Community affairs: Optimizing, protecting and enhancing clinical practice

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Robert Molnar

The SVS Community Practice Section (CPS) has put together an extensive 90-minute program for Thursday afternoon at VAM.

The session, entitled Community Practice Section: Optimizing and Protecting your Clinical Practice, will take place on Thursday, June 20, from 1:30 to 3:00 p.m. (West Building, Level 1). CPS Chair Robert Molnar, MD, and the VAM Postgraduate Education Committee Chair William Robinson III, MD, will moderate. It will consist of six talks from a variety of speakers across community practice in vascular surgery.

The session will cover a wide breadth of relevant topics, including supplemental income opportunities for practices, malpractice protection, retirement and signing a contract. The education portion will wrap with a 25-minute panel discussion where questions will be taken from the audience.

“The CPS session at VAM 2024 was developed to provide actionable opportunities to optimize, protect and enhance your clinical practice. Every vascular surgeon, regardless of practice type, recognizes how difficult it has become to successfully manage the practice while providing expert vascular care to their community. The Community Practice Section has created a robust session to assist in ensuring continued success,” said Molnar.

There will also be a clinical element to the session. Molnar’s talk will be the first of the six and is entitled, “Transfemoral carotid artery stenting (TF-CAS)—is your practice prepared?” His talk will delve into the detail of the November 2023 National Coverage Decision (NCD) on carotid angioplasty and stenting that decided facilities would no longer require approval by the Centers for Medicare and Medicaid Services (CMS) to perform TF-CAS procedures and that TF-CAS would furthermore be reimbursed for standard indications. The NCD suggests that there should be oversight at the hospital level, but there are no enforcement criteria required to ensure these procedures are being performed appropriately by adequately trained interventionalists.

“There is no registry requirement to follow patient outcomes. In addition, the NCD requires a shared decision-making process, but there has not been a verified tool developed to provide for said process,” said Molnar.

“In short, the guardrails that had been in place to ensure TF-CAS was being performed appropriately in the past have been removed and this potentially places our patients with carotid occlusive disease at risk.”

Molnar’s talk will highlight how community practices can be better prepared for TF-CAS procedures as they relate to the ruling—and so patients receive the best possible care.

The last 15 minutes of the session will be spent highlighting the 2024 Excellence in Community Practice Award recipients. Formerly known as the Excellence in Community Service Award, it is an honor the SVS bestows on members who have exhibited outstanding leadership within his or her community as a practicing vascular surgeon. Selection for this award recognizes an individual’s sustained contributions to patients and their community, as well as exemplary professional practice and leadership.

“It is important that community practice vascular surgeons know that they are an integral part of vascular care across the country,” said Molnar, who himself received the award in 2022.

Molnar will be presenting the awards as chair of the CPS to the 2024 recipients: Enrico Ascher, MD; Sachinder Hans, MD; Chistopher LeSar, MD; and Manish Mehta, MD.

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