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Ethics Colloquium: Money and Modern Surgical Practice: Navigating the Difficult Ethical Terrain (E)
Session Description
This ethics colloquium will explore the challenges faced by surgeons when financial incentives and constraints influence clinical practice. We will consider how the financing of health care impacts both patients and surgeons, and identify ethical norms and boundaries to guide surgeons through this difficult environment. The session will use case-based problem learning to address: (1) how best to care for patients with significant out of pocket costs; (2) how to respond to financial incentives for productivity while preserving important aspects of surgical care that are not tangibly rewarded; (3) how to allocate resources in the setting of scarcity (organs, intensive care unit (ICU) and tertiary care beds); and (4) what the surgeon’s duty is in addressing socioeconomic factors leading to surgical illness.
Course Outline
- Introduction
Margaret L. Schwarze, MD, FACS, Madison, WI
Sharmila Dissanaike, MD, FACS, Lubbock, TX - Point and Counterpoint: The Surgeon Should Not Consider the Financial Toxicity of the Patient’s Workup
Scott B. Grant, MD, MBE, New Brunswick, NJ - Point and Counterpoint: The Surgeon Must Consider and Adapt the Workup to Accommodate the Financial Toxicity
Catherine J. Hunter, MD, FACS, Chicago, IL - Discussion
Mark C. Weissler, MD, FACS, Chapel Hill, NC - Point and Counterpoint: Referring and Accepting Surgeons Should Not Decide Which Patients Should Get Access to Scarce Resources
Allan B. Peetz, MD, FACS, Nashville, TN - Point and Counterpoint: Referring and Accepting Surgeons Should Be Responsible Stewards of Scarce Resources and Not Transfer Patients Who Have Little to Gain from Transfer
Kristy K. Broman, MD, MPH, Nashville, TN - Discussion
Tyler G. Hughes, MD, FACS, Salina, KS - Point and Counterpoint: Financial Incentives Are Critically Important to Generating Productivity and Keep Physicians Focused on Important Aspects of Clinical Practice While Maintaining Salary Equity within a Group
Krista Haines, DO, Durham, NC - Point and Counterpoint: Volume-Based Incentives Are Harmful to Patient Care and Artificially Reward Surgeons for Procedures That May Not Be So Valuable to Patients
Lesly A. Dossett, MD, MPH, FACS, Ann Arbor, MI - Discussion
Julie A. Freischlag, MD, FACS, Winston-Salem, NC - Point and Counterpoint: Surgeons Have a Duty to Prevent Surgical Illness and Address Socioeconomic Disparities That Lead to Life-Limiting Traumatic Injury
Tanya L. Zakrison, MD, FACS, FRSCS, MPH, Miami , FL - Point and Counterpoint: These Are the Barriers to Addressing the Needs of Patients Who are Affected by Structural Violence and Inequality
Carrie A. Sims, MD, PhD, FACS, Philadelphia, PA - Discussion
L.D. Britt, MD, MPH, DSc(Hon), FACS, FCCM, FRCSEng(Hon), FRCSEd(Hon), FWACS(Hon), FRCSI(Hon), FCS(SA)(Hon),FRCSGlasg(Hon)
Target Audience
- Practicing surgeons
- Residents
Learning Objectives
- Apply new knowledge and ideas to improve their surgical practice
- Adapt concepts and quality measures in support of research advancements
- Enhance the quality of patient care
Contact
- For questions about the course content, please contact elearning@facs.org.
- If you have any technical questions, contact learning@facs.org.
Disclosure Information
In accordance with the ACCME Accreditation Criteria, the American College of Surgeons must ensure that anyone in a position to control the content of the educational activity (planners and speakers/authors/discussants/moderators) has disclosed all relevant financial relationships with any commercial interest. For additional information, please visit the ACCME website: http://www.accme.org/requirements/accreditation-requirements-cme-providers/policies-and-definitions/financial-relationships-and-conflicts-interest
The ACCME also requires that ACS manage any reported conflict and eliminate the potential for bias during the educational activity. Any conflicts noted below have been managed to our satisfaction. The disclosure information is intended to identify any commercial relationships and allow learners to form their own judgments. However, if you perceive a bias during a activity, please report it on the evaluation.
