American College of Surgeons

THE AMERICAN COLLEGE of Surgeons (ACS) is the world's largest organization of surgeons, with over 70,000 members, or Fellows (FACS). Approximately 4,000 members are based outside the United States. The ACS was founded in 1913 to promote the quality of care that surgeons provide for patients and also to set standards of education for future and practicing surgeons.

Today, the activities of the ACS include establishing and sponsoring educational programs, notably the Commission on Cancer, as well as monitoring standards of care in a range of medical fields. It monitors trends in the political and social environment for their implications for medical care and, through its Advocacy and Health Policy office in Washington, D.C., is involved in policy formulation. The ACS has also established the Office of Public Information to inform the public about issues relating to surgery and proper standards of care and to advertise the services of FACS above those of nonaccredited surgeons. It also promotes lifelong learning among its Fellows through sponsoring the Surgical Education and Self-Assess-ment Program, which provides the latest research and information on best practice to members so that they remain abreast of new developments and can prepare for certification or recertification. The ACS also sponsors a variety of scholarships in different surgical practices and supports information sources for the public, government, and medical practitioners.

The ACS is governed by a 22-person Board of Regents and is organized into 100 chapters around the world, 65 of which are located in the United States. The ACS mission statement is: “The American College of Surgeons is dedicated to improving the care of the surgical patient and to safeguarding standards of care in an optimal and ethical practice environment.” This has led to the creation of a series of ethical principles and statements by which FACS are required to abide and which also inform its choice of medical facilities that abide by its principles as approved centers.

The complexity of extant medical knowledge and practice make it very difficult to keep up with all of the latest developments within a particular medical field. This problem is intensified by the fact that patients frequently present with symptoms that fall within more than one area of specialization; hence, a team approach is preferable. In a litigious society, such as the United States, it is also critical for patients and practitioners to recognize the importance of the ethical principles maintained by the ACS. These include the need for continuity of care, as specified in the first principle: “The responsibility of a surgeon includes preoperative diagnosis and care, the selection and performance of the operation, and postoperative surgical care.” In other words, it is the individual surgeon who must be involved at all stages of the surgical process and who has full knowledge and understanding of the patient's condition. Other principles relate to the type of qualifications suitable for a reputable surgeon, the proper training of assistants, and the banning of itinerant surgery.

The principles strengthen the bond between surgeon and patient, which is advantageous in both a medical and a human sense, as well as representing a guarantee for the patient that any surgical procedure will be both necessary and completed by the designated and identified individual. The principles also specify the type and degree of information that is appropriate for the surgeon and his or her team to present to patients; research has shown that it is the presentation or apparent withholding of information that has a dominant impact on customer satisfaction and peace of mind.

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