Download - American Society of Colon and Rectal Surgeons

OF
COLON
THE AMERICAN SOCIETY
AND
RECTAL
1899
SURGEONS
ASCRS
News
The American Society of Colon and Rectal Surgeons
85 West Algonquin Road • Suite 550 • Arlington Heights, Illinois 60005 • (847)290-9184 • Fax: (847)290-9203 • http://www.fascrs.org/ Fall 2002
Dr. Fry makes clarion call for action
Dr. Robert Fry:
“We must
frame the
debate.”
In an eloquent, impassioned clarion call for action,
outgoing Society President Dr. Robert D. Fry,
Philadelphia, PA, called for drastic steps to fix
America’s health care delivery system.
In his presidential address to attendees at the ASCRS
Annual Meeting, Dr. Fry complained that “our very
ability to provide quality professional care is now
being threatened.” The causes of the problem
include “an aging population, a decreasing rate of
reimbursement for professional services, an uninsured
population that we cannot morally ignore,
[and] increasing and unreasonable liability judgments
that have elevated professional liability rates
to unacceptable and unsustainable levels,” he said.
Another major cause is “the recognition that managed care, which
was supposed to promote health and contain costs, has failed miserably
and is now despised by patients, physicians, and corporate
purchasers of health care,” he added.
The address used Philadelphia as an example of problems that
plague the health care system nationwide. “The total amount of
A blend of breakthrough science, prestigious
featured speakers and professional
camaraderie helped draw 1,870 registered
attendees to the ASCRS Annual Meeting,
June 3-8, in Chicago.
Nearly 800 spouses and guests, nurses/
physician assistants, exhibitors and media
representatives joined 1,071 ASCRS
members and nonmember physicians.
For those who missed a program
or couldn’t come to Chicago, ASCRS has
posted a Webcast of the 2002 Annual
Meeting on its Website, www.fascrs.org.
On the home page, click on “2002
Webcast” to access video presentations
of each topic at the meeting.
The Webcast makes it convenient for busy
surgeons to access programs of interest
when their schedules permit. Everyone
can access the presentations, although
no CME credit is available through the
online program.
The six-day Annual Meeting featured panel
discussions and symposia highlighting the
money awarded for liability damages in the city of Philadelphia
in 2001 exceeded the amount awarded for all damage claims
in the entire state of California,” he said.
“In 2001, the hospitals in Philadelphia were reimbursed by managed
care companies at the second highest rate in the United States.
But the reimbursement the physicians in Philadelphia received from
these very same managed care companies was the absolute lowest
in the country. What’s wrong with this picture?,” he asked.
“The system is now so strained that we surgeons can simply no
longer sustain our practice and deliver quality care,” Dr. Fry said.
“Our margins have been trimmed so severely that we cannot provide
charity care, cannot maintain our facilities, cannot sustain our staffs,
cannot, in short, practice surgery that will meet the standard of care.
“As surgeons, we have continued to be advocates for our patients, to
work harder, accept less. But the payers, including the federal government,
have mistaken our professionalism for weakness. We must
frame the debate, present the honest facts, educate the public, enlist
our patients to this cause and allow society to decide if this country
will provide the finest health care in the world,” he declared.
ASCRS Annual Meeting draws 1,870 to Chicago
newest technology to help colorectal surgeons
build their practices, test their judgment
and expand their knowledge base.
Highlights included:
• The Endorectal Ultrasound Hands-
On Lab, led by Dr. W. Douglas Wong,
New York City. The course focused on
using this emerging modality for colorectal
disease with training and education
in the basic use of ultrasound.
…continued on page 2
In this issue…
President’s Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .page 2
Dr. David Rothenberger receives Mentor Award . . . . . . . . .page 3
Progress slow in Congress on medical liability reform . .page 4
Socioeconomic Committee to focus on equitable
practice expense issues . . . . . . . . . . . . . . . . . . . . . . . . . .page 5
Dr. Richard Billingham elected President . . . . . . . . . . . . .page 7
DC&R’s key performance indicators increase . . . . . . . .page 11
Society’s public relations program reaches 19 million .page 12
Research Foundation report . . . . . . . . . . . . . . . . . . . . .page 13
Bringing colorectal surgery to developing countries . . .page 16

PRESIDENT’S MESSAGE
Chicago meeting confirms increasing interest in specialty
By Richard P. Billingham, MD
2
The great success of our Chicago meeting
is testimony to the excellent program
assembled by Dr. Jan Rakinic and her
committee. It confirms the increasing attraction
of colon and rectal surgery as an area
of special interest, both in North America
and abroad. The Webcast of the meeting
is available online, accessible through the
Society’s Website (www.fascrs.org). I
urge you to take advantage of this benefit,
which can be accessed without a fee.
We are gratified to see increasing interest
from outside the U.S. and Canada in attending
our Annual Meeting and in becoming
ASCRS members. Serving the needs of the
Society’s growing international membership
presents special challenges. These challenges
will be among the main areas of
concern during the coming year, as we
re-evaluate the Society’s Strategic Plan.
Another area of emphasis will be the
Society’s public relations efforts, directed
both to the general public and our physician
colleagues. I encourage you to review
the Strategic Plan, available through our
Website, to get an idea of the breadth and
depth of efforts of the ASCRS on behalf of
its members, and on behalf of the advancement
of colon and rectal surgery.
Member survey planned
This Fall, each ASCRS member will receive
a lengthy questionnaire, asking for evaluation
and input regarding virtually all the
functions of the Society. Member feedback
will be critically important as an updated
Chicago’s Annual Meeting... continued from page 1
Program Chair
Dr. Jan Rakinic
Strategic Plan is crafted during the first
quarter of 2003. While this questionnaire
will be a detailed, multi-page document,
I urge every member to respond in each
area of Society endeavor, so the Executive
• The New Technologies Update, moderated by Dr. M.
Parker Roberts, South Portland, ME, shed light on positron
emission scanning, the future of genetic testing and an
overview of WebSurg – a surgical teaching site on the Internet.
• The Research Forum, moderated by Dr. Walter Koltun,
Hershey, PA, gave surgeons the opportunity to discuss the work
of young researchers, helping enhance study design, interpret
data and guide research approaches to ongoing studies.
Emerging controversies involving ongoing patient treatment, combined
with a list of prominent international speakers, helped
members catch a glimpse of the specialty’s future.
A perennial favorite at ASCRS Annual Meetings, The Consultant’s
Dr. Robert D. Fry passes the Society’s presidential
medallion to Dr. Richard P. Billingham
(right).
Council can have the benefit of your perspectives
and plan accordingly for the
achievement of shared goals.
On the socioeconomic front, Dr. David
Margolin, Chair of the Socioeconomic
Committee, reports elsewhere in this
newsletter about activities of the RUC, PEAC
and CPT efforts. The colonoscopy bill
(S.710 or H.R. 1520, also called the
Eliminate Colorectal Cancer Act) would
mandate that all health plans cover
colorectal cancer screening for all patients
age 50 and over and for others who have
significant risk factors for the disease. It
was scheduled for markup by the Health,
Education, Labor and Pensions Committee
during the summer. It is meeting some
resistance from those who feel it would
drive insurance premiums higher, without
considering the lives and costs saved by prevention
and/or early detection of the disease.
Dr. Ernestine Hambrick has been
assisting in modifying the language of the
bill through the STOP Colorectal
Cancer Foundation.
Outcome research
In the area of outcome research, Drs. Neil
Hyman and Sam Labow have recently
reported a study in the State of Vermont
showing that surgeons can cooperatively
collect their own outcome data, and that the
process of collecting and analyzing the data
does, indeed, have an effect on quality
improvement (Arch. Surg. 137: 413-416,
2002). Efforts are now under way to mount
a similar project through regional societies
of colon and rectal surgery in New England,
with the goal of improving quality and
outcomes.
As I write this, our Society numbers an alltime
high 2,341 members. Together, we
strive to improve patient care by advancing
the science and technology of disease prevention
and management, while providing
education and giving perspective to these
advances. I welcome your involvement and
suggestions.
Scientific program
now online at
www.fascrs.org
Corner, featured panels of experts who described different
approaches to challenging patient management situations.
“Surgeons walked away from this year’s Annual Meeting with an
appreciation of tomorrow’s challenges facing our specialty,” said
Dr. Jan Rakinic, Springfield, IL, Program Committee Chair.
“Much of the success of the meeting can be attributed to extensive
interaction between attendees and presenters.
“The ‘Meet the Professor’ breakfasts were very popular, as
always,” Dr. Rakinic said. “The video session was well received.
The Presidential Address received an overwhelmingly positive
audience response.”

