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SSC Women’s Committee hosts leadership symposium teaser
The Society of Surgical Chairs (SSC) Women’s Committee hosted a leadership symposium for 40 women surgeons April 18–19 at the Union League of Philadelphia, PA, immediately preceding the annual meeting of the American Surgical Association. The event was sponsored by the American College of Surgeons (ACS) Foundation, Johnson & Johnson Ethicon, and the SSC Women’s Committee.
Anne C. Mosenthal, MD, FACS, Benjamin F. Rush, Jr. Endowed Chair and professor and chair of surgery at Rutgers New Jersey Medical School, Newark, and chair of the SSC’s Women’s Committee led the daylong educational program, which featured the following sessions:
• A team from Johnson & Johnson Ethicon spoke on the Changing Healthcare Landscape.
• Larry R. Kaiser, MD, FACS, Lewis Katz Dean, School of Medicine, senior executive vice-president for Health Affairs, Temple University, and president and chief executive officer (CEO), Temple University Health System, Philadelphia, spoke on the Healthcare System and Academic Medicine.
• ACS President-Elect Barbara L. Bass, MD, FACS, the John F. and Carolyn Bookout Distinguished Endowed Chair and chair, department of surgery, Houston Methodist Hospital, TX; and Past-Chair of the ACS Board of Regents Julie A. Freischlag, MD, FACS, president and CEO, Wake Forest Baptist Medical Center, Winston-Salem, NC, spoke on leadership challenges.
• Sandra Humbles, vice-president of Global Educational Solutions for One Medical Devices at Johnson & Johnson, and Vice-Chair of the ACS Board of Regents Leigh A. Neumayer, MD, MS, FACS, professor and chair, department of surgery, University of Arizona College of Medicine, Tucson, led a session on Performance, Impact, and Exposure.
• Dr. Mosenthal moderated a panel discussion on advancing women to leadership roles, which included the following panelists: Daniel V. Schidlow, MD, Drexel University, Walter H. and Leonore Annenberg Dean and senior vice-president, medical affairs, at Drexel University College of Medicine; Nancy Spector, MD, executive director, executive leadership in academic medicine, and associate dean for faculty development, Drexel University College of Medicine; Mary T. Hawn, MD, FACS, professor of surgery and chair, department of surgery, Stanford University, CA; and Jeffrey B. Matthews, MD, FACS, Dallas B. Phemister Professor of Surgery and chair, department of surgery, University of Chicago, IL.
The ACS Foundation hosted a dinner for the SSC Women’s Committee members and Shane Hollett, ACS Foundation Executive Director, spoke with them about the future of women in philanthropy.
The Society of Surgical Chairs (SSC) Women’s Committee hosted a leadership symposium for 40 women surgeons April 18–19 at the Union League of Philadelphia, PA, immediately preceding the annual meeting of the American Surgical Association. The event was sponsored by the American College of Surgeons (ACS) Foundation, Johnson & Johnson Ethicon, and the SSC Women’s Committee.
Anne C. Mosenthal, MD, FACS, Benjamin F. Rush, Jr. Endowed Chair and professor and chair of surgery at Rutgers New Jersey Medical School, Newark, and chair of the SSC’s Women’s Committee led the daylong educational program, which featured the following sessions:
• A team from Johnson & Johnson Ethicon spoke on the Changing Healthcare Landscape.
• Larry R. Kaiser, MD, FACS, Lewis Katz Dean, School of Medicine, senior executive vice-president for Health Affairs, Temple University, and president and chief executive officer (CEO), Temple University Health System, Philadelphia, spoke on the Healthcare System and Academic Medicine.
• ACS President-Elect Barbara L. Bass, MD, FACS, the John F. and Carolyn Bookout Distinguished Endowed Chair and chair, department of surgery, Houston Methodist Hospital, TX; and Past-Chair of the ACS Board of Regents Julie A. Freischlag, MD, FACS, president and CEO, Wake Forest Baptist Medical Center, Winston-Salem, NC, spoke on leadership challenges.
• Sandra Humbles, vice-president of Global Educational Solutions for One Medical Devices at Johnson & Johnson, and Vice-Chair of the ACS Board of Regents Leigh A. Neumayer, MD, MS, FACS, professor and chair, department of surgery, University of Arizona College of Medicine, Tucson, led a session on Performance, Impact, and Exposure.
• Dr. Mosenthal moderated a panel discussion on advancing women to leadership roles, which included the following panelists: Daniel V. Schidlow, MD, Drexel University, Walter H. and Leonore Annenberg Dean and senior vice-president, medical affairs, at Drexel University College of Medicine; Nancy Spector, MD, executive director, executive leadership in academic medicine, and associate dean for faculty development, Drexel University College of Medicine; Mary T. Hawn, MD, FACS, professor of surgery and chair, department of surgery, Stanford University, CA; and Jeffrey B. Matthews, MD, FACS, Dallas B. Phemister Professor of Surgery and chair, department of surgery, University of Chicago, IL.
The ACS Foundation hosted a dinner for the SSC Women’s Committee members and Shane Hollett, ACS Foundation Executive Director, spoke with them about the future of women in philanthropy.
The Society of Surgical Chairs (SSC) Women’s Committee hosted a leadership symposium for 40 women surgeons April 18–19 at the Union League of Philadelphia, PA, immediately preceding the annual meeting of the American Surgical Association. The event was sponsored by the American College of Surgeons (ACS) Foundation, Johnson & Johnson Ethicon, and the SSC Women’s Committee.
Anne C. Mosenthal, MD, FACS, Benjamin F. Rush, Jr. Endowed Chair and professor and chair of surgery at Rutgers New Jersey Medical School, Newark, and chair of the SSC’s Women’s Committee led the daylong educational program, which featured the following sessions:
• A team from Johnson & Johnson Ethicon spoke on the Changing Healthcare Landscape.
• Larry R. Kaiser, MD, FACS, Lewis Katz Dean, School of Medicine, senior executive vice-president for Health Affairs, Temple University, and president and chief executive officer (CEO), Temple University Health System, Philadelphia, spoke on the Healthcare System and Academic Medicine.
• ACS President-Elect Barbara L. Bass, MD, FACS, the John F. and Carolyn Bookout Distinguished Endowed Chair and chair, department of surgery, Houston Methodist Hospital, TX; and Past-Chair of the ACS Board of Regents Julie A. Freischlag, MD, FACS, president and CEO, Wake Forest Baptist Medical Center, Winston-Salem, NC, spoke on leadership challenges.
• Sandra Humbles, vice-president of Global Educational Solutions for One Medical Devices at Johnson & Johnson, and Vice-Chair of the ACS Board of Regents Leigh A. Neumayer, MD, MS, FACS, professor and chair, department of surgery, University of Arizona College of Medicine, Tucson, led a session on Performance, Impact, and Exposure.
• Dr. Mosenthal moderated a panel discussion on advancing women to leadership roles, which included the following panelists: Daniel V. Schidlow, MD, Drexel University, Walter H. and Leonore Annenberg Dean and senior vice-president, medical affairs, at Drexel University College of Medicine; Nancy Spector, MD, executive director, executive leadership in academic medicine, and associate dean for faculty development, Drexel University College of Medicine; Mary T. Hawn, MD, FACS, professor of surgery and chair, department of surgery, Stanford University, CA; and Jeffrey B. Matthews, MD, FACS, Dallas B. Phemister Professor of Surgery and chair, department of surgery, University of Chicago, IL.
The ACS Foundation hosted a dinner for the SSC Women’s Committee members and Shane Hollett, ACS Foundation Executive Director, spoke with them about the future of women in philanthropy.
NAPRC Now Accepting Applications from Hospitals teaser
National Accreditation Program for Rectal CancerRectal cancer programs interested in earning accreditation from the new National Accreditation Program for Rectal Cancer (NAPRC) may now apply for participation in the program. The goal of the NAPRC is to ensure that rectal cancer patients receive appropriate care using a multidisciplinary approach.
The NAPRC was developed through collaboration between the American College of Surgeons (ACS) Commission on Cancer (CoC) and the Optimizing the Surgical Treatment of Rectal Cancer (OSTRiCh) Consortium, with input from other stakeholder organizations. The NAPRC formed as a response to the success European countries have had in treating rectal cancer, while the quality of care in the U.S. has continued to vary.
Representatives from OSTRiCh presented data highlighting these differences to the CoC Accreditation Committee, which eventually led to the development of a standards manual and six pilot surveys to form the NAPRC, explained Steven D. Wexner, MD, FACS, a colorectal surgeon, ACS Regent, and member of the NAPRC Steering Committee. The standards evaluate program management, clinical services, and quality improvement efforts. The NAPRC also offers educational modules created and maintained by content experts from the American Society of Colon and Rectal Surgeons, College of American Pathologists, and American College of Radiology.
To attain accreditation from the NAPRC, cancer programs must assess and demonstrate compliance with the requirements for all standards outlined in The National Accreditation Program for Rectal Cancer Standards Manual: 2017 Edition, available at facs.org/quality-programs/cancer/naprc/standards.
For more information about the NAPRC, visit the ACS website at facs.org/quality-programs/cancer/naprc, contact [email protected], and read the ACS press release at facs.org/media/press-releases/2017/naprc062117.
National Accreditation Program for Rectal CancerRectal cancer programs interested in earning accreditation from the new National Accreditation Program for Rectal Cancer (NAPRC) may now apply for participation in the program. The goal of the NAPRC is to ensure that rectal cancer patients receive appropriate care using a multidisciplinary approach.
