Washington journal continues. Host good morning. We are back with dr. Patricia turner. She is good morning and were back of doctor patricia turner. She is the executive director in ceo of the American College of surgeons. Good morning good morning. Thank you for joining us, were going to talk about the coronavirus pandemic and other issues that are affecting the u. S. Health care system. Lets start off by talking about the American College of surgeons. What is this mission and what does your work involve . Thank you for having me. So, the American College of surgeons is a large organization, about 87,000 Members Around the world. We represent surgeons and we enhance the care of the surgical patient by supporting the surgeons. So we have educational component, so teaching surgeons what is on the cutting edge. We have quality programs to enhance the Quality Improvement process of hospitals around the world, and we communicate outwardly so that patients and hospitals and our members can know what is the right thing to do about surgical cases. How is it funded . We are a membership organization, so we have members, you may have seen the fac s designation after surgeons name, that means they are a fellow of the American College of surgeons. We also have programs, educational products, that we sell and we also participate in Quality Improvement efforts. Hospitals engaged with us to help them enhance Quality Improvement. You are talking about the quality movement, the American College of surgeons, i had this report from earlier last month. It says youre driving Quality Improvements amid challenging post pandemic environment for u. S. Hospitals. Its a new campaign that was launched last month. Can you tell us more about it . Of course, so that is in conjunction with our quality programs and our efficacy and Health Policy branch. We have a division here in d. C. That works on a regulatory matters and Advocacy Team along with their Quality Improvement team and we have launched a Quality Improvement campaign called the power of quality. Or gauge with hospitals around the country to bring our Quality Improvement programs to them. It may be breast surgery or geriatric surgery or cancer or trauma. Theres some of the wellknown ones, but we also have new programs and vascular surgery, new programs that come across the kind of operation. We have a children Verification Program or a geriatric surgery program. Our goal is to bring the highest quality of evidence based care to every patient in every hospital around the country. And let me give our listeners and viewers a number to call to either share any comments they have about the Health Care System or ask any questions of you. The numbers to call, if youre in the eastern or the central time zone we want you to call us at 202748 8000. If youre in the mountain or pacific time zone youre numbers 202748 8001. And if you are a medical professional and would like to weigh in, your number is 202748 8002. And can go ahead and start calling now and we will 2027488001 get to in just a moment. How would you define the current state of surgery in the current state of the u. S. Health care system in general . One of the challenges and strengths . Surgeons are so Surgical Care is the engine that drives many hospitals. The procedures are incredibly important and while we can have many members of the Health Care Committee to spin some elements of what we can do, if you need a sergeant, you have to have a certain. If you have a traumatic experience if you, have a cancer, you have to have a surgeon but there are things that we need is patients that require Surgical Care. Our job as the American College of surgeons is to make sure that our 110 year old motto, to heal all the skill interest, continues to be what guides us and brings us highest quality care to all patients who are cared for by all surgeons. When we think about what are the challenges, certainly abscess continues to be something we are concerned about. We want to make sure that we bring Surgical Care and evidence based article cared to his many individuals as possible. And the community in an academic settings. We also want to make sure that we are mindful of the elements of quality because that continues to be something that may not be as talked about, that is essential. How did the coronavirus pandemic you know, hospitals were such a priority. Essential. How did that highlight or exacerbate what issues exist in the Health Care Industry . So, one good example from the coronavirus pandemic is cancer. Lets talk about cancer. So, we know that screenings save lives. Whether its colonoscopy or mcguffey, we know that screening for cancer is essential and saves lives. In the pandemic, appropriately, we had to channel all of our resources into management of covid19. So, the early stage cancers, it might have been discovers on a mammogram or in a colonoscopy, way to put those on the backburner because we are focusing all of our energies on the pandemic. But we know from a recent study that was published is that there were fewer cancers found in the early days of the pandemic. Thats an example of where covid19 pushed off some of the essential screenings and some of the cases or the operations that surgeons would want to do. Way to push them off. That has impacts downstream for patits. Im going to show on our screen there is omnibus funding for Cancer Research and programs that has been requested. Tre is 47. 