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Grind it out
“And five more, four more, three more, two more, one more, and done!” Just when you thought you could not stand the searing pain any longer, it ends. Your spin instructor is not only helping you be fit, she is also teaching you an important lesson for life: Sometimes you just need to grind it out.
. College basketball teams need to simply grind it out to advance in the NCAA championship tournament. How might Tiger Woods recover from a disastrous few holes at the Masters? “He’ll just have to grind it out on the back nine.” How will you finally finish your PhD thesis? You’ll have to grind it out this month. It’s how I’m writing this column, how I got my taxes in on time, and, sometimes, how I get through clinic.
The phrase is used to describe something which needs to be done that is tedious, laborious, or joyless. Although the outcome of grinding it out is always pleasant, the task is often considered arduous.
In my dermatology practice, patient demand came in like a lion this March, and to meet our awesome access goals, we needed to add clinics on Saturdays, early mornings, and even a few nights. We met our goal, with supply to spare, and felt proud of our accomplishments. Physician wellness gurus (this author not included) say that, to avoid burnout from such excess work, you must find meaning in your work. Be grateful to help that 24-year-old with acne at 8:15 p.m. Think about how lucky you are to serve that lawyer with hand dermatitis at 8:45 p.m. Celebrate the mom’s cancer-free skin screening at 9:00 p.m. By finding meaning in our work, we’re told, we can achieve clinic nirvana. Except it doesn’t always work, and sometimes it serves us badly.
For the long days that ended in night clinic last month, I found myself counting down those last few patients – “four more, three more, two more, and last one.” I love my work and care about my patients, but sometimes I just have to grind it out. I’m proud of what I’ve accomplished.
Now it’s on to spin class.
Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].
“And five more, four more, three more, two more, one more, and done!” Just when you thought you could not stand the searing pain any longer, it ends. Your spin instructor is not only helping you be fit, she is also teaching you an important lesson for life: Sometimes you just need to grind it out.
. College basketball teams need to simply grind it out to advance in the NCAA championship tournament. How might Tiger Woods recover from a disastrous few holes at the Masters? “He’ll just have to grind it out on the back nine.” How will you finally finish your PhD thesis? You’ll have to grind it out this month. It’s how I’m writing this column, how I got my taxes in on time, and, sometimes, how I get through clinic.
The phrase is used to describe something which needs to be done that is tedious, laborious, or joyless. Although the outcome of grinding it out is always pleasant, the task is often considered arduous.
In my dermatology practice, patient demand came in like a lion this March, and to meet our awesome access goals, we needed to add clinics on Saturdays, early mornings, and even a few nights. We met our goal, with supply to spare, and felt proud of our accomplishments. Physician wellness gurus (this author not included) say that, to avoid burnout from such excess work, you must find meaning in your work. Be grateful to help that 24-year-old with acne at 8:15 p.m. Think about how lucky you are to serve that lawyer with hand dermatitis at 8:45 p.m. Celebrate the mom’s cancer-free skin screening at 9:00 p.m. By finding meaning in our work, we’re told, we can achieve clinic nirvana. Except it doesn’t always work, and sometimes it serves us badly.
For the long days that ended in night clinic last month, I found myself counting down those last few patients – “four more, three more, two more, and last one.” I love my work and care about my patients, but sometimes I just have to grind it out. I’m proud of what I’ve accomplished.
Now it’s on to spin class.
Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].
“And five more, four more, three more, two more, one more, and done!” Just when you thought you could not stand the searing pain any longer, it ends. Your spin instructor is not only helping you be fit, she is also teaching you an important lesson for life: Sometimes you just need to grind it out.
. College basketball teams need to simply grind it out to advance in the NCAA championship tournament. How might Tiger Woods recover from a disastrous few holes at the Masters? “He’ll just have to grind it out on the back nine.” How will you finally finish your PhD thesis? You’ll have to grind it out this month. It’s how I’m writing this column, how I got my taxes in on time, and, sometimes, how I get through clinic.
The phrase is used to describe something which needs to be done that is tedious, laborious, or joyless. Although the outcome of grinding it out is always pleasant, the task is often considered arduous.
In my dermatology practice, patient demand came in like a lion this March, and to meet our awesome access goals, we needed to add clinics on Saturdays, early mornings, and even a few nights. We met our goal, with supply to spare, and felt proud of our accomplishments. Physician wellness gurus (this author not included) say that, to avoid burnout from such excess work, you must find meaning in your work. Be grateful to help that 24-year-old with acne at 8:15 p.m. Think about how lucky you are to serve that lawyer with hand dermatitis at 8:45 p.m. Celebrate the mom’s cancer-free skin screening at 9:00 p.m. By finding meaning in our work, we’re told, we can achieve clinic nirvana. Except it doesn’t always work, and sometimes it serves us badly.
For the long days that ended in night clinic last month, I found myself counting down those last few patients – “four more, three more, two more, and last one.” I love my work and care about my patients, but sometimes I just have to grind it out. I’m proud of what I’ve accomplished.
Now it’s on to spin class.
Dr. Benabio is director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego. The opinions expressed in this column are his own and do not represent those of Kaiser Permanente. Dr. Benabio is @Dermdoc on Twitter. Write to him at [email protected].
FDA approves immunotherapy combo for advanced RCC
The Food and Drug Administration has granted approvals to
The approvals were based on statistically significant improvements in overall survival (OS) and objective response rate (ORR) for patients receiving the combination of nivolumab and ipilimumab (n = 425), compared with those receiving sunitinib (n = 422) in CheckMate 214, the FDA said in a press statement.
Median OS was not yet reached in the combination arm at follow-up of 32 months, compared with 25.9 months in the sunitinib arm (hazard ratio, 0.63; 95% confidence interval, 0.44-0.89; P less than .0001). The ORR was 41.6% (95% CI, 36.9-46.5) for the combination versus 26.5% (95% CI, 22.4-31) in the sunitinib arm (P less than .0001).
Efficacy of the combination was not established for patients with favorable-risk disease.
The most common adverse reactions were fatigue, rash, diarrhea, musculoskeletal pain, pruritus, nausea, cough, pyrexia, arthralgia, and decreased appetite.