(Download the full list of disclosures.)
Faculty and Disclosures
Margaret L. Schwarze, MD, FACS, Madison, WI - No Disclosures
Sharmila Dissanaike, MD, FACS, Lubbock, TX - No Disclosures
Scott B. Grant, MD, MBE, New Brunswick, NJ - No Disclosures
Catherine J. Hunter, MD, FACS, Chicago, IL - No Disclosures
Mark C. Weissler, MD, FACS, Chapel Hill, NC - No Disclosures
Allan B. Peetz, MD, FACS, Nashville, TN - No Disclosures
Kristy K. Broman, MD, MPH, Nashville, TN - No Disclosures
Tyler G. Hughes, MD, FACS, Salina, KS - No Disclosures
Krista Haines, DO, Durham, NC - No Disclosures
Lesly A. Dossett, MD, MPH, FACS, Ann Arbor, MI - No Disclosures
Julie A. Freischlag, MD, FACS, Winston-Salem, NC - No Disclosures
Tanya L. Zakrison, MD, FACS, FRSCS, MPH, Miami , FL - No Disclosures
Carrie A. Sims, MD, PhD, FACS, Philadelphia, PA - No Disclosures
L.D. Britt, MD, MPH, DSc(Hon), FACS, FCCM - No Disclosures
Program Committee and Disclosures
CHAIR: Henri R. Ford, MD, MHA, FACS, FAAP, FRCSEng(Hon), Miami, FL - No Disclosures
VICE-CHAIR: David T. Cooke, MD, FACS, Sacramento, CA - No Disclosures
Members
David C. Borgstrom, MD, FACS, Morgantown, WV - No Disclosures
Daniel L. Dent, MD, FACS, San Antonio, TX - No Disclosures
Roger R. Dmochowski, MD, FACS, Nashville, TN - Allergen: Honoraria: Consultant
Audra A. Duncan, MD, FACS, London, ON - No Disclosures
Mariam F. Eskander, MD, Boston, MA - No Disclosures
Paula Ferrada, MD, FACS, Richmond, VA - No Disclosures
Neil H. Hyman, MD, FACS, Chicago, IL - No Disclosures
Martin S. Karpeh, Jr., MD, FACS, New York, NY - No Disclosures
Dennis H. Kraus, MD, FACS, New York, NY - No Disclosures
Kenneth W. Sharp, MD, FACS, Nashville, TN - No Disclosures
David A. Spain, MD, FACS, Stanford, CA - No Disclosures
Ex-Officios
Mary T. Hawn, MD, FACS, Stanford, CA - No Disclosures
Daniel M. Herron, MD, FACS, FASBMS, New York, NY - No Disclosures
Consultants
Barbara Lee Bass, MD, FACS, FRCS(Hon), Houston, TX - No Disclosures
Quan-Yang Duh, MD, FACS, San Francisco, CA - No Disclosures
B. J. Hancock, MD, FACS, FRCSC, Winnipeg, MB - No Disclosures
Ronald V. Maier, MD, FACS, FRCSEd(Hon), Seattle, WA - No Disclosures
Valerie W. Rusch, MD, FACS, New York, NY - No Disclosures
Continuing Medical Education Credit Information
Accreditation
The American College of Surgeons is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA PRA Category 1 Credits™
The American College of Surgeons designates this enduring activity for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Of the AMA PRA Category 1 Credits™ listed above, a maximum of 3.0 credits meets the requirements for Self-Assessment.
Note: Residents will receive a Certificate of Completion.
Available Credit
- 3.00 AMA PRA Category 1 Credit™
- 3.00 Certificate of Completion
- 3.00 Self Assessment Credit