Leadership & Advocacy Summit Proves to Be Powerful Catalyst for Change

Washington, DC, served as the hub for aligning leaders, fueling collaboration, and strengthening advocacy strategies, as more than 600 surgeons descended on the nation’s capital last month for the ACS Leadership & Advocacy Summit. 

This dynamic event—held at the Grand Hyatt Washington, April 15–18, in-person and virtually—connected like-minded professionals, who engaged in meaningful discussions and learned from renowned experts about navigating the complexities of leadership and advocacy in the field of surgery. 

“The 2023 Leadership &Advocacy Summit was truly exceptional, bringing together ACS leaders and members and leaving us inspired, motivated, and equipped with invaluable leadership and advocacy knowledge and skills,” said Michael J. Sutherland, MD, MBA, FACS, Director of the ACS Division of Member Services. “The engaging sessions and thought-provoking panels were a testament to the power of collective wisdom and shared experiences, while reminding us of the limitless potential of effective leadership and influential advocacy.”

Don’t Lose Focus, Save the Salami

A special preconference seminar, Negotiation Practice and Principles: Tips, Tactics, and Traps, was offered as an add-on for attendees. In this session, Cathy A. Constantino, attorney and professor of law at Georgetown Law School in Washington, DC, promised to talk about “practical stuff.” She encouraged surgeons to use the same problem-solving skills that they use to treat patients within a negotiation.

She also underscored the importance of not losing focus during a negotiation and using words that make you stand out from competitors. 

“You don’t want to tell them you are different. You are not different; you are unique. Tell me what makes you special. What do you bring that no one else does?” Constantino advised.

In addition, she detailed how to make offers and counteroffers by adding visuals to the conversation to help increase the likelihood of a successful negotiation. She also explained how to become more comfortable with saying “no.” Constantino shared a “trick” that she uses often—the “no sandwich.” This method involves sandwiching something negative between two positives.

“Yes, I understand that your hospital has very specific needs and that you’re under a budget crunch right now. No, I’m not in a position to accept your offer. But yes, I think if we keep working on this, we might be able to come up with something,” she said. “Yes. No. Yes. It goes down easier.”

At the same time, when or if the negotiations reach a haggling stage, Constantino warned against what she calls “salami.” The “one more slice, one more slice, one more slice” likely will annoy the potential employers on the other side of the table. Instead, step away, come up with all your “one more whatevers,” and confidently return with your asks. In other words, know what you want—which includes non-monetary options—and what your concessions are.

Intersection of Ability and Aspiration 

The Leadership Summit officially kicked off on Sunday morning, with strong messages from Kimberly M. Lumpkins, MD, MBA, FACS, FRCS(Eng), surgeon-in-chief at the University of Maryland Children’s Hospital in Baltimore. 

In the session, Defining Your Path: Your Personal Mission Statement, Dr. Lumpkins started with a “hot take” on leadership: if someone wants to be a leader just for the title, prestige, and for people to follow them around, historical evidence suggests they are not going to be a very good leader. She urged everyone to understand their why.

“Why do you want to lead? You need to start by looking inside,” she said. 

Dr. Lumpkins also encouraged attendees to find their “intersection of ability and aspiration.” Ability is what you are good at; aspiration is what you love. When they overlap, it’s a calling. You deserve to live at that intersection, she said.

Acknowledging that she was talking to a room full of successful surgeons, Dr. Lumpkins admitted that “it’s a little too late for the ‘what do you want to do when you grow up’ talk.” But a career, she explained, is not what you trained in. A career is a portfolio of projects that teaches you new skills, helps you develop new capabilities, and constantly reinvents you.

“Surgery is a toolchest that you have. It’s not your straitjacket,” Dr. Lumpkins said, sharing the example of trauma surgeon and leader L. J. Punch, MD, FACS, from the Washington University School of Medicine in St. Louis, Missouri, who is an activist in the fight against gun violence and runs programs to educate the community on how to reduce the impact of trauma, injury, and violence.

