A new report finds the role of vascular surgeons may be underappreciated and suggests that an investment in the profession will provide a substantial return for the US healthcare system.
The Society for Vascular Surgery (SVS) has published ‘The value of the modern vascular surgeon to the healthcare system’ as a reference document for hospital administration, vascular section chiefs, and vascular surgeons that describes the scope of the modern-day vascular surgery practice and its financial impact on the healthcare system. Developed by the SVS Valuation Work Group, the 16-page report appears in the February edition of the Journal of Vascular Surgery. The work group is comprised of 11 physicians from medical institutions across the USA.
Vascular surgeons provide a unique mix of medical, open surgical, and endovascular skills and fulfil a vital role in the continuum of care of patients with vascular disease, the report stated. Additionally, because of their ability to control haemorrhage, vascular surgeons are critical to a safe operating room environment and often provide intraoperative consultations to surgeons, of almost every surgical specialty (gynaecology, orthopaedic, oncology, urology, and more). These consultations fall under two categories: planned and emergent. The percentage of emergent consults, in situations where unexpected bleeding results from incidental venous or arterial injury, are surprisingly high.
Vascular surgeons’ skills are needed in many nonsurgical situations, as well. For example, as experts in wound care, vascular surgeons are frequently the de facto lower extremity wound care physicians and work closely with podiatrists to provide care in both inpatient and outpatient settings.
“Vascular surgery is an integral part of a complete healthcare system,” said lead author Richard Powell, chief, Section of Vascular Surgery, at the Dartmouth-Hitchcock Medical Center (Lebanon, USA). “A multitude of specialties require vascular surgery assistance to perform complex procedures; but because vascular surgery is a relatively small specialty, the role and importance of the vascular surgeon in the healthcare system may be underestimated.
He added, “The attributes of the vascular surgery practice are frequently invisible to hospital administration. Not only does a vascular surgery service line improve operating room safety, it also has a profound impact on hospital margins that is frequently underappreciated.”
When developing its report, the SVS Valuation Work Group evaluated the following:
- The role of the modern vascular surgeon,
- Vascular service line revenue,
- Vascular surgeon contribution in different healthcare models, and
- How to hire and retain a vascular surgeon.
According to the report, “The particular niche of vascular surgeons is the ability to combine both open and endovascular therapy into hybrid procedures that can take advantage of the unique opportunities that endovascular and open surgery provide. Without the presence of vascular surgeons on stand-by, some hospitals may decide it is not safe to offer certain interventions, such as complex oncologic, neurosurgical, or orthopaedic operations, or be potentially susceptible to litigious complaints.”
Furthermore, the Valuation Work Group found the financial impact of having vascular surgeons “substantial”. The report states the specific fiduciary advantage of a vascular surgeon is difficult to measure; however, the value of both the direct revenue from the vascular surgery service line and the indirect revenue from off-service vascular consultations is considerable.
The report also provides data demonstrating the importance of the service line in increasing a hospital’s case-mix index, which can result in significantly increased revenue from the Centers for Medicare and Medicaid Services (CMS) for all hospitalised government-insured patients.
The report authors emphasise, “Modern-day vascular surgeons require significant investment from the healthcare system in order to fully leverage their skill set.” This investment appears justified when considering the substantial return on investment.
Powell said, “This document demonstrates the importance of vascular surgeons to the overall care and safety of patients within a hospital system and also brings to light many of the indirect benefits that can be largely underestimated by those in hospital administration.”
To read the full article, visit: https://www.jvascsurg.org/article/S0741-5214(20)31315-X/fulltext
