The Change Pro simulation involves physicians
working in small groups with 120 “days” to convince
24 members of an organization’s top management team
to adopt a Six Sigma quality improvement system. 5 The
goal is to get as many adopters as possible, even if participants have no formal authority in the organization.
“There is official influence and unofficial influence, and
the ability to understand and really leverage all those
different roles was highlighted in the simulation. I had
never been exposed to this concept before taking this
course,” Dr. Lorenz said.
The Heller Leadership Program attracts a mélange
of health care professionals, including private practi-
tioners, academics, front-line surgeons not yet in lead-
ership positions, as well as seasoned surgical leaders,
according to Dr. Lorenz. The mix also includes good
subspecialty representation. “There was a tremendous
amount of learning over meals and after hours where
people talked about their own challenges within their
subspecialty and within their organization. I don’t
know of any other venues where that happens as effi-
ciently as it did through this course.”
Dr. Lorenz said when the AAO-HNS introduces a
policy on a national or regional level, he taps fellow
Heller scholars for feedback. “I will make contact with
this network and say, ‘What are you doing in Texas?’
or ‘How is this going in Florida?’”
He suggested surgeons new to health policy devel-
opment keep in mind that “advocacy is a marathon
and not a sprint,” and that there are likely to be more
losses than wins. “Just because one initiative does not
meet with success, don’t let it dissuade you. You are in
it for the long term, and right now it is awkward. We
are getting paid for volume, but in an era in which we
are going to take on risk for disease prevention and
hospitalization readmission prevention, we’re going
to be in alternative payment models that will be spe-
cifically in contradiction to fee for service. It is our
professional responsibility to preserve the quality of
care while managing this transition as best we are
able. Our advocacy efforts need to keep the patient and
patient care as its North Star, and if we can accomplish
that, we’ll ultimately be successful in the evolution of
health care delivery.”
John Maa, MD, FACS
ACS Health Policy Scholarship for General Surgeons
After attending the Heller Leadership Program in
2009, Dr. Maa participated in more than 100 Capitol
Hill visits during a yearlong health policy sabbatical,
which included a six-month tenure in the College’s
Washington, DC, office.
“In May of 2010, I arrived in the DC office to bring
the surgical perspective to the front lines of policy-
making. The value to the DC ACS staff was to have
a surgeon who could share the practicing surgeon’s
insights into proposed legislation,” Dr. Maa said,
Immediate Past-President of the ACS Northern Cal-
ifornia Chapter and chair, University of California
(UC) Office of the President Tobacco-Related Disease
Research Program Scientific Advisory Committee.
“We worked on a number of projects, including the
pediatric loan repayment program, the general sur-
gery rural care bonus, and—the issue I became most
involved with—scope of practice regarding optom-
etrists and ophthalmologists.”
Before the Heller course, Dr. Maa was not involved
in public policy, focusing more on surgical program
development, specifically the surgical hospitalist pro-
gram at UC San Francisco Medical Center—an inno-
vative approach to the delivery of emergency surgical
care. After being encouraged to pursue the fellowship
by his mentor, former ACS Executive Director Thomas
R. Russell, MD, FACS, Dr. Maa applied for the fellow-
ship five consecutive times.
“I believed that the Brandeis course would foster a
deeper understanding of health policy outside of the
surgical arena and operating room [OR],” Dr. Maa said.
“Our advocacy efforts need to keep the patient
and patient care as its North Star, and if we can
accomplish that, we’ll ultimately be successful
in the evolution of health care delivery.”
—Dr. Lorenz
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