March 8, 1974 To: Members of The Society for Vascular Surgery Gentlemen: Enclosed is a copy of the report entitled "Optimum Criteria for Care of Heart Disease Patients" published in the JAMA in December 1973. Apparently the purpose of this document is to establish criteria to be used by the Joint Commission for Accreditation of Hospitals to prepare a list of hospitals capable of performing cardiac and vascular surgery and it appears that it will be transmitted to the Secretary of HEW. It is likely that it will be used to designate hospitals allowed to care for Medicare and Medicaid patients or patients under a National Health Program. Hospitals not meeting these standards may be excluded. The document affects many members of The Society for Vascular Surgery. Comment has been solicited by Dr. John D. Porterfield, Director of Joint Commission on Accreditation of Hospitals, 875 North Michigan Avenue, Chicago 60611. In the meantime the document has been referred to a previously established Committee of The Society for Vascular Surgery whose Chairman is Dr. H. Edward Garrett, 910 Madison Avenue, Suite 823, Memphis, Tennessee. A copy to him would be helpful. The continued use of numbers is of particular concern to me. It would be desirable that quality rather than quantity be stressed in a report such as this. On the other hand if numbers are to be used there should be a distinction between optimal numbers (which referred to in the title of this) being transferred into minimal numbers (which often occurs). Furthermore, there are many other items which are all of concern. The immediate attention of members of the SVS is therefore invited. It is believed that your letters to the responsible individual noted above will have some influence. This matter cannot wait until the annual meeting in June and is therefore being handled in this manner. Sincerely yours, W. Andrew Dale, M.D., President The Society for Vascular Surgery