In January, the Society for Vascular Surgery (SVS) Strategic Board met and forged its objectives for the coming fiscal year. Two months later the course is being set for action as goals translate into objectives, and objectives transform into programs embedded in the budget for the 2023 financial year, or FY2023. Here are a few highlights of the year to come.
It is going to be another year of intense battle over Medicare payment cuts as the enormous efforts to delay the full impact of 2022 cuts hit their deadlines and the full brunt are back on the table for potential implementation. The SVS Policy and Advocacy Council, led by Matthew Sideman, MD, and Megan Tracci, MD, and the PAC Steering Committee, led by Mark Mattos, MD, and Peter Connolly, MD, are standing firm to meet these challenges. But they need help… your help. They need your engagement, your voice, your letters to Congress and your PAC donations, which open doors to discussion and action.
But the first subtle winds of change are blowing as members of Congress and various Congressional staff tire of the seemingly endless annual battle, and begin to question whether there is a more permanent solution to current challenges with the Medicare Physician Fee Schedule. To accelerate these winds of change, the SVS Medicare Payment Reform Task Force is convening in a “Payment Reform” Summit in June to begin sculpting and shaping alternative solutions for Medicare payment.
To shape and strengthen the advocacy leaders of the future, the council is also implementing its first Advocacy Leadership Program Cohort, seeking 10–12 SVS members with a passion for public policy and advocacy to get into the pipeline for future SVS advocacy leadership. The Coding Committee is following a similar track in seeking interns and early-career vascular surgeons with a passion for coding policy to begin training as the next members who oversee work values and codes.
The Government Relations Committee, chaired by Sean Lyden, MD, will be pressing hard on payment, but also accelerating efforts to advance legislation to ease burdens on prior authorization and augment solutions for ever-growing workforce shortages and challenges.
The Education Council under the leadership of Linda Harris, MD, will introduce and implement a new three-year education strategic plan for the SVS, built upon results from the comprehensive Needs Assessment completed in 2021.
The future portends a holistic, integrated approach for the entire organization, with the goals of expanding SVS education offerings to meet the needs of a rapidly diversifying membership. To be relevant and competitive, the SVS will embrace an education strategy that allows for a centralized content planning and a decentralized implementation process.
Additional programs, new formats, personalized programs for different audiences and demographics, and more opportunities for vascular surgeons to earn continuing medical education (CME) credit, are around the corner.
And then there is the Vascular Annual Meeting (VAM) in Boston in June. VAM 2022 will continue the celebration of the 75th Anniversary of the SVS, which kicked off the festivities as an organization at VAM 2021 in San Diego, and will mark the 75th VAM in the Cradle of Liberty. The VAM Program Committee, led by Andres Schanzer, MD, and the Postgraduate Education Committee (PGEC), headed up by William P. Robinson, MD, have worked overtime to continue making improvements and enhancements to heighten the value and increase the reach of the meeting experience for SVS members and guests.
These improvements include expanding the number of streaming sessions, implementing several new innovative PGEC sessions, and adding sessions on policy and advocacy and our new Women’s and Young Surgeons Sections. In addition, we will be providing all available OnDemand content from the meeting within the week following the meeting. We will also create a plan to engage younger surgeons both in the development of content and accessing content through visual abstracts.
The Research Council, led by Raul Guzman, MD, is literally sculpting the future of vascular research. The council recently hammered out its top 10 research priorities for the decade to come, soon to be published in the Journal of Vascular Surgery (JVS). The top 10 will be leveraged to help shape focus and funding for vascular surgery research. The priorities tell a story about how the specialty and the SVS are evolving, with the introduction of vascular population health and vascular health disparities to the list.
The Vascular Research Initiatives Conference (VRIC), popular with the vascular research community, will link back up in May 2022 proximal to the American Heart Association’s Vascular Discovery Conference.
As a champion for research, the Research Council also has completed an extensive evaluation of key SVS and SVS Foundation research awards and found every dollar invested in early-career researchers leads to an almost 10-fold return in future research grant funding. SVS and Foundation programs are major career and discovery accelerators.
William Shutze, MD, chairs the Clinical Practice Council, which has launched some of the most important and innovative new efforts overseen by the SVS in the past several years. It has supported the initiation and growth of the Wellness Task Force, led by Dawn Coleman, MD, and Malachi Sheahan III, MD, into a full SVS standing committee, and is poised to implement an array of innovative programs and approaches to meet a growing need within the SVS membership.
This council also championed the workforce initiative to develop an economic valuation study of vascular surgery, published in 2021, which is driving the launch of a first-of-its-kind healthcare consulting initiative within SVS, partnering with SG2, to deliver solutions to systems seeking to optimize vascular care.
The council also supported and facilitated the evolution of the SVS Community Practice Committee, which under the leadership of Daniel McDevitt, MD, transitioned to the Community Practice Section, giving hundreds of SVS members the opportunity to engage more deeply with colleagues who share a common interest in community practice. The interest, investment in, and support of community and office-based programs will be enormous in the coming years—including establishment of new research networks, educational programs and representation within SVS.