The recommended schedule and dose is 3 mg/kg nivolumab, followed by 1 mg/kg ipilimumab, on the same day every 3 weeks for four doses, then 240 mg nivolumab every 2 weeks or 480 mg every 4 weeks, the FDA said.
Nivolumab is marketed as Opdivo and ipilimumab as Yervoy by Bristol-Myers Squibb.
The Food and Drug Administration has granted approvals to
The approvals were based on statistically significant improvements in overall survival (OS) and objective response rate (ORR) for patients receiving the combination of nivolumab and ipilimumab (n = 425), compared with those receiving sunitinib (n = 422) in CheckMate 214, the FDA said in a press statement.
Median OS was not yet reached in the combination arm at follow-up of 32 months, compared with 25.9 months in the sunitinib arm (hazard ratio, 0.63; 95% confidence interval, 0.44-0.89; P less than .0001). The ORR was 41.6% (95% CI, 36.9-46.5) for the combination versus 26.5% (95% CI, 22.4-31) in the sunitinib arm (P less than .0001).
Efficacy of the combination was not established for patients with favorable-risk disease.
The most common adverse reactions were fatigue, rash, diarrhea, musculoskeletal pain, pruritus, nausea, cough, pyrexia, arthralgia, and decreased appetite.
The recommended schedule and dose is 3 mg/kg nivolumab, followed by 1 mg/kg ipilimumab, on the same day every 3 weeks for four doses, then 240 mg nivolumab every 2 weeks or 480 mg every 4 weeks, the FDA said.
Nivolumab is marketed as Opdivo and ipilimumab as Yervoy by Bristol-Myers Squibb.
The Food and Drug Administration has granted approvals to
The approvals were based on statistically significant improvements in overall survival (OS) and objective response rate (ORR) for patients receiving the combination of nivolumab and ipilimumab (n = 425), compared with those receiving sunitinib (n = 422) in CheckMate 214, the FDA said in a press statement.
Median OS was not yet reached in the combination arm at follow-up of 32 months, compared with 25.9 months in the sunitinib arm (hazard ratio, 0.63; 95% confidence interval, 0.44-0.89; P less than .0001). The ORR was 41.6% (95% CI, 36.9-46.5) for the combination versus 26.5% (95% CI, 22.4-31) in the sunitinib arm (P less than .0001).
Efficacy of the combination was not established for patients with favorable-risk disease.
The most common adverse reactions were fatigue, rash, diarrhea, musculoskeletal pain, pruritus, nausea, cough, pyrexia, arthralgia, and decreased appetite.
The recommended schedule and dose is 3 mg/kg nivolumab, followed by 1 mg/kg ipilimumab, on the same day every 3 weeks for four doses, then 240 mg nivolumab every 2 weeks or 480 mg every 4 weeks, the FDA said.
Nivolumab is marketed as Opdivo and ipilimumab as Yervoy by Bristol-Myers Squibb.
MDedge Daily News: Can a nasal spray reverse suicidality?
Smoking boosts heart failure risk in black patients. Respiratory infections increase risk of heart attack and stroke. And pain relievers and inflammatory bowel disease? It’s complicated.
Listen to the MDedge Daily News podcast for all the details on today’s top news.
Smoking boosts heart failure risk in black patients. Respiratory infections increase risk of heart attack and stroke. And pain relievers and inflammatory bowel disease? It’s complicated.
Listen to the MDedge Daily News podcast for all the details on today’s top news.
Smoking boosts heart failure risk in black patients. Respiratory infections increase risk of heart attack and stroke. And pain relievers and inflammatory bowel disease? It’s complicated.
Listen to the MDedge Daily News podcast for all the details on today’s top news.
Is “Runner’s Kidney” a Thing?
Q) Many of my patients are athletes. I recall reading something about kidney disease in marathon runners. Am I remembering correctly?
Although data on acute kidney injury (AKI) in marathon runners are limited, two recent studies have added to our knowledge. In 2017, Mansour et al studied 22 marathon runners, collecting urine and blood samples 24 hours before, immediately after, and 24 hours after a race. The results showed that in 82% of the subjects, serum creatinine increased to a level correlated with stage 1 or 2 AKI (as defined by the Acute Kidney Injury Network criteria).1
Based on urine microscopy results, as well as serum creatinine and novel biomarker levels, the researchers concluded that the runners’ AKI was caused by acute tubular injury—likely induced by ischemia. However, the subjects did not show any evidence of chronic kidney disease (CKD), despite years of running and intensive training. One theory: Habitual running might condition the kidneys to transient ischemic conditions—in other words, they build tolerance to repetitive injury over time.1
Continue to: The other recent study
The other recent study examined use of NSAIDs by ultramarathon
In summary: While marathon runners are prone to AKI, the injury seems to be transient and does not progress to CKD. Furthermore, use of NSAIDs during endurance running may contribute to AKI development, so patients should be advised to use caution with these analgesics. Finally, remind your endurance runners to stay hydrated, since it may help to limit kidney damage. As for the casual runner? The impact on the kidney remains unclear and needs further investigation. —DSW
Danielle S. Wentworth, MSN, FNP-BC
Division of Nephrology, University of Viriginia Health System, Charlottesville
1. Mansour SG, Verma G, Pata RW, et al. Kidney injury and repair biomarkers in marathon runners. Am J Kidney Dis. 2017;70(2):252-261.
2. Lipman GS, Shea K, Christensen M, et al. Ibuprofen versus placebo effect on acute kidney injury in ultramarathons: a randomised controlled trial. Emerg Med J. 2017;34(10):637-642.
Clinician Reviews in partnership with
Renal Consult is edited by Jane S. Davis, CRNP, DNP, a member of the Clinician Reviews editorial board, who is a nurse practitioner in the Division of Nephrology at the University of Alabama at Birmingham and is the communications chairperson for the National Kidney Foundation's Council of Advanced Practitioners (NKF-CAP); and Kim Zuber, PA-C, MSPS, DFAAPA, a semi-retired PA who works with the American Academy of Nephrology PAs and is a past chair of the NKF-CAP. This month's responses were authored by Danielle S. Wentworth, MSN, FNP-BC, who practices in the Division of Nephrology at the University of Virginia Health System in Charlottesville, and Barbara Weis Malone, DNP, FNP-C, FNKF, who is an Assistant Professor in the Adult/Gerontology NP Program in the College of Nursing, and a Nurse Practitioner in the School of Medicine, at the University of Colorado Anschutz Medical Campus.
