American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Winter 2014

Message from the Editor

Parting Words from the Immediate Past-Chair

New YFA Chair and Chair-Elect

Reflections on Dr. Pellegrini's Presidential Address

Leadership Advice

SurgeonsVoice: Using Technology to Facilitate Advocacy for ACS Members

A Piece of My Mind: The Benefits of Surgical Society Membership

New Governing Council Members

Evidence-Based Decisions in Surgery



Message from the Editor

My thanks to all of you who attended the Young Fellows Association (YFA) events at this year’s Clinical Congress of the American College of Surgeons (ACS). We had a great Initiates Program on Titrating Your Leadership Skills and the Fifth Annual YFA business meeting was one of our most well-attended. The roundtable discussion with ACS President Carlos Pellegrini, MD, FACS, allowed attendees to gain early insight into the vision he has for the College. Another exciting aspect of Clinical Congress is the welcoming of surgeons onto the YFA Governing Council. In this edition of YFA e-News, we congratulate S. Rob Todd, MD, FACS, and Michael Sutherland, MD, FACS, on their new positions as Chair and Chair-Elect; welcome new members to the Governing Council; and enjoy the reflections of Laurel Soot, MD, FACS, on her service as outgoing YFA Chair. We thank Dr. Soot for her years of dedication to the College.

Joshua A. Broghammer, MD, FACS
YFA e-News Editor
Kansas City, KS


Parting Words from the Immediate Past-Chair

Time spent at meetings: 59 days
Time spent on phone conferences: 85 hours
Numbers of e-mails: 1,500+
Friendships, memories, education, professional and personal growth: TIMELESS (and PRICELESS)

I complete my seven years in the YFA with many of the feelings we all experience as we shift through a significant period of our lives. I started in the YFA during my sixth year of general surgery private practice in a five-person group. My children were ages four and six, and my husband, a general surgeon, had a private practice with three other general surgeons. I now leave the YFA as the mother of an 11- and a 13-year-old, have a husband who has changed his surgical practice, and have experienced change in my own practice, joining a multispecialty group of 130 specialty physicians. I have now served on the board of directors and have been the vice president of the executive committee for this surgical group as well as accepted the position as the regional director for breast health services for my hospital system. I claim this with the utmost humility and sincere appreciation and thanks to the ACS for believing in me when I was chosen to join the YFA Governing Council and giving me the opportunity to learn and grow both professionally and personally. This support has given me the experience and knowledge to pursue these opportunities.

Amazing changes in the College have occurred during my tenure with respect to the voice of the young surgeon. We are no longer viewed as the “teenager” in the room; rather being sought by the leadership of the College and our ideas implemented. For this I give great thanks to Thomas R. Russell, MD, FACS, former ACS Executive Director, for his interest in our well-being. It was then acted on and emphasized by the current ACS Executive Director, David B. Hoyt, MD, FACS. I had the great privilege and honor of serving on the YFA Governing Council with Patricia L. Turner, MD, FACS, Director of the ACS Division of Member Services, and truly count her as a friend and colleague as well as a vocal advocate within the College for the YFA.

All of the YFA Governing Council members have the qualities required to serve as the Chair, and I am extremely honored to have held this position and to pass it on to Dr. Rob Todd. I know that he has the same passion for the College and the YFA that we all have; to make the College relevant and important for Fellows in their first 10–15 years in practice. I will look back fondly at this time, which in some ways is reminiscent of residency. It is a time of “firsts”: first “real” job and changing jobs, marriage, children, grants/research, advocacy, outreach, and leadership within your community and state as well as nationally. It has given me the opportunity to make life-long friendships with surgeons of other specialties, states, nations, and academic, private, and rural practices. We have found the common denominator, and that is that we all care immensely for our patients, strive to provide high-quality care, and advocate for our patients within the confines of the external requests for our time and energy, changes in health care, and attempt to maintain a quality of life that keeps us laughing and fulfilled.

Humbly, I give thanks to this amazing organization and I look forward to my continued active involvement within the College.

Laurel C. Soot, MD, FACS
Immediate Past-Chair, Governing Council
Portland, OR


New YFA Chair and Chair-Elect

Our congratulations to S. Rob Todd, MD, FACS, on his new role as Chair of the YFA and Michael Sutherland, MD, FACS, on his position as Chair-Elect. Here is a little information about them.