5 billion dollars for the National Institutes health. Seven point 3. 2 billion for the National Cancer institute, 22. 4 million for the National ComprehensiveCancer Control program. 53. 4 million for the National Program of cancer registries and 1. 5 billion for advanced Research Projects agency for health. Which is that new agency that is being established to advance biomedical and health breakthroughs. That was in the omnibus funding package that passed the last congress, so its going to be implemented. How important is it that this new funding goes in place to address some of the lags that exist when it comes to cancer . So, this is essential but not sufficient. These numbers we obviously want more funding for research, more funding to demonstrate what the evidence is that there are other bones that need funding. Surgeon should be they should receive reimbursement that is commitment to quality American College of service that we know are demonstrated to enhance quality to save patients lives, to diminish complications are certain to be paid for participating in those high quality programs because those are better for patients. Firearm violence. It is not a political issue just like we do research in the Motor Vehicle accidents or wearing we need to invest in reducing the burden of firearms violence. Im going to bring up we do have another chart to show what was in the omnibus bill for Firearm Research to the National Institutes of health and the cdc to and Public Health research on firearm injury for prevention particularly when republicans were in control there wasnt as much money for fire arm prevention. What is the benefit for this money and how could it be used . This is essential investment firearm. Its a major Public Health crisis and just like all other Public Health crises, we have to invest money in the research to figure out how to benefit that curve, how to reduce lives lost. Again, i have to emphasize not a political issue at all. This is quite literally a Public Health crisis. In the same way that we would invest in cancer and invest more and cancer the same way that we would invest more in clean water or seatbelts to reduce death for motivational crashes, both on the quality for the surgeons investment to reduce fire arm and investment for cancer and we are receiving. For you the first one is via twitter she writes how do you physician quality reports . Our surgeries being denied for patients for fear of impacting physicians quality scores and thus that is a great question one of the compared to some others is that we do risk adjustment. So, we dont just give numbers of complications or thats after certain operation, we incorporate elements that are the patient factors. Did that person have diabetes, holds that person, did they have other health issues. We file into that. Were able to calculate what the complication rate should be and then what an individual surgeon or hospitals complication is. Sicker patients will get operated, on its where do you go to get the best care for your personal set of issues. Here is a question we received by message. Ray, in aurora colorado writes i was diagnosed with depression a few years ago. With Mental Health gaining attention in recent years, what can be said about surgeons in this area. On Mental Health all across the country there is a place where surgery overlaps with that and we work with our qualities favor to figure out how we bring that together and do the right operation for that patient when its the appropriate time for them to proceed. Lets go to the phone lines now as a reminder, if youre on the eastern or central time zones, 2027488000. If youre in the mountain or pacific time zones 2027488001 and if youre a medical professional he would like to weigh in 2027488002. John in johnstown pennsylvania, whats your question or comment . Wait. Hello . Youre on now. Its about the american medical association. Why dont they backup doctors that are being threatened by these governors for not performing certain government operations. The example im going to use is the one over the weekend. I was watching this hearing for this girl from texas who almost died because the doctors were afraid to board the baby. She had some kind of situation where the baby was causing her some kind of infection and they said they have to wait until she starts getting sick to perform the surgery. The doctors from that hospital actually called other doctors and other hospitals and they refused you can see here because of the laws. The american medical association, the ama, as got to step in and start helping these doctors and backing them up and start suing some of these state legislatures. This can go on. Women in this country have a higher mortality rate from pregnancy than any other place in the industrialized world. So its going on here . Where to do something about protecting these women, especially the ones that are in danger of losing their lives because of some stupid abortion laws. Ill take my answer off of you. Thank you for that question, youre right, that is a thorny issue, i say upfront i cant speak for the american medical association, certainly im not representing them, but what i will say is that the american medical association, the American College of surgeons, and in most organizations agree that we have to provide evidence based care of our patients. So that is, i think, the guiding light. As it relates to the specifics of your question about why lawsuits are not underway