The NAPRC was developed through collaboration between the American College of Surgeons (ACS) Commission on Cancer (CoC) and the Optimizing the Surgical Treatment of Rectal Cancer (OSTRiCh) Consortium, with input from other stakeholder organizations. The NAPRC formed as a response to the success European countries have had in treating rectal cancer, while the quality of care in the U.S. has continued to vary.
Representatives from OSTRiCh presented data highlighting these differences to the CoC Accreditation Committee, which eventually led to the development of a standards manual and six pilot surveys to form the NAPRC, explained Steven D. Wexner, MD, FACS, a colorectal surgeon, ACS Regent, and member of the NAPRC Steering Committee. The standards evaluate program management, clinical services, and quality improvement efforts. The NAPRC also offers educational modules created and maintained by content experts from the American Society of Colon and Rectal Surgeons, College of American Pathologists, and American College of Radiology.
To attain accreditation from the NAPRC, cancer programs must assess and demonstrate compliance with the requirements for all standards outlined in The National Accreditation Program for Rectal Cancer Standards Manual: 2017 Edition, available at facs.org/quality-programs/cancer/naprc/standards.
For more information about the NAPRC, visit the ACS website at facs.org/quality-programs/cancer/naprc, contact [email protected], and read the ACS press release at facs.org/media/press-releases/2017/naprc062117.
National Accreditation Program for Rectal CancerRectal cancer programs interested in earning accreditation from the new National Accreditation Program for Rectal Cancer (NAPRC) may now apply for participation in the program. The goal of the NAPRC is to ensure that rectal cancer patients receive appropriate care using a multidisciplinary approach.
The NAPRC was developed through collaboration between the American College of Surgeons (ACS) Commission on Cancer (CoC) and the Optimizing the Surgical Treatment of Rectal Cancer (OSTRiCh) Consortium, with input from other stakeholder organizations. The NAPRC formed as a response to the success European countries have had in treating rectal cancer, while the quality of care in the U.S. has continued to vary.
Representatives from OSTRiCh presented data highlighting these differences to the CoC Accreditation Committee, which eventually led to the development of a standards manual and six pilot surveys to form the NAPRC, explained Steven D. Wexner, MD, FACS, a colorectal surgeon, ACS Regent, and member of the NAPRC Steering Committee. The standards evaluate program management, clinical services, and quality improvement efforts. The NAPRC also offers educational modules created and maintained by content experts from the American Society of Colon and Rectal Surgeons, College of American Pathologists, and American College of Radiology.
To attain accreditation from the NAPRC, cancer programs must assess and demonstrate compliance with the requirements for all standards outlined in The National Accreditation Program for Rectal Cancer Standards Manual: 2017 Edition, available at facs.org/quality-programs/cancer/naprc/standards.
For more information about the NAPRC, visit the ACS website at facs.org/quality-programs/cancer/naprc, contact [email protected], and read the ACS press release at facs.org/media/press-releases/2017/naprc062117.
ACSPA-SurgeonsPAC maintains strong presence at 2017 Advocacy Summit teaser
During the American College of Surgeons (ACS) Leadership & Advocacy Summit 2017 in Washington, DC, May 6–9, the ACS Professional Association political action committee (ACSPA-SurgeonsPAC) raised more than $61,000 from more than 175 members, staff, and other attendees. In addition to raising funds to elect and reelect congressional candidates who support a pro-surgeon, pro-surgical patient agenda, the Advocacy Summit provided an opportunity to recognize 2017 SurgeonsPAC contributors. SurgeonsPAC notably recognized Gary Timmerman, MD, FACS, as its newest Willens Society member. To become a member of the Willens Society—SurgeonsPAC’s highest giving level named in memory of Past-PAC Vice-Chair Mitchell Willens, MD, FACS—members must pledge a sum total of $25,000 over 10 years.
SurgeonsPAC events showcased ACSPA members’ broad-based commitment to the PAC, particularly at the SurgeonsPAC-sponsored reception at the Smithsonian American Art Museum and National Portrait Gallery, which more than 175 program participants attended. Guests enjoyed VIP access to special exhibitions and views of downtown Washington, DC.
Other SurgeonsPAC-sponsored events included a political luncheon featuring special guest speaker Mara Liasson, national political correspondent for National Public Radio, and presentation of the 2016 PAC awards. For the second consecutive year, South Dakota achieved the highest percent of PAC participation. California was recognized for most dollars raised, and Michael Coburn, MD, FACS, professor and chairman, Scott Department of Urology, and the Russell and Mary Hugh Scott Chair in Urology, Baylor College of Medicine, Houston, TX, received the Warshaw-PAC MVP Award (named in honor of Andrew L. Warshaw, MD, FACS, founder of the PAC) for his leadership raising funds within the ACS Committee on Trauma.
To learn more about SurgeonsPAC fundraising or disbursements, visit www.surgeonspac.org (log in: ACS username and password) or contact ACSPA-SurgeonsPAC staff at 202-672-1520 or [email protected]. For more information about the College’s legislative priorities, go to www.surgeonsvoice.org. ♦
Note
Contributions to ACSPA-SurgeonsPAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of ACSPA have the right to refuse to contribute without reprisal. Federal law prohibits ACSPA-SurgeonsPAC from accepting contributions from foreign nations. By law, if your contributions are made using a personal check or credit card, ACSPA-SurgeonsPAC may only use your contribution to support candidates in federal elections. All corporate contributions to ACSPA-SurgeonsPAC will be used for educational and administrative fees of ACSPA and other activities permissible under federal law. Federal law requires ACSPA-SurgeonsPAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. ACSPA-SurgeonsPAC is a program of the ACSPA, which is exempt from federal income tax under section 501c (6) of the Internal Revenue Code.
During the American College of Surgeons (ACS) Leadership & Advocacy Summit 2017 in Washington, DC, May 6–9, the ACS Professional Association political action committee (ACSPA-SurgeonsPAC) raised more than $61,000 from more than 175 members, staff, and other attendees. In addition to raising funds to elect and reelect congressional candidates who support a pro-surgeon, pro-surgical patient agenda, the Advocacy Summit provided an opportunity to recognize 2017 SurgeonsPAC contributors. SurgeonsPAC notably recognized Gary Timmerman, MD, FACS, as its newest Willens Society member. To become a member of the Willens Society—SurgeonsPAC’s highest giving level named in memory of Past-PAC Vice-Chair Mitchell Willens, MD, FACS—members must pledge a sum total of $25,000 over 10 years.
SurgeonsPAC events showcased ACSPA members’ broad-based commitment to the PAC, particularly at the SurgeonsPAC-sponsored reception at the Smithsonian American Art Museum and National Portrait Gallery, which more than 175 program participants attended. Guests enjoyed VIP access to special exhibitions and views of downtown Washington, DC.
Other SurgeonsPAC-sponsored events included a political luncheon featuring special guest speaker Mara Liasson, national political correspondent for National Public Radio, and presentation of the 2016 PAC awards. For the second consecutive year, South Dakota achieved the highest percent of PAC participation. California was recognized for most dollars raised, and Michael Coburn, MD, FACS, professor and chairman, Scott Department of Urology, and the Russell and Mary Hugh Scott Chair in Urology, Baylor College of Medicine, Houston, TX, received the Warshaw-PAC MVP Award (named in honor of Andrew L. Warshaw, MD, FACS, founder of the PAC) for his leadership raising funds within the ACS Committee on Trauma.
To learn more about SurgeonsPAC fundraising or disbursements, visit www.surgeonspac.org (log in: ACS username and password) or contact ACSPA-SurgeonsPAC staff at 202-672-1520 or [email protected]. For more information about the College’s legislative priorities, go to www.surgeonsvoice.org. ♦
Note
Contributions to ACSPA-SurgeonsPAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of ACSPA have the right to refuse to contribute without reprisal. Federal law prohibits ACSPA-SurgeonsPAC from accepting contributions from foreign nations. By law, if your contributions are made using a personal check or credit card, ACSPA-SurgeonsPAC may only use your contribution to support candidates in federal elections. All corporate contributions to ACSPA-SurgeonsPAC will be used for educational and administrative fees of ACSPA and other activities permissible under federal law. Federal law requires ACSPA-SurgeonsPAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. ACSPA-SurgeonsPAC is a program of the ACSPA, which is exempt from federal income tax under section 501c (6) of the Internal Revenue Code.
During the American College of Surgeons (ACS) Leadership & Advocacy Summit 2017 in Washington, DC, May 6–9, the ACS Professional Association political action committee (ACSPA-SurgeonsPAC) raised more than $61,000 from more than 175 members, staff, and other attendees. In addition to raising funds to elect and reelect congressional candidates who support a pro-surgeon, pro-surgical patient agenda, the Advocacy Summit provided an opportunity to recognize 2017 SurgeonsPAC contributors. SurgeonsPAC notably recognized Gary Timmerman, MD, FACS, as its newest Willens Society member. To become a member of the Willens Society—SurgeonsPAC’s highest giving level named in memory of Past-PAC Vice-Chair Mitchell Willens, MD, FACS—members must pledge a sum total of $25,000 over 10 years.
SurgeonsPAC events showcased ACSPA members’ broad-based commitment to the PAC, particularly at the SurgeonsPAC-sponsored reception at the Smithsonian American Art Museum and National Portrait Gallery, which more than 175 program participants attended. Guests enjoyed VIP access to special exhibitions and views of downtown Washington, DC.
