The Needs of Vascular Surgery and the Added Benefits of an Independent ABVSVascular surgery needs to be recognized as a defined specialty. The fact that it is not, supports the intrusion of other surgical and interventional specialists, only partly interested in vascular disease, into the peripheral vascular field. Clinical inadequacies of these other disciplines in vascular disease management have been documented to frequently result in unnecessary and ill-advised costly procedures, as well as poorer outcomes. Vascular surgery, as a defined specialty distinct from General Surgery and Cardiac Surgery, could mount a much more effective effort to obtain appropriate reimbursement than it has in the past. An independent ABVS would make it much more difficult for general surgeons and cardiac surgeons to serve as expert witnesses against vascular surgeons in those states where plaintiff's experts must be certified by the same Board as the defendant physicians. By controlling our training, more well-trained vascular surgeons could be produced to care for patents in remote areas. Signature vascular cases would not have to be used for the training of general surgeons who do not perform them in their later practices. Creation of a Primary Certificate in Vascular Surgery within the ABS is inconsistent with ABMS actions regarding Surgical specialization. Other surgical specialties, no better defined or developed than Vascular Surgery are represented by ABMS recognized Boards. This has been the case with Colon and Rectal Surgery, Neurological Surgery, Orthopaedic Surgery, Otolaryngology, Plastic Surgery, Thoracic Surgery, and Urology. The concoction of a "Primary Specialty within the ABS" is unprecedented amongst mature surgical specialties. It is another means to keep Vascular Surgery under the control of General Surgery. An independent ABVS will clarify for referring physicians and others that Vascular Surgery is a distinct specialty not linked or subordinate to General Surgery or Cardiac Surgery. Divisions of Vascular Surgery, especially in large academic institutions, will become less reliant on other specialties or the whims and control of nonvascular surgeons. The ABS position that Vascular Surgery benefits by being "part of surgery" by remaining in its fold is a misrepresentation. The ABS has benefited Vascular Surgery only when pressured by outside forces, including the ABVS. Although the ABMS and ABS are careful to state that they do not set criteria for hospital credentials, the fact is that in many metropolitan areas the yellow pages for physicians and surgeons include listings of practitioners under the name and logo of the ABMS as "specialists." Vascular Surgery has not been part of this practical application of recognizing advanced training and certification in medicine. Frank J. Veith, MD |
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