However, real solutions may require a surgical approach; that is,
create a thoughtful, calculated plan that can be executed decisively.
of Advocacy and Health Policy stand on the wall daily
for surgeons and, most of all, for our patients. Most
surgeons have no concept of how our advocacy efforts
affect their daily practices.
All surgeons should be involved in advocacy. Be
an advocate for your profession with your patients
and your health care institutions. If you are a U.S. citizen, give of your talents and your treasure—that is,
consider contributing to the ACS Professional Association, a branch of the ACS focused largely on supporting
congressional candidates who have demonstrated an
understanding of how health policy affects surgical
patient care. For those surgeons who believe too much
money is spent trying to influence policy, I would
remind you that Americans spend billions annually
on Halloween candy. I cannot overstate the need for a
vibrant advocacy effort.
Changes in health care may require a different form
of advocacy in the future. Approximately 80 percent of
surgeons are now employees of health care networks or
institutions rather than in traditional private practice,
and the number of surgeon employees will likely reach
100 percent soon. Problems have already surfaced for
surgeons with contracts, terminations without cause,
and other issues. Bundled care payments may come,
which will mean that one lump-sum payment will be
made to a hospital or large group to share for all aspects
of care, including all physicians’ services. Who will
represent the interests of surgeons and their patients?
An organization with the College’s cachet may need
to continually reaffirm the benefit of surgical therapy
for our patients.
As corporate medicine continues to grow and consolidate, a new form of representation may be needed to
protect the interests of surgeons and their patients. The
College would be the ideal group to lead such an effort.
Whereas the ACS is the logical organization to protect the interests of general surgeons, those surgeons
who practice in the surgical specialties should support
the College as well. The collaboration between the ACS
and your specialty group or academies can represent
an enormous voice for surgical care.
The constancy of change
U.S. Founding Father Benjamin Franklin expressed
his concern about the permanence of the U.S. Constitution when he opined, “Nothing can be said to be
certain except death and taxes.” I posit that the third
certain feature of our lives is change itself. Although
this presentation has suggested challenges young College Fellows may encounter in the future, in truth, I
have no earthly idea what obstacles you may face in
your careers. However, I am confident there will always
be a hill to climb and that there will always be another
peak to scale.
When the seas get rough, and at times they likely
will, be certain of your anchors: your family, your
friends, your faith in whatever belief system you
embrace, and your profession. The American College of Surgeons can be that professional anchor with
the support of you and your fellow Initiates. Embrace
the College and build your own pillars; you and your
patients will be well served by your efforts. ♦