‘Vascular surgery is an integral part of a complete healthcare system’

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Vascular surgeons are integral members of a healthcare system, an SVS report found

A new Society for Vascular Surgery (SVS) report highlights both the critical skills vascular surgeons provide to a healthcare system and the specialty’s benefit to an institution’s bottom line.

“The value of the modern vascular surgeon to the healthcare system: A report from the Society for Vascular Surgery Valuation Work Group” was published in the February issue of the Journal of Vascular Surgery. The work group is comprised of 11 physicians from medical institutions across the country.

Vascular surgeons provide a unique mix of medical, open surgical and endovascular skills, and fulfill a vital role in the continuum of care of patients with vascular disease, the report stated.

They are also critical to a safe operating room (OR) environment and often provide intraoperative consultations to surgeons, of almost every surgical specialty, reported the authors, who were led by Richard Powell, MD, chief of the section of vascular surgery at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

The skills of vascular surgeons are needed in many nonsurgical situations, too: For example, as experts in wound care, vascular surgeons are frequently the de facto lower-extremity wound care physicians and work closely with podiatrists to provide care in both inpatient and outpatient settings.

“Vascular surgery is an integral part of a complete healthcare system,” according to Powell. “A multitude of specialties require vascular surgery assistance to perform complex procedures; but because vascular surgery is a relatively small specialty, the role and importance of the vascular surgeon in the healthcare system may be underestimated.”

Powell added: “The attributes of the vascular surgery practice are frequently invisible to hospital administration. Not only does a vascular surgery service line improve operating room safety, it also has a profound impact on hospital margins that is frequently underappreciated.”

The SVS Valuation Work Group evaluated the role of the modern vascular surgeon, vascular service line revenue, vascular surgeon contribution in different healthcare models, and how to hire and retain a vascular surgeon.

According to the report, “The particular niche of vascular surgeons is the ability to combine both open and endovascular therapy into hybrid procedures that can take advantage of the unique opportunities that endovascular and open surgery provide. Without the presence of vascular surgeons on stand-by, some hospitals may decide it is not safe to offer certain interventions, such as complex oncologic, neurosurgical, or orthopedic operations, or be potentially susceptible to litigious complaints.”

Furthermore, the Valuation Work Group found the financial impact of having vascular surgeons “substantial.” The report states the specific fiduciary advantage of a vascular surgeon is difficult to measure; however, the value of both the direct revenue from the vascular surgery service line and the indirect revenue from off-service vascular consultations is considerable.

The report also provides data demonstrating the importance of the service line in increasing a hospital’s case-mix index, which can result in significantly increased revenue from the Centers for Medicare and Medicaid Services (CMS) for all hospitalized government-insured patients.

The report authors emphasize, “Modern-day vascular surgeons require significant investment from the healthcare system in order to fully leverage their skillset.”

Powell said, “This document demonstrates the importance of vascular surgeons to the overall care and safety of patients within a hospital system and also brings to light many of the indirect benefits that can be largely underestimated by those in hospital administration.”

SOURCE: doi.org/10.1016/j.jvs.2020.05.056

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