Other SurgeonsPAC-sponsored events included a political luncheon featuring special guest speaker Mara Liasson, national political correspondent for National Public Radio, and presentation of the 2016 PAC awards. For the second consecutive year, South Dakota achieved the highest percent of PAC participation. California was recognized for most dollars raised, and Michael Coburn, MD, FACS, professor and chairman, Scott Department of Urology, and the Russell and Mary Hugh Scott Chair in Urology, Baylor College of Medicine, Houston, TX, received the Warshaw-PAC MVP Award (named in honor of Andrew L. Warshaw, MD, FACS, founder of the PAC) for his leadership raising funds within the ACS Committee on Trauma.
To learn more about SurgeonsPAC fundraising or disbursements, visit www.surgeonspac.org (log in: ACS username and password) or contact ACSPA-SurgeonsPAC staff at 202-672-1520 or [email protected]. For more information about the College’s legislative priorities, go to www.surgeonsvoice.org. ♦
Note
Contributions to ACSPA-SurgeonsPAC are not deductible as charitable contributions for federal income tax purposes. Contributions are voluntary, and all members of ACSPA have the right to refuse to contribute without reprisal. Federal law prohibits ACSPA-SurgeonsPAC from accepting contributions from foreign nations. By law, if your contributions are made using a personal check or credit card, ACSPA-SurgeonsPAC may only use your contribution to support candidates in federal elections. All corporate contributions to ACSPA-SurgeonsPAC will be used for educational and administrative fees of ACSPA and other activities permissible under federal law. Federal law requires ACSPA-SurgeonsPAC to use its best efforts to collect and report the name, mailing address, occupation, and the name of the employer of individuals whose contributions exceed $200 in a calendar year. ACSPA-SurgeonsPAC is a program of the ACSPA, which is exempt from federal income tax under section 501c (6) of the Internal Revenue Code.
Inaugural Chapter Officer Leadership Program promotes best practices for effective chapter management
The inaugural Chapter Officer Leadership Program took place May 6 in Washington, DC, prior to the kickoff of the American College of Surgeons (ACS) 2017 Leadership & Advocacy Summit. The program was designed to provide chapter officers with the tools they need to succeed as leaders and with an opportunity to network and share best practices with colleagues in similar roles.
More than 30 ACS chapter officers, primarily chapter Presidents and Presidents-Elect, attended the all-day session at the Renaissance Downtown Hotel.
“The Chapter Officer Leadership Program is an important component of the ACS strategy to support our domestic chapters,” said Patricia L. Turner, MD, FACS, Director, ACS Division of Member Services, Chicago, IL. “Chapters provide a significant benefit for our members, and this new approach to leadership education will help to ensure that our chapter officers are provided the support they need to deliver high-quality programs and services to ACS members.”
A range of leadership presentations
Program speakers represented a mix of ACS leadership, former and current chapter leaders, and ACS administrators, and addressed topics aimed at providing attendees with the skills and knowledge they need to effectively manage a chapter. Specific presentations included the following:
• Members Services Pillar Update on Efforts to Support Chapters
• Leading in Your Setting: How Effective Leaders Use Multiple Leadership Styles to Impact Change
• ACS Resources for Chapters
• Strategic Planning Strategies for ACS Chapters
• Panel Discussion: What I Wish I Knew Before Becoming a Chapter President
• Results of the 2016 Chapter Survey
• Chapter Communications & Marketing
• Volunteerism through Operation Giving Back: How Can We Help?
• Grassroots Advocacy at the State Level: Making Chapters Strong Advocates for Surgeons
• Resident and Associate Society and Young Fellows Association Engagement in Chapters
• Chapter Involvement in Stop the Bleed®
• Funding Chapter Activities through Sponsorship and Philanthropy
The day concluded with an opportunity for program attendees to discuss issues of concern with members of the Board of Governors Chapter Activities Domestic Workgroup, which serves as an advocate for ACS chapters in the U.S. and Canada. This meeting gave chapter leaders the opportunity to provide feedback on initiatives that the workgroup has been working on over the last year. One such initiative is revising the ACS Chapter Guidebook, a living document that is housed on the ACS website and that will be updated as new topics of interest arise, such as how to effectively use social media to promote chapter activities. The guidebook is available at facs.org/member-services/chapters/guidebook.
The agenda and presentations from the Chapter Officer Leadership Program are available at facs.org/member-services/chapters/acs-events/2017-leadership. For more information about chapter support services, contact Luke Moreau at [email protected] or 312-202-5737.
Mr. Moreau is Manager, Domestic Chapter Services, ACS Division of Member Services, Chicago, IL.
The inaugural Chapter Officer Leadership Program took place May 6 in Washington, DC, prior to the kickoff of the American College of Surgeons (ACS) 2017 Leadership & Advocacy Summit. The program was designed to provide chapter officers with the tools they need to succeed as leaders and with an opportunity to network and share best practices with colleagues in similar roles.
More than 30 ACS chapter officers, primarily chapter Presidents and Presidents-Elect, attended the all-day session at the Renaissance Downtown Hotel.
“The Chapter Officer Leadership Program is an important component of the ACS strategy to support our domestic chapters,” said Patricia L. Turner, MD, FACS, Director, ACS Division of Member Services, Chicago, IL. “Chapters provide a significant benefit for our members, and this new approach to leadership education will help to ensure that our chapter officers are provided the support they need to deliver high-quality programs and services to ACS members.”
A range of leadership presentations
Program speakers represented a mix of ACS leadership, former and current chapter leaders, and ACS administrators, and addressed topics aimed at providing attendees with the skills and knowledge they need to effectively manage a chapter. Specific presentations included the following:
• Members Services Pillar Update on Efforts to Support Chapters
• Leading in Your Setting: How Effective Leaders Use Multiple Leadership Styles to Impact Change
• ACS Resources for Chapters
• Strategic Planning Strategies for ACS Chapters
• Panel Discussion: What I Wish I Knew Before Becoming a Chapter President
• Results of the 2016 Chapter Survey
• Chapter Communications & Marketing
• Volunteerism through Operation Giving Back: How Can We Help?
• Grassroots Advocacy at the State Level: Making Chapters Strong Advocates for Surgeons
• Resident and Associate Society and Young Fellows Association Engagement in Chapters
• Chapter Involvement in Stop the Bleed®
• Funding Chapter Activities through Sponsorship and Philanthropy
The day concluded with an opportunity for program attendees to discuss issues of concern with members of the Board of Governors Chapter Activities Domestic Workgroup, which serves as an advocate for ACS chapters in the U.S. and Canada. This meeting gave chapter leaders the opportunity to provide feedback on initiatives that the workgroup has been working on over the last year. One such initiative is revising the ACS Chapter Guidebook, a living document that is housed on the ACS website and that will be updated as new topics of interest arise, such as how to effectively use social media to promote chapter activities. The guidebook is available at facs.org/member-services/chapters/guidebook.
The agenda and presentations from the Chapter Officer Leadership Program are available at facs.org/member-services/chapters/acs-events/2017-leadership. For more information about chapter support services, contact Luke Moreau at [email protected] or 312-202-5737.
Mr. Moreau is Manager, Domestic Chapter Services, ACS Division of Member Services, Chicago, IL.
The inaugural Chapter Officer Leadership Program took place May 6 in Washington, DC, prior to the kickoff of the American College of Surgeons (ACS) 2017 Leadership & Advocacy Summit. The program was designed to provide chapter officers with the tools they need to succeed as leaders and with an opportunity to network and share best practices with colleagues in similar roles.
More than 30 ACS chapter officers, primarily chapter Presidents and Presidents-Elect, attended the all-day session at the Renaissance Downtown Hotel.
“The Chapter Officer Leadership Program is an important component of the ACS strategy to support our domestic chapters,” said Patricia L. Turner, MD, FACS, Director, ACS Division of Member Services, Chicago, IL. “Chapters provide a significant benefit for our members, and this new approach to leadership education will help to ensure that our chapter officers are provided the support they need to deliver high-quality programs and services to ACS members.”
A range of leadership presentations
Program speakers represented a mix of ACS leadership, former and current chapter leaders, and ACS administrators, and addressed topics aimed at providing attendees with the skills and knowledge they need to effectively manage a chapter. Specific presentations included the following:
• Members Services Pillar Update on Efforts to Support Chapters
• Leading in Your Setting: How Effective Leaders Use Multiple Leadership Styles to Impact Change
• ACS Resources for Chapters
• Strategic Planning Strategies for ACS Chapters
• Panel Discussion: What I Wish I Knew Before Becoming a Chapter President
• Results of the 2016 Chapter Survey
• Chapter Communications & Marketing
• Volunteerism through Operation Giving Back: How Can We Help?
• Grassroots Advocacy at the State Level: Making Chapters Strong Advocates for Surgeons
• Resident and Associate Society and Young Fellows Association Engagement in Chapters
• Chapter Involvement in Stop the Bleed®
• Funding Chapter Activities through Sponsorship and Philanthropy
The day concluded with an opportunity for program attendees to discuss issues of concern with members of the Board of Governors Chapter Activities Domestic Workgroup, which serves as an advocate for ACS chapters in the U.S. and Canada. This meeting gave chapter leaders the opportunity to provide feedback on initiatives that the workgroup has been working on over the last year. One such initiative is revising the ACS Chapter Guidebook, a living document that is housed on the ACS website and that will be updated as new topics of interest arise, such as how to effectively use social media to promote chapter activities. The guidebook is available at facs.org/member-services/chapters/guidebook.