i cant speak to, that but i will emphasize our perspective on this, which is that we are very much focused on providing evidence based care. So what the science says is what we do. We also believe that we have to take care of patients in a way that does not allow interference between the patient and the physician. That is a private relationship between the patient and the physician and we endorse that. All right, our next caller is henry into soto, texas. What is your question or comment, henry . Yes, good morning, i would like to know how profound of an impact did the covid19 pandemic have on our Health Care System in terms but is it understated, overstated, or is it yet to be realized with regards to if negative impact in times of with workers unpaid bills, and the lake. Thank you for that question. It goes without question that the pandemic was of Epic Proportions and i dont use that lightly. More than 1. 1 million individuals lost their lives during the pandemic. Just a few moments ago, some of the screenings for cancer werent done so those individuals may percent now at later stage disease, more advanced disease. We know that there are people who lost their jobs, we know that there are Economic Impact as well as the Mental Health impact as well as the Health Impact on communities was profound its hard to say whether its more or less than what was published because i suppose it would depend on what you are reading. I think that the pandemic was profoundly impactful and an extremely negative way in many facets. It received another question on for you on twitter. They write, with a b any discussion of how the Affordable Care act made already High Health Care even higher . Thank you for that question. In many ways, what we want is for individuals to have access to care. That is the biggest priority. We know that if you dont have access to care for whatever reason that your Health Outcomes or worse. We know that if you dont get the screenings that we know save lives and your outcomes are worse. So, our goal is to have as many individuals have access to the Health Care System, have access to the evidence based care that we provide fellows of the American College of certain provide and we want to ensure that all patients are able to receive care i want to ask you, we had a caller bring up the issue of abortion, which is a thorny issue. Another one that has become part of the debate in politics care for transgender patients. The American College of surgeons but i have discussions about it on her website. How has your organization navigated transgender care and surgery for people who identify as transgender, being such a hot topic right now . It is a hot topic. As you can imagine, there is controversy. There are very strong opinions on both sides. We always focus on what the data shows. What is the right thing to do . Depending on the specialties, for example, we have urologists and gynecologist in pediatric surgeons who are all members of the acs. They are guided by what the evidence suggests. There are states where there are pieces of legislation being considered. We, obviously, abide by the laws. But we really focus on the Evidence Based Practice and what is best for the patient. Lets go back to that omnibus funding and the discussion. Your organization has advocated for more funding for health care workers. Can you talk about that as a priority . It is a priority. We know that the Health Care Workforce writ large was deeply impacted by the pandemic. We know that we have lost many people from the workforce. Not just positions, these physicians might be experiencing burnout. Or those who may have suffered with depression as a result of what they have seen. It is not the physicians, nurses are at an alltime low. In many of our hospitals we are unable to put patients there because there are not enough nurses. That is another priority area we need nurses, tax, and those in support functions. You need all of the members of the Health Care Team in order to run hospital. All right. Lets take another caller. We will go to oklahoma. Jen is on the line. What did your question . I, thank you for taking my call. I love cspan. Thank you, dr. Turner, for being here. I am a first year medical resident. I am in my psychiatry residency. I appreciate the discussions about Mental Health, especially in the wake of covid. My biggest question, kind of a global question that i would like to hear your thoughts on, we have, in the United States we have significantly horror outcomes per dollar spend than many other developed nations in the world. Some of which, many of which have universal health care programs. We hear a lot about the importance of preventative medicine, shifting our model of care to one that focuses on preventative medicine. We like to think about things from an evidence based lens. I guess i havent really found the exact framework to back this up but it seems to me that having a universal health care program, something where everyone is covered, would encourage this type of preventative model which, i think, most experts would agree would go towards improving outcomes, improving decreasing mortality, decreasing morbidity. I guess, you know, what if anything do you have to say on this . Thank you for your time. Thank you for that question, jab. I would agree with you that Preventative Care is the right way to go about improving Health Outcomes. If we can do Preventive Care on the front sign, we will have fewer