SVS clarifies surgeons’ role in diabetic foot care


The Society for Vascular Surgery (SVS) has responded to President Barack Obama’s remarks on 11 August 2009 at a town hall meeting in New Hampshire. Obama stated “Right now if we paid a family – if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they are taking their medications in a timely fashion, they might get reimbursed a pittance. But if that same diabetic ends up getting their foot amputated, that’s US$30,000, US$40,000, US$50,000 – immediately the surgeon is reimbursed.”

In the response, the SVS says, “This statement obviously does not accurately reflect the actual reimbursement to the surgeon for this procedure; surgeons receive reimbursement of less than US$1,000, which includes follow-up care provided for 90 days after the operation. Furthermore, surgeons perform amputations only as last resort in an effort to save a patient’s life, when and only when all attempts at limb salvage are exhausted.

“SVS is dismayed by those remarks. As vascular surgeons, we have the privilege of caring for a large number of Medicare beneficiaries. We perform minimally invasive intervention and bypass procedures to improve circulation to the lower extremities, thereby preventing amputation in many situations. While caring for their patients, SVS members attempt to use the best available medical evidence on which to make treatment recommendations. Since questions remain regarding optimal treatment of some forms of advanced vascular disease, SVS supports the efforts of the Administration to fund comparative effectiveness research; SVS published a position paper to this effect in the Journal of Vascular Surgery.

“SVS agrees with the Administration that prevention is an important part of health care reform. There is little doubt that death and disability caused by many forms of vascular disease could be alleviated with improved preventive measures such as smoking cessation, better diabetes management, and lipid control. In addition, thousands of Medicare beneficiaries die needlessly each year from ruptured abdominal aortic aneurysms. The Medicare screening benefit for aortic aneurysm is so restrictive that the great majority of at-risk beneficiaries are not eligible for this preventive benefit. We urge the Administration to work with Congress to eliminate the barriers to appropriately target aortic aneurysm screening. Lastly, SVS urges the Administration to include tort reform as a means of controlling health care spending.”