The agenda and presentations from the Chapter Officer Leadership Program are available at facs.org/member-services/chapters/acs-events/2017-leadership. For more information about chapter support services, contact Luke Moreau at [email protected] or 312-202-5737.
Mr. Moreau is Manager, Domestic Chapter Services, ACS Division of Member Services, Chicago, IL.
From the Washington Office: Ensuring an adequate surgical workforce in underserved areas
Increasing evidence indicates a current and growing shortage of surgeons available to serve our nation’s population. As Fellows, we clearly recognize that a shortage of general surgeons is a critical component of this crisis in our nation’s health care workforce. Accordingly, the American College of Surgeons (ACS) is urging policy makers to take appropriate action to recognize that surgeons are uniquely trained and qualified to provide certain necessary, lifesaving procedures through the designation of a formal surgical shortage area.
The ACS is pleased that the Ensuring Access to General Surgery Act of 2017 (S.1351 and H.R.2906) was recently introduced in both the Senate and the House of Representatives. The text of the bill, which is the same in both the Senate and House versions, can be found here: https://www.grassley.senate.gov/sites/default/files/constituents/surgery%20bill.pdf. The legislation has bipartisan sponsorship in both legislative bodies by Senators Charles Grassley (R-IA) and Brian Schatz (D-HI) and Representatives Larry Bucshon, MD, FACS (R-IN) and Ami Bera, MD (D-CA) in the House. This legislation directs the Secretary of the Department of Health and Human Services (HHS), through the Health Resources Services Administration (HRSA), to conduct a study on general surgery workforce shortage areas and provide a general surgery shortage area designation.
Senator Grassley’s office issued a press release on June 15, 2017, in which he, Senator Schatz, Representative Bucshon, and Representative Bera individually delineate the reasons why it is critically important to define and designate general surgery shortage areas. For those interested, that press release can be found here: https://www.grassley.senate.gov/news/news-releases/bipartisan-bill-grassley-schatz-bucshon-bera-would-help-document-areas.
Fellows who visited the offices of their representatives and senators in May as part of the ACS Leadership and Advocacy Summit were able to personally discuss this initiative with members and their staff at that time. Now that the legislation has been officially introduced in both houses of Congress, I would respectfully ask that all Fellows take the 3 minutes necessary to make their voice heard by logging on to www.surgeonsvoice.org and clicking on the Take Action tab on the right side of the landing page to send an e-mail message urging support of the Ensuring Access to General Surgery Act by their individual representatives and both senators.
Until next month …
Dr. Bailey is a pediatric surgeon and Medical Director, Advocacy, for the Division of Advocacy and Health Policy in the ACS offices in Washington, DC.
Increasing evidence indicates a current and growing shortage of surgeons available to serve our nation’s population. As Fellows, we clearly recognize that a shortage of general surgeons is a critical component of this crisis in our nation’s health care workforce. Accordingly, the American College of Surgeons (ACS) is urging policy makers to take appropriate action to recognize that surgeons are uniquely trained and qualified to provide certain necessary, lifesaving procedures through the designation of a formal surgical shortage area.
The ACS is pleased that the Ensuring Access to General Surgery Act of 2017 (S.1351 and H.R.2906) was recently introduced in both the Senate and the House of Representatives. The text of the bill, which is the same in both the Senate and House versions, can be found here: https://www.grassley.senate.gov/sites/default/files/constituents/surgery%20bill.pdf. The legislation has bipartisan sponsorship in both legislative bodies by Senators Charles Grassley (R-IA) and Brian Schatz (D-HI) and Representatives Larry Bucshon, MD, FACS (R-IN) and Ami Bera, MD (D-CA) in the House. This legislation directs the Secretary of the Department of Health and Human Services (HHS), through the Health Resources Services Administration (HRSA), to conduct a study on general surgery workforce shortage areas and provide a general surgery shortage area designation.
Senator Grassley’s office issued a press release on June 15, 2017, in which he, Senator Schatz, Representative Bucshon, and Representative Bera individually delineate the reasons why it is critically important to define and designate general surgery shortage areas. For those interested, that press release can be found here: https://www.grassley.senate.gov/news/news-releases/bipartisan-bill-grassley-schatz-bucshon-bera-would-help-document-areas.
Fellows who visited the offices of their representatives and senators in May as part of the ACS Leadership and Advocacy Summit were able to personally discuss this initiative with members and their staff at that time. Now that the legislation has been officially introduced in both houses of Congress, I would respectfully ask that all Fellows take the 3 minutes necessary to make their voice heard by logging on to www.surgeonsvoice.org and clicking on the Take Action tab on the right side of the landing page to send an e-mail message urging support of the Ensuring Access to General Surgery Act by their individual representatives and both senators.
Until next month …
Dr. Bailey is a pediatric surgeon and Medical Director, Advocacy, for the Division of Advocacy and Health Policy in the ACS offices in Washington, DC.
Increasing evidence indicates a current and growing shortage of surgeons available to serve our nation’s population. As Fellows, we clearly recognize that a shortage of general surgeons is a critical component of this crisis in our nation’s health care workforce. Accordingly, the American College of Surgeons (ACS) is urging policy makers to take appropriate action to recognize that surgeons are uniquely trained and qualified to provide certain necessary, lifesaving procedures through the designation of a formal surgical shortage area.
The ACS is pleased that the Ensuring Access to General Surgery Act of 2017 (S.1351 and H.R.2906) was recently introduced in both the Senate and the House of Representatives. The text of the bill, which is the same in both the Senate and House versions, can be found here: https://www.grassley.senate.gov/sites/default/files/constituents/surgery%20bill.pdf. The legislation has bipartisan sponsorship in both legislative bodies by Senators Charles Grassley (R-IA) and Brian Schatz (D-HI) and Representatives Larry Bucshon, MD, FACS (R-IN) and Ami Bera, MD (D-CA) in the House. This legislation directs the Secretary of the Department of Health and Human Services (HHS), through the Health Resources Services Administration (HRSA), to conduct a study on general surgery workforce shortage areas and provide a general surgery shortage area designation.
Senator Grassley’s office issued a press release on June 15, 2017, in which he, Senator Schatz, Representative Bucshon, and Representative Bera individually delineate the reasons why it is critically important to define and designate general surgery shortage areas. For those interested, that press release can be found here: https://www.grassley.senate.gov/news/news-releases/bipartisan-bill-grassley-schatz-bucshon-bera-would-help-document-areas.
Fellows who visited the offices of their representatives and senators in May as part of the ACS Leadership and Advocacy Summit were able to personally discuss this initiative with members and their staff at that time. Now that the legislation has been officially introduced in both houses of Congress, I would respectfully ask that all Fellows take the 3 minutes necessary to make their voice heard by logging on to www.surgeonsvoice.org and clicking on the Take Action tab on the right side of the landing page to send an e-mail message urging support of the Ensuring Access to General Surgery Act by their individual representatives and both senators.
Until next month …
Dr. Bailey is a pediatric surgeon and Medical Director, Advocacy, for the Division of Advocacy and Health Policy in the ACS offices in Washington, DC.
Self-injectable belimumab receives FDA approval for systemic lupus erythematosus
GlaxoSmithKline announced on July 21 that it had received approval from the U.S. Food and Drug Administration for a new, self-injectable form of belimumab (Benlysta) for adult patients with systemic lupus erythematosus (SLE). Belimumab has previously been approved for SLE, in 2011, in an intravenous formulation.
The new formulation is the first self-injectable subcutaneous treatment available for patients with SLE. The previous treatment required 1 hour of intravenous infusion every 4 weeks, while the new treatment is 1 weekly injection.
Two of the 280 patients receiving placebo (0.7%) died during the study, as did 3 of the 556 patients receiving belimumab (0.5%). Serious infections occurred in 4.1% and 5.4% of patients receiving belimumab and placebo, respectively.
“The safety profile observed for Benlysta administered subcutaneously was consistent with the known safety profile of Benlysta administered intravenously, with the exception of local injection site reactions,” noted GlaxoSmithKline in its announcement. Each form of the drug has a risk of a reaction, whether an infusion reaction for IV administration or a hypersensitivity reaction for self-injection. A patient who reacted to the intravenous formulation with anaphylaxis is contraindicated for the self-injectable version.
It is not known what effect belimumab has on the risk of birth defects or miscarriage, so birth control is recommended for patients on the drug. Likewise, the effects of the drug on breast milk are not known. As belimumab may interfere with immunizations, a patient should not be vaccinated 30 days before or after taking the drug.
GlaxoSmithKline announced on July 21 that it had received approval from the U.S. Food and Drug Administration for a new, self-injectable form of belimumab (Benlysta) for adult patients with systemic lupus erythematosus (SLE). Belimumab has previously been approved for SLE, in 2011, in an intravenous formulation.
The new formulation is the first self-injectable subcutaneous treatment available for patients with SLE. The previous treatment required 1 hour of intravenous infusion every 4 weeks, while the new treatment is 1 weekly injection.
Two of the 280 patients receiving placebo (0.7%) died during the study, as did 3 of the 556 patients receiving belimumab (0.5%). Serious infections occurred in 4.1% and 5.4% of patients receiving belimumab and placebo, respectively.
