“The course leaders are nationally recognized, with sig-
nificant experience in Washington, DC, and I believed
they would be excellent teachers and mentors.”
The Heller Leadership Program provided Dr. Maa
with successful strategies for managing health care
teams outside of the OR and the skills to make com-
plex management decisions with limited information.
“In the OR, you’re making vital decisions for a single patient, but as a surgeon leader, your decisions can
affect many more individuals simultaneously,” Dr. Maa
said. “An exercise that Dr. Chilingerian led was a theoretical business case modeled after the Challenger Space
Shuttle disaster that highlighted the steps and decisions
that contributed to the tragic outcome on that day.
Taught in the business school style, the activity illustrated how to manage a negative outcome and how to
determine what went wrong. We explored the decision-making process involved in terminating a project and
issuing the press release.
“The exercise underscored that when a surgeon
moves beyond the OR and seeks to make larger policy
decisions, the input and perspectives of many different
people are required. Ultimately, however, there will be
an executive who is responsible and accountable for the
endeavor,” said Dr. Maa. “Being involved in leadership,
catalyzing change, and working in advocacy, public
policy, and politics are essential to the future success
of the fields of medicine and surgery,” he added. “The
skill sets required are different from those that produce
success in the OR.”
Another important component of the course,
according to Dr. Maa, was an overview of the history
of health care economics in the U. S. and the competen-
cies necessary to understand financial reports.
“The program taught me to be thoughtful and
analytical in interpreting the economic reports that
are being presented to you. First, surgeons should
understand how these reports are prepared and their
format—and have a basic understanding of account-
ing principles. It’s similar to interpreting an opera-
tive record—surgeons understand the blood pressure
and heart rate information that is communicated in
the anesthesiologist’s notes. Similarly, for health eco-
nomic reports, surgeons should have a basic under-
standing of concepts such as net assets, liabilities,
and profit margins, though it’s foreign to us. They
don’t really teach this in medical school or residency,”
Dr. Maa explained.
In his role at the UC Office of the President
Tobacco-Related Disease Research Program, Dr. Maa
helps oversee the statewide tobacco tax grant funds
collected via Proposition 99. “We fund the tobacco
control research, epidemiology, and educational pro-
grams across the state of California. It is a very dif-
ferent world from the OR. Our meeting proceedings
are recorded, and the work is overseen by attorneys.
We carefully evaluate laws and provide scientific
feedback, which involves leading multidisciplinary
teams, having a long-range time frame, and carefully
analyzing budgets.”
“Most importantly, what I’ve learned both through
the Heller course and through my time in DC is the
[value] of time and patience. Progress in the public
policy arena involves a lengthy time frame. In the OR,
events happen quickly. When a surgeon needs some-
thing and requests it, the expectation is that it will be
available immediately to save the patient’s life. In the
public policy world, success requires substantially more
time, as it can take years for cases to be reviewed and
for laws to be passed,” Dr. Maa said.
For surgeons new to the public policy arena,
Dr. Maa said, learning to communicate with the public
is key. “When you speak to Congress and to the general
public, or when you write letters or editorials, learn to
be concise and to write in a language that the general
public can comprehend,” Dr. Maa advised. “You have
to also learn to communicate with policymakers—
many of whom are lawyers—in their language that is
different from the vocabulary of surgery, if your intent
is for them to respond to you.”
“In the OR, you’re making vital decisions
for a single patient, but as a surgeon
leader, your decisions can affect many
more individuals simultaneously.”
—Dr. Maa
JUN 2015 BULLETIN American College of Surgeons
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HELLER LEADERSHIP PROGRAM
