Vascular surgeons as community leaders in vascular disease


Value to the healthcare system, branding and success in competing in competitive environments and ensuring optimal patient care all play a role in defining the value of vascular surgeons to both hospital leadership and patients.

Richard Powell, MD, Joseph Mills, MD, and William Shutze, MD, in turn addressed the respective topics in an “Ask the Experts” session Wednesday, “Positioning vascular surgeons as community leaders in vascular disease.”


Powell discussed both the direct and indirect contributions of vascular surgery to service lines, important to consider in contract negotiations. In 2018, vascular surgery was the fifth highest revenue-producing section in the service line, behind cardiac surgery, neonatology, neurosurgery and hospital medicine. Vascular surgeons also assist non-vascular surgeons, indirectly adding value and revenue. “Vascular surgery provides significant value, revenue and margin opportunity to a hospital,” he said.

“Previous research and current assessments suggest the gross contribution margin per vascular surgeon full-time equivalent is the highest among the top five hospital-based surgical service lines.”

Hospital administrators may lack knowledge and appreciation for the scope of vascular surgery practices, the indirect service line from co-surgeries, the impact on patient safety and how vascular emergencies disrupt a busy vascular practice.”

These administrators may hire consultants, but those, too, may be unaware of vascular surgery’s contributions. Then, the consultants’ strategy becomes the hospital administration strategy, with the misconceptions still in place. “They don’t know what we do!” he exclaimed.

Powell was part of the creation of “The value of the modern vascular surgeon to the healthcare system: A Report from the Society for Vascular Surgery Valuation Work Group,” published in the Journal of Vascular Surgery. He recommended surgeons read that, and also download the informational report, “Value of Vascular Surgery, An Essential Component of a High-Performing Hospital’s Surgical Program.” It in a format administrators are familiar with and will appreciate.


Mills recently rotated off the SVS Public and Professional Outreach Committee, which he had chaired during the several years developing the SVS Branding Initiative, which culminated in the creation of the SVS Branding Toolkit.

He referenced cocktail party conversation, trying to give an answer to “What do you do?” as a question all SVS members face. Thus, branding, setting members apart, was in 2018 listed as a No. 1 member priority (it is now ranked No. 2, behind advocacy work). Through long conversations and discussions with the Springboard Brand and Creative Strategy group, the effort evolved into branding the “comprehensive care” that vascular surgeons provide, based on longitudinal relationships with patients.

“A lot of what we do is below the radar,” said Mills. Patients and hospital administrators just don’t know what vascular surgeons do, that they assist other specialties, that they provide comprehensive care. People also don’t that “surgery is only part of our story,” a phrase that’s now a tagline.”

That line has strongly resonated with members and “preserves the ‘surgical’ part of our heritage, which I don’t think we want to lose,” he said.

Springboard created many materials for the initiative, including videos and the “ultimate product,” according to Mills, the Branding Toolkit, dozens of pieces of referral-focused content that can be customized easily.

“We need to define ourselves,” he said of the need for the initiative, adding “We don’t want to just preserve our specialty, we want to grow.”


Shutze discussed “How to succeed in competitive environments and ensure optimal care for vascular patients,” based on his 30 years of practice. “Our specialty is very well-respected for being available,” he said. “Leverage that. Meet with the Emergency Room director, ‘meet’ your referrings and potential referrings.”

But, he emphasized surgeons should also “demonstrate our specialty is committed to quality. Make ‘quality’ your mantra. Live it, breathe it, own it.

He recommended becoming part of the SVS Patient Safety Organization’s Vascular Quality Initiative, taking part in the American College of Surgeons/SVS vascular verification program, now in its pilot phase, creating a multidisciplinary forum to review and appraise (in a setting that does not promote defensive responses) all vascular procedures and poor outcomes, and creating a vascular team. “Look for opportunities to improve,” he urged of the vascular review process.

He also advocated that surgeons incorporate SVS guidelines into their practices, reviewing them with patients and providing hyperlinks in communications for patients and referrings to access. “SVS clearly leads the world in practice guidelines,” he said. “Use them.”

Take every opportunity to educate referrings, he added. “They’ll be grateful. And out-communicate your competitors.”

“And,” he said, looking at the audience that included a fair number of younger surgeons, “if you’re really motivated become an ‘influencer’” in social media.


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