In light of continuing Medicare and other third party-payer physician reimbursement issues and changes, the American College of Surgeons (ACS) and 20 other specialty surgical organizations have jointly published the sixth edition of Physicians as Assistants at Surgery, a guide that indicates whether an operation may call for the use of a physician as an assistant.
First released in 1994, the 2011 study reflects significant changes. Since its last publication in 2007, 371 new CPT codes have been added. Each participating organization reviewed codes applicable to their respective specialty in the "Surgery" section of the American Medical Association's Current Procedural Terminology (CPTTM) 2010 to determine the need of a physician as an assistant. CPT is the most frequently used medical nomenclature for reporting medical services and procedures to private and public health insurance payers.
Published in a table format, the study indicates whether an operation requires a physician as an assistant "almost always," "almost never," or "some of the time."
Recognizing that numerous factors can affect what type of health care professional is asked to serve as an assistant at surgery, Physicians as Assistants at Surgery presents information only about the need for a physician as an assistant.
The American College of Surgeons maintains that a physician as an assistant used during an operation should be a trained individual who is able to participate in and actively assist the surgeon in completing the operation safely. Furthermore, ACS supports using a qualified surgeon or surgery resident, at appropriate levels of training, as an assistant whenever possible.
Because a physician as an assistant helps to provide exposure, maintain hemostasis, and serve other technical functions during an operation, they perform their duties under the supervision of the surgeon. When a surgeon is not available to serve as an assistant, other physicians, registered nurses, surgeon's assistants, or physician's assistants who have undergone additional surgical training and with experience in assisting during operations could be used, according to the ACS position as published in its Statements on Principles.
In addition to the American College of Surgeons, the organizations that participated in the development of the 2011 edition of Physicians as Assistants at Surgery study are:
•American Academy of Ophthalmology
•American Academy of Orthopaedic Surgeons
•American Academy of Otolaryngology-Head and Neck Surgery, Inc.
•American Association of Neurological Surgeons
•American Association of Oral and Maxillofacial Surgeons
•American College of Obstetricians and Gynecologists
•American Pediatric Surgical Association
•American Society for Surgery of the Hand
•American Society of Breast Surgeons
•American Society of Cataract and Refractive Surgery
•American Society of Colon and Rectal Surgeons
•American Society of General Surgeons
•American Society of Plastic Surgeons
•American Society of Transplant Surgeons
•American Urological Association
•Congress of Neurological Surgeons
•Society for Surgical Oncology
•Society of American Gastrointestinal Endoscopic Surgeons
•Society of Thoracic Surgeons
•Society for Vascular Surgery
American College of Surgeons