[ccm-l] American College of Surgeons a "Trade Group"???

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http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2005-October/_http://www.timesunion.com/AspStories/storyprint.asp?StoryID=413143_ 
(http://www.timesunion.com/AspStories/storyprint.asp?StoryID=413143) 
 
I am aware of workforce and market driven trends in the medical  marketplace. 
  My comments are mine alone and do not represent any  organization to which 
I belong.    
 
My concerns relate to continuity of care.    Who assumes  continuing care and 
when complications occur, just who assumes what portion of  what piece of the 
complication.     One final rhetorical  question, is what would most surgeons 
want for themselves and their families  when surgery and followup is needed.  
 
I can see how the original posting could and would see surgeons as becoming  
clock punching tradesmen.    Shift work for surgeons is a  total anathema to 
me.   I do not understand how a surgeon or a patient  would accept such a 
concept.  But I also realize that many on these  list servers believe differently 
from me and have differing value  systems.     One big danger in painting 
ourselves into the  "tradesman" box is that we become just what it is that we 
structure ourselves to  be.   What would follow is a specific targeted salary for 
hours worked  with an expectation of product delivered.   Huge debate is 
currently  underway at the AMA regarding Payment for Performance laws coming into 
being at  the legislature, hospital, and HMO levels.      I  cannot imagine one 
surgeon simply stopping an operation in mid suture and  handing the remainder 
of the surgery off as one would hand off a relay  stick.     One might ask if 
this mind set also includes  collective bargaining?     
 
This group has had a discussion in the past as just what is a professional  
and what is a tradesman?    Can a professional be a tradesman and  is a 
tradesman a professional.   If ones answer is yes, then this  discussion is a mute 
point and one chalks all of this concern down to age  specific theoretic.    On 
the other hand, if this is a  market driven attempt to survive the managed 
care and physician  profiling effects on patient care, then we must object to the 
suggested  direction.       
 
k  

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