Dr. David Rothenberger receives Mentor Award
Dr. David A. Rothenberger, Minneapolis, MN, received the
ASCRS Research Foundation’s Mentor Award during the Society’s
Chicago Annual Meeting. It is given every other year to a nominee
who meets six criteria, including evidence of “mentoring” young
faculty in colon and rectal surgery and involvement in training
residents in the operative and post-operative management of
colon and rectal disease.
A past president of the Society and the American Board of Colon
and Rectal Surgery, Dr. Rothenberger is currently Professor of
Surgery and holds the John P. Delaney, M.D., Ph.D. Chair in
Clinical Surgical Oncology at the University of Minnesota.
“(Dr. Rothenberger has been) a
driving force behind the University
of Minnesota residency program for
the last 25 years…(who) trained
nearly 100 clinical and research
residents…”
In a tribute submitted to support the award, Dr. Robert D.
Madoff, Minneapolis, MN, who trained under Dr. Rothenberger,
called his mentor “a driving force behind the University of
Minnesota residency program for the past 25 years...[who]
trained nearly 100 clinical and research residents whose
widespread contributions to colon and rectal
surgery attest to his commitment to academic
and clinical excellence.”
Dr. Rothenberger was cited for his “tireless
fundraising efforts for the Minnesota Colon and
Rectal Foundation [of which he is founding
President] and the ASCRS Research Foundation
[of which he is currently Vice President].”
Dr. Madoff said Dr. Rothenberger established
an anorectal physiology laboratory, an
endorectal ultrasound laboratory, and a
prospective colorectal database within the
Division of Colon and Rectal Surgery. He also
spearheaded the development of a multidisciplinary hereditary
colorectal cancer registry.
“Having laid this essential groundwork, he nurtured the careers of
junior colleagues by entrusting the development of these programs
to them. In addition, he actively promoted the academic careers of
promising young colorectal surgeons nationwide,” Dr. Madoff’s
tribute says.
Born in Sioux Falls, SD, Dr. Rothenberger is a graduate of
Princeton University and the Tufts University Medical School. He
also holds a BS in Medicine from the University of South Dakota.
Dr. W. Douglas Wong, New York, NY, presented the Mentor
Award plaque at the Society’s annual business meeting in Chicago.
Dr. David A.
Rothenberger (left)
accepts the Research
Foundation’s Mentor
Award from
Dr. W. Douglas Wong
Regional awards presented to outstanding researchers
ASCRS presented seven regional awards
at the 2002 Annual Meeting in Chicago
to honor researchers for their outstanding
papers and posters. The Awards Committee,
chaired by Dr. Donald Buie, Calgary, AB,
Canada, selected the following honorees:
• The Chicago Society of Colon &
Rectal Surgeons Durand Smith,
MD, Award — Drs. A. Sheen,
D. Gilham, R. Guest, J. Irlam,
N. Kirollova, A. O’Neill, D. Sherlock,
R. Hawkins, Manchester, United
Kingdom, “Gene Therapy of Patient
Derived T Lymphocytes to Target and
Eradicate Colorectal Hepatic Metastases.”
• The Ohio Valley Society of Colon
and Rectal Surgery Award —
Drs. S. Jeong, K. Shin, J. Shin,
J. Ku, Y. Shin, S. Park, W. Kim,
J. Park, Goyang and Seoul, South
Korea, “Microsatellite Instability and
Mutations in DNA Mismatch Repair
Genes in Sporadic Colorectal Cancers.”
• The New England Society of Colon
and Rectal Surgeons Award —
Drs. A. Senagore, H. Abcarian, M.
Corman, S. Wexner, S. Nivatvongs,
J. Fleshman, M. Singer, Cleveland,
OH, Chicago, IL, Los Angeles, CA,
Weston, FL, Rochester, MN, St. Louis, MO,
“Safety of Stapled Hemorrhoidopexy:
Initial Results from a Multicenter Trial.”
• The Northern California Society of
Colon and Rectal Surgeons Award —
Drs. O. Zmora, A. Mahajna, B.
Bar-Zakai, D. Rosin, D. Hershko,
M. Shabtai, M. Krausz, A. Ayalon,
Tel Aviv and Haifa, Israel, “Left Sided
Anastomosis Without Mechanical Bowel
Preparation. A Randomized Prospective
Trial.”
• The Pittsburgh Society of Colon
and Rectal Surgeons Karl A.
Zimmerman, MD, Award — Drs.
B. Peng, D. Jayne, Y. Ho, Singapore,
Singapore, “Randomized Trial of
Rubber-Band Ligation Versus Stapled
Haemorrhoidectomy for Prolapsing Piles.”
• The Midwest Society of Colon
and Rectal Surgeons William
C. Bernstein, MD, Award —
Drs. A. Beham, M. Vogel,
M. Rentsch, A. Fürst, K. Jauch,
Regensburg, Germany, “Adenoviral
Transfer of Bax Under the Control of the
CEA Promoter Induces Apoptosis in Colon
Cancer Cell Lines in Vitro and in Vivo.”
• The Pennsylvania Society of Colon
and Rectal Surgery Award —
Drs. A. Fürst, M. Anthuber,
S. Suttner, L. Hutzel, A. Beham,
K. Jauch, Regensburg, Germany,
“Colonic J-Pouch vs. Coloplasty Following
Resection of Distal Rectal Cancer —
Early Results of a Prospective
Randomized Pilot Study.”
3

W A S H I N G T O N U P D A T E
Progress slow in Congress on medical liability reform,
relief from declines in Medicare physician payment rates
By Erin J. LaFlair, American College of Surgeons
4
As the 2002 midterm elections approach,
members of Congress seem inclined to
introduce and pass controversial legislation
to impress their constituents. Physicians are
pleading with Congress for medical liability
reform and relief from a seemingly unending
series of drops in reimbursement rates
over the past six years. Surgeons are feeling
the pain in both areas, and their increased
involvement with Capitol Hill has led to
introduction and passage of legislation crucial
to surgery’s future.
Medical Liability Reform
Surgeons continue to identify medical liability
reform as one of their top legislative
priorities. The urgency became more
intense in recent months, as surgeons
nationwide received 2002 premium notices
that were much higher than their 2001 premiums.
These rate increases and the lack
of available insurance, coupled with the
St. Paul Companies’ announcement that
they are discontinuing medical malpractice
insurance, have caused widespread concern
within the medical community.
A series of medical malpractice reforms
passed the House of Representatives six
times in the past 10 years. Unfortunately, the
Senate has not been as supportive on this
issue. It has failed to pass medical liability
reform even once. At last count, only 42 or
43 Senators definitely support the reforms.
In April, Rep. James Greenwood, (R-PA)
introduced the HEALTH Act of 2002 (H.R.
4600), a bill to safeguard
patient access to care and
give physicians some relief
from increasing liability
premiums. It proposes
the following reforms:
• Assure speedy resolutions
to claims.
Lawsuits must be filed
no later than three
years after the date of
injury.
• Allocate responsibility. Damages
are allocated fairly and in proportion
to a party’s degree of fault.
• Compensate patient injury.
Economic compensation will be unlimited.
All injured patients will be able to
recover economic damages such as future
medical expenses and loss of future earnings.
These payments can be paid periodically
rather than in one lump sum.
Medicare Payment Services for Surgical Services
CPT Code Procedure 1989 2003 2003
Average 6/28 Proposal with 2% increase
44050 Reduce Bowel Obstruction $706 $748 $798
44125 Removal of Small Intestine $1,035 $923 $985
44140 Partial Removal of Colon $1,218 $1,113 $1,187
44150 Removal of Colon $1,615 $1,376 $1,468
44310 Ileostomy/jejunostomy $710 $947 $1,010
44320 Colostomy N/A $1,064 $1,135
44850 Repair mesentery $467 $592 $631
45112 Removal of Rectum $1,608 $1,600 $1,707
*Payments in the second column were calculated using the Conversion Factor in the Proposed Rule published on June 28, 2002. Payments in
the third column were calculated using the 2% increase in HR 4954.
• Maximize patient recovery. Patient
awards are maximized by limits on
attorney’s fees.
• Put reasonable limits on punitive
damages. The bill allows for punitive
damages to be the greater of two times
economic damages or $250,000.
“There is broad support on Capitol
Hill for payment increases to
physicians, but it is not at all
clear that legislators will be able
to reach agreement on a prescription
drug proposal.”
• Allow for state flexibility. States will
be able to keep caps already enacted by
their state legislators.
On the other side of Capitol Hill, Sen. Mitch
McConnell (R-KY) introduced similar legislation.
Sen. John Ensign (R-NV) has also
announced his intention to introduce a
Senate companion to the HEALTH Act of
2002. Sen. Ensign’s home state of Nevada
is one of many in which surgeons and other
physicians are experiencing significant premium
increases for their medical liability
insurance. Unfortunately, passage of meaningful
medical liability reform in the Senate
will continue to be a struggle due to aggressive
efforts of the American Trial Lawyers
Association.
Members of Congress respond best when
we can document “real life” implications
of policy with actual stories of hardships
physicians or patients have experienced
due to medical liability. The American
College of Surgeons would like to use these
“real-life” stories to document the need
for immediate congressional action. If
you know surgeons or patients whom the
liability crisis has directly affected, please
forward their stories to Barbara Cebuhar
at bcebuhar@facs.org, or contact her
at 202-337-2701.
Medicare Reimbursement
In June, the House of Representatives
passed H.R. 4954, the Medicare
Modernization and Prescription Drug Act
of 2002, to address a variety of Medicare-
…continued on page 6

