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Ann Thorac Surg 2003;76:2156-2166
© 2003 The Society of Thoracic Surgeons

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Workforce Report

The STS future planning conference for adult cardiac surgery

^* Address reprint requests to Dr Bonchek, 555 N Duke St, Lancaster, PA 17603, USA.
e-mail: lbonchek@prodigy.net

The first 300 words of the full text of this article appear below.

The specialty of adult cardiac surgery faces unprecedented pressures from third-party payers, purchasing consortia, and government agencies, not only to intensify our quality improvement efforts and to conduct public audits, but also to conform to arbitrary standards for surgery volumes and outcomes. Payments have been declining steadily and steeply, and the volume of adult cardiac surgery in many institutions is threatened by advances in interventional cardiology. Hospital support for cardiac surgery programs has therefore become much less generous. It is no surprise that our specialty has lost some of its desirability as a career choice, and some residency positions have not filled in the initial match.

To begin addressing the impact of the forces that will shape our specialty over the next decade, the STS conducted a polydisciplinary, interactive conference at Heart House in Bethesda, MD from November 1 to 3, 2002. In addition to considering projected changes in clinical care, we focused on the effects of nonclinical forces, such as: the actions of those who pay for cardiac surgical services; those who influence its supply (eg, medical schools, training programs, hospitals, nursing schools); those who supply its tools and technology (equipment manufacturers, venture capitalists); and those in policy-making positions or consulting practices who are focused on health care.

To assure an interactive process, in which all attendees participated in discussions, attendance was kept under 50 participants (Appendix) by inviting only the speakers, the officers of the STS and AATS, and representatives of the industry sponsors. In selecting speakers, we were constantly mindful of the opportunity to expose nonsurgeons to viewpoints they may not have previously heard or considered, and we hoped their thinking, as well as ours, would be influenced by a forthright exchange of ideas. These hopes were justified. For example, the interaction with Kenneth Kizer, MD, President . . . [Full Text of this Article]

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