Profiles in ACS Leadership: A Few Questions for Anton N. Sidawy, MD, MPH, FACS, DFSVS, MAMSE

Editor’s note: The Bulletin of the American College of Surgeons publishes a series of articles profiling leaders of the College. The series is intended to give readers a look at the person behind the surgical mask and inspire members to consider taking on leadership positions within the organization and the institutions where they practice.

This month’s profile features Anton N. Sidawy, MD, MPH, FACS, DFSVS, MAMSE, Chair of the American College of Surgeons (ACS) Board of Regents. He is a vascular surgeon, professor, and the Lewis B. Saltz Chair, department of surgery, George Washington University, Washington, DC.

Why did you decide to become a surgeon?

That was a decision I made before even entering medical school; actually, I went to medical school to become a surgeon. I was influenced by two surgical giants who made international news: Prof. Christiaan Barnard, who performed the first human-to-human heart transplant in South Africa, and Michael DeBakey, MD, FACS, about whom I read a Time magazine article describing how he fixed an abdominal aortic aneurysm by replacing the diseased aorta with a graft. When I started my surgery residency, I was very carefully looking into cardiac and vascular surgery as future career choices. Obviously, I ended up going into vascular surgery.

What I really liked about surgery in general was the immediate outcome to an operation or intervention. In a patient with acute appendicitis, when the surgeon performs an appendectomy, the patient starts to feel better shortly after the operation. In vascular surgery, when a surgeon performs a bypass operation, it is easy to know that the bypass is working and providing optimal blood flow to the extremity. That immediate reaction to what the surgeon does really impressed me and attracted me to surgery.

Also, I have always loved working with my hands, and surgery requires manual dexterity—vascular surgery in particular, especially those fine operations that require work on small arteries. While performing an anastomosis in such situations, attention to detail is extremely important and the anastomosis has to be perfect; one stitch in the wrong place and the bypass would fail, resulting in a poor outcome. The surgeon recognizes that right away. Surgery requires a constant drive for perfection, even if we never reach it.

Most importantly, the number one reason why I was attracted to surgery was that I wanted to help people, and surgery provides that immediate satisfaction in doing so. Most of the time, patients feel better very quickly, and they are so appreciative. The surgeon can feel it. There is no better feeling than that.

How did your parents shape your experience?

My paternal grandfather died at a very young age, so my father, who wanted to be a physician, could not finish his college education because he had to work to support the family. As I was growing up, my father encouraged me to go into medicine. While in high school, during the summer break, he would buy me medical books; I enjoyed reading them and found them very interesting, and I became excited about going into medicine.

When I finished my surgical residency in 1983, I pursued vascular surgery fellowship with two excellent mentors at Boston University Hospital, MA: Frank LoGerfo, MD, FACS, and James Menzoian, MD, FACS, who introduced me to academic vascular surgery and the joy of scientific exploration. That was a pivotal year that influenced even more my career choice. I decided that I wanted to be an academic vascular surgeon and took a position at the Veterans Affairs (VA) Medical Center in Washington, DC, to pursue this career path. These two events, excellent mentorship and starting my academic career at the VA, shaped my professional career and led me to where I am today: past-president of the two national vascular surgery societies, a chair of a department of surgery in the nation’s capital, and Chair of the Board of Regents of the ACS—honors that I little thought at the time I would achieve.

What are some of the greatest challenges facing surgeons today?

There are so many challenges facing surgeons, but the two I feel most pressing are worsening reimbursement and surgeon wellness. The two are interconnected. The College was founded on the premise of improving the quality of patient care. I can’t think of any other professional surgical organization that has done more or has had a longer history of improving the quality of patient care in the US and, probably, around the world.

The stress of running a surgical practice from the financial point of view, especially during the COVID-19 pandemic, has led to further deterioration of surgeon satisfaction and surgeon wellness. Recognizing the importance of these factors on the quality of patient care, the College has become increasingly engaged in providing resources to help members of the surgical care team stay well emotionally and physically, in addition to expending all efforts to improve the financial health of surgical practices.

Leading the Surgical Care Coalition, the College was successful in mitigating the draconian cuts in physician reimbursement of more than 9% that were to be implemented starting January 1, 2022. Although it was not a complete win, the negative impact on all types of practices has lessened. This fix is temporary. More important work needs to be done to provide a real fix to the year-to-year yo-yo of financial threats devaluing our work and worsening our well-being. This is a serious issue for all surgeons no matter what practice environment they work in—academic or private practice, group or solo practice, urban or rural practice; all are affected. We are all in it together, and through the ACS Professional Association Political Action Committee (ACSPA-SurgeonsPAC), the ACS is working on all our behalf. I encourage all surgeons to contribute to the PAC.