S O C I O E C O N O M I C L E G I S L A T I V E R E P O R T
Socioeconomic Committee to focus on equitable practice
expense issues By David A. Margolin MD, ASCRS Socioeconomic Chair
The Society’s Socioeconomic Committee will focus on three key
issues during the next year:
1
Continue to work through the established framework of
the American Medical Association’s (AMA) Relative Value
Update Committee (RUC) and Practice Expense Advisory
Committee (PEAC) to develop appropriate practice expense
values for colorectal surgery codes. PEAC is considering practice
expense values for office-based flexible sigmoidoscopy
and colonoscopy. Working closely with related professional
specialty organizations, the Committee will attempt to refine
the non-facility-based practice expense values of these codes.
Participation in the PEAC is essential to guarantee fair reimbursement
for office-based procedures. As the Centers for
Medicare and Medicaid Services (CMS) continues to change
RVUs based on the site of service, it is imperative that the Society
play a role in developing fair and equitable reimbursement.
Participation in this process and the dissemination of this information
allows individuals to determine where they can safely
perform procedures in the most cost-efficient setting.
2
Over the past year, the Committee has successfully developed
and received RUC valuation for a number of laparoscopic
colon codes, an intraoperative colonic lavage code and
a code for the repair of an anal fistula with fibrin glue. These
codes will be published in CPT 2003.
CPT
CODE
PROCEDURE
44153 Colectomy, total, abdominal, without proctectomy; with ileostomy or
ileoproctostomy, with rectal mucosectomy, ileoanal anastomosis,
creation of ileal reservoir (S or J), with or without loop ileostomy
44388 Colonoscopy through stoma: diagnostic, with or without collection
of specimen(s) by brushing or washing (separate procedure)
45119 Proctectomy, combined abdominoperineal pull-through procedure
(e.g., colo-anal anastomosis), with creation of colonic reservoir
(e.g., J-pouch), with or without proximal diverting ostomy
46060 Fissurectomy, with or without sphincterotomy
46280 Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous,
complex or multiple, with or without placement of seton
The Committee plans to continue working through the CPT
process to complete the set of laparoscopic colon codes.
Currently, CPT has a push to determine which “with or without”
and “and /or” codes
would be better split
into their individual
components.
According to the
CPT/AMA, this would
help in data collection
and clarification of practice patterns. The Committee and
its CPT representative will participate in the evaluation of these
codes and any others pertinent to colon and rectal surgery.
With ASCRS member input, the Committee will determine
which codes should be adjusted. The chart shows some representative
codes in CPT 2002.
To nominate a new code, contact
Dr. David Margolin (dmargol1@hfhs.org),
Dr. Guy Orangio (gorangio @bellsouth.net)
or Dr. Eric Weiss (weisse@ccf.org).
As has been the practice, the Committee will put forth any
new codes nominated by a member. To nominate a new code,
contact Dr. David Margolin (dmargol1@hfhs.org), Dr. Guy
Orangio (gorangio @bellsouth.net) or Dr. Eric Weiss
(weisse@ccf.org). Remember that any changes or additions
to CPT require survey data for appropriate valuation. Therefore,
be generous with your time and complete a survey if contacted
by a Socioeconomic Committee member. Contact the American
College of Surgeons coding hotline (1-800-227-7911) for
answers to any specific coding questions.
3
The Committee will survey ASCRS members
to learn how it can best serve them. This survey
will focus at the national, regional and local
levels. The Committee is also interested in how it
can disseminate pertinent socioeconomic information
to members in a more efficient and timely
fashion.
Finally, it is extremely important to acknowledge
and recognize the time and effort put forth by Dr.
Anthony Senagore, as he completes his tenure
as Socioeconomic Committee chair. He has created
a solid foundation on which the Society can
build. His work as Socioeconomic Committee
chair is greatly appreciated.
Abstracts for 2003 Annual Meeting accepted only online
Abstracts for the 2003 Annual Meeting June 21-26, 2003, in New
Orleans, LA, will only be accepted online, beginning September 3,
2002, at www.fascrs.org. No paper submissions will be accepted.
Deadline for receipt of abstracts is December 2, 2002.
To qualify for a podium presentation, abstracts must represent original
work that has not previously been published or presented and
will not be under consideration for publication or presentation at a
major regional, national or international meeting before the ASCRS
Annual Meeting.
5

Washington Update: Progress shown in Congress… continued from page 4
related issues, including reimbursement
for physicians. This legislation will:
• Provide a statutory physician payment
update of two percent in 2003, 2004
and 2005;
• Reform the sustainable growth rate
(SGR) formula to include a 10-year
“rolling average” of the gross domestic
product to stabilize payment fluctuations;
• Use actual 2002 physician spending figures
as the starting point for calculating
allowable costs used in the update formula
for future years; and
• Eliminate the remaining three years of
budget neutrality adjustments for payment
policy changes previously implemented
(currently amounting -0.2%
in 2003, -0.2% in 2004, and +0.8%
in 2005).
The plan will cost an estimated $20 billion
over five years and an additional $11.5 billion
over 10 years. If Congress does not
approve a permanent solution to replace the
current SGR formula before 2005, physician
payments will return to the levels projected
under current law, resulting in a drastic 18-
20% reduction in payments for 2006.
In July, the Senate considered and voted
down two proposals that would have created
a new Medicare prescription drug benefit.
Such legislation is widely considered
the most likely vehicle for securing relief for
physicians from additional Medicare payment
cuts. If Congress does not pass a prescription
drug bill, the health care
community will have to identify a new vehicle
for physician payment reform.
There is broad support on Capitol Hill for
payment increases to physicians, but it is
THANKS TO OUR SUPPORTERS
ASCRS is grateful to the following companies and organizations for their generous support of the following
projects and programs, which contributed greatly to the success of the Annual Meeting.
ASCRS Research Foundation — The Norman Nigro Research Lectureship.
Harry E. Bacon Foundation — The Harry E. Bacon Lectureship.
Adolor Corporation — The Preliminary Convention Program....The Convention Program Guide....
the Tuesday symposium, “Can We Reduce Post-operative Hospital Length of Stay and Still Provide
Quality?”....and a grant to Webcast the symposium on the ASCRS website.
B-K Medical Systems, Inc. — The Endorectal Ultrasound Course on Monday and Tuesday.
Cellegy Pharmaceuticals, Inc. — The Tuesday symposium, “Anal Fissure — Current Management
Options”....and the Tuesday evening Welcome Reception.
Curon Medical, Inc. — The lanyards (badge holders).
Ethicon Endo-Surgery — The Friday symposium, “State of the Art Stapling: Open, Laparoscopic,
Hand-Assisted”...The Executive Council Dinner...The Abstracts on Disk...and the Colon and Rectal Surgery
Educational Program (CARSEP).
Genzyme Biosurgery — A Wednesday evening reception in honor of the Research Foundation of
ASCRS.
GlaxoSmithKline Consumer Healthcare — All morning refreshment breaks....and the hotel key.
Merck & Company —The Wednesday morning “Meet the Professor” breakfasts.
Procter & Gamble Company — The Membership Directory...and registration bags.
Shire US Inc. — The Resident’s Breakfast Meeting on Wednesday...and the Annual Reception and Dinner
Dance on Friday.
United States Surgical — The Past President’s Reception and Luncheon on Wednesday.
not at all clear that legislators will be able
to reach agreement on a prescription drug
proposal. There are disagreements over
the size of the new benefit and fundamental
disagreements over structural aspects of the
bill. If they cannot agree on the larger prescription
drug bill, the provider assistance
provisions would have to be incorporated
into another bill that can pass.
New Medicare Fee Schedule
On June 27, the Centers for Medicare &
Medicaid Services (CMS) announced proposed
changes to the Medicare fee schedule
for 2003. The most important change is calculation
of the Medicare Economic Index
(MEI), one of the key factors used in determining
the annual fee schedule update. CMS
proposes to use a different “productivity
adjustment” for physicians, something that
physician organizations including the
College have long advocated. Using the old
productivity adjustment, the annual update
under current law is projected to be minus
5.5% next year; under the proposed revisions,
next year’s update is estimated to be
minus 4.4%.
Unfortunately, the proposed rule did not
contain any revisions to the data or methodology
involved in calculating malpractice
relative values. It was hoped that meaningful
changes would be proposed to more fairly
compensate specialists experiencing rapidly
escalating malpractice premiums while their
payments overall continue to decline.
The chart on page 4 illustrates the impact
of payments without the legislative fix and
the conversion factor decreasing by 4.4%,
and payments with the legislative fix and
an increase of 2.0%.
Impact Political Process
It is important for surgeons to become more
involved in the political process. Write or
call your congressional representatives and
inform them of the need for medical liability
reform and tell them the impact lower reimbursement
rates will have on access to care.
The American College of Surgeons has
recently created a Legislative Action Center
to give surgeons a vehicle to write their
members of Congress. Please go to the following
site and help educate your legislators:
http://capwiz.com/facs/home.
6