Dr. S. Rob Todd
Chair, Governing Council
New York, NY

Dr. Todd received his medical degree in 1996 and completed his general surgery residency in 2001 at Texas Tech University Health Sciences Center School of Medicine, Lubbock. In 2003, he completed a fellowship in trauma and surgical critical care at Oregon Health & Science University in Portland. In 2011, he was recruited to the New York University School of Medicine as an acute care surgeon where he serves as the chief of trauma and emergency surgery for Bellevue Hospital Center, New York, NY. His current research focus is blood product use in the surgical population.

Dr. Todd has participated in extensive activities within the College, including serving on the Board of Governors (B/G), as Vice-Chair of the Chapter Activities Domestic Workgroup of the B/G, as a YFA Governing Council member, Committee on Trauma Liaison, and as YFA Nominating Committee Chair. He now moves forward to become Chair, and we look forward to fulfilling his vision for the future of Young Fellows.

Dr. Michael Sutherland
Chair-Elect, Governing Council
Pine Bluff, AR

Dr. Sutherland received his medical degree in 1998 at Louisiana State University Medical Center in New Orleans. He completed a general surgery residency in 2003 at Keesler Air Force Base Medical Center in Biloxi, MS. He stayed in Biloxi at the VA Gulf Coast Veterans Health Care System where he completed a fellowship in general thoracic and vascular surgery. During his time in residency and fellowship, he was an active member of the Resident and Associate Society of the ACS (RAS-ACS) and eventually served as the Chair of RAS-ACS.

Dr. Sutherland completed his time in the Air Force at Travis Air Force Base near Sacramento, CA, and served a tour of duty in Iraq as a trauma surgeon at Balad’s Air Force Theater Hospital. He is currently in private practice in Pine Bluff, AR, and on faculty at the University of Arkansas for Medical Sciences in Little Rock. His practice interests include trauma, vascular, and general surgery.

Dr. Sutherland has served on numerous committees during his seven years in the RAS-ACS. He serves on the YFA Governing Council and is Chair of the YFA Member Services Committee. He is on the ACSPA-SurgeonsPAC Board of Directors, the General Surgery Coding and Reimbursement Committee, and now steps into the role of YFA Chair-Elect.


Reflections on Dr. Pellegrini’s Presidential Address

ACS President Carlos A. Pellegrini, MD, FACS, offered insight on a variety of subjects as he introduced the “Year of the Surgeon” during the Convocation Ceremony at the 2013 ACS Clinical Congress. His address focused on a collection of principles required for professional well-being and the future of the ACS: professionalism, excellence, innovation, inclusion, and introspection. The first four values reaffirm the foundation of the ACS and are reflected in ACS meetings and activities. For me, however, it is the fifth value—introspection—that drew my attention. Why should self-examination prove such an important part of this Year of the Surgeon? Why is this principle so important to the daily exercise of my profession?

Merriam-Webster defines introspection as “a reflective looking inward; an examination of one’s own thoughts and feelings.” It took me a while to understand how this concept applied to my life as a surgeon. Dr. Pellegrini was able to provide some perspective on the use of this specific term. He emphasized the need to look in the mirror not only as an organization, but as individual surgeons.

We all most certainly have a picture somewhere in a photo album under the coffee table or on your parents’ mantle—perhaps in a photo collage—of someone who looks suspiciously like a younger version of you at a time when what you wanted more than anything in your professional life was to become a surgeon.

Find the picture of that medical student or young resident and study it for a moment. Is the coat clean and starched, or wrinkled and perhaps more coffee-stained than you remember? Take a minute to marvel at how many random pieces of paper, reference materials, or half-eaten granola bars you might have had crammed in the pockets. You may even ask yourself, “Whatever happened to that stethoscope or reflex hammer?”

Take a moment to entertain these musings and then look into the eyes in the photo. Note the twinkle there. Oh sure, it might be a bit glazed over depending on your workload at the particular moment it was taken, but if you look carefully, I bet it is there. That guy or gal was inspired by a promising future of becoming a surgeon. How do we recapture that feeling on a daily basis? How do we move from retrospection—or focus on how we used to feel when that picture was taken—to introspection and capturing that feeling again?

It is a personal question to be sure, but one that we need to ask ourselves on a daily basis. The answer, likewise, is almost certainly as unique as the individual who asks it. I think, however, that was Dr. Pellegrini’s point.

