or calls an insurance company on behalf of a patient to get
preapproval for an operation or medication, that surgeon is
advocating for the health and well-being of his or her patient.
Surgeons are uniquely suited to serve as advocates because
of our close interaction with patients, our understanding of
the determinants of health, and the fact that we care for a
diverse patient population in the inpatient and outpatient
setting, both electively and emergently. This range of experiences allows surgeons to contribute to the development
of sound, meaningful health care policy.
27
There are many examples of individual surgeon-advocates who have made a major impact on health care
and our profession at the national and local levels. Peter
Masiakos, MD, FACS, a pediatric surgeon in Boston, helped
enact legislation in Massachusetts in 2010 involving restrictions on all-terrain vehicle use based on a patient experience,
and is now working to promote firearm safety awareness.
28-29
Dr. Cochran, a burn surgeon and immediate past-president
of the Association of Women Surgeons, has brought issues of
gender pay equity in surgery to the national limelight30 (see
statement on page 57). John Maa, MD, FACS, a trauma surgeon in San Francisco, CA, led a collaboration between the
California chapters of the ACS and the California Medical
Association, which ultimately helped to defeat a statewide
ballot measure in 2014 (Proposition 46) that would have
raised the cap on noneconomic damages in medical liability
lawsuits.
31 The list of similar surgeon-led activities is seemingly endless, and young surgeons and trainees are fortunate
to have these surgeon-advocate role models to emulate.
The ACS offers many resources for surgeons who are
interested in increasing their involvement in advocacy
efforts at the national, state, and local levels. Examples
include the Leadership & Advocacy Summit in Washington, DC, which several hundred surgeons from across the
country attend annually, and the state Lobby Days grant
program (see related article on the Bulletin website).
32
Who shall lead?
Surgeons have always played an integral role in both
research and advocacy efforts. However, the significance
of those roles has evolved over time with environmental and
regulatory changes. Therefore, the debate as to whether the
54 |
RAS-ACS SYMPOSIUM: REFRAMING SURGICAL LEADERSHIP
REFERENCES, CONTINUED
continued on next page
13. Grillo HC. To impart this art: The development of
graduate surgical education in the United States.
Surgery.1999;125( 1): 1-14.
14. Cosimi BA. Surgeons and the Nobel Prize. Arch Surg.
2006;141( 4):340-348.
15. Neill US. A conversation with Thomas Starzl. J Clin
Invest. 2012;122( 12):4304-4305.
16. Mattox KL. Michael E. DeBakey: The consummate
leader. Methodist DeBakey Cardiovasc J. 2009; 5( 2): 32-36.
17. Fraser CD. In memoriam: Denton A. Cooley,
MD, FACS, a fierce competitor. Bull Am Coll Surg.
2017; 102( 4): 70-73.
18. Singer S. A tribute to Murray F. Brennan, MD. J Surg
Oncol. 2008; 97( 4):297.
19. Editorial. Four physicians who signed the Declaration
of Independence. N Engl J Med. 1961;265:1318-1319.
20. American College of Surgeons. Advocacy overview.
Available at: facs.org/advocacy. Accessed May 31,
2017.
21. American College of Surgeons. Advocacy
committees. Available at: facs.org/advocacy/
committees. Accessed May 31, 2017.
22. Collicott PE. Highlights of the ACSPA Board of
Directors and the ACS Board of Regents meeting:
June 7–8, 2002. Bull Am Coll Surg. 2002; 87( 9): 36-38.
Available at: facs.org/~/media/files/publications/
bulletin/2002/ 2002%20september%20bulletin.ashx.
Accessed May 31, 2017.
23. American College of Surgeons. ACS declares victory
with passage of law repealing the SGR. June 2015.
Available at: bulletin.facs.org/2016/08/the-acs-and-
advocacy-a-tradition/. Accessed May 31, 2017.
24. Steinbrook R. The repeal of Medicare’s sustainable
growth rate for physician payment. JAMA.
2015;313( 20):2025-2026.
25. American Medical Association. Declaration of
Professional Responsibility: Medicine’s social
contract with humanity. Available at: www.ama-assn.
org/ama/upload/mm/ 369/decofprofessional.pdf.
Accessed April 11, 2017.
26. Earnest MA, Wong SL, Federico SG. Perspective:
Physician advocacy: What is it and how do we do it?
Acad Med. 2010; 85( 1): 63-67.