Dr. Richard Billingham elected President of ASCRS
Dr. Richard P. Billingham, Seattle, WA,
was elected President of the American
Society of Colon and Rectal Surgeons
(ASCRS) for 2002-2003 at its annual business
meeting, June 7, in Chicago. He succeeds
Dr. Robert D. Fry, Philadelphia, PA.
Other newly elected officers to the ASCRS
Executive Council include: Drs. David J.
Schoetz, Burlington, MA, President-Elect;
Sergio W. Larach, Orlando, FL, Vice
President; Lester Rosen, Dallas, TX,
Secretary; James W. Fleshman, Jr.,
St. Louis, MO, Research Foundation
President; and Drs. Steven D. Wexner,
Weston, FL, and W. Douglas Wong,
New York City, Members-at-Large.
President
Dr. Billingham is Clinical Professor,
Department of Surgery at the University
of Washington, Seattle, WA. He also has a
private colon and rectal surgery practice,
with offices at Swedish Medical Center
and Northwest Hospital, Seattle.
He is President of the Northwest Colorectal
Foundation and the Foundation for Colorectal
Surgical Education. Dr. Billingham
is a member of the American Board of
Colon and Rectal Surgery (ABCRS) and
board member of the STOP Colorectal
Cancer Foundation.
A Fellow of both ASCRS and the American
College of Surgeons, Dr. Billingham served
on the ASCRS Research Foundation’s Board
of Trustees from 1992-1998. He served
on the Society’s Executive Council from
1990-1993, then again as Secretary from
1996-1999.
Dr. Billingham was Associate Editor
of Diseases of the Colon and Rectum
(DC&R) from 1987-1996. He has chaired
the Bylaws Committees of both the Society
and the Research Foundation, and served
on the Society’s Public Relations, CME and
Self-Assessment Committees.
President-Elect
Dr. Schoetz is Chair of the Department
of Colon and Rectal Surgery and the
Department of Education at Lahey Clinic
Medical Center, Burlington, MA. He is
Professor of Surgery at Tufts University.
He has been a member of the of the
Residency Review Committee for colon
and rectal surgery, serving as Examination
Chairman and President of the Board.
An ASCRS Fellow since 1987, Dr. Schoetz
served as Secretary on the Executive Council
from 1999 - 2002. He has served on
numerous committees within the Society
and has chaired the Program and Local
Arrangements Committees.
Vice President
Dr. Larach is Program Director of the Colon
and Rectal Fellowship Program at the Colon
and Rectal Clinic of Orlando, FL. He also
holds the title of Associate Professor of
Surgery, University of Florida, College
of Medicine, Gainesville, FL.
Dr. Larach served on the Continuing
Education, Social Impact, Research
Foundation Awards, Membership, and
Awards Committees. He served as Associate
Board Examiner – Certification
Examinations, from 1997 to 2000.
Secretary
Dr. Rosen is Professor of Clinical Surgery
at the College of Medicine, Penn State
University/Hershey Medical Center. He is
an attending colorectal surgeon at Lehigh
Valley Hospital, Allentown, PA.
Dr. Rosen served on the Executive Council
from 1993-97. He has served on the
Society’s Awards, Self-Assessment, Scientific
Technology, Workforce and Quality
Assessment and Safety Committees.
Dr. Rosen chaired the Standards Task Force
from 1987 to 1994. During that time, the
Task Force developed nine guidelines that
were published in DC&R.
Research Foundation President
Dr. Fleshman is Chief of the Colon and
Rectal Surgery Section at Barnes-Jewish
Hospital of St. Louis, Washington University
Medical Center, and Professor of Surgery,
Washington University School of Medicine.
An ASCRS Fellow, Dr. Fleshman is an active
member of the Society, previously serving
on the Laparoscopy and CME Committees,
among others. He is also a past chairman
of the Program Committee. He was elected
to the Executive Council as Member-at-Large
in 2001, a seat he continues to hold in
conjunction with his duties as Research
Foundation President.
In 1992, he was the recipient of the ASCRS
Young Researchers Award. He currently
serves as ABCRS Examinations Committee
Chairman and as representative to the
American Board of Surgery.
Members-at-Large
Dr. Wexner is Chief of Staff at the Cleveland
Clinic Hospital, Weston, FL, and Professor of
Surgery, Cleveland Clinic Foundation Health
Sciences Center of the Ohio State University,
Columbus, OH. He is Clinical Professor of
the Division of
General Surgery,
Department of
Surgery at the
University of South
Florida College
of Medicine.
Dr. Wexner was
chair of the ASCRS Dr. David Schoetz
International
Advisory Committee
and the Membership
Committee, and was
a member of the
Program Committee
and Self Assessment
Committee. In addition,
he is an associate
editor of DC&R.
Dr. Lester Rosen
Dr. Wong is Chief of
Colorectal Surgery,
Memorial Sloan-
Kettering Cancer
Center, and Associate
Professor of Surgery,
Cornell University Dr. Steven Wexner
Medical College,
New York City.
An ASCRS member since 1984, Dr. Wong
has served on the Standards, Recertification,
Program, and Continuing Education
Committees. In addition, he was the Core
Subjects Director from 1997-2000. He is
Chairman of the Emerging Technologies
Committee and sits on the American Joint
Committee on Cancer.
Continuing Members
Members continuing to serve on the
Executive Council are Drs. Robert Fry,
Past President; Ann C. Lowry, Edina, MN,
Treasurer; Charles Littlejohn, Stamford,
CT, and Frank Opelka, Boston, MA, both
Members-at-Large.
Dr. Sergio Larach
Dr. James Fleshman
Dr. Douglas Wong
7

Annual Meetin
The winners at “Colorectal Jeopardy” celebrate their victory.
Enjoying ASCRS fellowship
are (below) 1990-91
President Dr. Peter A.
Volpe and his wife,
Theresa, and (right)
Dr. Elliott D. Prager
and his wife, Phyllis.
Lisa Bruce kept kids
fascinated while their
parents attended the
scientific program.
A group representing Foundation suppo
Research Foundation. From left: Jim Mc
Business Development; Dr. Nelson; Duk
Product Manager.
Research Foundation hosts
fundraising event
The ASCRS Research Foundation supported a
highly successful fundraising event, “An Evening
to Remember at Chicago’s Famous Aragon
Ballroom,” during the 2002 Annual Meeting.
Guests enjoyed a nostalgic revival of the big
band era featuring the award-winning, 30-piece
Illinois Brass Band, with complimentary food
and drink. The event was supported by a grant
from Genzyme Biosurgery.
8
Dr. Richar
plays the alto horn at th
Foundation spe

ng g Highlights
Enjoying hospitality at the Annual Reception (from left): Vice President Dr. Yanek S.Y.
Chiu, 1993-94 President Dr. Samuel B. Labow, Mrs. Mary Chiu, and Dr. Michael E. Abel.
Catching up on old times are 1986-87 President Dr. H. Whitney
Boggs (right) and 2001-02 President Dr. Robert D. Fry.
ter Genzyme Biosurgery joined Dr. Heidi Nelson, Past President of the ASCRS
Gorry, Senior Vice President; Bill Densee, Senior Director of Marketing and
Collier, President; John Connolly, Executive Vice President; and Brett Fleshman,
Former ASCRS Vice President Dr. Daniel Rosenthal (second from the right) and
his wife, Joyce, greet Dr. Jeffery Nelson, of Walter Reed Army Medical Center (left)
and Dr. Radzislaw Trzcinski of Lodz, Poland (right).
L. Nelson
Research
ial event.
Dr. David A.
Rothenberger stops to thank
corporate supporter Norman Stahlsberg,
Shire US Inc., at the Annual Dinner Dance.
1994-95 President Dr. Philip H. Gordon (center) and his wife, Rosalie, greet
President-elect Dr. David J. Schoetz, Jr.
9