Surgeons, like all physicians, are socially conscious because we take care of patients from all walks of life. What happens to our patients outside the hospital—social justice issues, issues that negatively impact specific patient populations—all affect surgeons on a day-to-day basis. We feel the emotions our patients are feeling, and we react to them. I am proud of what the College implemented in such a short time in the area of anti-racism, diversity, equity, and inclusion. In particular, a task force empaneled by the Board of Regents in the summer of 2020—under the leadership of then-ACS President J. Wayne Meredith, MD, FACS, MCCM—led to a standing committee and an administrative infrastructure to support the efforts of the College in that regard. (For more information on this task force, see the January 2021 Bulletin.

Describe your journey to becoming Chair of the ACS Board of Regents.

My journey to the position of Chair of the ACS Board of Regents started during my surgical residency, when I attended the ACS Clinical Congress in Chicago, IL, and I loved the variety of presentations in all surgical specialties. Then, as a young surgical faculty member, I presented my research work at the Surgical Forum (now the Scientific Forum) and interacted with many young surgeons from all surgical specialties, and I felt that the College was my surgical home, clinically and academically.

Locally, I became an active member of the Metropolitan Washington Chapter of the ACS and ascended in its ranks to the position of Chapter President in 2000. I also was involved in the Washington Academy of Surgery, a surgical organization that predated the local ACS chapter. In the late 1990s, as President of the chapter and immediate past-president of the academy, I led an effort to merge the two organizations under the banner of the chapter. LaSalle D. Leffall Jr., MD, FACS, a highly respected senior surgeon in Washington and chair of the department of surgery at Howard University, advised me and helped me navigate surgical politics to make the merger happen. That merger, I believe, was extremely important at the time to the survival of both organizations in Washington, DC. So, when it came time to nominate a Governor at-Large from DC, I was nominated by the chapter and served on the Board of Governors, chairing the Committee on Chapter Activities and the International Governors Subcommittee. I also served on the Committee on Patient Safety and Quality Improvement and the DC Credentials Committee.

Around the time my term as Governor was winding down, I was elected president of two national vascular societies: the Society for Clinical Vascular Surgery in 2006, and then the Society for Vascular Surgery in 2010. So, when the time came to nominate a vascular Regent in 2015, I was nominated and was elected to succeed Julie Freischlag, MD, FACS, DFSVS. That also was the year I completed my term as editor-in-chief of the Journal of Vascular Surgery publications. My appointment as the vascular Regent allowed me to pursue my work for the College at a higher level, serving on the Advisory Council for Vascular Surgery, the Regent’s Anti-Racism Committee, the Honors Committee, the Nominating Committee, and the Committee on Research and Optimal Patient Care. I also have been serving as the Regental Liaison to the ACS Surgical Research Committee.

I’ve been a Regent for a little more than 6 years, and I have tremendously enjoyed my work on the board. It has been fun, consequential, and rewarding. The 24 Regents, including the President, all are accomplished surgeons devoted to the work of the College. As Regents, our agenda is simple and straightforward—to improve the lives of surgeons and the patients they take care of. Although our agenda can be simple, the work can be rather complex and time-consuming due to the variety and number of the programs at the College.

I don’t think Fellows and members realize the scope and depth of all the work that the surgeon volunteers and staff of the College perform. I did not. It took me a while on the Board of Regents to do so. The College has an amazing array of programs, and leaders of the College at the staff and volunteer levels work day in and day out to make the ACS the most valuable surgical organization in the world.

Lastly, for a specialty Regent, one very rewarding aspect of serving on the Board of Regents is the opportunity to form friendships with surgeons from all different specialties with varied life and career experiences and interests. For me, that has been very special. I became friends with accomplished surgeons whom I would not have met if I had not become a member of the Board of Regents. These experiences really made me realize that being a Regent, and now Chair of the Board of Regents, is a phenomenal opportunity. We all share one goal—to make the College even more successful in its mission “to heal all with skill and trust.”

What milestones contributed to your ascension in organized medicine?

Getting involved in organized medicine is impactful. I encourage all surgeons, especially those entering the specialty, to roll up their sleeves and get engaged. It is important for us to do so with all the challenges facing medicine and surgery now and for years to come.

I started very early on in my surgical career in the local chapter of the College. I found the chapter to be the best place to start getting engaged. I participated in all its activities and served on its committees. I got to meet and network with surgeons at different stages of their careers working in different practice environments. Such interactions provided me with valuable opportunities, and I learned from their experiences, which were useful to me as a young surgeon. I also participated in the local vascular society, which allowed me to engage with vascular surgeons practicing in the city and the region.

In 2000, I became President of the chapter and remained engaged in its activities for years after finishing my term. So, when it was time for the chapter to nominate a Fellow to serve on the Board of Governors, I was nominated and served a 6-year term.

