Presidential Address: ‘We Care!’

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“Vascular surgeons are unique in the management of patients with circulatory disease. We are unique because we are exclusively devoted, 100% of our specialty, to the management of patients with vascular disease,” said Dr. Bruce A. Perler in his Presidential Address.

“We are unique in the field of circulatory disease because we’re the only vascular specialists who offer the entire spectrum of treatment options, medical, endovascular and open surgery…. But also, we don’t (just) treat lesions. We take care of patients, and we follow our patients long-term, and we get to know our patients, as people, and we dedicate ourselves to optimizing our patients’ vascular health. This is our brand!”

Dr. Bruce A. Perler

©Martin Allred

Dr. Bruce A. Perler

He described how SVS membership is at more than 5,400, including podiatry partners, cardiologists, radiologists, and other allied health specialists such as PAs and nurses, and more than 700 international members and 10 international chapters.

Dr. Perler stressed how the majority of vascular surgical care in this country today is delivered in the community by private practice vascular surgeons. To support this constituency, SVS established a Community Practice Committee, and this year, despite a tight budget, SVS appropriated $100,000 to fund a strategic plan for the committee.

In addition, SVS’s full-time Washington office is working with CMS and key Congressional leadership to represent the interests of community practitioners and to allow them to succeed in this new world order.

He discussed a number of other highlights of the year as well.

“Our VQI is now certified as a Qualified Clinical Data Registry for meaningful use. In fact … SVS is the first medical Society to have a government-certified Patient Safety Organization.

“Our PSO and VQI leadership is now collaborating with the FDA and several device manufacturers to capture post-market surveillance data, and we’re tracking the outcomes of vena cava filters and novel endovascular devices … and our influence is only going to grow!”

The shortage of vascular practitioners is a major concern, and may be made worse by the graying of the surgeon workforce, and accelerated retirement, both voluntary and involuntary, said Dr. Perler, adding that 27% of SVS members are over the age of 60.

Adding to the physician shortage is an inadequate number of training positions. “And while some have suggested that we can utilize nurses and other allied health professionals to compensate for these physician shortages, in fact we’re facing an even greater shortage of nurses and PAs in the near future.” He emphasized that “we need to train more vascular surgeons.”

Among the major surgical specialties, vascular surgery is second only to ophthalmology in annual Medicare spending, Dr. Perler pointed out. This makes vascular surgery a key player in health care system economics.

In fact, “Vascular surgical care specifically will be one of the most significant contributors to hospital margins,” he said.

Dr. Perler pointed out that “this year as President I made it my highest priority to devote the financial and human resources necessary to develop a comprehensive SVS public relations infrastructure to communicate our brand to the key stakeholders: hospital and health care system administrators, payors, the media, and the public.

“We’ve begun with a complete remake of our website, with voluminous new patient-oriented educational material.

“Seventy percent of our website traffic comes from the public seeking medical information. . .And we’re recruiting an SVS member rapid– response team of experts at the national and local levels to be available in real time for news interviews as stories break.

“But we’ll also be proactive in distributing press releases on a regular basis to the media, and we’re going to partner with major national newswires to distribute content to more than 200,000 media points and 10,000 websites.”

Dr. Perler went on to discuss the economics and ethics of many unnecessary procedures being performed today. He stated how this year adherence to the Society’s Code of Ethics is being included in the requirements for membership.

“If approved at our business meeting,” he said, “it will not be enough to do a sufficient number of vascular surgical cases, and do them well, to qualify for membership. If there is credible evidence that comes forward that an applicant for membership has engaged in the performance of inappropriate procedures, or unethical practices, that applicant will be disqualified for membership in our Society.”

On the other hand, he stressed the importance of a strong relationship with industry as exemplified by Dr. Juan Parodi, “who dreamed, and he cared, and believed you could actually repair an aortic aneurysm through incisions in the groin — an idea so preposterous at the time, that the Journal of Vascular Surgery rejected his first case report. Our industry partners believed in this technology, and believed in our specialty, and invested heavily in this technology, and worked with us to continually improve this revolutionary approach to aneurysm repair, as they continue to do today.”

Dr. Perler stressed that appropriate partnership and collaboration with industry is proper and ethical, and critical to improving and saving the lives of patients.

He returned again and again to his theme of caring, that he and fellow vascular surgeons care for and treat the person, not simply a vascular health issue.

“We all belong to a truly exceptional and vibrant specialty, and while our numbers are small, we are unique in the care of patients with circulatory disease, not just because of the totality of care we deliver, not because we’re necessarily better, but much more importantly, because we care; we care deeply about what we do, our patients, and each other,” Dr. Perler said.

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