ASCRS welcomes new Fellows, Members,
Allied Health Members and Candidates
ASCRS welcomed 67 new Fellows, 110 new
Members, 3 new Allied Health Members,
and 81 new Candidates into the Society at
the annual business meeting in June.
Following are the Society’s new Fellows,
Members, Allied Health Members, and
Candidates for 2002:
Allied Health Members
Jennifer L. Kimberling, ARNP
Denise M. Stumpf, RN
Joan S. Nelson, RN
Fellows
Raffi Eprat Agopian, MD
Abed El Mannan Alo, MD
Tracey D. Arnell, MD
Michael W. Barrett, MD
Eric M. Bass, MD
Dennis G. Begos, MD
Bruce M. Belin, MD
Malak B. Bokhari, MD
Steven H. Brown, MD
Frank J. Caliendo, MD
Lynn Chao, MD
Vincent Cifello, MD
Jeffrey S. Cohen, MD
Susan M. Congilosi, MD
Bard C. Cosman, MD
Randall W. Crim, MD
Jay A. Crockett, MD
Lynda S. Dougherty, MD
Gary D. Dunn, MD
Jonathan E. Efron, MD
Brent K. Evetts, MD
Linda Marie Farkas, MD
Stanley B. Fuller, MD
Gregory J. Gallina, MD
David H. Gibbs, MD
Tito F. Gorski, MD
Sharon G. Gregorcyk, MD
Nathaniel J. Holmes, MD
Glen D. Hooker, MD
Jefferson B. Hurley, MD
Evelyn Irizarry, MD
Jean A. Jaffke, MD
Beth R. Jaklic, MD
Garner P. Johnson, MD
Kristina H. Johnson, MD
Nicole J. Kafka, MD
Andrew Kassir, MD
Clifford Y. Ko, MD
Philip D. Kondylis, MD
Soren R. Kraemer, MD
Alexander Kurchin, MD
Eric D. Lederman, MD
Chong S. Lee, MD
Anthony Macaluso, Jr, MD
Peter W. Marcello, MD
Jennifer J. McNeil, MD
Carolyn E. Million, MD
Manuel Munoz-Juarez, MD
Mary Lou O’Neill, MD
Dean P. Pappas, MD
Patrick Y. Park, MD
David P. Parsons, MD
Benjamin M. Piperno, MD
Ronald J. Place, MD
Howard M. Ross, MD
Jonathan Sack, MD
Richard G. Saleeby, Jr, MD
Graham J. Sellers, MD
Michael DuWayne Stratton, MD
Gene L. Syn, MD
Tatsuo Teramoto, MD
Fuad H. Turfah, MD
Madhulika G. Varma, MD
Harry Wasvary, MD
Stephanie A. Wishnev, MD
Laurence F. Yee, MD
Tonia M. Young-Fadok, BM,
BCh, MS
Members
Byung-Kwon Ahn, MD, PhD
Mohammad Abdullah
Al-Amin, MD
Paul E. Bernick, MD
Marcella W. Bradway, MD
James P. Brooks, MD
Michael A. Buckmire, MD
Stuart E. Bussell, MD
Sergio Casillas-Romero, MD
Hee-Chul Chang, MD
Vivek Chaudhry, MD
Hung-Chang Chen, MD
Jy-Ming Chiang, MD
Ian D. Chin, MD
Chong-Wha Chung, MD
Paul F. Conarty, Jr, MD
Earl C. Damallie, MD
Conor P. Delaney, MD, PhD
Eduardo J. Dell’Acqua, MD
Edward P. DelleDonne, MD
David W. Dietz, MD
Mario Diurni, MD
Howard D. Dobson, III, MD
John T. Dvorak, MD
Eloy Espin-Basany, PhD
Chung-Wei Fan, MD
Julio Faria, MD
Kenneth J. Foster, MD
Charles E. Frankum, Jr, MD
Mark A. Fusco, MD
Graham K. Gibb, MD
Quintin H. Gonzalez, MD
Richard T. Guttman, Jr, MD
Hannah-Ngoc Tieu Ha, MD
Timothy D. Haley, MD
George E. Hazlehurst, MD
Augustus H. Hill, MD
Hyoun Kee Hong, MD
Pao-Shiu Hsieh, MD
Sing-Man Hui, MD
Mikio Imamura, MD
Ahmad Izadpanah, MD
Seung Kyu Jeong, MD
Baik-Hyeon Jo, MD
Roberto Luiz Kaiser, Jr, MD
Jung-Cheng Kang, MD
Vikram Kate, MD, PhD
Nickos G. Kelessis, MD, PhD
Hee Cheol Kim, MD
Jong-Ik Kim, MD, PhD
WanSoo Kim, MD
Yong-Soo Kim , MD, PhD
Peter F. Klein, MD
Jong Eun Lee, MD, PhD
Jong Ho Lee, MD
Mark Lindsey, MD
Cui Long, MD, PhD
Khaled M. Madbouly, MD
Bahar Mahjoubi, MD
Najjia N. Mahmoud, MD
Ramon M. Malaya, Jr, MD
Joseph E. Martz, MD
David S. Mason, MD
Nagahide Matsubara, MD, PhD
James M. McClane, MD
Steven J. McClane, MD
Michael A. Moffa, MD
Samad Mosaddeghi Kheyavi, MD
Timothy B. Murray, MD
Jeffery M. Nelson, MD
Thomas R. Newton, MD
Robert B. Noone, Jr, MD
Michael Oberwalder, MD
Jae Hwan Oh, MD
So Hyang Oh, MD
Mustafa Oncel, MD
David J. Orcutt, MD
Rattaplee Pak-art, MD
Samir Nalin Parikh, MD
Taeseok Park, MD, PhD
Gabriel M. Peal, MD
Darren R. Pollock, MD
Ibrain S. Prieto, MD
Sanhua Qing, MD, PhD
Jai-Hyun Rhyou, MD
Roberto Rodriguez-Ruesga, MD
Kun-Young Roh, MD
William G. Rudolph, MD
John B. Ryan, MD
William Sanchez-Maldonado, MD
Yash Pal Sangwan, MD
John M. Sayles, MD
Neriman Sengul, MD
Ali Ahmed Shafik, MD
Joaquim Simoes-Neto, MD
Iain J. Skinner, MD
Scott P. Sligh, MD
Selman Sokmen, MD
Jeffrey A. Sternberg, MD
Jonathan Stewart, MD
Owen T. Su, MD
William E. Taylor, MD
George E. Theodoropoulos, MD
Lisa S. Weinstein, MD
Kim Steven Wiley, MD
John H. Winston, MD
Ling S. Wong, MD
Benson Yip, MD
Peter Y. Youn, MD
Moises J. Zielanowski
Mansbach, MD
Oded Zmora, MD
Candidates
10
Khalid Abdullah Al-Rosini, MD
Ahmed S. Alkoraishi, MD
Ravinder K. Annamaneni, MD
Mirza K. Baig, MD
Brian J. Bansidhar, DO
Abhijit Basu, MD
Carl J. Brown, MD
Craig L. Brown, MD
Kelli M. Bullard, MD
Justin M. Burns, MD
Sridhar Chalasani, MD
Emily L. Chan, MD
Kristie A. Chiscano, MD
Eugene A. Choi, MD
Robert D. Church, MD
Costanza Cocilovo, MD
James D. Curry, MD
Hans-Joachim Duepree, MD
Mitra Ehsan, MD
Darryl S. Fernandes, MD
Alessandro Fichera, MD
David R. Fischer, MD
David R. Giammar, MD
John A. Griffin, MD
Brooke H. Gurland, MD
Eric M. Haas, MD
Robert M. Hagood, MD
Tara L. Hahn, MD
Maohao Han, MD
Charles P. Heise, MD
Kristina G. Hobson, MD
J.B. Joo, MD
Joshua A. Katz, MD
Adam A. Klipfel, MD
Eduardo Krajewski, MD
Jorge A. Lagares-Garcia, MD
Thomas R. Lake, III, MD
John A. Lang, MD
William C. Lewis, MD
Paul A. Mancuso, MD
Mark W. Mattingly, MD
Donald A. Maynard, MD
Jeffrey D. McNeil, MD
Steven D. Mills, MD
Emilio Morpurgo, MD
Arden M. Morris, MD
Santosh Nandi, MD
Shekar Narayanan, MD
Rick Ngo, MD
Wyn Dinh Nguyen, MD
James A. Olson, MD
Ashraf I. Osman, MD
Michael J. Page, MD
John J. Park, MD
Sanjiv K. Patankar, MD
Nikhil Mulji Patel, MD
Ranganath Pathak, MD
Connie J. Pennington, MD
Jason Penzer, MD
Timothy A. Pritts, MD
Manoj J. Raval, MD
Craig Rezac, MD
Rocco Ricciardi, MD
Uwe J. Roblick, MD
Christopher D. Roman, MD
Douglas M. Rosen, MD
Andrew A. Rosenthal, MD
Heather L. Rossi, MD
Carmen Ruiz, MD
Dana R. Sands, MD
David M. Schaffzin, MD
Oliver Schwandner, MD
Andrei S. Smolenkov, MD
David E. Stein, MD
Lawrence E. Stern, MD
Amy J. Thorsen, MD
Brian T. Valerian, MD
Frank J. Wessels, MD
James M. Wheeler, MD
Emily R. Winslow, MD
Paul E. Wise, MD

