At the 2013 ACVS Veterinary Symposium, a Diplomates-only forum was held to discuss what ACVS, individual surgeons, AVMA and other organizations can do to proactively address issues regarding training general practitioners in advanced surgical procedures. A Diplomate panel* presented:
- what the ACVS is doing to support Diplomates,
- the pros and cons of teaching advanced surgical techniques to general practitioners, and
- concerns about sponsors’ roles in continuing education, societies granting certificates that may mislead the public and AVMA’s support of specialists.
Attendees offered their comments, with a general consensus that focusing on educating the public about specialists and remaining inclusive with general practitioners is a reasonable approach for the College. All Diplomates are asked to live up to the guiding principle, “ACVS board certified veterinary surgeons provide the highest quality of surgical care for all animals.”
The Board of Regents’ activities regarding several of issues are summarized. Additional comments and concerns emphasized during the forum included:
- New veterinarians do not have the same surgical experience as those graduating 20 years ago. Most veterinary schools have limited the number and variety of procedures students are exposed to in laboratories, concentrating primarily on fundamental skills learned on models and during sterilization procedures. Defining and teaching procedures that were once believed to be entry level are those that continuing education courses and laboratories should focus on offering to general practitioners to avoid the dilemma of being “unskilled and unaware.” A tiered system of procedures is recommended.
- Referral surgeons should educate general practitioners on a case-by-case basis to improve their knowledge and ability to manage surgical cases. Explain what is needed to properly manage the case, including the facilities, equipment, staff expertise, etc. Educating the general practitioner, in addition to the public, will shift cases to specialists.
- Diplomates who are not up-to-date or are willing to perform surgery in less than optimal surgical facilities cause erosion of our credibility as surgeons whose standards, skills and expertise are expected to be above reproach. Facility and care criteria should be established for mobile surgeons and others to follow to maintain an appropriate standard of care for surgical cases.
- We, as Diplomates, need to do a better job of policing our profession. The ACVS is not a policing organization, therefore, when inappropriate procedures or poorly performed procedures are identified they must be reported to the state licensing boards whether they are performed by a general practitioner or a Diplomate.
- ACVS and Diplomates should appeal to companies that sponsor independent lectures and laboratories to support continuing education that teaches basic rather than advanced skills and procedures. The focus of this training should be mastery of fundamental entry level procedures and awareness of when to refer.
The Board of Regents will take these concerns and the general sentiment that ACVS should focus on educating the public about specialists and remain inclusive of general practitioners into account during their deliberations of issues. We thank the panel and other members for their comments and willingness to participate in this forum. Please direct additional comments and concerns to me or another member of the Board of Regents.
Cheryl S. Hedlund, DVM, MS, Diplomate ACVS
Chair, ACVS Board of Regents
John Payne, Moderator, Pittsburgh Veterinary Specialty and Emergency Center
Earl Gaughan, Chair, ACVS Board of Regents, VA-MD Regional College of Veterinary Medicine
Barb Gores, Veterinary Specialty Center of Tucson
Cheryl Hedlund, ACVS President, Iowa State University
Ian Holsworth, Veterinary Medical and Surgical Group
Ross Lirtzman, Arizona Canine Orthopedics & Sports Medicine
Ann Loew, ACVS Chief Executive Officer