Clinician Reviews in partnership with
Renal Consult is edited by Jane S. Davis, CRNP, DNP, a member of the Clinician Reviews editorial board, who is a nurse practitioner in the Division of Nephrology at the University of Alabama at Birmingham and is the communications chairperson for the National Kidney Foundation's Council of Advanced Practitioners (NKF-CAP); and Kim Zuber, PA-C, MSPS, DFAAPA, a semi-retired PA who works with the American Academy of Nephrology PAs and is a past chair of the NKF-CAP. This month's responses were authored by Danielle S. Wentworth, MSN, FNP-BC, who practices in the Division of Nephrology at the University of Virginia Health System in Charlottesville, and Barbara Weis Malone, DNP, FNP-C, FNKF, who is an Assistant Professor in the Adult/Gerontology NP Program in the College of Nursing, and a Nurse Practitioner in the School of Medicine, at the University of Colorado Anschutz Medical Campus.
Clinician Reviews in partnership with
Renal Consult is edited by Jane S. Davis, CRNP, DNP, a member of the Clinician Reviews editorial board, who is a nurse practitioner in the Division of Nephrology at the University of Alabama at Birmingham and is the communications chairperson for the National Kidney Foundation's Council of Advanced Practitioners (NKF-CAP); and Kim Zuber, PA-C, MSPS, DFAAPA, a semi-retired PA who works with the American Academy of Nephrology PAs and is a past chair of the NKF-CAP. This month's responses were authored by Danielle S. Wentworth, MSN, FNP-BC, who practices in the Division of Nephrology at the University of Virginia Health System in Charlottesville, and Barbara Weis Malone, DNP, FNP-C, FNKF, who is an Assistant Professor in the Adult/Gerontology NP Program in the College of Nursing, and a Nurse Practitioner in the School of Medicine, at the University of Colorado Anschutz Medical Campus.
Q) Many of my patients are athletes. I recall reading something about kidney disease in marathon runners. Am I remembering correctly?
Although data on acute kidney injury (AKI) in marathon runners are limited, two recent studies have added to our knowledge. In 2017, Mansour et al studied 22 marathon runners, collecting urine and blood samples 24 hours before, immediately after, and 24 hours after a race. The results showed that in 82% of the subjects, serum creatinine increased to a level correlated with stage 1 or 2 AKI (as defined by the Acute Kidney Injury Network criteria).1
Based on urine microscopy results, as well as serum creatinine and novel biomarker levels, the researchers concluded that the runners’ AKI was caused by acute tubular injury—likely induced by ischemia. However, the subjects did not show any evidence of chronic kidney disease (CKD), despite years of running and intensive training. One theory: Habitual running might condition the kidneys to transient ischemic conditions—in other words, they build tolerance to repetitive injury over time.1
Continue to: The other recent study
The other recent study examined use of NSAIDs by ultramarathon
In summary: While marathon runners are prone to AKI, the injury seems to be transient and does not progress to CKD. Furthermore, use of NSAIDs during endurance running may contribute to AKI development, so patients should be advised to use caution with these analgesics. Finally, remind your endurance runners to stay hydrated, since it may help to limit kidney damage. As for the casual runner? The impact on the kidney remains unclear and needs further investigation. —DSW
Danielle S. Wentworth, MSN, FNP-BC
Division of Nephrology, University of Viriginia Health System, Charlottesville
Q) Many of my patients are athletes. I recall reading something about kidney disease in marathon runners. Am I remembering correctly?
Although data on acute kidney injury (AKI) in marathon runners are limited, two recent studies have added to our knowledge. In 2017, Mansour et al studied 22 marathon runners, collecting urine and blood samples 24 hours before, immediately after, and 24 hours after a race. The results showed that in 82% of the subjects, serum creatinine increased to a level correlated with stage 1 or 2 AKI (as defined by the Acute Kidney Injury Network criteria).1
Based on urine microscopy results, as well as serum creatinine and novel biomarker levels, the researchers concluded that the runners’ AKI was caused by acute tubular injury—likely induced by ischemia. However, the subjects did not show any evidence of chronic kidney disease (CKD), despite years of running and intensive training. One theory: Habitual running might condition the kidneys to transient ischemic conditions—in other words, they build tolerance to repetitive injury over time.1
Continue to: The other recent study
The other recent study examined use of NSAIDs by ultramarathon
In summary: While marathon runners are prone to AKI, the injury seems to be transient and does not progress to CKD. Furthermore, use of NSAIDs during endurance running may contribute to AKI development, so patients should be advised to use caution with these analgesics. Finally, remind your endurance runners to stay hydrated, since it may help to limit kidney damage. As for the casual runner? The impact on the kidney remains unclear and needs further investigation. —DSW
Danielle S. Wentworth, MSN, FNP-BC
Division of Nephrology, University of Viriginia Health System, Charlottesville
1. Mansour SG, Verma G, Pata RW, et al. Kidney injury and repair biomarkers in marathon runners. Am J Kidney Dis. 2017;70(2):252-261.
2. Lipman GS, Shea K, Christensen M, et al. Ibuprofen versus placebo effect on acute kidney injury in ultramarathons: a randomised controlled trial. Emerg Med J. 2017;34(10):637-642.
1. Mansour SG, Verma G, Pata RW, et al. Kidney injury and repair biomarkers in marathon runners. Am J Kidney Dis. 2017;70(2):252-261.
2. Lipman GS, Shea K, Christensen M, et al. Ibuprofen versus placebo effect on acute kidney injury in ultramarathons: a randomised controlled trial. Emerg Med J. 2017;34(10):637-642.
Dr. Pellegrini receives Seattle Business Leaders in Health Care Lifetime Achievement Award
Carlos A. Pellegrini, MD, FACS, FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), a Past-President of the American College of Surgeons, has received Seattle Business magazine’s 2018 Leaders in Health Care Lifetime Achievement Award for his committed service to improving the quality of patient care in the Seattle, WA, area.