Similar to the “unique” theme emphasized in the negotiation session, Dr. Lumpkins stressed the importance of a personal brand and identifying what makes you “indispensable.” Uniqueness equals leverage, she said.

While identifying your uniqueness may sound simple, it’s often very challenging. If you’re struggling with finding your points of difference, look inward and outward, Dr. Lumpkins advised, while recommending that everyone should have their own “personal board of directors”—a group of three to five people who you trust and can talk to about these issues. 

Once you know what makes you stand out, you’re able to start crafting your brand and creating your personal mission statement. When working on developing your statement, Dr. Lumpkins suggested “disabling” your frontal lobe and having a free stream of consciousness, writing down problems you are interested in solving and activities you enjoy, and thinking about podcasts and articles that interest you. 

“What are the themes in talks you go to, articles you read, and podcasts you listen to? Somewhere within that, in those spaces, is your mission statement, and your mission statement will continue to change and evolve over your career, and that’s just fine, because if you’re not changing, you’re dying,” Dr. Lumpkins said.  

Leadership in Times of Crisis 

In the session, Can We Find a Silver Lining? The Role of Leadership in Times of Challenge, Robert S. D. Higgins, MD, MSHA, FACS, president of Brigham and Women’s Hospital and executive vice-president of Mass General Brigham, both in Boston, Massachusetts, detailed his career as a cardiothoracic surgeon and shared personal stories and “pearls” garnered from his leadership journey.

Can you be a leader? This important question was one that Dr. Higgins examined closely during his presentation. He shared, with candor, that he asked himself this very question about 18 months ago when he was considering his current position.

“I really had to do some soul-searching. Can I lead in such a distinguished academic environment? I’m not a funded investigator. I’m a surgeon and clinician. I’m an underrepresented minority in a predominately white organization. I’m the only person of color at the organizational leadership meetings. So, I had to decide if I could lead in that environment,” Dr. Higgins said. 

In addition to expert advice about becoming a leader, he generously shared some wisdom he received from his late mother and that he lives by every day, including: 

• Understand your challenges (preparation).
• Situational awareness is critical (adaptability).
• Pick your battles (prioritize).
• Rome wasn’t built in a day (patience).
• You may lose battles and still win the war (resilience).
• Don’t fight too many battles on too many fronts (focus). 

Get Off the Hamster Wheel

Paula A. Ferrada, MD, FACS, FCCM, division and system chief for acute care surgery and trauma at Inova Healthcare System in Falls Church, Virginia, carried on the conversation about growing as a leader.

In another popular session during the Leadership Summit, Strategies to Get What You Deserve, Dr. Ferrada recommended finding your why, understanding and managing your environment, “getting off the hamster wheel” and dedicating time to introspection, focusing on your happiness, and accepting that everything—especially things that are hard—is an opportunity.

“Nothing about this is easy, but every single thing we do is worth it. Are you going to persevere or not? That’s the difference. Be the hero of your own story,” she said. 

Executive Director’s Update

ACS Executive Director and CEO Patricia L. Turner, MD, MBA, FACS, provided a comprehensive overview of the College’s performance, key achievements, interesting challenges, and future plans—all staying true to the ACS’s 110-year-old motto, “To Heal All with Skill and Trust.” 

Importantly, she also outlined how the ACS is working to meet the needs of its members through quality, education, member services, advocacy, and communications. In the quality arena, Dr. Turner recognized how the ACS is embracing an “ambitious goal.”

“We are working to bring ACS Quality Programs to every patient cared for in every hospital in this country,” she said. “We lean into this unabashedly because we know that we can make the care of the surgery patient better by using our Quality Programs.” 

Dr. Turner discussed future plans for the College and its members, explaining that the ACS thoughtfully works to make it “impossible” that surgeons of any specialty would not engage with the College. Among the membership value-adds is that the ACS meets the learners where they are with “just-in-time education.”

