Message From the President - February 2012

Steve SAGES President, Dr. Steve Schwaitzberg

 

Leadership is Synonymous with Service and Collaboration

To provide leadership in surgery, particularly gastrointestinal and endoscopic surgery, to optimize patient care through education, research and innovation – SAGES Mission Statement

This is my final president's message. To say that it has been an extraordinary honor and privilege to serve the Society is an understatement. It has been humbling to work amidst the amazing talent that makes up SAGES. I am sure my successors -- Scott Melvin, then Gerry Fried -- will also experience the unique vigor swirling within the SAGES community which energizes the various committees to do the spectacular work that makes our mission statement more than words on a webpage. SAGES members who read this should realize that your actions have spoken loudly throughout the surgical world. I have learned this by traveling and conversing with surgeons in 5 countries, our industry partners and to the leaders of the *AAGL, ABS, ACS, AHS, AHPBA, ALACE, AORN, APSF, ASCRS, ASGE, ASMBS, AUA, CAGS, CSS, EAES, FDA, IPEG, ISOBS, Joint Commission, JSES, SLS and SSAT about our programs such as FLS, FES, FUSE, SAGES University, SAGES TV, SAGES iMAGES, S-Wiki, NOSCAR, SAGES guidelines, our global/humanitarian efforts, and of course, our annual program. Each of these projects has moved forward through the leadership provided by the chairs and co-chairs of the committees, liaison groups, task forces, projects, the amazing SAGES staffers (led by the incomparable Sallie Matthews), and the SAGES members of these teams who have dedicated themselves to achieving our shared goals. These accomplishments are the result of incalculable hours of volunteer service by surgeons and allied health members. The sum of these efforts is inspiring.

I would personally like to thank the SAGES Board of Governors for their advice, guidance and the significant additional commitment that is required of them. The SAGES Executive Committee: Mike Brunt, Adrian Park, Danny Scott, Gerry Fried, Scott Melvin, and Jo Buyske deserve special mention. For them, SAGES is nearly an every day event. In addition to the monthly conference calls and extended meetings required to operate the Society, I have sent them innumerable emails (and attachments) often requiring an immediate response. (My apologies!) If SAGES is a nimble organization capable of making thoughtful decisions in an appropriate time frame, the SAGES Executive Committee is the reason. You have made my job a joy.

If you are already a member or just thinking about whether or not to join in on the fun (and work), consider this. The vertical distance between even the newest member and the SAGES President is likely the shortest amongst any major surgical society. Maybe, that is in part, our “special sauce”. I can already see the contributions from some of those wrote me last spring asking to participate, who then attended their first committee meeting just a few months ago. New energy not only is added constantly to the mix, but welcomed here. There really is no reason to be on the outside looking in.

SAGES is the largest of the general surgery specialty societies, not because we are all things to all surgeons. It is unlikely we will cover trauma or breast care anytime in the near future. However, we are united in the goal to minimize pain and suffering in the management of GI, endocrine, and hernia problems that beset our patients. We have come a long way from just being those crazy surgical endoscopists and video surgeons (yes we still have those too, thank goodness) to a more mature society that also wrestles with issues of quality of care, patient outcomes, guidelines, research, legislative issues, as well as education and training. The role of SAGES as an assessment organization for the 1000+ general surgical residents who must take the FLS examination in order to take the ABS qualifying examination is significant ground breaking work for a specialty society. It has been gratifying to hear from gynecologic, urologic, and orthopedic groups who are embarking on their own journeys to develop assessment methodologies within their specialties. Their respect for what FLS has meant to general surgery is palpable especially after they become aware how heavy the “lift” was to get where we are today. This has been echoed in many countries as well. However, success is not without obligation.

In the same fashion that we manage SAGES in a highly organized yet personal fashion (thanks SAGES staff!), we must have meaningful dialogues with our sister societies in and out of general surgery. At the end of the day, we must primarily be about achieving the best patient outcomes by having the most knowledge and well trained teams. Like it or not, this is best achieved through collaboration. Those who lead must put their personal interests aside at times in order to achieve this shared goal of optimal patient care. We can do this. This year the leaders of SAGES, SSAT, ASMBS, ASCRS and ASGE have worked together to create an active working group to develop a curriculum for the ABS to teach flexible endoscopy to surgical residents. Clearly there are differing priorities amongst these constituencies. SAGES has worked recently with ASBMS and ASCRS on common guidelines initiatives. SAGES and the ACS collaborate to deliver FLS to the broadest possible audience and are currently working on potential collaborations in others areas such as NSQIP. The GI Surgery Societies have all co-endorsed the SAGES Statement on Surgical Society-Industry Relationships1 commissioned by Dan Smith during his SAGES presidential year. This year NOSCAR (SAGES/ASGE) will work with members of AAGL to craft a statement on transvaginal access for minimally invasive surgery. I have written previously about the immense value of this relationship with ASGE. The FUSE program is yet another example of leadership through collaboration. The FUSE leadership (Dan Jones, Pascal Fuchshuber and Liane Feldman) has engaged participants from anesthesia, gynecology, urology, general surgery and perhaps most importantly, nursing organizations to design and implement a comprehensive didactic and assessment program in the safe use of surgical energy. The power of this collaboration will undoubtedly lead to far reaching acceptance by the key patient safety organizations. The SAGES Hernia Task force (led by Adrian Park, Carla Pugh, Melina Vassiliou and Guy Voeller) are working diligently to create didactics and validated assessment for laparoscopic and open hernia repair. This task force includes 5 past presidents of the American Hernia Society, clearly building a bridge to that society. All of these examples point to one thing - - to lead is to serve and collaborate.

I will have to confess that sometime around the turn of the millennium when just about the last of “lap-everything” had been shown at the SAGES meeting, I wondered what the future of SAGES would be? Hadn't everything been done? Hardly – the journey continues as vibrant and exciting as the 1990's. There is so much still to do.

From my vantage point there are several things we should consider for the near future. In order to do make these happen we will need to engage even more members to work towards the mission. Here are just a few…

  • Shorten the refresh and initiation cycle on our guidelines and position statements, collaborating where appropriate to avoid duplication of effort and conflicting statements
  • Bring FLS and other validated programs to other countries.
  • Train more surgical endoscopists
  • Develop competency assessments in more procedures and work them into residency training and surgical practice.
  • Prove that the training and assessment programs we develop impact outcome. It is time to embrace the comparative effectiveness of training.
  • Work at reducing the expense (to SAGES) and/or cost (to the participant) of these educational programs such as the “Fundamentals” (FLS, FES, FUSE), SAGES University (already a benefit of membership) or the annual meeting.
  • Continue to build and reinforce the working relationships we have established among the various societies (in all surgical disciplines, nursing, and internationally)
  • Harness the power of the Internet and social media to strengthen the ties that bind and make the surgical world a smaller place.

To all of the SAGES committee members and staff - whether I have mentioned you by name or not, this year please accept my sincere thanks for the work you have done. We moved forward only by your efforts.

As I close my final message, all I can say is thank you for this singular honor and opportunity to serve (and collaborate). SAGES remains in great hands with Scott Melvin and the incoming executive committee at the helm. The Society is financial stable and looking forward to a bright future ahead.

Steven D. Schwaitzberg, MD FACS
Cambridge, MA

1 Surg Endosc. 2010 Apr;24(4):742-4.

Some Alphabet Soup of the World of Surgery

To become (more) involved in SAGES ongoing activities write to president@sages.org