DC&R’s key performance indicators increase,
Editor-in-Chief Dr. Victor Fazio reports
Most of Diseases of the Colon and
Rectum’s key performance indicators
showed increases during first quarter,
Editor-in-Chief Dr. Victor W. Fazio,
Cleveland, OH, reported at the Society’s
Annual Meeting.
Strong performance indications include:
• Subscription revenues increased 14%
• Advertising revenues were up 40%
• Total revenue increase of 30%, while
• Operating income grew by 49%
• The journal published 486 editorial
pages, compared to 465 in the prior
period.
Still, Dr. Fazio expressed concern about cost
increases related to online publication and
a slight decline in paid circulation, perhaps
also linked to the evolution of electronic
journal publishing.
“The first quarter’s operations for the
Journal has shown marked improvements
in advertising sales revenue and commercial
reprints. These increases, coupled with
increasing revenues and additional charges
for color illustration usage, are all strong
indicators of year-end profitability,”
Dr. Fazio said.
Dr. Fazio reported that DC&R’s “impact
factor,” a measure of quality based on total
number of citations and articles published,
declined during the last reporting period.
“This is of concern, and we are addressing
it by reducing acceptance rates, reducing
time to publication to 6 months, and developing
a more efficient ‘fast track’ protocol.
Our goal is to improve quality and the rate
of review. We are encouraging ASCRS members
and our editorial board to send the
best ‘stuff’ to DC&R,” he said.
Dr. Fazio also noted that DC&R publishes a
large number of articles (279 per year with
monthly issues) compared to its specialty
journal competitor, International Journal
of Colorectal Disease (51 in 2000 with
issues every other month).
Of the journals above DC&R in ranking, over
half publish less than 100 articles per year,
Dr. Fazio noted. The Society’s Journal ranks
9th in citations in the gastroenterology list
and 18th among all surgical journals.
“The past year has been a solid one for
DC&R. Journal submissions remain high
(around 600 manuscripts per
year), but it will be a challenge
to maintain this rate and promote
continued high quality submissions.
Newer specialty journals
and many others now compete
with DC&R for manuscripts.
“The first quarter’s
operations
for the Journal has shown marked
improvements in advertising sales
revenue and commercial reprints…
strong indicators of year-end
profitability.”
— Dr. Victor Fazio, Editor-in-Chief
Nevertheless, our goal is to increase
the overall quality of what we publish,”
Dr. Fazio said.
“Maintenance of high quality reviews is the
key to increasing the Journal’s reputation
and Impact Factor,” he said.
2002-2003 Committee Chairs
Awards. . . . . . . . . . . . . . . . . . . . . . . . Dr. Marcus J. Burnstein
Bylaws . . . . . . . . . . . . . . . . . . . . . . . . Dr. H. Randolph Bailey
Continuing Education . . . . . . . . . . . . . . . . Dr. Alan G. Thorson
Emerging Technologies. . . . . . . . . . . . . . Dr. W. Douglas Wong
Finance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dr. Ann C. Lowry
Hospitality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mrs. Susan Fry
International. . . . . . . . . . . . . . . . Dr. Anthony M. Vernava, III
International Advisory . . . . . . . . . . . . Dr. Graham L. Newstead
Local Arrangements. . . . . . . . . . . . . . . . . Dr. Alan E. Timmcke
Membership . . . . . . . . . . . . . . . . . . . . . . Dr. Susan Galandiuk
Professional Outreach . . . . . . . . . . . . . . Dr. Michael J. Stamos
Program. . . . . . . . Drs. Bruce A. Orkin & Deborah A. Nagle
Public Relations. . . . . . . . . . . . . . . . . . Dr. Michael P. Spencer
Quality Assessment & Safety. . . . . . . . . . Dr. Marvin L. Corman
Regional Societies . . . . . . . . . . . . . . . . . . Dr. Donald B. Colvin
Residents . . . . . . . . . . . . . . . . . . . . . . . . . . . Dr. Ronald Bleday
Self Assessment . . . . . . . . . . . . . . . . . . Dr. Patricia L. Roberts
Socioeconomic . . . . . . . . . . . . . . . . . . . Dr. David A. Margolin
Standards . . . . . . . . . . . . . . . . . . . . . Dr. Clifford L. Simmang
Technologies . . . . . . . . . . . . . . . . . . . . Dr. M. Parker Roberts
Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dr. John A.Coller
Young Surgeons . . . . . . . . . . . . . . . . . . Dr. William C. Cirocco
11

Society’s public relations program reaches 19 million
Dr. Michael Spencer
12
A public relations program directed by the Society’s Public Relations
Committee over the past year garnered media exposure in more
than 700 consumer and trade publications reaching nearly 19 million
people, including many professionals, Committee Chair Dr.
Michael P. Spencer, Minneapolis, MN, reports.
For 2002-2003, the Committee is considering alternative media
relations efforts to raise consumer and professional awareness of
colorectal diseases and the colon and rectal surgeon’s role in treating
them. A bowel incontinence initiative and an emphasis on maintaining
good colorectal health will be centerpieces of the Society’s
strategy, according to Dr. Spencer.
A Public Relations Committee member,
Dr. Yanek Chiu, San Francisco,
reported a successful contact with NBC-
TV “Today” Show host Katie Couric
through the Los Angeles-based colorectal
cancer foundation she founded in
1998, NCCRA. He reports interest from NCCRA in partnering with
ASCRS in a campaign for colorectal cancer prevention involving
colon and rectal surgeons.
The Public Relations Committee is pursuing the potential of partnering
with NCCRA to gain recognition for the expertise of colon and
rectal surgeons, according to Dr. Spencer. A partnership could
include opportunities for joint fundraising, he added.
Under the leadership of Drs. Sergio W. Larach, Orlando, FL, and
Dr. Spencer, the Public Relations Committee continues to update
existing patient information brochure titles and develop new entries
in the Society’s library. Several million copies of these brochures
have been distributed, and they are now the biggest draws to the
Society’s Website. In fact, the top 16 downloads from the Website
are patient education brochures.
Patient brochures have been available on topics ranging from Anal
Abscess/Fistula to Surgery for Ulcerative Colitis. New publications on
anal cancer and rectocele have been recently released, bringing the
total number of brochures to 21. Brochures in preparation include
laparoscopic colorectal surgery, Hidradenitis, surgical options for
Research Foundation awards grants of up to $80,000
The ASCRS Research Foundation has
awarded four Limited Project Grants, one
Career Development Award, and one
International Fellowship Grant.
Limited Project Grants (LPGs) provide funding
up to $40,000 in support of one-year
colorectal projects. LPGs awarded in 2001 are:
• Predicting Outcomes in Colon and
Rectal Cancer Using Population-
Based Databases, Dr. Clifford Ko,
University of California, Los Angeles.
• Characterization of IL4R-State6
Signaling Pathway in IBD, Dr. Walter
The ASCRS Website will feature a section
on Colorectal Cancer Awareness with
information for patients, the media and
member physicians.
Koltun, Pennsylvania State University,
Hershey, PA.
• Development of a Validated Measure
to Assess Bowel Function after Rectal
Cancer Therapy, Dr. Larissa Temple,
Memorial Sloan-Kettering, New York, NY.
• Effect of Sulindac on Gene
Expression in Rectal Mucosa, Dr.
Harvey G. Moore, Memorial Sloan-
Kettering, New York, NY.
Career Development Awards support the
efforts of young investigators launching
academic careers. The award provides grant
funding of $40,000 per year for two years
Crohn’s disease, and radiation proctitis. The Committee completed a
line-by-line review of drafts of the brochures on Hidradenitis, surgical
options for Crohn’s disease, and radiation proctitis during the
Chicago Annual Meeting.
“The Committee is always interested in new brochure ideas, and
we encourage members to contact us with their suggestions,” Dr.
Spencer said.
The Public Relations Committee also represents the Society with a
booth at the annual meeting of the United Ostomy Association and
contributes articles to Ostomy Quarterly, under the leadership of
Dr. David E. Beck, New Orleans.
In March 2003, the Committee will
coordinate the Society’s participation
in its fourth year of official activities for
Colorectal Cancer Awareness Month.
The Committee’s media relations campaign
will complement national efforts such as Dr. Ernestine
Hambrick’s STOP Foundation, NCCRA, and the Cancer Research
Foundation of America (CFRA) program and local and regional
efforts planned during the month.
The Society is preparing a press release accompanied by a package
of video clips that will be sent to major media markets to encourage
development of stories during the month. Additionally, an audio
news release will be sent to radio stations nationwide.
As in years past, several members of the Society’s Public Relations
Committee and other members-at-large will participate in CFRA’s
March symposium. In addition, the Committee will support CFRA’s
effort to promote colorectal cancer awareness with its traveling
Colossal Colon tours.
All ASCRS members are encouraged to log on in early February to
see what is available to use for their own colorectal cancer awareness
efforts. Marketing professionals at Harris, Baio &, McCullough,
the public relations firm contracted by ASCRS, are available to assist
members in developing their own awareness programs.
and is designed as a cooperative venture,
requiring a commitment from both the institution
and the Research Foundation. Last
year’s Career Development Award winner was:
• Dr. Lisa S. Poritz, assistant professor
of surgery in the section of Colon and
Rectal Surgery at the Pennsylvania State
University Milton S. Hershey Medical
Center, Hershey, PA, Tight Junction
Structure and Function in Intestinal
Inflammation. She is mentored and
supported by Drs. Walter Koltun and
Wiley Souba. She has trained in the
experimental field of immunology, investi-
…continued on page 13