Joe DuBose, MD, FACS
YFA Governing Council
Lt Col USAF MC
Houston, TX


Leadership Advice

Leaders inspire people to accomplish missions for a common vision and often move organizations through change. Effective leaders are rarely born; rather, they are the product of deliberate preparation, even before leadership opportunities exist. Here are three things that you can do to set conditions for your success as a leader.

  1. You should gain insights into your leadership style by determining how you learn and how you respond to the world around you. Key tools to answer these questions include a learning styles inventory (for example, Kolb or online) and personality type assessment (for example, Myers–Briggs).
  2. Just as you read the Journal of the American College of Surgeons to keep abreast of changing surgical practices, you need to remain current in changing leadership practice. Adding the Harvard Business Review and Physician Executive Journal of Medical Management (American College of Physician Executives) to your reading list will help shape your thinking with leadership science.
  3. An essential quality of an effective leader is clear verbal communication. As words are spoken, nonverbal gestures, postures, and eye contact can have an even greater effect on your ability to connect with an audience. Have some of your presentations videotaped and review them for the non-verbal signals that you are sending. This will help you improve your presentation style.

Louis Pasteur observed, "Chance favors the prepared mind." By understanding your learning and personality styles, regularly reading leadership literature, and reflecting on your communication style, you will be better equipped to step forward as a leader.

John H. Armstrong, MD, FACS
Surgeon General and Secretary of Health for the State of Florida


SurgeonsVoice: Using Technology to Facilitate Advocacy for ACS Members

SurgeonsVoice is an interactive grassroots advocacy program that provides surgeons with the tools needed to strengthen their advocacy impact in Congress and around the country. It is a new initiative from the College to make it easier for Fellows to contact their congressional representatives regarding pending legislation.

How does it work? The College maintains an e-mail database of its membership along with corresponding practice addresses. Those addresses are cross referenced with the congressional membership representing that geographic location. When legislation is pending in Congress that requires advocacy from the membership, you will receive an e-mail from the College asking you to contact your representative. Click on a link in the e-mail, which takes the user to a sign-in page on the SurgeonsVoice website. From there, you can easily generate correspondence letters to your senator or representative supporting ACS-endorsed legislation. This can even be completed from your smartphone, which helps a surgeon to easily engage in advocacy.

Not only does the SurgeonsVoice website facilitate contact with members of Congress, it also offers Fellows direction on how to improve advocacy at the local and state levels through the SurgeonsVoice toolkit. In addition, it provides a schedule of pending legislation in your area that is important to the College.

In an era of health care reform, advocacy has become more important than ever to ensure the interests of surgeons are well represented in Congress. SurgeonsVoice leverages technology to enable grassroots-level advocacy for the busy membership of the College. Log in and take a look today!

James W. Suliburk, MD, FACS
YFA Governing Council
Houston, TX


A Piece of My Mind: The Benefits of Surgical Society Membership

As a young surgeon, I was blessed with excellent mentorship from my department chair as well as other senior members of our surgical community. A common theme among my mentors has been the importance of active involvement in local, regional, and national surgical societies. As my career has progressed, this advice has provided critical guidance. Surgical societies are an integral part of U.S. surgery, providing opportunities for scientific advancement, networking, and professional recognition. E. Christopher Ellison, MD, FACS, in his presidential address to the Central Surgical Association in 2008, addressed the “vital signs” of regional surgical societies and found that while membership and participation in attending the annual meetings were down, the academic productivity and quality of patient care remain high.* Dr. Ellison endorsed the expansion of membership in societies and efforts to make membership more attractive to surgeons.

Local societies provide excellent networking opportunities, which may be particularly advantageous to a young surgeon trying to build a practice. As a relatively new surgeon in Norfolk, VA, I became involved in the Norfolk Academy of Medicine, which allowed me to interact with many of my nonsurgical peers as well as participate in activities of the Medical Society of Virginia and the American Medical Association. These activities served as both an introduction to organized medicine as well as a fantastic method to get to know the area's referring physicians. The local or state chapters of the ACS also provide networking among surgeons and opportunities to get involved on the Chapter Council or various committees. Many ACS chapters will pick several “Young Surgeons” to represent the Chapter at the spring ACS Leadership and Advocacy Summit. The meeting is an excellent chance to network with other young surgeons from around the country and is offered to surgeons who have been active within the local chapters of the ACS.

