Brothers and sisters, unite!
Some also have questioned whether busy community practice surgeons will be equally able to comply with the time-consuming demands of the Executive Committee. The presidency is almost a full-time position, yet it remains unpaid. Accordingly, a private-practice surgeon will need the backing of his or her partners or sufficient finances to counter the loss of income. Academic surgeons also have busy lives running departments, lecturing students, and operating on the most-challenging cases. Surely then, if candidates have proven themselves through years of conscientious labor on SVS committees, the manner of their employment or source of income should not influence their electability.
Dennis also explains that many private practice surgeons have a laissez-faire attitude leaving the multitude of committee appointments to these dedicated academic surgeons. On the contrary, I have spoken with numerous community surgeons who claim to have volunteered for committee or leadership positions and have not yet been appointed. Perhaps it is a self-fulfilling situation. The composition of the SVS Nominating Committee, which proposes the slate for SVS officers, originally comprised the immediate past, current, and future presidents. The composition was changed several years ago and now includes the two immediate past presidents, a representative from the affiliated vascular societies, a representative from the SVS Councils, and recently, an at-large member elected by the SVS membership. The objective was to encourage participation from someone, possibly a community practice surgeon, who had the support of the general membership.
However, it is problematic for community surgeons to gain sufficient exposure or national recognition to be elected unless they publish and lecture prolifically. Since the nominating committee has always consisted of academic surgeons, it could be argued that they would necessarily favor academics. On the other hand, such favoritism may be based simply on the fact that they are more familiar with one another. It is conceivable that as more community surgeons prove their organizational skills by serving on various committees, some will become well known and electable. As yet, the current pool of eligible community surgeons is small, whereas there are many academic surgeons clearly deserving of appointment.
Interestingly, there are now academic members of the current Executive Committee who were formerly in private practice or are currently in situations that can be regarded as both academic and community based. This suggests that the lines between academic and community practice have blurred sufficiently enough that we should no longer consider ourselves as belonging to different camps. Also, for the last 3 years, I have been a guest at the SVS Board of Directors meetings, where I have witnessed intense deliberation on multiple issues of equal concern to both academic and private surgeons. In fact, some current leaders are so certain that we are all the same that they question whether the addition of community surgeons will add new insights that might modify the daily function and future agenda of the SVS.
Consistent with the necessity for full disclosure, I am a community-practice surgeon, although I was in full-time academics for the first 6 years of my practice and now hold a position as a clinical professor at Florida State University Medical School in Tallahassee. With this background, I suggest that negating the value of community input is an incorrect concept. Private practice has many challenges, which include diverse issues such as maintaining IT departments, staffing, electronic medical records, Stark issues, malpractice insurance requirements, PQRS requirements, contract issues, partnership contracts, and competition with other specialists and hospital groups. Even current training paradigms are affecting private practitioners. Accordingly, it is imperative that their concerns are heard at the highest level. Perhaps, too, having community-practice representation on the Executive would be seen as a positive impetus to encourage more unaffiliated community doctors to join the Society.In September, Pope Francis visited America. During his speech to the United Nations, he made the following statement: “The contemporary world, with its open wounds which affect so many of our brothers and sisters, commands that we confront every form of polarization which would divide it into these two camps.”
Vascular surgeons and the Society for Vascular Surgery would do well to heed his words.
Dr. Samson is a clinical professor of surgery (vascular) at Florida State University Medical School, is president of Mote Vascular Foundation, and an attending vascular surgeon, Sarasota (Fla.) Vascular Specialists. Dr. Samson also considers himself a member of his proposed American College of Vascular Surgery.
