Message from the President, Jeffrey B. Rich

STS News, Spring 2012 -- It is an honor to be elected President of The Society of Thoracic Surgeons and I would be remiss if I didn’t express my deep gratitude to you, the STS membership, at the beginning of my inaugural STS News column. It is a true privilege to be able to serve you and our surgical specialty this year. These first few months have been very busy and rewarding. Our STS leaders immersed themselves into the issues facing our specialty, both in Washington and in the Chicago headquarters. I look forward to working with STS leaders, members, and staff as we tackle the challenges and opportunities that lay before us in the coming year.

In this endeavor, I am surrounded by excellent senior leadership on the STS Executive Committee. I would like to extend special congratulations to First Vice President Doug Wood, Second Vice President and Secretary Dave Fullerton, Secretary-Elect Keith Naunheim, and Treasurer Bob Higgins on their well-deserved elections to office. They join me and Mike Mack on a dedicated team of surgeon leaders. I would also like to personally thank Carolyn Reed as outgoing Treasurer and Doug Mathiesen as he leaves the STS Executive Committee for their many years of outstanding service to the Society.

Our new leadership team was officially installed this past January at our 2012 STS Annual Meeting in Fort Lauderdale. Hopefully, you were able to join us for what I believe was one of the most exciting Annual Meeting programs in recent memory. The hard work of the STS staff and particularly the Program Committee led by Todd Dewey was evident throughout the meeting, from our innovative scientific sessions to our first Late Breaking Clinical Trial Abstract presentation.

In Florida, I had the opportunity to meet many of you personally and I very much enjoyed hearing the compelling stories about your practices, as well as your concerns about the future of our specialty. Many of your concerns reflected a professional passion of mine – health policy and its effect on physicians.

In 2008, I was fortunate to spend a year as Director of the Center for Medicare Management (CMM), the largest of the three components at CMS, where I was responsible for the Medicare Fee for Service Program. During this time I was able to immerse myself in the world of health care policy, and payment and regulatory reform. I worked together with the Secretary of Health, the White House and Congress to enact needed change, particularly regarding value based purchasing. That position gave me invaluable insights and experiences that I hope to apply for the betterment of the Society, the specialty at large, and ultimately, our patients.

My previous experience has well prepared me to represent the best interests of STS members as we continue to engage in the world of public policy. Working at CMM reinforced my belief that we are obligated to help policy makers understand what changes are necessary to improve care for surgical patients, reduce health care costs, and provide fair reimbursement.

As we enter the beginning of an exciting election season, I especially look forward to working on policy issues related to reimbursement and quality improvement. I also want to encourage our U.S. STS members to embrace this responsibility by supporting STS-PAC with your contributions.

As you may know, the U.S. Supreme Court recently spent three days hearing arguments in four separate challenges to the Affordable Care Act. While recent news reports indicate that President Obama is confident the law will be upheld, it could still be struck down. No matter what side the scales of justice come down on, STS will be prepared to pursue the best course of advocacy action on behalf of our members.

As surgeons, we are facing some potential payment system changes under the health care law, if it is upheld. On a substantive level, our focus at STS must continue to support a payment system that fosters professional responsibility based upon what is most effective and most appropriate for the patient. The Society will continue to support data-driven approaches to quality measurement, improvement, and reporting. STS has a deep tradition of pioneering quality improvement through our family of clinical registries and we remain committed the development of outcomes-focused clinical registries.

We are entering a new era where the STS Adult Cardiac Surgery Database has the potential to be combined with CMS administrative data, as has occurred in the state of Virginia.

This will provide STS Database participants with an advanced clinical financial tool that will allow them to improve quality, reduce costs, and lead the way in the development of new care delivery models for our speciality that will include shared savings and quality incentive payments.

Finally, our commitment to quality improvement through clinical registries goes beyond health care reform and has even opened new doors of collaboration, particularly with the American College of Cardiology.

Our collegial relationship and professional collaboration with the ACC grew leaps and bounds under the steadfast leadership of our Immediate Past President Michael J. Mack, MD. He was essential toward establishing this relationship and it is my hope that the efforts of my presidential year can match Dr. Mack’s efforts!

Currently, STS and the ACC are continuing our collaboration on all aspects of TAVR – from our joint STS/ACC TVT Registry to the national rollout of coverage for this exciting new heart valve technology. Most recently, we released a joint statement of support with the ACC on CMS’s release of a proposed National Coverage Determination for TAVR therapy in February. In December 2011, STS and ACC launched the STS/ACC TVT Registry, the first-of-its-kind benchmarking tool to track outcomes of TAVR. Built to deliver insight into clinical practice patterns, the STS/ACC TVT Registry provides a data repository that captures and reports patient demographics, procedure details, and facility and physician information. CMS is also close to issuing a final national coverage decision for TAVR, which was requested by STS and ACC late last year.

Beyond our TAVR collaborations, ACC honored two STS leaders for their outstanding contributions to the cardiovascular field at its recent Annual Meeting in Chicago. STS Past President John E. Mayer, Jr., MD was named an ACC Fellow and Dr. Mack was awarded the prestigious ACC Presidential Citation. Please join me in congratulating our two esteemed colleagues!

As my presidential year here at STS begins to ramp up, I encourage you to reach out to me with any suggestions, concerns, or ideas that you may have for our Society. Once again, I thank you for bestowing this great honor on me; it is a responsibility that I am grateful for and I look forward to leading the Society during my time as its President.