Dr. Pellegrini has worked in the University of Washington (UW), Seattle, department of surgery since 1993, first as chair of the department and then in 1996 as the Henry N. Harkins Professor and Chair, until 2015, when he was appointed to serve as UW Medicine’s first chief medical officer (CMO).
According to the Seattle Business article on Dr. Pellegrini’s achievement, as CMO, Dr. Pellegrini oversees thousands of health care providers and has led a program that has visibly improved patient care quality, reduced costs, and “ensured that all of the health care system’s 270,000 patients have an assigned primary care provider across its primary care clinics.” He also integrated clinical services for key programs and created a training program to prepare young clinicians for leadership roles.
Dr. Pellegrini said that his motivation has always been to help people, as a surgeon, a mentor, or, as he notes about his role as CMO, by “advancing social issues and the care that we provide our patients.”
Read more about Dr. Pellegrini’s life and career in the Seattle Business article at http://seattlebusinessmag.com:8080/health-care/2018-leaders-health-care-lifetime-achievement-award-carlos-pellegrini-uw-medicine.
Carlos A. Pellegrini, MD, FACS, FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), a Past-President of the American College of Surgeons, has received Seattle Business magazine’s 2018 Leaders in Health Care Lifetime Achievement Award for his committed service to improving the quality of patient care in the Seattle, WA, area.
Dr. Pellegrini has worked in the University of Washington (UW), Seattle, department of surgery since 1993, first as chair of the department and then in 1996 as the Henry N. Harkins Professor and Chair, until 2015, when he was appointed to serve as UW Medicine’s first chief medical officer (CMO).
According to the Seattle Business article on Dr. Pellegrini’s achievement, as CMO, Dr. Pellegrini oversees thousands of health care providers and has led a program that has visibly improved patient care quality, reduced costs, and “ensured that all of the health care system’s 270,000 patients have an assigned primary care provider across its primary care clinics.” He also integrated clinical services for key programs and created a training program to prepare young clinicians for leadership roles.
Dr. Pellegrini said that his motivation has always been to help people, as a surgeon, a mentor, or, as he notes about his role as CMO, by “advancing social issues and the care that we provide our patients.”
Read more about Dr. Pellegrini’s life and career in the Seattle Business article at http://seattlebusinessmag.com:8080/health-care/2018-leaders-health-care-lifetime-achievement-award-carlos-pellegrini-uw-medicine.
Carlos A. Pellegrini, MD, FACS, FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), a Past-President of the American College of Surgeons, has received Seattle Business magazine’s 2018 Leaders in Health Care Lifetime Achievement Award for his committed service to improving the quality of patient care in the Seattle, WA, area.
Dr. Pellegrini has worked in the University of Washington (UW), Seattle, department of surgery since 1993, first as chair of the department and then in 1996 as the Henry N. Harkins Professor and Chair, until 2015, when he was appointed to serve as UW Medicine’s first chief medical officer (CMO).
According to the Seattle Business article on Dr. Pellegrini’s achievement, as CMO, Dr. Pellegrini oversees thousands of health care providers and has led a program that has visibly improved patient care quality, reduced costs, and “ensured that all of the health care system’s 270,000 patients have an assigned primary care provider across its primary care clinics.” He also integrated clinical services for key programs and created a training program to prepare young clinicians for leadership roles.
Dr. Pellegrini said that his motivation has always been to help people, as a surgeon, a mentor, or, as he notes about his role as CMO, by “advancing social issues and the care that we provide our patients.”
Read more about Dr. Pellegrini’s life and career in the Seattle Business article at http://seattlebusinessmag.com:8080/health-care/2018-leaders-health-care-lifetime-achievement-award-carlos-pellegrini-uw-medicine.
Royal Australasian College of Surgeons partners with ACS for Annual Scientific Congress
The Royal Australasian College of Surgeons (RACS), along with the American College of Surgeons (ACS), will host the 87th Annual Scientific Congress, May 7–11 at the International Convention Centre in Sydney, Australia.
The theme of the 2018 Scientific Congress, Reflecting on What Really Matters, explores the challenges of providing quality patient care within complex health care systems—a universal situation familiar to U.S. surgeons.
The ACS has partnered in the planning of this program, and many U.S. surgeons will be featured as speakers throughout the week. Additionally, an ACS panel will take place the morning of Thursday, May 10. The ACS also will be involved in other Annual Scientific Congress activities, including the following:
• ACS Lecture, The Surgical Patient in the ICU—Insights into Survivorship, by Mayur B. Patel, MD, MPH, FACS, a neurosurgeon and surgical intensivist, from Nashville, TN
• Region 16 meeting for ACS Fellows from Australia and New Zealand, the U.S., and other Pacific countries
Among the ACS leaders attending the Congress are Barbara L. Bass, MD, FACS, FRCS(Hon),
ACS President; Clifford Y. Ko, MD, MS, MSHS, FACS, FASCRS, Director, ACS Division of
Research and Optimal Patient Care; Ronald V. Maier, MD, FACS, ACS President-Elect; M.
Margaret (Peggy) Knudson, MD, FACS, Medical Director, Military Health System Strategi
Partnership American College of Surgeons; and Tyler G. Hughes, MD, FACS, Co-Editor, ACS
Surgery News, and Editor-in-Chief, ACS Communities.
For more information on the conference and to register, visit the RACS 87th Annual Scientific Congress website at https://asc.surgeons.org/.
The Royal Australasian College of Surgeons (RACS), along with the American College of Surgeons (ACS), will host the 87th Annual Scientific Congress, May 7–11 at the International Convention Centre in Sydney, Australia.
The theme of the 2018 Scientific Congress, Reflecting on What Really Matters, explores the challenges of providing quality patient care within complex health care systems—a universal situation familiar to U.S. surgeons.
