ACS Past-President and Trailblazer Dr. Julie Freischlag Describes Her Path to Becoming a Chair

Few have paved the way for future surgeons with more authority than Julie Ann Freischlag, MD, FACS.

Recently retired from her role as chief executive officer of Atrium Health Wake Forest Baptist, Chief Academic Officer at Advocate Health, and Executive Vice President of Health Affairs at Wake Forest University in Winston-Salem, North Carolina, she is uniquely positioned to understand the challenges facing young surgeons today.

A Natural Leader

Originally wanting to be a teacher, she enrolled in medical school when the education program got cut.

Her undergraduate training at University of Illinois in Urbana-Champaign, medical school at Rush Medical College in Chicago, and being the only woman in a residency class of 40 to 50 men at the University of California, Los Angeles (UCLA), started Dr. Freischlag down a groundbreaking, prestigious path. She would become the first female surgeon-in-chief at The Johns Hopkins University in Baltimore, Maryland, be elected to the National Academy of Medicine in 2014 and find a home at Wake Forest in 2017.

Shortly after landing at Wake Forest, she was elected President of the ACS.

“The reason I got so involved in the College is because in the 80s and 90s, when I was coming up, I was only the sixth female vascular surgeon in the US,” she said. She first presented research as a resident at the surgical forum and joined the pre- and post-operative committee.

Her path to president began because of a desire to get involved and meet other women in surgery. “The College is where I met people like Barbara [Bass, MD, FACS, former ACS President]. You need to get involved and meet people because it’s a great avenue to present research.”

At the ACS and Beyond

Dr. Freischlag, the first woman Chair of the Board of Regents, and, at the time, the only woman president of the Society for Vascular Surgery (SVS), knows what being first truly means.

“When I was looking at chair jobs, I was told by a few places they couldn’t hire their first woman. When I got the Hopkins job, I succeeded John Cameron [MD, FACS, former ACS President]—it was a big deal. But you just can’t give up.”

In surgery, there are many qualified individuals for few positions of leadership. Environments can be intimidating, but young surgeons who are passionate must take steps to stand out and become leaders.

“Being a great surgeon means having great relationships. Listen well, make sure people know that you publish. Stand up and introduce yourself, and make sure you say where you are in your career,” she advised young surgeons.

She is adamant that leaders must always keep learning. “We must make sure we pay attention so that everyone gets a chance to contribute. We need to know when there aren’t enough perspectives in the room.”

In 2003, surgery faced a major problem: programs weren’t being filled. It was the first and only time this happened, but it highlighted just how much work had to be done to make students feel there was a place for them.

“Programs were hard on people,” Dr. Freischlag said. “They thought it was to build resilience, but we lost a lot of good surgeons by not allowing those following different paths to grow. Surgeons, and the ACS, wanted to encourage people to get into surgery, but to do that, we had to make sure they felt accepted.”

The Way Forward

To create an environment where everyone felt the freedom to learn in their own way, Dr. Freischlag leaned into communication at the ACS and in her own institution.

“We put so much effort into bringing people in. We went out there and found them—we had people talk about how much they love being a surgeon, we had people who enjoyed teaching and research. We really showed people they have a place here and can be a part of it,” she said.

As times continue to change, especially in healthcare, a crisis cannot go by without learning something. With successive generations of surgeons continuing their training, leaders like Dr. Freischlag are looking at problems from a new angle. There are barriers to education, namely cost and time commitment, that can be mitigated through creative solutions.

“The federal government wasn’t funding enough residencies anyway,” she said. “How can we get companies to fill those gaps and help teach and train physicians? We run a program in Charlotte, North Carolina, and lots of [medical device] companies help us. We ask new questions: could we get fellowships and residencies paid for? Can we decrease length of training where appropriate, or the cost of college?”

Staying Hopeful

In the hard times, think of the good times.

“We have so many people in the College who love every minute,” she said. “We need to use our people to tell stories, talk about the patients we’ve saved through surgery and research, and talk about the students we’ve trained.”

As healthcare providers push through the current challenging environment, which sometimes appear adversarial towards research and medical advancements, surgeons must stay true to the ACS’s mission of healing all with skill and trust.

“This too will pass,” she said. “We’ve made it through the 2008 financial crisis. We’ve made it through the hardest parts of COVID. There’s a chance to make things better, and we must commit to that,” she explained.

As an organization, Dr. Freischlag is a firm believer that the ACS can help improve the healthcare environment by providing the means for surgeons to support each other. It starts in small ways, like helping each other to stay positive and coming to in-person meetings when possible.

Though the technology certainly has its place, not all challenges can be solved virtually. Having different people in the room to advocate for different priorities continues to center the patient in the work the ACS does.

“We must continue fighting—some people delay procedures because they can’t afford it. North Carolina expanded Medicaid, and people come to routine appointments. It’s about going to the people who make the decisions on behalf of our patients and their stories,” she said. “Stay focused, know where you’re going, what is happening, and how it can be made better.”

And, when in doubt, Dr. Freischlag’s belief can be a mantra: “Of course you can do it—people have phenomenal capacity, and you can manage anything.”