“The safety profile observed for Benlysta administered subcutaneously was consistent with the known safety profile of Benlysta administered intravenously, with the exception of local injection site reactions,” noted GlaxoSmithKline in its announcement. Each form of the drug has a risk of a reaction, whether an infusion reaction for IV administration or a hypersensitivity reaction for self-injection. A patient who reacted to the intravenous formulation with anaphylaxis is contraindicated for the self-injectable version.
It is not known what effect belimumab has on the risk of birth defects or miscarriage, so birth control is recommended for patients on the drug. Likewise, the effects of the drug on breast milk are not known. As belimumab may interfere with immunizations, a patient should not be vaccinated 30 days before or after taking the drug.
GlaxoSmithKline announced on July 21 that it had received approval from the U.S. Food and Drug Administration for a new, self-injectable form of belimumab (Benlysta) for adult patients with systemic lupus erythematosus (SLE). Belimumab has previously been approved for SLE, in 2011, in an intravenous formulation.
The new formulation is the first self-injectable subcutaneous treatment available for patients with SLE. The previous treatment required 1 hour of intravenous infusion every 4 weeks, while the new treatment is 1 weekly injection.
Two of the 280 patients receiving placebo (0.7%) died during the study, as did 3 of the 556 patients receiving belimumab (0.5%). Serious infections occurred in 4.1% and 5.4% of patients receiving belimumab and placebo, respectively.
“The safety profile observed for Benlysta administered subcutaneously was consistent with the known safety profile of Benlysta administered intravenously, with the exception of local injection site reactions,” noted GlaxoSmithKline in its announcement. Each form of the drug has a risk of a reaction, whether an infusion reaction for IV administration or a hypersensitivity reaction for self-injection. A patient who reacted to the intravenous formulation with anaphylaxis is contraindicated for the self-injectable version.
It is not known what effect belimumab has on the risk of birth defects or miscarriage, so birth control is recommended for patients on the drug. Likewise, the effects of the drug on breast milk are not known. As belimumab may interfere with immunizations, a patient should not be vaccinated 30 days before or after taking the drug.
Physician burnout common, not readily recognized
CHICAGO – Physician burnout is common, and occurs across specialties including gastroenterology, according to a discussion held at the annual Digestive Disease Week.
A number of studies and surveys have reported on physician burnout, including a large 2015 report from the Mayo Clinic, which found that 54% of the physicians surveyed had at least one symptom of burnout (Mayo Clin Proc. 2015 Dec;90[12]:1600-13).
Still, physicians often fail to recognize burnout symptoms in themselves. At the meeting, Laurie A. Keefer Levine, PhD, a GI health psychologist and the director of psychobehavioral research at the Icahn School of Medicine at Mount Sinai, New York, recounted the story of a medical student who jumped from her apartment building and killed herself.
One of the main questions that came out of this discussion was why burnout isn’t more readily recognized. “It had to do with our strength as medical professionals,” she explained. “One common strength is that the pressure is self generated, and we put a lot of pressure on ourselves to excel.”
Health care providers are passionate about their work and it is difficult to give up opportunities that are important to them. “We can delay gratification a really long time until research results come out, or wait a long time for that promotion,” Dr. Keefer said, “But burnout is a very slow and insidious process. A lot of the time we don’t recognize it, and we think ‘just as long as we publish that paper,’ everything will get better.”
Also as time goes on, and physicians become more secure in their work and take on more responsibility, and that becomes another avenue for burnout. But importantly, she emphasized, burnout can be confused with stress, and many people mistake encroaching burnout for stress.
There are pronounced differences between stress and burnout even though they can be co-occurring. The difference, Dr. Keefer explained, is that stress is a problem of too much – work, pressure, and so on, and it is an “overreaction” of the nervous system in that “we’ve got to get it done.”
There is damage associated with chronic stress, but burnout is very different. Instead, burnout is a problem of “not enough.”
“We do not have enough to mount necessary responses to deal with the stressors that we have,” she said. “We are disengaged, our emotions are blunted. We feel helpless or hopeless and lose our motivation. And don’t care about the things we were once passionate about. We don’t have it in us any longer to contribute.”
Physicians use any number of coping strategies, rather than recognizing the problem. The unhealthiest coping strategy is venting. “We all do it, and it feels great, and it is meant to make us feel better,” said Dr. Keefer. “But if continues to happen over and over again, I would encourage you to think it through – that you are engaging in a coping strategy and may be missing burnout.”
It is imperative that medical providers recognize burnout early on, and not wait until it is too late, when there may be major consequences, she said.
Arthur DeCross, MD, professor of medicine at the University of Rochester (N.Y.), discussed some of the subgroups of gastroenterologists who may be at the highest risk of burnout.
Gender plays a strong role, and female gastroenterologists were more likely to identify themselves as being burned out, compared to their male peers. “They may be at risk in the lower domain for a sense of personal accomplishment,” said Dr. DeCross.
“There are respect issues that may come into play, as the literature shows,” he said. “For example, women are more likely to be addressed by their first name by patients and their peers. Also, even at meetings such as this one, how many times is a female presenter simply introduced by her first name?”
There are implicit respect issues here, said Dr. DeCross. “How many times do we hear something like, ‘and now the lovely Millie will present her findings on …?’ ”
He noted that he didn’t think that this lack of respect is intentional, but that it is happening. In addition, there is an issue of wages, and reported data show that women gastroenterologists earn 15% less than their male peers, he noted.
Women are more likely to have competing elements of family and career that put them on the slower track to promotion, he added.
The duration of one’s career also figured into the equation. Burnout was more noticeable early in the career process, suggesting that physicians with young families may be facing more conflicts and stress, and this is an issue that needs to be further explored, he noted.
“Early in the career, there is also the stress of proving oneself,” said Dr. DeCross.
Another contributor to burnout is when physicians spend an increasing amount of time on weekends and holidays doing work-related activities, along with an increase in internal regulatory burdens in the workplace.
Digestive Disease Week® is jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).
CHICAGO – Physician burnout is common, and occurs across specialties including gastroenterology, according to a discussion held at the annual Digestive Disease Week.
A number of studies and surveys have reported on physician burnout, including a large 2015 report from the Mayo Clinic, which found that 54% of the physicians surveyed had at least one symptom of burnout (Mayo Clin Proc. 2015 Dec;90[12]:1600-13).
Still, physicians often fail to recognize burnout symptoms in themselves. At the meeting, Laurie A. Keefer Levine, PhD, a GI health psychologist and the director of psychobehavioral research at the Icahn School of Medicine at Mount Sinai, New York, recounted the story of a medical student who jumped from her apartment building and killed herself.
One of the main questions that came out of this discussion was why burnout isn’t more readily recognized. “It had to do with our strength as medical professionals,” she explained. “One common strength is that the pressure is self generated, and we put a lot of pressure on ourselves to excel.”
Health care providers are passionate about their work and it is difficult to give up opportunities that are important to them. “We can delay gratification a really long time until research results come out, or wait a long time for that promotion,” Dr. Keefer said, “But burnout is a very slow and insidious process. A lot of the time we don’t recognize it, and we think ‘just as long as we publish that paper,’ everything will get better.”
Also as time goes on, and physicians become more secure in their work and take on more responsibility, and that becomes another avenue for burnout. But importantly, she emphasized, burnout can be confused with stress, and many people mistake encroaching burnout for stress.
There are pronounced differences between stress and burnout even though they can be co-occurring. The difference, Dr. Keefer explained, is that stress is a problem of too much – work, pressure, and so on, and it is an “overreaction” of the nervous system in that “we’ve got to get it done.”
There is damage associated with chronic stress, but burnout is very different. Instead, burnout is a problem of “not enough.”
“We do not have enough to mount necessary responses to deal with the stressors that we have,” she said. “We are disengaged, our emotions are blunted. We feel helpless or hopeless and lose our motivation. And don’t care about the things we were once passionate about. We don’t have it in us any longer to contribute.”
Physicians use any number of coping strategies, rather than recognizing the problem. The unhealthiest coping strategy is venting. “We all do it, and it feels great, and it is meant to make us feel better,” said Dr. Keefer. “But if continues to happen over and over again, I would encourage you to think it through – that you are engaging in a coping strategy and may be missing burnout.”
It is imperative that medical providers recognize burnout early on, and not wait until it is too late, when there may be major consequences, she said.
Arthur DeCross, MD, professor of medicine at the University of Rochester (N.Y.), discussed some of the subgroups of gastroenterologists who may be at the highest risk of burnout.
Gender plays a strong role, and female gastroenterologists were more likely to identify themselves as being burned out, compared to their male peers. “They may be at risk in the lower domain for a sense of personal accomplishment,” said Dr. DeCross.
“There are respect issues that may come into play, as the literature shows,” he said. “For example, women are more likely to be addressed by their first name by patients and their peers. Also, even at meetings such as this one, how many times is a female presenter simply introduced by her first name?”
There are implicit respect issues here, said Dr. DeCross. “How many times do we hear something like, ‘and now the lovely Millie will present her findings on …?’ ”
He noted that he didn’t think that this lack of respect is intentional, but that it is happening. In addition, there is an issue of wages, and reported data show that women gastroenterologists earn 15% less than their male peers, he noted.
Women are more likely to have competing elements of family and career that put them on the slower track to promotion, he added.