The ACS has partnered in the planning of this program, and many U.S. surgeons will be featured as speakers throughout the week. Additionally, an ACS panel will take place the morning of Thursday, May 10. The ACS also will be involved in other Annual Scientific Congress activities, including the following:
• ACS Lecture, The Surgical Patient in the ICU—Insights into Survivorship, by Mayur B. Patel, MD, MPH, FACS, a neurosurgeon and surgical intensivist, from Nashville, TN
• Region 16 meeting for ACS Fellows from Australia and New Zealand, the U.S., and other Pacific countries
Among the ACS leaders attending the Congress are Barbara L. Bass, MD, FACS, FRCS(Hon),
ACS President; Clifford Y. Ko, MD, MS, MSHS, FACS, FASCRS, Director, ACS Division of
Research and Optimal Patient Care; Ronald V. Maier, MD, FACS, ACS President-Elect; M.
Margaret (Peggy) Knudson, MD, FACS, Medical Director, Military Health System Strategi
Partnership American College of Surgeons; and Tyler G. Hughes, MD, FACS, Co-Editor, ACS
Surgery News, and Editor-in-Chief, ACS Communities.
For more information on the conference and to register, visit the RACS 87th Annual Scientific Congress website at https://asc.surgeons.org/.
The Royal Australasian College of Surgeons (RACS), along with the American College of Surgeons (ACS), will host the 87th Annual Scientific Congress, May 7–11 at the International Convention Centre in Sydney, Australia.
The theme of the 2018 Scientific Congress, Reflecting on What Really Matters, explores the challenges of providing quality patient care within complex health care systems—a universal situation familiar to U.S. surgeons.
The ACS has partnered in the planning of this program, and many U.S. surgeons will be featured as speakers throughout the week. Additionally, an ACS panel will take place the morning of Thursday, May 10. The ACS also will be involved in other Annual Scientific Congress activities, including the following:
• ACS Lecture, The Surgical Patient in the ICU—Insights into Survivorship, by Mayur B. Patel, MD, MPH, FACS, a neurosurgeon and surgical intensivist, from Nashville, TN
• Region 16 meeting for ACS Fellows from Australia and New Zealand, the U.S., and other Pacific countries
Among the ACS leaders attending the Congress are Barbara L. Bass, MD, FACS, FRCS(Hon),
ACS President; Clifford Y. Ko, MD, MS, MSHS, FACS, FASCRS, Director, ACS Division of
Research and Optimal Patient Care; Ronald V. Maier, MD, FACS, ACS President-Elect; M.
Margaret (Peggy) Knudson, MD, FACS, Medical Director, Military Health System Strategi
Partnership American College of Surgeons; and Tyler G. Hughes, MD, FACS, Co-Editor, ACS
Surgery News, and Editor-in-Chief, ACS Communities.
For more information on the conference and to register, visit the RACS 87th Annual Scientific Congress website at https://asc.surgeons.org/.
ACS releases 2018 update to the Physicians as Assistants at Surgery report
The American College of Surgeons (ACS), in collaboration with 15 other national specialty surgical organizations, has recently published the eighth edition of the Physicians as Assistants at Surgery report, a study first undertaken in 1994. The 2018 report reflects the most recent clinical practices and provides guidance on how often an operation might require a physician to assist at surgery. The report is available on the ACS website at www.facs.org/~/media/files/advocacy/pubs/2018_pas.ashx.
Using the American Medical Association’s Current Procedural Terminology (CPT) codes from the 2018 manual, each participating organization reviewed new or revised codes since 2016 and any other codes of interest that are applicable to their specialty and indicated whether the operation requires a physician as an assistant with the following frequency: almost always, almost never, or some of the time. The 2018 report adds 93 codes that the CPT Editorial Panel has approved since the last report was issued in 2016. In addition, the 2018 report updates 384 revised codes and deletes 48 codes that are no longer in CPT.
The ACS maintains that a physician who assists with an operation should be trained to participate in and actively assist the surgeon in safely completing the operation. When a surgeon is unavailable to serve as an assistant, a qualified surgical resident or other qualified health care professional, such as a nurse practitioner or physician assistant with experience in assisting, may participate in operations, according to the ACS Statements on Principles (available at www.facs.org/about-acs/statements/stonprin).
Organizations that collaborated with the ACS to conduct the study include the American Academy of Ophthalmology, the American Academy of Orthopaedic Surgeons, the American Academy of Otolaryngology–Head and Neck Surgery, the American Association of Neurological Surgeons, the American Pediatric Surgical Association, the American Society of Colon and Rectal Surgeons, the American Society of Plastic Surgeons, the American Society of Transplant Surgeons, the American Urological Association, the Congress of Neurological Surgeons, the Society for Surgical Oncology, the Society for Vascular Surgery, the Society of American Gastrointestinal Endoscopic Surgeons, the American College of Obstetricians and Gynecologists, and the Society of Thoracic Surgeons.
The American College of Surgeons (ACS), in collaboration with 15 other national specialty surgical organizations, has recently published the eighth edition of the Physicians as Assistants at Surgery report, a study first undertaken in 1994. The 2018 report reflects the most recent clinical practices and provides guidance on how often an operation might require a physician to assist at surgery. The report is available on the ACS website at www.facs.org/~/media/files/advocacy/pubs/2018_pas.ashx.
Using the American Medical Association’s Current Procedural Terminology (CPT) codes from the 2018 manual, each participating organization reviewed new or revised codes since 2016 and any other codes of interest that are applicable to their specialty and indicated whether the operation requires a physician as an assistant with the following frequency: almost always, almost never, or some of the time. The 2018 report adds 93 codes that the CPT Editorial Panel has approved since the last report was issued in 2016. In addition, the 2018 report updates 384 revised codes and deletes 48 codes that are no longer in CPT.
The ACS maintains that a physician who assists with an operation should be trained to participate in and actively assist the surgeon in safely completing the operation. When a surgeon is unavailable to serve as an assistant, a qualified surgical resident or other qualified health care professional, such as a nurse practitioner or physician assistant with experience in assisting, may participate in operations, according to the ACS Statements on Principles (available at www.facs.org/about-acs/statements/stonprin).
Organizations that collaborated with the ACS to conduct the study include the American Academy of Ophthalmology, the American Academy of Orthopaedic Surgeons, the American Academy of Otolaryngology–Head and Neck Surgery, the American Association of Neurological Surgeons, the American Pediatric Surgical Association, the American Society of Colon and Rectal Surgeons, the American Society of Plastic Surgeons, the American Society of Transplant Surgeons, the American Urological Association, the Congress of Neurological Surgeons, the Society for Surgical Oncology, the Society for Vascular Surgery, the Society of American Gastrointestinal Endoscopic Surgeons, the American College of Obstetricians and Gynecologists, and the Society of Thoracic Surgeons.
