Target 2021: SVS councils and committees drill down on key goals for year ahead (Part 4)

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Ronald L. Dalman

While there is little doubt the pandemic has impacted each vascular surgeon and the SVS as a Society in numerous ways, the commitment and dedication of SVS committee, council and task force members to deliver on the mission has remained undaunted. Thanks to outstanding leadership by the Executive Board and Strategic Board, and impeccable stewardship and professional support by our staff, the SVS has not lost a beat, and, if anything, is poised to step on the gas as some semblance of normalcy reappears. Despite incredible challenges in local practice conditions across the country, councils, committees and task forces kept meeting, thinking and producing results for members and patients.

SVS even generated some new committees and task forces during this challenging time, such as the Diversity Committee and the Population Health Task Force—reflective of the new opportunities for change on our horizon. I would like to take this opportunity to thank all of our SVS leaders, volunteers and staff for their steadfast commitment to our higher mission and cause as a Society. The reports presented (Part 1 is located here; the second installment is here; the third is here) show a vibrant, forward-looking Society, positioned to embrace whatever comes.—Ronald L. Dalman, MD, SVS president

Health tech task force aims for SVS SET pilot program expansion

The SVS Health Information Technology Task Force was established to analyze the potential application of digital health, virtual care, clinical informatics and augmented intelligence within the specialty of vascular surgery. Current dysfunction in healthcare drives administrative burdens, physician burnout, persistent health inequity, patient disengagement and rising costs, says Judith Lin, MD, task force chair. The task force seeks to identify current applications of health information technology that can reduce the administrative burden plus engage patients, support vascular surgeons and reduce costs as well as promote equity.

In addition to supporting and educating members in health information technology, the task force will also focus on overseeing SVS SET, a first-of-its-kind mobile phone-based exercise therapy program for management of claudication. A pilot program is underway to evaluate the feasibility, efficacy and potential impact of SVS SET. To date, 14 clinics from 11 states have joined the pilot, with further expansion in 2021 expected.

To date, 14 clinics from 11 states have joined the SVS SET pilot

This all follows a busy inaugural year, which also included several presentations on telehealth and technology initiatives. A Town Hall in the spring aimed to help our members stay safe while providing care to vascular patients. Manuscripts were published online as an SVS Telemedicine Primer for Vascular Surgeons (visit vsweb.org/TelemedicinePrimer) and in the Journal of Vascular Surgery. In 2021, task force members also will actively identify speakers in the digital health and technology arena, and develop CME sessions.— Beth Bales

Foundation looks to up contribution levels in 2021

Led by chair Peter Nelson, MD, the SVS Foundation Development Committee works with Foundation chair Peter Lawrence, MD, and the SVS Foundation Board to develop strategies to promote SVS member donations. The active membership contribution percentage continues to grow, with last fiscal year hitting 17.5%, Nelson says. “Our goal is to have 100% support from SVS members and leaders in advancing our field.”

Giving tends to be more weighted toward the end of the tax year, he continues. “However, the Committee is working on ways to encourage donation more continuously throughout the year by approaching specific audiences and creating seasonal promotions. This starts with peer-to-peer solicitation and encouraging the SVS leadership to lead by example. We can then appeal to younger and senior members, among others, to encourage participation with matching programs and other incentives.”— Beth Bales

Vascular policing: Developing a ‘robust’ internal evaluation program

The Conflict of Interest and Professional Conduct Committee occupies an important role in the SVS polity. “One of our committee’s charges is to evaluate the actual or potential conflicts of interest of its members who serve in leadership positions,” chair O. William Brown, MD, tells Vascular Specialist.

“For 2021, we want to develop a robust internal evaluation program and encourage members to report any actions they believe are code of ethics violations. As per protocol, the committee routinely evaluates such conflicts each year and forwards its recommendations to the Executive Committee.”

However, the second charge—to evaluate concerns regarding the professional conduct of the SVS membership—is rarely performed, Brown explains.

This has most often been a result of the membership’s reluctance to report cases of misconduct, and the Society’s reluctance to review cases it believes most often are the result of local politics, he says. However, the SVS code of conduct states that a “member shall not participate in any activity that is not in the best interest of the patient.”

Today, as evidenced by articles in national newspapers like the Wall Street Journal and the New York Times, the vascular community is under siege, Brown goes on to argue. Vascular surgeons have been accused of practicing medicine purely for their own benefit—and not for the benefit of the patients they treat, he points out. “Accordingly, it is clear that when a physician places his or her income above the quality of patient care, it falls under the auspices of the SVS,” Brown continues.

A committee goal this year is to encourage all members to report any activities they see within the vascular community that they believe rise to the level of a code of ethics violation. Vascular surgeons are being evaluated by the public, insurance companies and the legal community, Brown argues. “However, vascular surgeons are the most capable of evaluating the actions of other vascular surgeons. If we do not assume this role now, as noted, others will take our place,” he explains.

“I believe that the last thing vascular surgeons want is to have lay people evaluate the medical treatment that a vascular surgeon provides to his/her patient. Physicians agree that such an approach has not been very successful or satisfying when applied in the field of medical malpractice litigation.

“If vascular surgeons do not police themselves lay people or—even worse—the government will assume that role. The committee’s goal is to develop a robust internal evaluation program and avoid others from assuming a duty that we are most suited to perform.”—Beth Bales and Bryan Kay

Pushing forward VA facilities for the betterment of vascular surgery

The SVS VA Vascular Surgeons Committee is looking ahead this year to reclaim procedural volume at Department of Veterans Affairs (VA) facilities—ravaged by COVID-19—and to facilitate construction of hybrid suites.

The VA committee focuses on improving the vascular surgery community by spurring gains in the resources available for vascular surgeons and by maintaining and improving the training and research environment for the specialty, both at the trainee and the junior faculty level within the VA.

“Maintaining the VA as a robust environment for vascular surgery helps maintain the pipeline for training future SVS members as well as allows the use of VA resources to accomplish vascular surgery-based research,” explains committee chair Gale Tang, MD.

“The VA remains an extremely fertile training environment for bread-and-butter vascular surgery, because of the heavy burden of vascular disease among veterans. However, COVID-19 has had a profound impact within the VA, significantly decreasing vascular surgery procedural and clinic volumes, heavily damaging the trainee experience.”

Most VA offices, in fact, are lagging behind their academic affiliates in terms of recovering volume. In addition to the committee’s plan to develop strategies to maintain appropriate vascular surgical case volumes within the VA, it will also include analyzing the effect of COVID-19 on vascular surgery referrals outside of the VA. The committee plans to develop strategies to maintain appropriate vascular surgical case volumes. This will also include facilitating best practices to improve trainee participation in telehealth.

Updating aging infrastructure within the VA to include hybrid suites remains a priority, as currently only 50% of VA vascular surgeons have access, says Tang.

By establishing what has worked for the successful facilities, the committee hopes to establish more uniform access to appropriate resources to facilitate vascular care within the VA, which will help facilitate the important role of the VA for vascular surgery training, research and careers for SVS members.— Beth Bales

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