The Clinical Practice Council and Quality Council are working together to develop an educational series of webinars to facilitate learning and transfer of knowledge to assist in translating clinical practice guidelines into vascular surgery practice.
The long-range future of the Clinical Practice Council has also started to come into focus with initiatives to explore the potential of regional emergency vascular care networks, and the potential development of a vascular emergency care course, working closely with the SVS Physician Assistant Section and the Society for Vascular Nursing (SVN).
New future initiatives under exploration also include development of a third-party peer-review program for smaller community and outpatient practices that have sporadic access to feedback, and the development of an expert witness program.
The SVS Quality Council was established four years ago and is currently led by Thomas Forbes, MD. It is focused on advancing and optimizing the SVS as the go-to center delivering guidance and education derived from evidence-based models of quality and appropriateness in vascular care. Many of the council’s initiatives that began with its inception are nearing launch-ready in the coming year.
The SVS has been working with the American College of Surgeons (ACS) for the past two years on the design, testing and launch of a national verification program for vascular centers of excellence that will add vascular to the portfolio of such programs within the ACS. Eights pilot sites—four in-patient and four office-based center—have helped shape and refine the program standards and process in 2021 and the Vascular Center Verification and Quality Improvement (VCVQI) program appears ready for launch by mid- 2022. This effort began within the SVS under the leadership of Kim Hodgson, MD, and Tony Sidawy, MD, and is now led by R. Clement Darling III, MD, and William Shutze, with continued support and engagement of Sidawy who is the chair of the Board of Regents of the ACS.
No topic has sparked more interest and discussion this past year than appropriateness of care, and the role and responsibility of the SVS as a society to provide clinical guidance. This is especially challenging in areas of practice where strong evidence is sparse. Establishing appropriate use criteria (AUC) is the mechanism, process and tool utilized by medical societies to provide some guidance.
The SVS Appropriateness Committee, led by Jeffrey Siracuse, MD, has been working on producing its first AUC on intermittent claudication, with the AUC process led and expertly facilitated by Karen Woo, MD. The first SVS AUC is expected to be approved and published soon. Next up for an AUC? Carotid disease treatments.
Another major challenge has been to advance quality improvement initiatives throughout the SVS and its membership. To that end, the Quality Council helped establish a new Quality Improvement Committee, led by Jessica Simons, MD, to develop and deliver education and initiatives. Work has begun to compile survey and needs assessment data from SVS members about their approaches to quality improvement in practice, and a compendium of articles forming a primer is under development for publication in JVS.
The centerpiece, or core, of SVS quality initiatives is our registry, the Vascular Quality Intiative (VQI). Under the leadership of Fred Weaver, MD, and Jens Eldrup-Jorgensen, MD, the VQI continues to set the bar, not only for quality in registry data integrity, structure and process, but also in leveraging the power of real-world evidence to advance quality and safety in vascular care. In the year ahead, the VQI will continue to drive quality initiatives in its regional network, foster and expand original real-world evidence research, and continue discussions regarding optimal position and utilization of the VQI to advance and accelerate national and international quality initiatives.
With regard to the health and vitality of the SVS as a medical society, there is virtually no aspect of the SVS that has not been explored for potential change and innovation the past several years. The willingness to do this by past SVS Presidents Ronald Fairman, MD, R. Clement Darling , Michel Makaroun, MD, Kim Hodgson, and Ronald L. Dalman, MD, as well as current President Ali AbuRahma, MD, and President-elect Michael Dalsing, MD, has literally reshaped the SVS and positioned it well for whatever the future brings.
Over the past six years, the SVS has restructured its governance with a new Executive and Strategic Board model; moved to an internet election for open officer positions, providing a choice of two candidates for each vacancy; established new governance-level Diversity, Equity and Inclusion (DEI) and Communications committees to organize and advance SVS in such areas as its branding campaign and toolkit; and established four new pilot member sections for Community Practice, Young Surgeons, Women and Physician Assistants to drive and enhance member value.
The SVS appointments process has been overhauled to maximize the number of members who can engage and serve on SVS committees, with an eye toward early-career and DEI representation. The SVS also developed a management relationship with the SVN in alignment with the goal of supporting the “vascular team.”
On the horizon for the SVS is exploration of ways to further enhance communications and value for members through a potential SVS Enterprise App; continued investment in furthering and integrating DEI principles across SVS activities and initiatives, including a planned multi-vascular society DEI Summit; a substantial increase in focus, investment, and engagement of early-career members; and further focus on dialogue and collaboration with vascular societies to strengthen unity across the specialty and diminish divisions.
The FY2023 budget, approved March 29, and effective April 1–March 31, 2023, is embedded with the resources and support to move all of these key initiatives forward.