The American College of Surgeons (ACS), in collaboration with 15 other national specialty surgical organizations, has recently published the eighth edition of the Physicians as Assistants at Surgery report, a study first undertaken in 1994. The 2018 report reflects the most recent clinical practices and provides guidance on how often an operation might require a physician to assist at surgery. The report is available on the ACS website at www.facs.org/~/media/files/advocacy/pubs/2018_pas.ashx.
Using the American Medical Association’s Current Procedural Terminology (CPT) codes from the 2018 manual, each participating organization reviewed new or revised codes since 2016 and any other codes of interest that are applicable to their specialty and indicated whether the operation requires a physician as an assistant with the following frequency: almost always, almost never, or some of the time. The 2018 report adds 93 codes that the CPT Editorial Panel has approved since the last report was issued in 2016. In addition, the 2018 report updates 384 revised codes and deletes 48 codes that are no longer in CPT.
The ACS maintains that a physician who assists with an operation should be trained to participate in and actively assist the surgeon in safely completing the operation. When a surgeon is unavailable to serve as an assistant, a qualified surgical resident or other qualified health care professional, such as a nurse practitioner or physician assistant with experience in assisting, may participate in operations, according to the ACS Statements on Principles (available at www.facs.org/about-acs/statements/stonprin).
Organizations that collaborated with the ACS to conduct the study include the American Academy of Ophthalmology, the American Academy of Orthopaedic Surgeons, the American Academy of Otolaryngology–Head and Neck Surgery, the American Association of Neurological Surgeons, the American Pediatric Surgical Association, the American Society of Colon and Rectal Surgeons, the American Society of Plastic Surgeons, the American Society of Transplant Surgeons, the American Urological Association, the Congress of Neurological Surgeons, the Society for Surgical Oncology, the Society for Vascular Surgery, the Society of American Gastrointestinal Endoscopic Surgeons, the American College of Obstetricians and Gynecologists, and the Society of Thoracic Surgeons.
Applications for ACS Academy of Master Surgeon Educators are now being accepted –
The American College of Surgeons (ACS) Academy of Master Surgeon Educators, a new College enterprise that will advance the science and implementation of education across all surgical specialties, is now accepting applications for Membership and Associate Membership. Applications are due May 14, 2018.
You could be considered for membership in the Academy through two avenues:
• You may apply directly.
• You may be nominated by a colleague and then complete the application.
Background
In October 2014, the American College of Surgeons (ACS) Board of Regents approved a proposal from the ACS Division of Education to establish the ACS Academy of Master Surgeon Educators. A Steering Committee was appointed to create a model for the Academy, which articulated the desired outcomes, defined standards and criteria for membership, and developed the process for application. The ACS Steering Committee for the Academy of Master Surgeon Educators is co-chaired by ACS Past-President L.D. Britt, MD, MPH, DSc(Hon), FACS, FCCM, FRCSEng(Hon), FRCSEd(Hon), FWACS(Hon), FRCSI(Hon), FCS(SA)(Hon), FRCSGlasg(Hon), and Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education. Other members include Sir Murray Brennan, MD, FACS, ACS Distinguished Service Award recipient; Haile Debas, MD, FACS, founding executive director, Global Health Sciences, University of California, San Francisco; David B. Hoyt, MD, FACS, ACS Executive Director; L. Scott Levin, MD, FACS, ACS Regent; Leigh Neumayer, MD, FACS, Chair, ACS Board of Regents; and Carlos Pellegrini, MD, FACS, FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), ACS Past-President.
The Academy formally launched at the ACS Clinical Congress 2017 in San Diego, CA, and was received enthusiastically.
Purposes of the Academy
The goals of this unique Academy are to define megatrends in surgical education, steer advances in this field, and underscore the critical importance of surgical education in the changing milieu of health care. The Academy will meet these goals by recognizing and assembling a cadre of master surgeon educators of national and international renown who will support cutting-edge surgical education and provide mentorship to the next generation of surgeon educators.
Members of the Academy will be selected through a rigorous peer-review process, and induction will be a high honor in the field of surgical education. Members of the Academy will be expected to engage in activities to address the aforementioned goals. Membership in the Academy will be open to Master Surgeon Educators from across the surgical specialties.
Three categories of membership will be available: Member, Associate Member, and Affiliate Member. Applications for Membership and Associate Membership in the Academy are now being accepted. You are invited to apply or nominate a colleague for membership via the ACS website at facs.org/acsacademy.
The ACS is truly excited about this seminal endeavor, which will impact the profession of surgery for generations to come.
The American College of Surgeons (ACS) Academy of Master Surgeon Educators, a new College enterprise that will advance the science and implementation of education across all surgical specialties, is now accepting applications for Membership and Associate Membership. Applications are due May 14, 2018.
You could be considered for membership in the Academy through two avenues:
• You may apply directly.
• You may be nominated by a colleague and then complete the application.
Background
In October 2014, the American College of Surgeons (ACS) Board of Regents approved a proposal from the ACS Division of Education to establish the ACS Academy of Master Surgeon Educators. A Steering Committee was appointed to create a model for the Academy, which articulated the desired outcomes, defined standards and criteria for membership, and developed the process for application. The ACS Steering Committee for the Academy of Master Surgeon Educators is co-chaired by ACS Past-President L.D. Britt, MD, MPH, DSc(Hon), FACS, FCCM, FRCSEng(Hon), FRCSEd(Hon), FWACS(Hon), FRCSI(Hon), FCS(SA)(Hon), FRCSGlasg(Hon), and Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education. Other members include Sir Murray Brennan, MD, FACS, ACS Distinguished Service Award recipient; Haile Debas, MD, FACS, founding executive director, Global Health Sciences, University of California, San Francisco; David B. Hoyt, MD, FACS, ACS Executive Director; L. Scott Levin, MD, FACS, ACS Regent; Leigh Neumayer, MD, FACS, Chair, ACS Board of Regents; and Carlos Pellegrini, MD, FACS, FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), ACS Past-President.