I was very fortunate, in 2015, to start serving on the Board of Regents. My service on the Board in the last 6 years has been extremely rewarding. What the board does to improve the quality of life of surgeons and their patients is simply amazing. On a personal note, I tremendously enjoyed meeting accomplished surgeons from all specialties, not only my own. We became friends and found many things in common, the most important of which are our love for surgery, passion to optimize the care of the surgical patients, and improving the practice environment of surgeons of all specialties.

This commitment was best displayed during the once-in-a-century COVID-19 pandemic when the leadership of the College performed extremely well by leading and advising its members on how to deal with the pandemic; springing into action to work on anti-racism, diversity, equity, and inclusion; and recruiting a new Executive Director, Patricia Turner,  MD, MBA, FACS. We all worked together as Regents in choosing Dr. Turner through a national search process. She is a superb choice to position the College for success while facing the many challenges in the continually changing surgical world technologically, financially, politically, and societally.

So, when I was nominated and elected by my fellow Regents to the position of Chair of the Board, I was honored and humbled to be chosen in this pivotal year that presents an opportunity to work closely with Dr. Turner and my fellow Regents to chart the College’s path for the next few years.

Describe your interests outside of surgery and public health.

Number one is friendships. I enjoy people and interactions. I have many surgical and nonsurgical friends. I love being around them and learning about what they do and learning from them.

I love history. I am fascinated by it. I read a lot about US and world history and about the history of surgery. This is why when I received the most recent book from the College, The History of Black Surgeons and Surgery in America, by Don Nakayama, MD, FACS, ACS Treasurer and Chair of the ACS History and Archives Committee, I was very excited to start reading it. I have been in Washington, DC, since 1978, and as a junior surgeon I encountered a few of the surgeons profiled in the book and they became mentors of mine, such as Dr. Leffall, who became President of the College in 1995. I was introduced to Dr. Leffall by Edward Cornwell Jr., MD, whom I consider to be my first mentor in surgery, and who is the father of Edward E. Cornwell III, MD, FACS, who became the chair of surgery at Howard University, Secretary of the College, and one of the two principal contributors to the book. Dr. Cornwell taught me more than surgical skills and procedures; he taught me how to care for the patient as a whole, physically and emotionally.

Dr. Leffall became my mentor in organized surgery in Washington, DC, especially in the local chapter of the College, as I mentioned earlier. I heard from Dr. Leffall a few of the interesting historical events discussed in the book, the most captivating of which were the events surrounding the passing of Charles R. Drew, MD, FACS, who was a pioneer in blood preservation and transfusion and who later became the chair of surgery at Howard University. Dr. Drew died April 1, 1950, in a car accident driving to Tuskegee, AL, to attend the meeting of the John A. Andrew Clinical Society. Dr. Lefall was succeeded as a chair of surgery by Clive O. Callender, MD, FACS, an accomplished transplant surgeon and a good friend who established the National Minority Organ Tissue Transplant Education Program (MOTTEP) credited with increasing organ donation nationwide.

Another distinguished surgeon known to many of us and to whom a chapter is dedicated in the book is L.D. Britt, MD, MPH, FACS. Dr. Britt also has been a mentor of mine in the College and became President of the College in 2010. So, reading this book allowed me to learn more about distinguished surgeons I encountered throughout my surgical career—surgeons whom I personally know and respect. I strongly recommend downloading an electronic version or getting the print version of this excellent book. It describes an important aspect of American surgery.

What advice would you offer to a young surgeon who would like to achieve a leadership position in the College?

Interested young surgeons should start working locally, engaging regionally, planning nationally, and be prepared to work hard. Get involved as soon as you can in your local chapter and participate in its committees and events. Then get engaged in regional societies and work toward becoming a specialty society Governor or Governor at-Large, but you should always be thinking about how you can contribute to committees of national organizations that are focused on your specialty or of particular interest to you.

If you get engaged and do a good job, people will notice and sponsor you. You should always be thinking about where you want to be next and where you want to end up. Don’t be impatient. Set a goal for yourself and be persistent in reaching that goal. Focus on your primary goal, and don’t distract yourself with unproductive “office politics” at your institution. When you accept a task in a professional organization such as the College, get it done well and on time. Don’t overstretch yourself and overcommit. That will negatively affect the quality of your work. You may have to decline an assignment at times, but when you do, explain why and express your willingness to be involved in the future. However, always remember that your main responsibility is to your family and your primary job as a surgeon.

So, my advice is simple: get engaged early, and when you are assigned a task, do the work, and do it well and on time, every time. More than 40 years ago when I became a Candidate Member of the College, I never thought I would become the Chair of the Board of Regents, but here I am, and I am ecstatic to have this opportunity to continue to work for the College, my fellow surgeons, and our patients.