Involvement within regional and specialty societies is another means for young surgeons to interact with peers with similar interests. As a young faculty member, I began attending meetings of the Southeastern Surgical Congress (SESC). These meetings provide a showcase for residents and young faculty to present papers as well as network with peers. I became involved with the continuing medical education (CME) committee of the SESC, which allowed me to interact with leaders in U.S. surgery as well as appreciate the complexity of planning and running a meeting. My involvement with this regional organization has opened a number of doors both regionally and nationally and led to many friendships.

Many national and specialty societies offer opportunities for involvement. It is critical to choose society membership in areas that are relevant to your practice. When joining a society, ask about opportunities for involvement and to volunteer for committees. This information will allow you to learn how the organization functions and provide an opportunity for close working relationships with surgeons of similar interest. Within the ACS, the YFA provides opportunities for surgeons new to practice to get involved on a variety of committees, including as a member of the YFA Governing Council. As a member of the YFA Governing Council, I have had the opportunity to become friends with fellow young surgeons from throughout the country and become more involved on a variety of ACS committees.

My participation in various local, regional, and national societies has profoundly influenced my surgery practice and has opened a number of doors. I believe that we must be active participants to maintain our sphere of influence. Set a timeframe for your career in terms of society membership and activities, and make an effort to stick to your timeframe. Find a mentor who can help you develop goals for society participation. The more you participate in the societies, the higher the yield will be to your career goals and your personal satisfaction.

If you have ideas or would like to become more involved, please contact youngfellows@facs.org.

Rebecca C. Britt, MD, FACS
YFA Governing Council
Norfolk, VA


* Ellison EC. Assessing the vital signs of regional surgical societies: What is the prognosis? Surgery. 2008;144(4):483-491.


New Governing Council Members

A warm welcome to several new members to the YFA Governing Council who represent a diverse cross section of North American surgeons.

Dr. Cynthia Downard
YFA Governing Council
Louisville, KY

Cynthia Downard, MD, MMSc, FACS, is a pediatric surgeon in Louisville, KY. She went to medical school at Vanderbilt University, Nashville, TN, and trained in general surgery at Oregon Health & Science University in Portland. She completed a fellowship in surgical critical care at Children’s Hospital Boston (MA) and in pediatric surgery at Emory University in Atlanta, GA. She is married with two daughters, ages 8 and 10. Her hobbies include traveling, playing tennis, cheering on the Louisville Cardinals, and serving as a very opinionated amateur food critic. She has been a Councilor for the Kentucky Chapter of the ACS, and is currently the Secretary-Treasurer of the chapter. In addition, she serves on her regional Committee on Applicants for the College and represented Kentucky at the 2013 ACS Leadership and Advocacy Summit.

Dr. Joshua Mammen
YFA Governing Council
Kansas City, KS

Joshua Mammen, MD, PhD, FACS, grew up in Kaplan, LA, and completed both his undergraduate and medical training at Boston University (MA). After completing his general surgery residency at the University of Cincinnati (OH), he completed a clinical fellowship in surgical oncology at the University of Texas MD Anderson Cancer Center, Houston. During this time, he also completed a PhD in molecular and cellular physiology at the University of Cincinnati. He is board certified by the American Board of Surgery and a member of the Society for Surgical Oncology. He was active in the RAS-ACS and served as Chair. He is the State Chair for Kansas for the ACS Commission on Cancer. Earlier this year, he served as the Program Co-Chair for the Annual Meeting of the ACS Kansas Chapter.

Dr. Brian Santin
YFA-RAS Liaison
Wilmington, OH

Brian J. Santin, MD, FACS, has recently opened a private practice (Ohio Vein & Vascular, Inc.) in vascular surgery in Wilmington, OH. His undergraduate (economics) and medical degrees are from The Ohio State University in Columbus. He completed general surgery residency at Mount Carmel in Columbus, OH, and recently finished a vascular surgery fellowship at Good Samaritan Hospital in Cincinnati, OH. Prior to his role as the Liaison to the YFA from RAS-ACS, Dr. Santin served on multiple RAS-ACS committees including Chair of the Issues Committee and progressing to Secretary, Vice-Chair, and most recently as Chair of RAS-ACS. He continues to serve on the B/G Workgroup on Physician Competency and Health. Dr. Santin is excited to participate on the YFA Governing Council this year and is already enjoying interactions with YFA members, especially on the Communications Committee.