The Academy formally launched at the ACS Clinical Congress 2017 in San Diego, CA, and was received enthusiastically.
Purposes of the Academy
The goals of this unique Academy are to define megatrends in surgical education, steer advances in this field, and underscore the critical importance of surgical education in the changing milieu of health care. The Academy will meet these goals by recognizing and assembling a cadre of master surgeon educators of national and international renown who will support cutting-edge surgical education and provide mentorship to the next generation of surgeon educators.
Members of the Academy will be selected through a rigorous peer-review process, and induction will be a high honor in the field of surgical education. Members of the Academy will be expected to engage in activities to address the aforementioned goals. Membership in the Academy will be open to Master Surgeon Educators from across the surgical specialties.
Three categories of membership will be available: Member, Associate Member, and Affiliate Member. Applications for Membership and Associate Membership in the Academy are now being accepted. You are invited to apply or nominate a colleague for membership via the ACS website at facs.org/acsacademy.
The ACS is truly excited about this seminal endeavor, which will impact the profession of surgery for generations to come.
The American College of Surgeons (ACS) Academy of Master Surgeon Educators, a new College enterprise that will advance the science and implementation of education across all surgical specialties, is now accepting applications for Membership and Associate Membership. Applications are due May 14, 2018.
You could be considered for membership in the Academy through two avenues:
• You may apply directly.
• You may be nominated by a colleague and then complete the application.
Background
In October 2014, the American College of Surgeons (ACS) Board of Regents approved a proposal from the ACS Division of Education to establish the ACS Academy of Master Surgeon Educators. A Steering Committee was appointed to create a model for the Academy, which articulated the desired outcomes, defined standards and criteria for membership, and developed the process for application. The ACS Steering Committee for the Academy of Master Surgeon Educators is co-chaired by ACS Past-President L.D. Britt, MD, MPH, DSc(Hon), FACS, FCCM, FRCSEng(Hon), FRCSEd(Hon), FWACS(Hon), FRCSI(Hon), FCS(SA)(Hon), FRCSGlasg(Hon), and Ajit K. Sachdeva, MD, FACS, FRCSC, Director, ACS Division of Education. Other members include Sir Murray Brennan, MD, FACS, ACS Distinguished Service Award recipient; Haile Debas, MD, FACS, founding executive director, Global Health Sciences, University of California, San Francisco; David B. Hoyt, MD, FACS, ACS Executive Director; L. Scott Levin, MD, FACS, ACS Regent; Leigh Neumayer, MD, FACS, Chair, ACS Board of Regents; and Carlos Pellegrini, MD, FACS, FRCSI(Hon), FRCS(Hon), FRCSEd(Hon), ACS Past-President.
The Academy formally launched at the ACS Clinical Congress 2017 in San Diego, CA, and was received enthusiastically.
Purposes of the Academy
The goals of this unique Academy are to define megatrends in surgical education, steer advances in this field, and underscore the critical importance of surgical education in the changing milieu of health care. The Academy will meet these goals by recognizing and assembling a cadre of master surgeon educators of national and international renown who will support cutting-edge surgical education and provide mentorship to the next generation of surgeon educators.
Members of the Academy will be selected through a rigorous peer-review process, and induction will be a high honor in the field of surgical education. Members of the Academy will be expected to engage in activities to address the aforementioned goals. Membership in the Academy will be open to Master Surgeon Educators from across the surgical specialties.
Three categories of membership will be available: Member, Associate Member, and Affiliate Member. Applications for Membership and Associate Membership in the Academy are now being accepted. You are invited to apply or nominate a colleague for membership via the ACS website at facs.org/acsacademy.
The ACS is truly excited about this seminal endeavor, which will impact the profession of surgery for generations to come.
ACS WiSC seeks ACS Fellows to serve as new members
The mission of the WiSC is to enable women surgeons of all ages, specialties, and practice types to develop their individual potential as professionals; promote an environment that fosters inclusion, respect, and success; develop, encourage, and advance women surgeons as leaders; and provide a forum and networking opportunities to enhance women’s surgical career satisfaction.
Surgeons interested in advancing the role of women in the ACS and encouraging and mentoring women in surgery should apply. Nominations are open to both men and women, and the committee encourages representation by individuals of diverse cultural, racial, and ethnic backgrounds.
Read the full eligibility requirements and how to apply on the ACS website at facs.org/about-acs/governance/acs-committees/women-in-surgery-committee/wisc-call. Eligible candidates will be selected and notified by the committee in June, and will be invited to attend the October 22 meeting of the WiSC, held in conjunction with Clinical Congress 2018 in Boston, MA. Travel reimbursement will not be provided.
Apply online at www.surveymonkey.com/r/2018WiSCMbrApp. Applications are due May 31, 2018. Questions can be directed to Connie Bura at [email protected].
The mission of the WiSC is to enable women surgeons of all ages, specialties, and practice types to develop their individual potential as professionals; promote an environment that fosters inclusion, respect, and success; develop, encourage, and advance women surgeons as leaders; and provide a forum and networking opportunities to enhance women’s surgical career satisfaction.
Surgeons interested in advancing the role of women in the ACS and encouraging and mentoring women in surgery should apply. Nominations are open to both men and women, and the committee encourages representation by individuals of diverse cultural, racial, and ethnic backgrounds.
Read the full eligibility requirements and how to apply on the ACS website at facs.org/about-acs/governance/acs-committees/women-in-surgery-committee/wisc-call. Eligible candidates will be selected and notified by the committee in June, and will be invited to attend the October 22 meeting of the WiSC, held in conjunction with Clinical Congress 2018 in Boston, MA. Travel reimbursement will not be provided.
Apply online at www.surveymonkey.com/r/2018WiSCMbrApp. Applications are due May 31, 2018. Questions can be directed to Connie Bura at [email protected].
The mission of the WiSC is to enable women surgeons of all ages, specialties, and practice types to develop their individual potential as professionals; promote an environment that fosters inclusion, respect, and success; develop, encourage, and advance women surgeons as leaders; and provide a forum and networking opportunities to enhance women’s surgical career satisfaction.