The duration of one’s career also figured into the equation. Burnout was more noticeable early in the career process, suggesting that physicians with young families may be facing more conflicts and stress, and this is an issue that needs to be further explored, he noted.
“Early in the career, there is also the stress of proving oneself,” said Dr. DeCross.
Another contributor to burnout is when physicians spend an increasing amount of time on weekends and holidays doing work-related activities, along with an increase in internal regulatory burdens in the workplace.
Digestive Disease Week® is jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).
CHICAGO – Physician burnout is common, and occurs across specialties including gastroenterology, according to a discussion held at the annual Digestive Disease Week.
A number of studies and surveys have reported on physician burnout, including a large 2015 report from the Mayo Clinic, which found that 54% of the physicians surveyed had at least one symptom of burnout (Mayo Clin Proc. 2015 Dec;90[12]:1600-13).
Still, physicians often fail to recognize burnout symptoms in themselves. At the meeting, Laurie A. Keefer Levine, PhD, a GI health psychologist and the director of psychobehavioral research at the Icahn School of Medicine at Mount Sinai, New York, recounted the story of a medical student who jumped from her apartment building and killed herself.
One of the main questions that came out of this discussion was why burnout isn’t more readily recognized. “It had to do with our strength as medical professionals,” she explained. “One common strength is that the pressure is self generated, and we put a lot of pressure on ourselves to excel.”
Health care providers are passionate about their work and it is difficult to give up opportunities that are important to them. “We can delay gratification a really long time until research results come out, or wait a long time for that promotion,” Dr. Keefer said, “But burnout is a very slow and insidious process. A lot of the time we don’t recognize it, and we think ‘just as long as we publish that paper,’ everything will get better.”
Also as time goes on, and physicians become more secure in their work and take on more responsibility, and that becomes another avenue for burnout. But importantly, she emphasized, burnout can be confused with stress, and many people mistake encroaching burnout for stress.
There are pronounced differences between stress and burnout even though they can be co-occurring. The difference, Dr. Keefer explained, is that stress is a problem of too much – work, pressure, and so on, and it is an “overreaction” of the nervous system in that “we’ve got to get it done.”
There is damage associated with chronic stress, but burnout is very different. Instead, burnout is a problem of “not enough.”
“We do not have enough to mount necessary responses to deal with the stressors that we have,” she said. “We are disengaged, our emotions are blunted. We feel helpless or hopeless and lose our motivation. And don’t care about the things we were once passionate about. We don’t have it in us any longer to contribute.”
Physicians use any number of coping strategies, rather than recognizing the problem. The unhealthiest coping strategy is venting. “We all do it, and it feels great, and it is meant to make us feel better,” said Dr. Keefer. “But if continues to happen over and over again, I would encourage you to think it through – that you are engaging in a coping strategy and may be missing burnout.”
It is imperative that medical providers recognize burnout early on, and not wait until it is too late, when there may be major consequences, she said.
Arthur DeCross, MD, professor of medicine at the University of Rochester (N.Y.), discussed some of the subgroups of gastroenterologists who may be at the highest risk of burnout.
Gender plays a strong role, and female gastroenterologists were more likely to identify themselves as being burned out, compared to their male peers. “They may be at risk in the lower domain for a sense of personal accomplishment,” said Dr. DeCross.
“There are respect issues that may come into play, as the literature shows,” he said. “For example, women are more likely to be addressed by their first name by patients and their peers. Also, even at meetings such as this one, how many times is a female presenter simply introduced by her first name?”
There are implicit respect issues here, said Dr. DeCross. “How many times do we hear something like, ‘and now the lovely Millie will present her findings on …?’ ”
He noted that he didn’t think that this lack of respect is intentional, but that it is happening. In addition, there is an issue of wages, and reported data show that women gastroenterologists earn 15% less than their male peers, he noted.
Women are more likely to have competing elements of family and career that put them on the slower track to promotion, he added.
The duration of one’s career also figured into the equation. Burnout was more noticeable early in the career process, suggesting that physicians with young families may be facing more conflicts and stress, and this is an issue that needs to be further explored, he noted.
“Early in the career, there is also the stress of proving oneself,” said Dr. DeCross.
Another contributor to burnout is when physicians spend an increasing amount of time on weekends and holidays doing work-related activities, along with an increase in internal regulatory burdens in the workplace.
Digestive Disease Week® is jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).
AT DDW
Physician burnout common, not readily recognized by sufferers
CHICAGO – Physician burnout is common, and occurs across specialties including gastroenterology, according to a discussion held at the annual Digestive Disease Week®.
A number of studies and surveys have reported on physician burnout, including a large 2015 report from the Mayo Clinic, which found that 54% of the physicians surveyed had at least one symptom of burnout (Mayo Clin Proc. 2015 Dec;90[12]:1600-13).
“While she is not the first medical student to kill herself, this was an opportunity for the medical students to sit down and talk with the faculty,” said Dr. Keefer Levine, noting that specifically it focused on how this young woman’s distress had been missed, what was going on with students, and what is missing in medical education.
One of the main questions that came out of this discussion was why burnout isn’t more readily recognized. “It had to do with our strength as medical professionals,” she explained. “One common strength is that the pressure is self-generated, and we put a lot of pressure on ourselves to excel.”
Health care providers are passionate about their work, and it is difficult to give up opportunities that are important to them. “We can delay gratification a really long time until research results come out, or wait a long time for that promotion,” Dr. Keefer Levine said, “But burnout is a very slow and insidious process. A lot of the time we don’t recognize it, and we think ‘just as long as we publish that paper,’ everything will get better.”
Also as time goes on, and physicians become more secure in their work and take on more responsibility, that becomes another avenue for burnout. But importantly, she emphasized, burnout can be confused with stress, and many people mistake encroaching burnout for stress.
There are pronounced differences between stress and burnout even though they can be co-occurring. The difference, Dr. Keefer Levine explained, is that stress is a problem of too much – work, pressure, and so on, and it is an “overreaction” of the nervous system in that “we’ve got to get it done.”
There is damage associated with chronic stress, but burnout is very different. Instead, burnout is a problem of “not enough.”
“We do not have enough to mount necessary responses to deal with the stressors that we have,” she said. “We are disengaged, our emotions are blunted. We feel helpless or hopeless and lose our motivation. And don’t care about the things we were once passionate about. We don’t have it in us any longer to contribute.”
Physicians use any number of coping strategies, rather than recognizing the problem. The unhealthiest coping strategy is venting. “We all do it, and it feels great, and it is meant to make us feel better,” said Dr. Keefer Levine. “But if continues to happen over and over again, I would encourage you to think it through – that you are engaging in a coping strategy and may be missing burnout.”
It is imperative that medical providers recognize burnout early on, and not wait until it is too late, when there may be major consequences, she said.
Arthur DeCross, MD, AGAF, professor of medicine at the University of Rochester (N.Y.), discussed some of the subgroups of gastroenterologists who may be at the highest risk of burnout.
Gender plays a strong role, and female gastroenterologists were more likely to identify themselves as being burned out, compared to their male peers. “They may be at risk in the lower domain for a sense of personal accomplishment,” said Dr. DeCross.
“There are respect issues that may come into play, as the literature shows,” he said. “For example, women are more likely to be addressed by their first name by patients and their peers. Also, even at meetings such as this one, how many times is a female presenter simply introduced by her first name?”
There are implicit respect issues here, said Dr. DeCross. “How many times do we hear something like, ‘and now the lovely Millie will present her findings on ...?’ ”
He noted that he didn’t think that this lack of respect is intentional, but that it is happening. In addition, there is an issue of wages, and reported data show that women gastroenterologists earn 15% less than their male peers, he noted.
Women are more likely to have competing elements of family and career that put them on the slower track to promotion, he added.
The duration of one’s career also figured into the equation. Burnout was more noticeable early in the career process, suggesting that physicians with young families may be facing more conflicts and stress, and this is an issue that needs to be further explored, he noted.
“Early in the career, there is also the stress of proving oneself,” said Dr. DeCross.
Another contributor to burnout is when physicians spend an increasing amount of time on weekends and holidays doing work-related activities, along with an increase in internal regulatory burdens in the workplace.
Dr. DeCross sat down with DDW TV to talk about the results of the survey, which you can watch at http://www.gastro.org/news_items/physician-burnout-amongst-gastroenterologists. Join your colleagues to discuss this important topic in the AGA Community at http://ow.Ly/aYyh30diuq3.
Digestive Disease Week® is jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).
CHICAGO – Physician burnout is common, and occurs across specialties including gastroenterology, according to a discussion held at the annual Digestive Disease Week®.
A number of studies and surveys have reported on physician burnout, including a large 2015 report from the Mayo Clinic, which found that 54% of the physicians surveyed had at least one symptom of burnout (Mayo Clin Proc. 2015 Dec;90[12]:1600-13).
“While she is not the first medical student to kill herself, this was an opportunity for the medical students to sit down and talk with the faculty,” said Dr. Keefer Levine, noting that specifically it focused on how this young woman’s distress had been missed, what was going on with students, and what is missing in medical education.
One of the main questions that came out of this discussion was why burnout isn’t more readily recognized. “It had to do with our strength as medical professionals,” she explained. “One common strength is that the pressure is self-generated, and we put a lot of pressure on ourselves to excel.”
Health care providers are passionate about their work, and it is difficult to give up opportunities that are important to them. “We can delay gratification a really long time until research results come out, or wait a long time for that promotion,” Dr. Keefer Levine said, “But burnout is a very slow and insidious process. A lot of the time we don’t recognize it, and we think ‘just as long as we publish that paper,’ everything will get better.”