Dr. Joseph Scharpf
YFA Governing Council
Cleveland, OH

Joseph Scharpf, MD, FACS, is a staff member of the Cleveland (OH) Clinic's Head and Neck Institute in the head and neck surgery section. He is board certified in otolaryngology. His clinical and research interests focus on head and neck cancer with a particular interest in thyroid surgery. He completed a general surgery internship and an otolaryngology, head and neck surgery residency, including an additional year of research at the Cleveland Clinic. He pursued further fellowship training in advanced head and neck cancer, endocrine, and reconstructive surgery at the University of Iowa in Iowa City before returning to the Cleveland Clinic. He is a member of the American Thyroid Association, American Head and Neck Society, and American Academy of Otolaryngology-Head and Neck Surgery. He serves on the Cleveland Clinic Robotic Surgical Steering Committee and Laser Safety Committee. He has been married for 15 years to Tanya, who has a PhD in epidemiology, and they have two children, Joseph and Alexandra. Personal interests include soccer, running, and skiing.

Dr. Shoaib Sheikh
YFA Governing Council
Newfoundland and Labrador, Canada

Shoaib Sheikh, MD, FACS, is a practicing rural surgeon in Newfoundland and Labrador and was born in Kitchener, ON, Canada. After medical school, he was a postdoctoral fellow at Brown University, Providence, RI, in the department of orthopaedic surgery, where his research focused on aspects of fractures healing. He completed his residency at Brown University in general surgery and his clinical fellowship in orthopaedic hand/wrist/elbow surgery and microvascular reconstruction of the upper limb at the University of Miami, FL. He joined the department of orthopaedics at the University of Arizona Medical Center, Tucson, as faculty of hand and microvascular surgery where he was engaged in teaching medical students, residents, and fellows. Later he was appointed the director of orthopaedic research at the University of Arizona and cross appointed to the department of surgery for teaching surgical residents. Approximately four years ago, he returned to Canada to provide care in underserved areas and joined Eastern Health in Newfoundland and Labrador as a rural surgeon. Last year, he was elected to the ACS B/G. He also serves on the YFA Governing Council.

Dr. James W. Suliburk
YFA Governing Council
Houston, TX

James Suliburk, MD, FACS, completed his medical training at the University of Oklahoma College of Medicine, Oklahoma City. After finishing his general surgery residency at the University of Texas, Houston, he completed a clinical fellowship in endocrine surgery at the University of Sydney, Australia. He is now an assistant professor of surgery at Baylor College of Medicine in Houston. Dr. Suliburk’s clinical interests include treatment of both benign and malignant endocrine disease.

 


Evidence-Based Decisions in Surgery

The ACS Division of Education has developed a new product called Evidence-Based Decisions in Surgery (EBDS), which was unveiled at the 2013 Clinical Congress in Washington, DC. These point-of-care modules are based on currently available evidence and practice guidelines that address diagnoses and conditions most relevant to general surgeons. The modules are available electronically on desktop computers, tablets, and mobile devices. They can be used for decision support, patient-focused interactions with other health care professionals, and for patient education.

Professional medical organizations develop practice guidelines using expert committees and standard rules of medical evidence analysis. These guidelines run in length from 100 to 250 pages and can be cumbersome for everyday surgical practice. The clinical guideline summaries produced by ACS in EBDS provides recommendations based on the full guideline content and grades the supporting evidence to make this information digestible and widely accessible to surgeons.

Each EBDS module includes six to eight pages of concise information in an electronic format. Module development has involved a rigorous multi-step process, including contributions from experts on the ACS Board of Governors and the ACS Advisory Council for General Surgery.

This platform is now available only to ACS Fellows, but it is expected to be available to other health care professionals and patients in the future. EBDS is not intended to reflect standards of care as defined by the ACS but to serve as educational resources that practicing surgeons may use within the context of their respective practices. These guidelines should be used when appropriate based on the surgical condition and the surgeon’s experience, as well as needs and preferences of individual patients.

To learn more, please visit www.ebds.facs.org to access the modules (ACS login required). For additional information or questions, please e-mail ebds@facs.org.