R E S E A R C H F O U N D A T I O N R E P O R T
To build on legacy of accomplishment,
expand funding for clinical studies
By James W. Fleshman, MD, President, Research Foundation of ASCRS
The Foundation’s immediate Past President,
Dr. Heidi Nelson, has left a legacy of
accomplishment on which we will build.
She has done an outstanding job of leading
the Foundation over the past two years. With
her guidance, we have created a true
research granting agency.
She supervised the addition of Career
Development Awards and International
Fellowship Awards to the Foundation’s program.
She standardized the review process
and increased the representation of scientists
within the Society on the Research
Foundation’s committees. As Dr. Nelson said
repeatedly, “Supporting cutting-edge colorectal
research is the agenda of The
Research Foundation.” Her actions as
President showed that she meant what
she said.
While thanking Dr. Nelson for her inspiring
leadership, I well appreciate that she did not
work alone. I want to thank every member
of the Research Foundation Board and its
committees for their hard work, especially
in reviewing grants. Let me also take this
opportunity to thank all of our corporate
supporters for their continued contributions,
especially Genzyme Biosurgery for
its support of “An Evening to Remember at
Chicago’s Famous Aragon Ballroom,” the
Research Foundation’s 2002 special event.
My goal as Research Foundation President
will be to expand the funding available for
clinical studies, as opposed to pure basic
research projects. We have begun to spend
more money on research every year than
ever before, and we are currently cutting
into the principal of the $4.9 million endowment
raised in the Centennial Campaign
started in 1997.
To expand funding for clinical studies, we
will approach all members who have joined
the Society since the Centennial Campaign
and any others who may not yet have had
an opportunity to give to the Research
Foundation or who may be able to continue
their support. We will make our case for the
importance of clinical studies of colorectal
diseases and seek their support.
The special fundraising event held during
the Chicago Annual Meeting was highly successful.
We plan to sponsor a similar special
fundraising event during every Annual
Meeting. It is one way to reach out and
involve all members in the work of the
Research Foundation.
These events will be
social occasions that
everyone should enjoy,
and their purpose will
be to raise funds for
research.
Our preliminary plan
now is to hold the
2003 Research
Foundation fundraising
event at the
Aquarium during the
June Annual Meeting
in New Orleans. I urge
every member to plan
now to participate in this corporatesupported
event. Take advantage of this
once-a-year opportunity for social interaction
with professional colleagues, friends,
and family while helping to increase the
funds available for research.
We appreciate your support of the
Foundation’s ultimate goals: to achieve excellence
in research that will save lives today
and promote the cures of the future.
Research Foundation
President Dr. James
W. Fleshman presents
outgoing President
Dr. Heidi Nelson a
plaque in honor of
her service.
Research grants… continued from page 12
gating graft-versus-host disease. She will study the pathogenesis
of inflammatory bowel disease using cell culture techniques and
a graft-versus-host disease animal model.
The International Fellowship Award takes a worldwide view in supporting
efforts of young investigators, including Americans and
Canadians with opportunities in foreign countries and physicians
from other countries seeking opportunities in the U.S. and Canada.
Dr. Kouros Moozar, Mount Sinai Hospital, Toronto, won an
International Fellowship last year for his project, Tumor
Microsatellite Instability, Chemosensitivity and Patient
Outcome: A Molecular Reanalysis of Adjuvant 5
FU/Leucovorin in Colon Cancer. Dr. Moozar will be working
with Dr. Steven Gallinger on a project incorporating microsatellite
status in a reanalysis of the effects of chemotherapy on colon
cancer survival using the IMPACT (International Multicentre Pooled
Analysis of Colon Cancer Trials) database.
Dr. James Fleshman elected
Research Foundation President
Dr. James W. Fleshman, St. Louis, MO, became President
of ASCRS Research Foundation during the Annual Meeting in
Chicago. Dr. Heidi Nelson remains on the Board as Past
President.
Other newly elected officers of the Research Foundation are: Drs.
David A. Rothenberger, Minneapolis, MN, Vice President;
Jose Guillem, New York, NY, Secretary; and Ann C. Lowry, St.
Paul, MN, Treasurer.
Newly elected Research Foundation Trustees are: Drs. Walter A.
Koltun, Hershey, PA; David J. Schoetz, Burlington, MA; and
Scott A. Strong, Cleveland, OH. Continuing as Trustees are:
Drs. Richard P. Billingham, Seattle, WA; Susan Galandiuk,
Louisville, KY; Robert M. Honigberg, Cincinnati, OH; and
Richard K. Reznick, Toronto, ON, Canada.
13

STOP’s colorectal cancer education program
reaches 17,000 Chicago police officers
Dr. Ernestine
Hambrick
In March, the STOP Colon/Rectal Cancer Foundation chaired by Dr.
Ernestine Hambrick, Chicago, rolled out its colorectal cancer
educational program for the 17,000-member Chicago Police
Department. It reached all police watches and all civilian members.
The program began with a department-wide showing of a video
and distribution of a risk assessment questionnaire. Officers were
then mailed STOP’s brochure, accompanied by a letter from
Superintendent Terry Hillard, a colorectal cancer survivor
and former patient of Dr. Hambrick.
The Chicago Police program creates a template for colorectal
cancer education and testing in any
municipal department and will be
extended to other organizations nationwide,
according to Dr. Hambrick.
Already a group called the Police
Executives Research Forum has made
300 copies of the video and distributed
them to officials across the nation. In June, Dr. Hambrick brought
the program to a meeting of major police chiefs in Idaho.
STOP has also created an interactive teaching program in colorectal
cancer prevention for primary care physicians, working with the
Department of Medical Education at the University of Illinois.
Information about this program is available online at www.cmeonline.org.
Donations may be sent to the
STOP Colon/Rectal Cancer Foundation
30 N. Michigan Ave. #1118
Chicago, Illinois 60602
In another development, Dr. Angelita Habr Gama, Sao Paulo,
Brazil, has translated STOP’s brochure, “The Cancer Nobody Has to
Have & How to Stop It,” into Portuguese and is using it in a colorectal
cancer awareness campaign. STOP has distributed more than
240,000 of its brochures to physicians, individuals, organizations
and corporations. They have been used in a variety of locations,
events, health fairs, and meetings across the U.S., in recent meetings
in Singapore and Brazil, and many other foreign countries.
STOP attracted more than 225 people to a March fundraising
event in downtown Chicago. Alderman Ed Burke, a prominent
Chicago politician, and Michael
Sneed, Chicago Sun-Times columnist,
served as honorary chairs. STOP
Board Member Barbara Barrie autographed
copies of her book, Don’t Die
of Embarrassment. Among attendees
were STOP Board Members Drs.
Richard P. Billingham, Seattle, WA,
now ASCRS President, and J. Byron Gathright, Jr., New Orleans,
a Society Past President.
Dr. Hambrick said STOP has hired a grant writer and is now launching
a fundraising campaign “to take the Foundation to the next
level.” She said the Foundation’s current budget is not adequate to
support all the activities needed to accomplish STOP’s mission: to
eradicate colorectal cancer through education directed toward preventive
screening, early detection and healthy lifestyle choices.
ABCRS 2002 Recertification Examination Pass Rate 98%
Source: ABCRS
Colon and Rectal Surgery’s 2002
Recertification Examination was 98%, as 42
of 43 participants passed with an average
score of 82%, ABCRS announced.
This year’s group had the highest pass rate
and tied for the highest average score in the
past five years. ABCRS released recertification
performance results, as shown in the
table below.
ABCRS Recertification performance results, statistics, 1998-2002
Year Participants Passed % Failed % Maximum Minimum Average
2002 43 42 98% 1 2% 94% 59% 82%
2001 24 23 96% 1 4% 90% 69% 81%
2000 16 13 81% 3 19% 90% 59% 80%
1999 68 62 91% 6 9% 94% 61% 82%
1998 46 44 96% 2 4% 93% 57% 81%
Total 197 184 93% 13 7% Passing score: 70%
14
ABCRS will conduct its 2003 Recertification
Examination at the New Orleans Hilton
Riverside Hotel, Saturday, June 21, during
the ASCRS Annual Meeting.
Recertification certificates are valid for 10
years and dated January 1 of the year following
the expiration date of the original
certificate. ABCRS strongly encourages
diplomates to register for the recertification
examination at least two years
before certificates expire.
Taking the exam early safeguards
the surgeon’s certified
status in case of unforeseen
circumstances. Since expiration
is not based on the date
the test is taken, there is
no penalty for passing the
exam early.
ABCRS tracks certificate
expiration dates and notifies
diplomates at least three
years before expiration.
In April 2003, ABCRS will mail applications
and examination details for the 2004 examination,
which will be given Saturday, May 8,
2004, in Dallas, TX.
All diplomates whose certificates expire on
or before December 31, 2006, will receive
applications. The deadline for receipt of
completed applications is August 15, 2003
(application fee $350) and for late applications,
September 15, 2003 (application fee
$450). Applicants must provide validation
of 100 Category I CME credit hours.
Direct questions about replacement certificates,
changes in the recertification process
or exam applications to:
American Board of Colon
and Rectal Surgery
20600 Eureka Road, Suite 600
Taylor, Michigan 48180
(734)282-9400-phone
(734)282-9402-fax
e-mail: admin@abcrs.org