Surgeons interested in advancing the role of women in the ACS and encouraging and mentoring women in surgery should apply. Nominations are open to both men and women, and the committee encourages representation by individuals of diverse cultural, racial, and ethnic backgrounds.
Read the full eligibility requirements and how to apply on the ACS website at facs.org/about-acs/governance/acs-committees/women-in-surgery-committee/wisc-call. Eligible candidates will be selected and notified by the committee in June, and will be invited to attend the October 22 meeting of the WiSC, held in conjunction with Clinical Congress 2018 in Boston, MA. Travel reimbursement will not be provided.
Apply online at www.surveymonkey.com/r/2018WiSCMbrApp. Applications are due May 31, 2018. Questions can be directed to Connie Bura at [email protected].
Disproportionately low U.S. research funding targets gynecologic cancers
NEW ORLEANS – The National Cancer Institute is woefully underfunding gynecologic cancer research, compared with several other cancer types, when the money the institute is spending annually is factored by the incidence and lethal impact of each cancer using U.S. data from 2007 to 2014.
That period featured “systematic and pervasive underfunding of gynecologic cancers in relation to other cancer sites,” Ryan J. Spencer, MD, said at the annual meeting of the Society of Gynecologic Oncology. The trends over the period he studied worsened with time and pose the risk that progress in gynecologic cancers – uterine, cervical, and ovarian – will “lag behind” other cancers’ progress in prevention, treatment, and improved survival, said Dr. Spencer, a gynecologic oncologist at the University of Wisconsin–Madison.
Additional time trend analyses showed that the annual funding-to-lethality score for each of the three gynecologic cancers declined during the period studied.
“We must do everything we can to reverse these trends,” Dr. Spencer concluded.
SOURCE: Spencer R et al. SGO 2018, Abstract 3.
The data reported by Dr. Spencer and his associates are very sobering. They present an elegant analysis that documents a lag and decline in funding for gynecologic cancers that factors in the lethality of various cancers. By several other measures as well, funding for research into gynecologic cancers has been slipping in recent years. During 2011-2016, we saw a 90% drop in enrollment into U.S. clinical trials for gynecologic cancers, and from a peak in 2012-2016 the total number of trials for gynecologic cancers fell by more than two-thirds.
Paola A. Gehrig, MD , is professor of ob.gyn. and director of gynecologic oncology at the University of North Carolina at Chapel Hill. She had no disclosures. She made these comments as designated discussant for the report.
The data reported by Dr. Spencer and his associates are very sobering. They present an elegant analysis that documents a lag and decline in funding for gynecologic cancers that factors in the lethality of various cancers. By several other measures as well, funding for research into gynecologic cancers has been slipping in recent years. During 2011-2016, we saw a 90% drop in enrollment into U.S. clinical trials for gynecologic cancers, and from a peak in 2012-2016 the total number of trials for gynecologic cancers fell by more than two-thirds.
Paola A. Gehrig, MD , is professor of ob.gyn. and director of gynecologic oncology at the University of North Carolina at Chapel Hill. She had no disclosures. She made these comments as designated discussant for the report.
The data reported by Dr. Spencer and his associates are very sobering. They present an elegant analysis that documents a lag and decline in funding for gynecologic cancers that factors in the lethality of various cancers. By several other measures as well, funding for research into gynecologic cancers has been slipping in recent years. During 2011-2016, we saw a 90% drop in enrollment into U.S. clinical trials for gynecologic cancers, and from a peak in 2012-2016 the total number of trials for gynecologic cancers fell by more than two-thirds.
Paola A. Gehrig, MD , is professor of ob.gyn. and director of gynecologic oncology at the University of North Carolina at Chapel Hill. She had no disclosures. She made these comments as designated discussant for the report.
NEW ORLEANS – The National Cancer Institute is woefully underfunding gynecologic cancer research, compared with several other cancer types, when the money the institute is spending annually is factored by the incidence and lethal impact of each cancer using U.S. data from 2007 to 2014.
That period featured “systematic and pervasive underfunding of gynecologic cancers in relation to other cancer sites,” Ryan J. Spencer, MD, said at the annual meeting of the Society of Gynecologic Oncology. The trends over the period he studied worsened with time and pose the risk that progress in gynecologic cancers – uterine, cervical, and ovarian – will “lag behind” other cancers’ progress in prevention, treatment, and improved survival, said Dr. Spencer, a gynecologic oncologist at the University of Wisconsin–Madison.
Additional time trend analyses showed that the annual funding-to-lethality score for each of the three gynecologic cancers declined during the period studied.
“We must do everything we can to reverse these trends,” Dr. Spencer concluded.
SOURCE: Spencer R et al. SGO 2018, Abstract 3.
NEW ORLEANS – The National Cancer Institute is woefully underfunding gynecologic cancer research, compared with several other cancer types, when the money the institute is spending annually is factored by the incidence and lethal impact of each cancer using U.S. data from 2007 to 2014.
That period featured “systematic and pervasive underfunding of gynecologic cancers in relation to other cancer sites,” Ryan J. Spencer, MD, said at the annual meeting of the Society of Gynecologic Oncology. The trends over the period he studied worsened with time and pose the risk that progress in gynecologic cancers – uterine, cervical, and ovarian – will “lag behind” other cancers’ progress in prevention, treatment, and improved survival, said Dr. Spencer, a gynecologic oncologist at the University of Wisconsin–Madison.
Additional time trend analyses showed that the annual funding-to-lethality score for each of the three gynecologic cancers declined during the period studied.
“We must do everything we can to reverse these trends,” Dr. Spencer concluded.
SOURCE: Spencer R et al. SGO 2018, Abstract 3.
REPORTING FROM SGO 2018
Key clinical point: The National Cancer Institute underfunds gynecologic cancer research.
Major finding: Ovarian cancer research funding averaged $97,000 per year of life lost per 100 new cases, compared with $1.8 million for both breast and prostate cancer.
Study details: A review of U.S. data collected by the National Cancer Institute during 2007-2014.
Disclosures: Dr. Spencer had no disclosures.
Source: Spencer R et al. SGO 2018, Abstract 3.