develop a group of younger surgeon-researchers who can continue studying the key areas of interest, according to Dr. Ricketts. The institute intends to move to the college’s new headquarters in Washington once it is complete in 2010. “Hopefully over the next 3 years, we will find some surgeons and clinical people who have the interest in and capacity to do these things who will populate that building in D.C.,” said Dr. Ricketts. ■ http://chloraprep.com http://chloraprep.com

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Surgery News - October 2008

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