From the Immediate Past President of American College of Surgeons, Delaware Chapter Thank you to Dr. Glen Tinkoff for his unselfish dedication of time and energy on behalf of the American College of Surgeons, Delaware Chapter. He has created new hope and optimism for all of us. I also wish to thank many of my colleagues for their friendship and support throughout my professional career. I am proud and honored to have been given the opportunity to serve as the President of our Chapter of the American College of Surgeons. As you know, I am a man of few words but I believe in action. I have the highest regard for our profession and you should know that you have the highest respect and trust of our patients that nourish the soul of medicine. We must constantly strive to increase the standards of care for our patients so that we can continue to gain their trust. Dr. Edward Hill, the American Medical Association Past President, recently reminded us of Joseph Cardinal Bernardin’s in these words. First the practice of medicine is a moral endeavor that takes the form of a covenant, a bond between physician and patient. Second, a covenant involves a moral obligation to the patient, the profession, and the society. Third, the moral compass that guides physicians in meeting these obligations needs to be fully restored so that the covenant can be renewed. We need to familiarize our patients, friends and neighbors, with concerns we have and demonstrate a commitment to their concerns and increase their trust. I have made it a habit of discussing my concerns with my patients and turning their trust into activism and understanding of the issues such as quality of care and basic medical needs. We must contribute more time and energy and funding for effort in place of complaints and complacency. We should give of ourselves for the future good of our profession and our patients. We should attempt to help our colleagues in a time of crisis. The American College of Surgeons has become increasingly involved in serving the interests of the surgical specialty societies in advocating on their behalf. The College meets the leadership of these organizations regularly, semi-annually with physician leaders in Chicago, IL, and approximately once per month with executive staff in Washington, DC. The area of concerns that are in need of the ACS support are as follows: Abdominal Aortic Aneurism Screening. Early screening of over one million abdominal aortic aneurisms will result in 95% success in treatment. The American College of Surgeons is urging members of congress to co-sponsor this screening for abdominal aortic aneurism introduced in February by Senator Christopher Dodd (Democrat-CT), and Jim Bonning (R-KY). This recourse allows extending of ultrasound screening coverage to at-risk beneficiaries. This legislation could help prevent more than 15,000 death caused by abdominal aortic aneurisms. Imaging. The college supports in-office imaging because it has proven to result in a faster diagnosis, improved patient compliance, better outcomes, and fewer repeat office visits. Furthermore, a recent poll conducted by the Coalition for Patient-Centered Imaging by Fabrizio McLanghlin and Associates indicates that 85% of Americans want the option of medical imaging performed by their specialist. Scope of Practice. Ophthalmologist. After heavy lobbying by the American College of Surgeons, its partner in Veteran Affairs in December 2004 rescinded a directive allowing non-surgeons to perform laser eye surgery at Veteran health administration facilities. Under the VA new guidelines, the performance of therapeutic eye surgery is limited to only qualified ophthalmologists. Otolaryngologists. The have concerns about expanding scope of practice for audiologists. In January 2007, Representative Jim Ryan (R-KS) introduced H.R. 415, the Healing Health Accessibility Act, which would provide direct access to audiologists for Medicare beneficiaries without regard for any requirement that the individual be under the care of a physician. In response to a request from the American Academy of Otolaryngologists, the College has sent a letter to members of the House stating strong opposition to this legislation. The letter stated while we agree that all Medicare beneficiaries deserve timely access to healthcare professionals and their services, this legislation would remove the physician from the most crucial segment of any patients consultation; that is, initial examination and diagnosis. Single Degree Oral Surgeons. The College has actively participated in an effort to stop expansion of the scope of the practice of the single degree oral surgeons into cosmetic surgery of the head and neck. As a part of the Coalition for Safe Plastic Surgery, the College, American Society of Plastic Surgeons, and others were most recently successful in defeating this legislation (S.B. 438) in CA in 2004, when governor Arnold Schwarzenegger vetoed the bill. The supporters of this legislation have reintroduced it for consideration in 2006 CA legislature. Should the legislation pass in the assembly, CA surgeons need to encourage the Governor to veto this bill again. Practice of Physical Therapists. In April 2007, the College and seven other medical specialty groups sent a letter in opposition of Medicare Patient’s Access to Physical Therapy Act (H.R. 1333) introduced by representative Melissa Hart (R-PA), this legislation would inappropriately expand the scope of the practice of physical therapists and would allow direct access to physical therapists without first consulting a physician. Provider Taxes. During the 2005 legislative session, at least half a dozen states have legislation assessment of taxes on elective cosmetic surgical procedures. So far this year the coalition of American College of Surgeons have defeated passage of these taxes in states in considering them unfair. These states include AR, IL, NY, TN, TX, WA. In 2004, NJ became the first and only state to pass a 6% tax on elective cosmetic procedure. Since then they adjusted projected income from this tax is 75% less than expected revenue. These types of taxes are likely to be proposed in much other legislation over the next few years, and physicians will need to be prepared to combat them. Policy Scholarships. In May 2005, the college co-sponsored seven health policy scholarships for the specialty societies in support of scholars representing general surgery. The scholars attended a week-long leadership program in health policy arrangements at the Heller School of Social Policy and Management at Brandeis University in Waltham, MA. During the year following completion of the course, these scholars will serve as pro-tempore of the health policy committee for the College and equivalent body for their specialty society. The College anticipates that a new group of surgical leaders will emerge from these scholars. Membership Committee. American College of Surgeons is a most pertinent and active organization that serves all surgical specialties, it has a rich tradition in leading major national efforts to enhance the care of surgical patients. The intention of being a member is to invite supportive colleagues, who will assist in the invitation process by emphasizing the need for partnership for success in our endeavors. Finally, the Chapter would like to hear from each individual member about their ideas and recommendations on what the American College of Surgeons, Delaware Chapter’s future priorities should be. Sincerely, Mehdi Balakhani, MD, FACS Immediate Past President American College of Surgeons, Delaware Chapter