Also as time goes on, and physicians become more secure in their work and take on more responsibility, that becomes another avenue for burnout. But importantly, she emphasized, burnout can be confused with stress, and many people mistake encroaching burnout for stress.
There are pronounced differences between stress and burnout even though they can be co-occurring. The difference, Dr. Keefer Levine explained, is that stress is a problem of too much – work, pressure, and so on, and it is an “overreaction” of the nervous system in that “we’ve got to get it done.”
There is damage associated with chronic stress, but burnout is very different. Instead, burnout is a problem of “not enough.”
“We do not have enough to mount necessary responses to deal with the stressors that we have,” she said. “We are disengaged, our emotions are blunted. We feel helpless or hopeless and lose our motivation. And don’t care about the things we were once passionate about. We don’t have it in us any longer to contribute.”
Physicians use any number of coping strategies, rather than recognizing the problem. The unhealthiest coping strategy is venting. “We all do it, and it feels great, and it is meant to make us feel better,” said Dr. Keefer Levine. “But if continues to happen over and over again, I would encourage you to think it through – that you are engaging in a coping strategy and may be missing burnout.”
It is imperative that medical providers recognize burnout early on, and not wait until it is too late, when there may be major consequences, she said.
Arthur DeCross, MD, AGAF, professor of medicine at the University of Rochester (N.Y.), discussed some of the subgroups of gastroenterologists who may be at the highest risk of burnout.
Gender plays a strong role, and female gastroenterologists were more likely to identify themselves as being burned out, compared to their male peers. “They may be at risk in the lower domain for a sense of personal accomplishment,” said Dr. DeCross.
“There are respect issues that may come into play, as the literature shows,” he said. “For example, women are more likely to be addressed by their first name by patients and their peers. Also, even at meetings such as this one, how many times is a female presenter simply introduced by her first name?”
There are implicit respect issues here, said Dr. DeCross. “How many times do we hear something like, ‘and now the lovely Millie will present her findings on ...?’ ”
He noted that he didn’t think that this lack of respect is intentional, but that it is happening. In addition, there is an issue of wages, and reported data show that women gastroenterologists earn 15% less than their male peers, he noted.
Women are more likely to have competing elements of family and career that put them on the slower track to promotion, he added.
The duration of one’s career also figured into the equation. Burnout was more noticeable early in the career process, suggesting that physicians with young families may be facing more conflicts and stress, and this is an issue that needs to be further explored, he noted.
“Early in the career, there is also the stress of proving oneself,” said Dr. DeCross.
Another contributor to burnout is when physicians spend an increasing amount of time on weekends and holidays doing work-related activities, along with an increase in internal regulatory burdens in the workplace.
Dr. DeCross sat down with DDW TV to talk about the results of the survey, which you can watch at http://www.gastro.org/news_items/physician-burnout-amongst-gastroenterologists. Join your colleagues to discuss this important topic in the AGA Community at http://ow.Ly/aYyh30diuq3.
Digestive Disease Week® is jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).
CHICAGO – Physician burnout is common, and occurs across specialties including gastroenterology, according to a discussion held at the annual Digestive Disease Week®.
A number of studies and surveys have reported on physician burnout, including a large 2015 report from the Mayo Clinic, which found that 54% of the physicians surveyed had at least one symptom of burnout (Mayo Clin Proc. 2015 Dec;90[12]:1600-13).
“While she is not the first medical student to kill herself, this was an opportunity for the medical students to sit down and talk with the faculty,” said Dr. Keefer Levine, noting that specifically it focused on how this young woman’s distress had been missed, what was going on with students, and what is missing in medical education.
One of the main questions that came out of this discussion was why burnout isn’t more readily recognized. “It had to do with our strength as medical professionals,” she explained. “One common strength is that the pressure is self-generated, and we put a lot of pressure on ourselves to excel.”
Health care providers are passionate about their work, and it is difficult to give up opportunities that are important to them. “We can delay gratification a really long time until research results come out, or wait a long time for that promotion,” Dr. Keefer Levine said, “But burnout is a very slow and insidious process. A lot of the time we don’t recognize it, and we think ‘just as long as we publish that paper,’ everything will get better.”
Also as time goes on, and physicians become more secure in their work and take on more responsibility, that becomes another avenue for burnout. But importantly, she emphasized, burnout can be confused with stress, and many people mistake encroaching burnout for stress.
There are pronounced differences between stress and burnout even though they can be co-occurring. The difference, Dr. Keefer Levine explained, is that stress is a problem of too much – work, pressure, and so on, and it is an “overreaction” of the nervous system in that “we’ve got to get it done.”
There is damage associated with chronic stress, but burnout is very different. Instead, burnout is a problem of “not enough.”
“We do not have enough to mount necessary responses to deal with the stressors that we have,” she said. “We are disengaged, our emotions are blunted. We feel helpless or hopeless and lose our motivation. And don’t care about the things we were once passionate about. We don’t have it in us any longer to contribute.”
Physicians use any number of coping strategies, rather than recognizing the problem. The unhealthiest coping strategy is venting. “We all do it, and it feels great, and it is meant to make us feel better,” said Dr. Keefer Levine. “But if continues to happen over and over again, I would encourage you to think it through – that you are engaging in a coping strategy and may be missing burnout.”
It is imperative that medical providers recognize burnout early on, and not wait until it is too late, when there may be major consequences, she said.
Arthur DeCross, MD, AGAF, professor of medicine at the University of Rochester (N.Y.), discussed some of the subgroups of gastroenterologists who may be at the highest risk of burnout.
Gender plays a strong role, and female gastroenterologists were more likely to identify themselves as being burned out, compared to their male peers. “They may be at risk in the lower domain for a sense of personal accomplishment,” said Dr. DeCross.
“There are respect issues that may come into play, as the literature shows,” he said. “For example, women are more likely to be addressed by their first name by patients and their peers. Also, even at meetings such as this one, how many times is a female presenter simply introduced by her first name?”
There are implicit respect issues here, said Dr. DeCross. “How many times do we hear something like, ‘and now the lovely Millie will present her findings on ...?’ ”
He noted that he didn’t think that this lack of respect is intentional, but that it is happening. In addition, there is an issue of wages, and reported data show that women gastroenterologists earn 15% less than their male peers, he noted.
Women are more likely to have competing elements of family and career that put them on the slower track to promotion, he added.
The duration of one’s career also figured into the equation. Burnout was more noticeable early in the career process, suggesting that physicians with young families may be facing more conflicts and stress, and this is an issue that needs to be further explored, he noted.
“Early in the career, there is also the stress of proving oneself,” said Dr. DeCross.
Another contributor to burnout is when physicians spend an increasing amount of time on weekends and holidays doing work-related activities, along with an increase in internal regulatory burdens in the workplace.
Dr. DeCross sat down with DDW TV to talk about the results of the survey, which you can watch at http://www.gastro.org/news_items/physician-burnout-amongst-gastroenterologists. Join your colleagues to discuss this important topic in the AGA Community at http://ow.Ly/aYyh30diuq3.
Digestive Disease Week® is jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract (SSAT).
AT DDW
Fujifilm issues recall to update ED-530XT duodenoscopes
Fujifilm has issued an Urgent Medical Device Correction and Removal notification for all ED-530XT duodenoscopes, according to a Safety Alert from the Food and Drug Administration.
The recall, initiated voluntarily by Fujifilm, includes replacement of the ED-530XT forceps elevator mechanism including the O-ring seal, replacement of the distal end cap, and new operation manuals. The FDA authorized the changes on July 21, 2017.
“Reprocessing is a detailed, multistep process to clean and disinfect or sterilize reusable devices. The FDA has been working with duodenoscope manufacturers as they modify and validate their reprocessing instructions to further enhance the safety margin of their devices and show with a high degree of assurance that their reprocessing instructions, when followed correctly, effectively clean and disinfect the duodenoscopes,” the FDA said in the press release.
Find the full Safety Alert on the FDA website.
Fujifilm has issued an Urgent Medical Device Correction and Removal notification for all ED-530XT duodenoscopes, according to a Safety Alert from the Food and Drug Administration.
The recall, initiated voluntarily by Fujifilm, includes replacement of the ED-530XT forceps elevator mechanism including the O-ring seal, replacement of the distal end cap, and new operation manuals. The FDA authorized the changes on July 21, 2017.
“Reprocessing is a detailed, multistep process to clean and disinfect or sterilize reusable devices. The FDA has been working with duodenoscope manufacturers as they modify and validate their reprocessing instructions to further enhance the safety margin of their devices and show with a high degree of assurance that their reprocessing instructions, when followed correctly, effectively clean and disinfect the duodenoscopes,” the FDA said in the press release.
Find the full Safety Alert on the FDA website.
Fujifilm has issued an Urgent Medical Device Correction and Removal notification for all ED-530XT duodenoscopes, according to a Safety Alert from the Food and Drug Administration.
The recall, initiated voluntarily by Fujifilm, includes replacement of the ED-530XT forceps elevator mechanism including the O-ring seal, replacement of the distal end cap, and new operation manuals. The FDA authorized the changes on July 21, 2017.