“We have learners in medical school and up to and through retirement, so when we think about what is on the cutting edge, we are thoughtful and make sure we know what you need as members and that we bring you the education that will help you in your day-to-day practice,” said Dr. Turner. “We need to be the gold standard...the arbiter of all things surgery.” 

Also during the Leadership Summit, leaders from three ACS chapters—San Diego, New York, and Bolivia—shared their success stories. Additional sessions included A Novel Approach to Understanding Surgeon Burnout and Operationalizing Solutions at Individual Institutions, Effective Performance-Based Teaching: Lessons from Aviation, and The Equity Imperative of Graduate Medical Education.

Advocacy Summit

For the first time since 2019, the Advocacy Summit included in-person visits on Capitol Hill.

In preparation for the visits, attendees engaged in several lively panels and educational sessions to better understand the College’s legislative priorities and what information to present when meeting with elected officials and their staff members.

“We’re not just talking about problems. We’re also talking about solutions and bringing those solutions forward,” said Christian Shalgian, Director of the ACS Division of Advocacy and Health Policy (DAHP). “Those solutions are a critical component of what makes us unique and are an important part of this conversation.”

Less Transactional, More Partnership

In the first panel, The Value of a Surgeon: Exploring the Nuances of the Contributions Surgeons Make to Healthcare, moderator Don Selzer, MD, FACS, chief of the Division of General Surgery and associate chair of the Department of Surgery at the Indiana University School of Medicine in Indianapolis, led a robust discussion on the evolving landscape of surgeon compensation and developments in value-based care.

Dr. Selzer asked audience members if they understand how their compensation is determined. Using their phones, 8% responded that they understood their compensation completely; whereas 27% said they had no idea how their compensation was calculated.

According to Kimberly Russo, MBA, MS, CEO at George Washington Hospital in Washington, DC, “This is a sign that the industry must pivot. It’s a true indicator that we have some work to do around being much more of a partnership and understanding the valued contributions of surgeons. We have to start moving toward a much less transactional approach to how we are engaging.”

What Does Good Look Like?

Advancing health equity, simplifying and refining quality measures, and improving health outcomes were some of the topics discussed during A Conversation with CMS about Updates in Quality, featuring Clifford Y. Ko, MD, MS, MSHS, FACS, FASCRS, Director of the ACS Division of Research and Optimal Patient Care, Doug Jacobs, MD, MPH, chief transformation officer in the Center for Medicare within the Centers for Medicare & Medicaid Services (CMS), and Courtney Collins, MS, MD, FACS, clinical assistant professor of surgery at The Ohio State University in Columbus.

Dr. Jacobs touched on the concept of Universal Foundation—a CMS initiative to drive meaningful quality by standardizing and better aligning measures used to report quality performance across the agency’s many healthcare programs. The program also aims to reduce administrative burden for physicians, support CMS efforts to advance health equity, allow for cross-comparisons across programs, and help identify measurement gaps.

It’s likely that hospitals have hundreds of quality metrics that they’re “chasing to look good to CMS,” which diverts the attention of healthcare providers, including surgeons, and prohibits them from being able to concentrate on taking care of patients, according to Dr. Ko.

“What does good look like? What would good look like in our system, not in the confines of this role, that policy, or this program? What does good look like for our patients, and how do we get there?” he asked. “There are a lot of really smart people who define good care. So, if we all understand what quality is, why aren’t we there?”

One of the first steps, Dr. Ko explained, is “sunsetting a lot of these things and working with CMS to get a unified, much more integrated way of looking at the measures.” He also recommended that when attendees visit the Hill, they deliver two important messages: the current system is not working for surgeons, but more importantly, it’s not working for the patients; and the College has data-driven, evidence-based Quality Programs proven to enhance patient care.