Esquire, Lovett Productions Win Media Awards
A six-part series published in Esquire
Magazine and a 60-minute documentary
televised on the Discovery Health Channel
were selected as winners of the Society’s
2002 National Media Awards and recognized
at an awards luncheon during the
ASCRS Chicago Annual Meeting in June.
In the Esquire series, “My Cancer Story,”
Curtis Pesmen chronicles his diagnosis
and treatment for colorectal cancer.
Excruciating in detail, Pesmen takes readers
on a journey through aggressive chemotherapy,
radiation and total colectomy. Judges
praised his sense of humor and eye for detail
that “educates us about diagnosis and diagnostic
error, about the latest infusion pumps
for on-the-go chemo, about weight-loss, love
and sexual function – the human as well as
the scientific story of colorectal cancer.”
Joe Lovett, of Lovett Productions, New
York City, accepted the broadcast award
for “Catching a Killer: Colon Cancer.” The
documentary “is a comprehensive look at
colon cancer” that “corrects the myths and
presents the medical facts and risks,” judges
said. The program follows several patients
through their treatment.
Judges cited excellent writing that made a
complex medical procedure understandable
to the lay person. “This documentary promotes
a better understanding of colon cancer
by answering the key questions about
the disease and the treatments available,”
they added.
The winning entries were chosen from 45
entries submitted by newspapers, magazines,
television and radio stations from across the
U.S. Winners each received a $1,000 cash
prize, a plaque, and an expense-paid trip to
Chicago for the Annual Meeting.
Judges from the Medill School of
Journalism, Northwestern University,
Evanston, IL, selected the winning entries
after evaluation and
screening for medical
accuracy by members
of the ASCRS Public
Relations Committee.
The journalistic merit
of each submission was
evaluated based on writing
quality, amount of
research, production
excellence, impact of
message and originality.
ASCRS began the National
Media Awards in 1995 to
acknowledge achievement
in communication to promote
a greater public
understanding of colon
and rectal disease, such
as colon cancer, hemorrhoids,
diverticulitis and
Crohn’s Disease.
Professional Outreach Committee to post anorectal disease,
colorectal screening presentations on ASCRS Website
Two Power Point presentations on colorectal and anorectal
cancer diseases, produced by the Professional Outreach
Committee of ASCRS, will be posted on the Society’s Website
this fall, announced Dr. Michael J. Stamos, Orange, CA,
committee chair.
“Screening and Prevention of Colorectal Cancer” and “Diagnosis
and Management of Common Anorectal Disorders” will be available
for members to use in educating primary care physicians.
This fall, surgeons can log onto www.fascrs.org and use their
membership number password to access the presentations,
downloading the programs at their convenience for personal use.
“The slide presentations are a logical extension of the work we
have been doing to help primary care and other physicians identify
serious conditions that warrant the attention of a specialist,”
Dr. Stamos said. “Patients benefit when their doctors have the
tools to recognize colorectal cancer risks and anorectal disease.
The process certainly saves time and, more importantly, may
save lives.”
Last year, the committee established the ASCRS Speakers Bureau
to provide qualified speakers to represent the specialty at primary
care physician conferences and annual meetings. The ASCRS
Writer’s Bureau, in turn, submits articles on colorectal disease
to interested medical journals.
The committee created these slide presentations to assist surgeons
in the education of their primary care counterparts,
according to Dr. Stamos. It is currently working on a third presentation,
focusing on rectal cancer, that should be available
for use sometime in 2003.
2002 winners of ASCRS National Media
Awards: Curtis Pesman (left), Esquire
magazine, and Joe Lovettt, Lovett
Productions.
Resources available online at ASCRS Website: www.fascrs.org
A range of resources are available online at
www.fascrs.org:
• Webcast of the 2002 Chicago
Meeting – This Webcast is available free
of charge to surgeons and patients alike.
• ASCRS Listserv – An e-mail discussion
group for Society members that provides a
forum for the discussion of clinical cases
and other issues of general interest to the
colon and rectal surgical community.
• Colon and Rectal Surgery
Educational Program (CARSEP)
information and order form.
• Core Subject Update from 1998-
2002 presentations for members to
review at leisure.
• Links to inherited colorectal cancer
registries in North and South
America.
• Membership Directory
• Committee Listings
• Patient Brochures
• Practice Parameters
• Residency Programs
• Practice Registry
15

Bringing colorectal surgery to developing countries
By Dr. Thandinkosi Enos Madiba, Durban, South Africa, International Scholarship Recipient 2002
Dr. Thandinkosi
Enos Madiba
The speciality of colorectal surgery is not
well established in developing countries
like South Africa where an urgent need for
the discipline exists. Diagnosis of colorectal
conditions is on the increase, and the clinicopathological
spectrum of these conditions
differs amongst the various population
groups, specifically the African and
Caucasian groups. Research in this field
is, therefore, encouraged.
The general surgeon performs colorectal
surgery in South Africa, and a small number
of surgeons pursue research in this
area and specialize in colorectal surgery.
“I relish the opportunity of developing
this discipline in South Africa
and, indeed, in the rest of the
African continent.”
I started doing research in colorectal
surgery as early as 1992. My interest in this
area was further stimulated when I worked
for the colorectal unit at the Edinburgh
Royal Infirmary. I had the good fortune
to attend several “Colorectal Disease
Symposia” instituted by the Cleveland Clinic
Foundation in Florida. It was at one of
these meetings that I obtained an application
for an ASCRS International
Scholarship. The scholarship was an
imperative if I was to enhance and further
develop my skills in colorectal surgery.
The experience has been most rewarding
and I relish the opportunity of developing
this discipline in South Africa and, indeed,
in the rest of the African continent. The
scholarship exposed me to different
approaches to colorectal and anorectal
procedures such as, for example, the prone
position for anorectal surgical procedures.
I was also able to witness operations that
I had read about and not had the opportunity
to perform. Laparoscopic colectomy
is one such example, as it is not performed
in the city of Durban, South Africa, where
I reside and practice.
It was a special privilege to work with
Professor Stanley Goldberg, of the
University of Minnesota — even though this
was just for a week. I deeply appreciate the
time he spent demonstrating the many different
procedures performed by his unit.
The administrative officers at the various
medical centers participating in the scholarship
— the University of Illinois in
Chicago, the University of Minnesota and
the Mayo Clinic — were outstanding and
did everything possible to make my visit
a rewarding experience.
I enviously marveled at the many impressive
operating theaters in all the hospitals
that I visited. Also impressive was the
“Center for Pelvic Floor Disorders” that
is run by the Colon and Rectal Surgery
Associates in Minnesota.
It was a privilege to deliver lectures at all
three institutions. The focus of my talks
was on the cases we surgeons see in
Southern Africa.
My attendance at the Annual Meeting of
the American Society of Colon and Rectal
Surgeons in Chicago, 3 to 8 June 2002,
afforded an opportunity to meet with
the International
Advisory
Committee and to
discuss the practice
of both general
and colorectal surgery in South Africa.
My June 8 presentation, “Morphology of
the sigmoid colon — Factors favouring
development of sigmoid volvulus,” lent an
interesting and different perspective to the
theme of the meeting, as it highlighted a
condition that is commonly seen in developing
countries. Of course, it was a great
privilege for my wife and I to be invited to
the ASCRS Executive Council Dinner as the
guests of the ASCRS president and to attend
other associated social functions.
In summary, the Scholarship afforded me
a wonderful opportunity to gain exposure
to other colon and rectal surgeons, to
engage in meaningful discussions and to
gain insight into this fascinating discipline.
I record my gratitude to Drs. Ann Lowry,
of the University of Minnesota, Rick
Nelson of the University of Illinois, Heidi
Nelson, Eric Dozois and Santhat
Nivatvongs of the Mayo Clinic.
I also record my appreciation to Ms. Stella
Zedalis, Associate Executive Director of
the ASCRS, for her invaluable assistance
with my itinerary and other travels in
the USA.
Charm of old New Orleans
awaits ASCRS, June 21-26
New Orleans, a favorite
destination that combines the
charm and grace of Southern
living with the pulsing excitement
of Bourbon Street, will
be the site of the Society’s 2003
Annual Meeting, June 21-26.
This photo captures the streetcar
that travels St. Charles
Avenue to Tulane University
through the heart of the City’s
stylish Garden District.
16