Fellows identify key issues affecting surgery.

All changes in our health care delivery system during the past three years have had an effect on reimbursement rates, net income, and practice satisfaction among surgeons. Implementation of the Medicare fee schedule and increasing penetration of the health care market by managed care firms have clearly had the most profound influence. Sixty percent of practicing surgeons have experienced a decrease in net practice income since 1992.

The PPRC: 1994 update.

The health care debate will continue throughout much of the summer in the legislative committees and subcommittees of Congress. Both the American College of Surgeons and the PPRC will participate in that process through invitations to testify on many of the issues discussed in this article. The author will begin his third three-year term on the PPRC in July 1994, and will continue to express the concerns of the surgical community to that body.