In the Inside Politics and Policy Experts session, Frank Opelka, MD, FACS, ACS Medical Director for Quality and Health Policy, echoed much of what Drs. Jacobs and Ko said. “There is a need to measure the things that are meaningful to us and our patients.”

Dr. Opelka also stressed the value of transparency, which “serves you better than anything and just makes you better.” He shared the story of the Martini-Klinik—a highly specialized private clinic in Hamburg, Germany, that treats patients with prostate cancer and shares long-term outcomes data from more than 34,000 previous patients.

“The Martini-Klinik is the largest prostate cancer treatment program in the world. That’s because they publish their results: Here’s our complication rate. Here’s our success rate. Here’s our stage IV survival rate. Here’s what the treatment costs,” said Dr. Opelka. “People from all over the world are flocking to the clinic because it holds itself publicly accountable to the social contract and social good they have with the patient community.”

Congressional Asks

After an almost full day of informative panels, staff members from the ACS DC office detailed the “asks” and provided background information in preparation for the in-person visits to the Congressional offices. The attendees broke into groups by state to prepare for their visits and discuss the following issues:

• Stop cuts to Medicare physician payment 
• Support legislation banning non-compete agreements
• Ensure access to general surgery
• Support the physician workforce by addressing student loan debt
• Ensure funding for ACS priorities in fiscal year 2024 (MISSION ZERO Act, cancer prevention research, firearm injury prevention research, National Health Care Workforce Commission, neglected surgical conditions)
• Support ACS priorities in the Pandemic and All Hazards Preparedness Act (National Trauma and Emergency Preparedness System, MISSION ZERO Act, Prevent BLEEDing Act, Good Samaritan Health Professionals Act, and the Bipartisan Solution to Cyclical Violence Act)

Just before the official advocacy training started, Speaker of the House Kevin McCarthy (R-CA) stopped by the Advocacy Summit for a surprise visit to discuss the important role surgeons play in advocating for their patients and shaping federal healthcare policy.

Several other invited congressional speakers—Reps. Mariannette Miller-Meeks, MD (R-IA), Drew Ferguson, DDS (R-GA), Kathy Castor (D-FL), and Susan Wild (D-PA), as well as Sen. Ben Cardin (D-MD)—underscored the importance of the College’s legislative efforts such as firearm injury prevention and Medicare physician payment.

On Hill Day, 263 Advocacy Summit attendees representing 39 states participated in 211 meetings.

Advocacy and Health Policy Abstract Competition

Another highlight of the Leadership & Advocacy Summit was the inaugural Advocacy and Health Policy Abstract Competition for ACS residents and trainees. Ten authors were invited to present their abstracts at the summit, and the top three were recognized:

• First place ($500): Stephanie Jensen, MD—State Helmet Laws Greatly Increase the Use of Helmets and Protect Motorcycle Crash Victims  
• Second place ($250): Courtney H. Meyer, MD—Improving Equitable Access to STOP THE BLEED^® Training Courses through Multilingual Outreach Initiatives
• Third place ($100): Madeline Matthys—Actionable Sustainability Guidelines for Surgeons, by Surgeons

Individuals still can register for the Leadership portion of the Summit to access on-demand content at facs.org/summit. Registrants can earn up to 4.75 AMA PRA Category 1 Credits™ for attending or viewing the Leadership Summit; another 2.0 AMA PRA Category 1 Credits™ are available for the Negotiations Seminar. The deadline to access content and claim CME credits is July 31, 2023. 

The 2024 Leadership & Advocacy Summit will be in Washington, DC, April 13–16.  

Jennifer Bagley is the Editor-in-Chief of the Bulletin and Senior Manager in the ACS Division of Integrated Communications in Chicago, IL.

The following ACS Hill Day photos were provided by Drs. Doug Wood, Jason Wilson, Joshua Mammen, Amy Liepert, Angela Thelen, Elise Fannon, and Samuel Wade Ross.