The U.S., as an ideal, as a nation, and as a republic is much better than what we saw unfold that day. The First Amendment of the U.S. Constitution guarantees all citizens freedom of speech and the right to peaceably assemble and to petition the government for a redress of grievances. The right to have and freely express by legal, nonviolent means our individual political perspective is an inalienable right and at the heart of democracy as enshrined in the Constitution. The January 6 mob exceeded the scope of those protections by behaving in ways that were reckless, contrary to the principles of our government, violent, illegal, and lethal. The incident served as a stark reminder of how divided and uncivil our nation has become.
Subsequent to that event, some of you contacted leaders of the American College of Surgeons (ACS) or posted in the online Communities, requesting that the ACS Professional Association Political Action Committee (ACSPA-SurgeonsPAC) withdraw or withhold financial contributions to the campaigns of certain members of Congress. In this column we explain that SurgeonsPAC is just one component of the College’s advocacy tool kit. We also urge members to separate their personal politics from their professional politics and issue a plea for unity moving forward.
The role of the PAC
When the ACS started the ACSPA-SurgeonsPAC nearly 20 years ago, we did so to enhance the effectiveness of our Division of Advocacy and Health Policy (DAHP), Washington, DC, and it has served us well in that capacity. The ACS now is not only able to educate members of Congress about the issues that affect surgeons’ ability to provide accessible, quality surgical care, but also to ensure that elected officials can introduce and pass legislation that is aligned with our professional political agenda.
The PAC distributes funds to candidates who understand and are supportive of our priorities, regardless of the nominee’s party or personal politics. The PAC also works to ensure that financial contributions are distributed equitably across party lines in any given year. Hence, when Congress is led by a Republican majority, more funds are distributed to Republicans, and when led by Democrats, the opposite is true. Like the College as a whole, the PAC is nonpartisan.
SurgeonsPAC also chooses the candidates it supports based on their track record of supporting the College’s position on the issues. As a result, we have been able to encourage the introduction and passage of legislation that prevents Medicare payment cuts, restricts surprise billing, addresses issues in trauma care, and more.
Furthermore, the College does much work independent of the PAC to promote the interests of surgeons and their patients. The DAHP has a team of lobbyists who meet regularly with members of Congress and their health care advisors to make certain your voice is heard.
At the grassroots level, we also have SurgeonsVoice, which allows Fellows and other members of the ACS to expeditiously express their views on key issues that affect their ability to provide quality care to surgical patients. We host the Leadership & Advocacy Summit, which provides an opportunity for surgeon leaders to meet with their elected officials on Capitol Hill. In addition, our team in the DAHP can help arrange in-district meetings when Congress is in recess. And last year, the ACS formed the Surgical Care Coalition to allow all surgical specialties to speak with a united voice.
Personal versus professional politics
Sometimes we may disagree with the personal politics of individual politicians, and often it is difficult to gauge a first-time candidate’s individual beliefs. We can only look at their track record and understanding of the issues that are relevant to medicine, surgery, and patient care.
Members of the ACS, as an organization of surgeons who have pledged “to serve all with skill and fidelity,” must put aside personal politics and develop and freely express a professional political perspective. This approach applies not only to how members advocate with federal and state legislators, but also in our online ACS Communities and when attending meetings and conferences with other members as well.
Inevitably, our personal and professional perspectives sometimes will appear to be at odds with each other. In those instances, we must balance our internal arguments analogous to how we make clinical judgments. In other words, we must make decisions and act in response to the evidence, not what we personally believe is right. As Past-ACS Executive Director Thomas R. Russell, MD, FACS, used to say, “We are all entitled to our own opinion, but we are not entitled to our own facts.”
We must approach elected officials and policymakers armed with data that reflect the realities of how their decisions affect our ability to provide optimal patient care. We must offer evidence to support the changes in legislation and regulations that we have found will lead to a more equitable, accessible, inclusive, patient-centric, and value-based health care delivery system.
The spirit of collegiality
Likewise, we must engage with each other—colleagues and patients of different ethnicities, races, backgrounds, and, yes, political beliefs—in a tolerant way. Sometimes we will disagree based upon our individual beliefs. The amount of overlap between personal and professional politics will be a matter of individual choice, and it is important that we respect each other’s viewpoints. We don’t have to agree on everything, but we should be willing to hear each other out and consider the ramifications of our actions. Odds are, you can find common ground on many issues, even with people who may hold divergent personal political beliefs.
I anticipate that individuals who are members of this organization will carefully consider the facts about the ACS—that we are dedicated to doing what’s right for our patients, to curing disease, and to adding to the quality of life for our patients.
There is value in considering politically controversial matters from the perspective of both our personal and professional convictions. But we must do so with a tone of civility and with the goal of improving the lives of our patients. As then Sen. John F. Kennedy said in a 1958 speech to Loyola College alumni, “Let us not seek the Republican answer or the Democratic answer, but the right answer. Let us not seek to fix the blame for the past. Let us accept our own responsibility for the future.”*
*John F. Kennedy Presidential Library and Museum. Remarks of Senator John F. Kennedy at the Loyola College Annual Alumni Banquet, Baltimore, Maryland, February 18, 1958. Available at: www.jfklibrary.org/archives/other-resources/john-f-kennedy-speeches/baltimore-md-19580218. Accessed January 30, 2021.