“Reprocessing is a detailed, multistep process to clean and disinfect or sterilize reusable devices. The FDA has been working with duodenoscope manufacturers as they modify and validate their reprocessing instructions to further enhance the safety margin of their devices and show with a high degree of assurance that their reprocessing instructions, when followed correctly, effectively clean and disinfect the duodenoscopes,” the FDA said in the press release.
Find the full Safety Alert on the FDA website.
Increased risk of death seen in PPI users
Proton pump inhibitors (PPIs) are associated with a significantly higher risk of death than are H2-receptor antagonists, according to a 5-year longitudinal cohort study.
The study, published online in BMJ Open, found that increased risk of death was evident even in people without gastrointestinal conditions, and it increased with longer duration of use.
Yan Xie, MPH, of the VA Saint Louis Health Care System and coauthors, wrote that PPIs are linked to a range of serious adverse outcomes – such as acute interstitial nephritis, chronic kidney disease, incident dementia, and Clostridium difficile infection – each of which is associated with higher risk of mortality.
Researchers saw a 25% higher risk of death in the 275,977 participants treated with PPIs, compared with that in those who were treated with H2-receptor antagonists (95% confidence interval, 1.23-1.28), after adjusting for factors such as estimated glomerular filtration rate, age, hospitalizations, and a range of comorbidities, including gastrointestinal disorders.When PPI use was compared with no PPI use, there was a 15% increase in the risk of death (95% CI, 1.14-1.15). When compared with no known exposure to any acid suppression therapy, the increased risk of death was 23% (95% CI, 1.22-1.24).
In an attempt to look at the risk of death in a lower-risk cohort, the researchers analyzed a subgroup of participants who did not have the conditions for which PPIs are normally prescribed, such as gastroesophageal reflux disease, upper gastrointestinal tract bleeding, ulcer disease, Helicobacter pylori infection, and Barrett’s esophagus.
However, even in this lower-risk cohort, the study still showed a 24% increase in the risk of death with PPIs, compared with that in H2-receptor antagonists (95% CI, 1.21-1.27); a 19% increase with PPIs, compared with no PPIs; and a 22% increase with PPIs, compared with no acid suppression.
Duration of exposure to PPIs was also associated with increasing risk of death. Participants who had taken PPIs for fewer than 90 days in total had only a 5% increase in risk, while those taking them for 361-720 days had a 51% increased risk of death.
“Although our results should not deter prescription and use of PPIs where medically indicated, they may be used to encourage and promote pharmacovigilance and emphasize the need to exercise judicious use of PPIs and limit use and duration of therapy to instances where there is a clear medical indication and where benefit outweighs potential risk,” the authors wrote.“Standardized guidelines for initiating PPI prescription may lead to reduced overuse [and] regular review of prescription and over-the-counter medications, and deprescription, where a medical indication for PPI treatment ceases to exist, may be a meritorious approach.”
Examining possible physiologic mechanisms to explain the increased risk of death, the authors noted that animal studies suggested PPIs may limit the liver’s capacity to regenerate.
PPIs are also associated with increased activity of the heme oxygenase-1 enzyme in gastric and endothelial cells and impairment of lysosomal acidification and proteostasis and may alter gene expression in the cellular retinol metabolism pathway and the complement and coagulation cascades pathway.
However, the clinical mediator of the heightened risk of death was likely one of the adverse events linked to PPI use, they said.
The authors declared no relevant financial conflicts of interest.
Review AGA’s “Guide to Conversations About the Latest PPI Research Results” for tips on talking with your patients about this research study.
Proton pump inhibitors (PPIs) are associated with a significantly higher risk of death than are H2-receptor antagonists, according to a 5-year longitudinal cohort study.
The study, published online in BMJ Open, found that increased risk of death was evident even in people without gastrointestinal conditions, and it increased with longer duration of use.
Yan Xie, MPH, of the VA Saint Louis Health Care System and coauthors, wrote that PPIs are linked to a range of serious adverse outcomes – such as acute interstitial nephritis, chronic kidney disease, incident dementia, and Clostridium difficile infection – each of which is associated with higher risk of mortality.
Researchers saw a 25% higher risk of death in the 275,977 participants treated with PPIs, compared with that in those who were treated with H2-receptor antagonists (95% confidence interval, 1.23-1.28), after adjusting for factors such as estimated glomerular filtration rate, age, hospitalizations, and a range of comorbidities, including gastrointestinal disorders.When PPI use was compared with no PPI use, there was a 15% increase in the risk of death (95% CI, 1.14-1.15). When compared with no known exposure to any acid suppression therapy, the increased risk of death was 23% (95% CI, 1.22-1.24).
In an attempt to look at the risk of death in a lower-risk cohort, the researchers analyzed a subgroup of participants who did not have the conditions for which PPIs are normally prescribed, such as gastroesophageal reflux disease, upper gastrointestinal tract bleeding, ulcer disease, Helicobacter pylori infection, and Barrett’s esophagus.
However, even in this lower-risk cohort, the study still showed a 24% increase in the risk of death with PPIs, compared with that in H2-receptor antagonists (95% CI, 1.21-1.27); a 19% increase with PPIs, compared with no PPIs; and a 22% increase with PPIs, compared with no acid suppression.
Duration of exposure to PPIs was also associated with increasing risk of death. Participants who had taken PPIs for fewer than 90 days in total had only a 5% increase in risk, while those taking them for 361-720 days had a 51% increased risk of death.
“Although our results should not deter prescription and use of PPIs where medically indicated, they may be used to encourage and promote pharmacovigilance and emphasize the need to exercise judicious use of PPIs and limit use and duration of therapy to instances where there is a clear medical indication and where benefit outweighs potential risk,” the authors wrote.“Standardized guidelines for initiating PPI prescription may lead to reduced overuse [and] regular review of prescription and over-the-counter medications, and deprescription, where a medical indication for PPI treatment ceases to exist, may be a meritorious approach.”
Examining possible physiologic mechanisms to explain the increased risk of death, the authors noted that animal studies suggested PPIs may limit the liver’s capacity to regenerate.
PPIs are also associated with increased activity of the heme oxygenase-1 enzyme in gastric and endothelial cells and impairment of lysosomal acidification and proteostasis and may alter gene expression in the cellular retinol metabolism pathway and the complement and coagulation cascades pathway.
However, the clinical mediator of the heightened risk of death was likely one of the adverse events linked to PPI use, they said.
The authors declared no relevant financial conflicts of interest.
Review AGA’s “Guide to Conversations About the Latest PPI Research Results” for tips on talking with your patients about this research study.
Proton pump inhibitors (PPIs) are associated with a significantly higher risk of death than are H2-receptor antagonists, according to a 5-year longitudinal cohort study.
The study, published online in BMJ Open, found that increased risk of death was evident even in people without gastrointestinal conditions, and it increased with longer duration of use.
Yan Xie, MPH, of the VA Saint Louis Health Care System and coauthors, wrote that PPIs are linked to a range of serious adverse outcomes – such as acute interstitial nephritis, chronic kidney disease, incident dementia, and Clostridium difficile infection – each of which is associated with higher risk of mortality.
Researchers saw a 25% higher risk of death in the 275,977 participants treated with PPIs, compared with that in those who were treated with H2-receptor antagonists (95% confidence interval, 1.23-1.28), after adjusting for factors such as estimated glomerular filtration rate, age, hospitalizations, and a range of comorbidities, including gastrointestinal disorders.When PPI use was compared with no PPI use, there was a 15% increase in the risk of death (95% CI, 1.14-1.15). When compared with no known exposure to any acid suppression therapy, the increased risk of death was 23% (95% CI, 1.22-1.24).
In an attempt to look at the risk of death in a lower-risk cohort, the researchers analyzed a subgroup of participants who did not have the conditions for which PPIs are normally prescribed, such as gastroesophageal reflux disease, upper gastrointestinal tract bleeding, ulcer disease, Helicobacter pylori infection, and Barrett’s esophagus.
However, even in this lower-risk cohort, the study still showed a 24% increase in the risk of death with PPIs, compared with that in H2-receptor antagonists (95% CI, 1.21-1.27); a 19% increase with PPIs, compared with no PPIs; and a 22% increase with PPIs, compared with no acid suppression.
Duration of exposure to PPIs was also associated with increasing risk of death. Participants who had taken PPIs for fewer than 90 days in total had only a 5% increase in risk, while those taking them for 361-720 days had a 51% increased risk of death.
“Although our results should not deter prescription and use of PPIs where medically indicated, they may be used to encourage and promote pharmacovigilance and emphasize the need to exercise judicious use of PPIs and limit use and duration of therapy to instances where there is a clear medical indication and where benefit outweighs potential risk,” the authors wrote.“Standardized guidelines for initiating PPI prescription may lead to reduced overuse [and] regular review of prescription and over-the-counter medications, and deprescription, where a medical indication for PPI treatment ceases to exist, may be a meritorious approach.”
Examining possible physiologic mechanisms to explain the increased risk of death, the authors noted that animal studies suggested PPIs may limit the liver’s capacity to regenerate.
PPIs are also associated with increased activity of the heme oxygenase-1 enzyme in gastric and endothelial cells and impairment of lysosomal acidification and proteostasis and may alter gene expression in the cellular retinol metabolism pathway and the complement and coagulation cascades pathway.
However, the clinical mediator of the heightened risk of death was likely one of the adverse events linked to PPI use, they said.
The authors declared no relevant financial conflicts of interest.
Review AGA’s “Guide to Conversations About the Latest PPI Research Results” for tips on talking with your patients about this research study.
