Efficiency can be misunderstood as simply working faster. In reality, true efficiency in the operating room is about making every movement count, communicating clearly so that needs are understood, understanding the needs of the team, and simplifying the system. Efficiency is a collective achievement—one that the surgeon is uniquely positioned to lead, and it requires a coordinated, high-performing team.
The next generation of cardiothoracic surgeons took a major step forward in their training during the 2025 STS Boot Camp, held August 21–24 in Chicago. Over four days, 60 junior residents from across the country received intensive, hands-on guidance from leading CT surgeons. Attendees engaged in high-fidelity simulations of real-world and emergency scenarios, gaining valuable experience in a structured instructional framework.
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Participants practiced core critical thinking skills in a focused setting.
“This year’s Boot Camp offered first-year residents a unique chance to practice fundamental cardiothoracic skills in a low stress setting,” said program co-chair Jonathan Nesbitt, MD, of Vanderbilt University. “Personalized instruction from experienced faculty, combined with realistic scenarios, helped participants build both competence and confidence in a focused environment.”
The curriculum included training in cardiopulmonary bypass techniques, vessel anastomosis, diagnostic and therapeutic endoscopies, open and robotic lobectomy, TAVR/TEVAR, and wire skills. Participants also received instruction on mitral and aortic valve surgery, echocardiography, communication in the operating room, and the role of surgical ablation.
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First-year CT surgery residents simulated real-world and emergency scenarios.
For many participants, the Boot Camp also sparked inspiration and enthusiasm about their path ahead. "I'm truly excited about building a foundation at the beginning of my fellowship and what the future holds for me," said Boot Camp participant Weston Andrews, MD, a cardiothoracic fellow at the Medical College of Wisconsin.
“We designed this program to strengthen technical skills while also fostering reflection, discussion, and connection,” said Dr. Nesbitt. “From complex procedures to feedback in the OR, this experience supports a smooth, engaged transition into surgical training—with mentorship every step of the way.”
CHICAGO, IL — August 18, 2025 — A new study published in The Annals of Thoracic Surgery, a journal from The Society of Thoracic Surgeons, has identified early hemodynamic valve deterioration (HVD) in more than 6% of patients just one year after undergoing transcatheter aortic valve implantation (TAVI), raising new questions about valve durability in younger, lower-risk populations.
Don’t miss the latest Thinking Thoracic episode as host Erin Gillaspie, MD, is joined by Stephanie Worrell, MD, associate professor, University of Arizona, and thoracic surgeon, Banner Health, for a lively and insightful post-ASCO discussion. Together, they unpack the significance of the CheckMate 577 and Matterhorn trials, and explore what these groundbreaking studies mean for the future of esophageal and gastroesophageal junction cancer care.
As a new cardiothoracic surgeon, interacting with referring providers can be a confusing and daunting experience at times. We have little training or exposure to this critical aspect of practice in residency and fellowship, yet it dramatically affects your success as a surgeon. In some larger and/or academic practices, referring networks and mechanisms may be well established; in smaller community practices, these relationships can determine your survival as a surgeon.
When I was selected for the Looking to the Future Scholarship Program by The Society of Thoracic Surgeons (STS), I expected the 61st Annual Meeting in Los Angeles, California to be an inspiring academic experience. But it was much more than that.
3 min read
Jad Elharake, The Ohio State University College of Medicine
WASHINGTON, DC – July 16, 2025 – The Society of Thoracic Surgeons (STS) strongly supports the reintroduction of the Mobile Cancer Screening Act, a bipartisan bill aimed at expanding access to lifesaving cancer screening services, especially low dose CT scans for lung cancer, in rural and underserved communities. The legislation was introduced this week by Representatives Raul Ruiz, MD (D-CA), Gabe Evans (R-CO), and Debbie Wasserman Schultz (D-FL).
This afternoon, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2026 Medicare Physician Fee Schedule Proposed Rule. STS has compiled a summary of the rule’s key provisions affecting cardiothoracic surgery.
Physician Payment
Starting in calendar year (CY) 2026, the Centers for Medicare & Medicaid Services (CMS) will introduce two distinct conversion factors under the Medicare Access and CHIP Reauthorization Act (MACRA). Clinicians participating in Advanced Alternative Payment Models (APMs) will receive a conversion factor of $33.59, which reflects a 3.83 percent increase. Meanwhile, all other fee-for-service clinicians under the Merit-based Incentive Payment System (MIPS) will have a conversion factor of $33.42, representing a 3.32 percent increase. This new structure of two conversion factors replaces the previous lump-sum bonuses for physicians participating in APMs. Additionally, this is the first time in several years that CMS has proposed a positive adjustment to the conversion factor.
It is important to note that reimbursement still lags behind inflation.
Efficiency Adjustment
CMS also is proposing a new efficiency adjustment that will affect work relative value units (RVUs) and the intra-service time component of non-time-based services, where it believes efficiencies have been gained over time in the delivery of care. This adjustment has the potential to reduce overall payments by approximately 1% for most surgeons. STS is conducting further analyses to assess the impact of this adjustment on our membership.
Practice Expenses
CMS has updated the indirect practice expense methodology, which involves shifting costs from facility-based to non-facility-based services. Under this new approach, only 50% of the physician work related to facility-based services will be included in the indirect cost calculation. As a result, there will be a significant shift in payments across different sites of service. Specifically, physician payments for facility-based care are expected to decrease by 7%, while payments for non-facility-based care will increase by 4%. STS is currently reviewing how this change in practice expense will affect CT procedures.
Quality Payment Program (QPP)
CMS is moving forward with the requirement for mandatory subgroup reporting for all multispecialty groups participating in a MIPS Value Pathway (MVP) during the 2026 performance year, which affects payment for CY 2028. Currently, cardiothoracic surgery measures are included in the Surgical Care MVP. This group of measures is designed for surgical specialists to report separately from traditional MIPS. STS has submitted detailed recommendations to CMS to improve the Surgical Care MVP.
Deregulation Request for Information (RFI)
CMS is seeking feedback on ways to streamline regulations and reduce administrative burdens on providers and other stakeholders participating in the Medicare program. STS has previously responded to similar RFIs, offering recommendations to use existing clinical data registries instead of extraneous quality programs like MIPS, to reconsider global surgical package poster-operative data reporting, and to rescind the Appropriate Use Criteria program.
The conversion factor for the CY 2026 Medicare Physician Fee Schedule is projected to remain stable, offering a welcome break from years of fluctuating reimbursement policies.
In this episode of Thinking Thoracic, Dr. Elliot Servais, Lahey Hospital & Medical Center, joins host Dr. Erin Gillaspie to share how he developed a robotic 1st rib resection program. Initially trained in the traditional transaxillary open approach, Dr. Servais was candid about his early reluctance to take on these technically challenging cases. That changed when he saw the potential of a minimally invasive, robotic technique that aligned with his existing surgical skill set. Recognizing an unmet need at his institution, he seized the opportunity to build a dedicated program.
Congress has passed a finalized reconciliation package that includes a 2.5% increase in physician payment for 2026. This is a substantial win for our community, especially after experiencing a 2.8% reduction in Medicare physician payments in 2025. STS will continue to advocate for long-term reform in Medicare physician payment policies.
Transcatheter aortic valve implantation (TAVI) has dramatically changed the landscape of care for patients with severe aortic stenosis (AS), evolving from a palliative option for those deemed inoperable to a widely accepted alternative to surgical aortic valve replacement (SAVR) in high-risk groups.
7 min read
Mateo Marin-Cuartas, MD, Leipzig Heart Center in Germany
