The May 2013 Digital Edition of General Surgery News

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GENERALSURGERYNEWS.COM

May 2013 • Volume 40 • Number 5

The Independent Monthly Newspaper for the General Surgeon

Opinion

Doctor Group Claims Drug Purchasing Organizations Causing Chronic Shortages

It’s Not the Economy, Stupid B Y J ON C. W HITE , MD

T

he 1992 Clinton campaign headquarters had a poster on the wall stating, “It’s the economy, stupid.” This mantra, chanted by his staff for that entire campaign season, is thought to have been the strategy that convinced the U.S. electorate to choose a virtually unknown governor of a small, southern state over a popular, sitting president. The belief that the economy is all-important is shared by health care discussants who point to the increasing difficulties we have in financing our large and complicated industry. Most health care programs, such as

We have to take the long view and imagine new ways to train physicians. Obamacare and Romneycare, or health care strategies, such as fee for service, socialized medicine, managed care and medical savings accounts are just different ways of financing the same industry. I was one of those who had been seduced by the notion that our system would be fine as long as we figured out how to pay for it. The more I study the health care industry, however, the more I see that I was wrong and the industry is not fine. It has problems that are more serious than its high price tag. I am now convinced see NOT THE ECONOMY page 20

Assays Face Off On Breast Cancer Recurrence Risk BCI Outdoes Other Genetic Tests FFor Long-Term Prognosis

B Y T ED A GRES

F

rustrated d with ongoing shoortages of key drugs, a new grassroots group is calling for the repeal off federal leg-islation thaat permits grroup purchasing organizations (G GPOs) to engage in what they call collusive ll i and d anticompeti itive activities. Several senior U.S. lawmakers have asked the Government Accountability Office (GAO), the investigative arm of Congress, to look into the allegations that

B Y K ATE O'R OURKE

GPOs are at least partly responsible for the nation’s drug shortages. “We are convinced that the anticompetitive contracting and pricing see DRUG SHORTAGE page 10

SAN ANTONIO—The Breast Canceer Index (BCI, bioTheranosticcs) outperforms the Oncotype DX X Recurrence Score (RS; Genomic Heaalth) and the immunohistochemicall (IHC)4 in accurately predicting breeast cancer recurrence risk five to 10 yyears after a disease-free period, accord ding to the TransATAC (Arimidex, Tamoxifen, Alone or in Comid bination) study, presented by Dennis Sgroi, MD, director of breast pathology at Massachusetts General Hospital in Boston, at the San Antonio Breast Cancer Symposium (abstract S1-9).

SAGES Issues Recommendations On Endoluminal Therapies for GERD B Y M AUREEN S ULLIVAN

T

wo endoluminal treatments for gastroesophageal reflux disease (GERD) were the subject of a recent assessment by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Published in February, the clinical spotlight review recommended Stretta (Mederi Therapeutics), a radiofrequency therapy,

as an appropriate option for patients who meet certain indications for GERD. However, the review committee found insufficient evidence to recommend EsophyX (EndoGastric Solutions), a device used for transoral incisionless fundoplication, as a treatment option.

The ATAC trial 10-year follow-up data demonstrated that late disease recurrence is a hallmark of estrogen receptor (ER)-positive breast cancer, with greater than 50% of recurrences occurring after five years of adjuvant tamoxifen or anastrozole therapy. TransATAC collected tumor blocks for biomarker assessment.

see ENDOLUMINAL page 8

see FACEOFF page 4

INSIDE Surgeons’ Lounge

In the News

Letters to the Editor

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Coverage of the 24th Annual International Colorectal Disease Symposium

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Antireflux Procedures Increase at Low-Volume Centers, Despite Worse Outcomes Than at HighVolume Centers

Preparedness of Surgical Graduates; Flawed Data on Ambulatory Surgery Centers


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