ICACS Governors Poll 2002

1
ICACS Governors Poll 2002

• James A. Madura, MD FACS
• Governor at Large, Indiana

2
ICACS Governors PollThe Stimulus

• Questions were raised at a past Clinical Congress
  as to the volunteer activities of the members of
  the ACS
• In 2000 we had a good response to our last poll
  from the membership in Indiana concerning meeting
  attendance

3
ICACS Governors Poll 2001-2002

• Purpose To take the pulse of the membership
  and gather information about the attitudes and
  activities of the membership.
• To determine what problems the members are seeing
  in their practices, and to see if the Chapter and
  the College were fulfilling perceived needs

4
ICACS Governors Poll 2002

• gt 400 questionnaires mailed out to members of
  IC/ACS twice and also placed on Chapter Web Site
• 216 members responded and make up the basis for
  this report
• Mean age 49.5 11.1 years
• Males 200 (93) Females 16 (7)
• General Surgery 214 Specialties 102

5
How long in practice (years)

• Total respondents 216 surgeons
• 16.7 10.9 years
• GNS 114 surgeons
• 17.4 11.6 years
• Specialties 102 surgeons
• 16.1 9.8 years

6
Respondents practice modes
7
Practice Modes 216 respondents
8
Respondents City Size
9
Where the Indiana surgeons practice
10
Make up of Surgical Respondents
11
Responding Surgeons by Specialty
12
ICACS Members volunteer activities
13
ICACS Members hospital activities
14
Participation in medical organizations
societies 216 respondents
15
Important issues to the members

• Declining fees
• Quality of care
• Malpractice
• Managed care
• Surgical competency issues
• Insurance exclusion
• Patient privacy legislation
• Competition for cases

16
Importance of issues ( rank 1-8)GNS vs.
Specialty Surgeons
17
Importance of issues ( rank 1-8)Sorted by age
18
Has practice changed?

• Yes 178/216 82.4
• Age lt 50 years 71.1
• Age gt 51 years 98.9
• General surgeons 84.2
• Specialty surgeons 73.5

19
How has practice changed??Most frequent answers

• Decreased reimbursement for more work
• Exciting new technology (the only positive)
• More paper work
• Managed care interfering with quality of care
• Difficulties dealing with 3rd party payors
• Less respect for general surgeons
• Loss of autonomy in practice
• More regulations in patient care (esp Medicare
  Medicaid)
• More time with business issues, less with
  patients

20
Retirement

• At what age do you plan on retiring?
• All comers 62.2 4.7 years
• GNS 62.2 5.0 years
• Specialties 62.5 4.8 years
• lt 50 yrs. 61.2 4.3 years
• gt 51 yrs. 64.8 4.5 years
• Will you stay in current community
• Yes 163/216 74.9
• No 26/216 12.3
• Undecided 27/216 13.2

21
Do you have computer access to the
Chapter Web site?

• All comers 184/216 85
• GNS 100/115 88
• Specialties 81/102 80
• Age lt 50 113/120 88.3
• Age gt 51 71/88 80.7

22
What can the IN Chapter ACS do for you?Most
frequent answers

• Communicate important present and future issues
• Lobby over reimbursement issues with State Govt..
• More subspecialty emphasis
• Provide a forum for publication of interesting
  cases
• Be a stronger advocate for General Surgery with
  AMA, HCFA, etc.
• Form a real union for collective bargaining
• Get younger surgeons residents involved
• Seminars on contract negotiation

23
Conclusions

• In Indiana, more general surgeons than
  specialists practice solo and in small
  communities
• Indiana surgeons are very involved with volunteer
  activities, and other medical/surgical
  organizations
• Their major concerns are declining fees,
  malpractice, managed care and the quality of care
  they are able to give in the current environment
• Most surgeons consider retirement at age 62
• Most will remain in current communities
• Greater than 80 have computer access to our web
  site

24
Where do we go from here?

• Make ACS aware of Hoosier concerns
• Make broader appeal to specialists small town
  practitioners with ICACS educational programs
• Use the Web site more effectively
• Publish ways to act effectively for reform
• Educational forum
• Links to government, educational opportunities
• Interesting case forum??
• Surgical Grand Rounds on the Web
• Links to Surgery Education Sites. IUMC, ACS, etc.

25
Thanks to

• All 216 Hoosier surgeons who took the time to
  thoughtfully fill out the questionnaire
• (Especially to those who filled them out multiple
  times!)
• Thanks to Carolyn Downing who made sure I got all
  the forms sent to her
• Larry Micon, the program director for this years
  meeting