I would like to thank Chapter President Amy A. McDonald, MD, FACS, a critical care specialist at MetroHealth in Cleveland, and the members of the Executive Council of the ACS Ohio Chapter for this extraordinary opportunity to present the Ohio Oration.
The invitation invoked a flood of emotions, including disbelief, excitement, and then panic about whether I was in possession of anything important or worthy enough to present to this esteemed group of individuals. Once the initial shock subsided, I felt tremendous gratitude toward my Ohio surgical colleagues. I am, and will forever be, incredibly humbled and honored by this invitation.
I finished my surgical training in 1987 and accepted a position in the small town of Cambridge—happy to be back in my home state of Ohio. In 1989, I was introduced to a concept that I termed “statewide surgical collegiality” in the form of the Ohio Chapter. I had been appointed as the Cancer Liaison Physician for my hospital, dutifully attended the state ACS Commission on Cancer (CoC) meeting, and stayed for the Ohio Chapter meeting. I had not yet met many surgeons outside of my small community and, as a newcomer, honestly felt a little intimidated.
As the first day’s session ended, I was approached by a lively bunch of seasoned Ohio Chapter members and literally “kidnapped” to join them for dinner. They immediately sunk their hooks in deeply, and I have been a committed member ever since.
Over these many years I have experienced and realized the real value of membership, and more importantly, involvement in the Ohio Chapter. More than 10 years ago, I wrote a column for the ACS Bulletin about the value of chapter membership. I have an even greater appreciation for the chapter and its members since I penned that piece.
Individual member surgeons have the opportunity to meet, interact, and become friends with colleagues all over the state and from every type of specialty and practice situation. We share knowledge, experiences, and ideas, while building long-lasting, mutually respectful relationships that break down any perceived differences between community and academic or rural, and urban or general, and specialty surgeons.
One benefit of chapter membership is a statewide personal support system assuring that there is always another surgeon on the other end of a phone call or text, ready and willing to assist a colleague in need. I feel so fortunate to have incredible colleagues in every corner of this state and in every specialty on speed dial willing to listen and lend advice or take a critically ill or clinically challenging patient.
The collegiality of the Ohio Chapter benefits our individual patients as well. I refer several patients every month to my colleagues in academic settings that can offer my patients procedures and expertise not available locally. Often these referrals are expedited by a single phone call or even a text between surgeons. The patients also are comforted by the knowledge that I personally know the surgeon they are going to see in the “big city.”
Frequently, I will present cases to my tertiary colleagues and am reassured that they can be cared for locally, avoiding a trip out of town. Patients truly appreciate and understand the value of these types of interactions between colleagues. Academic surgeons also reap the benefits of chapter involvement in the form of additional referrals from community colleagues.
Statewide surgical collegiality also benefits residents and students in the form of opportunities and collaborations for unique rotations and personalized recommendations. Randy J. Woods, MD, chair of the training program at Wright State University in Dayton, Ohio, and I chatted at a chapter meeting years ago about the potential value of sending some of his residents for a rotation at my rural facility to help crystallize their interest in rural surgery. We just published a paper summarizing the benefits of such a collaboration.
A number of years ago my small group found ourselves down a partner, leaving just two of us to cover the community, and we were desperate for help with call coverage. David M. Hasl, MD, FACS, a chapter colleague, stepped up, and his group helped us with call coverage.
The population of the entire state of Ohio unknowingly benefits mightily from the presence of the Ohio Chapter and its members. Through my CoC activities, I have been assisting a group in another Midwestern state working on a project to increase the number of small- and medium-sized facilities working to become CoC-accredited. Unlike Ohio, a majority of patients in their state with breast, colon, and lung cancers are not treated in accredited cancer facilities. In unaccredited facilities, patients might not benefit from care based on national guidelines.
During a Zoom meeting, I was asked why Ohio has so many CoC-accredited facilities. Ohio has 73 accredited facilities and is third, behind only California and Texas, in the number of accredited cancer programs. I thought about their question and had no answer. I took the question to Dr. Ellison, William C. Sternfeld, MD, FACS, Michael E. Stark, MD, FACS, and others who have been involved in cancer care in Ohio for decades.
Every answer led back to the strong leadership of members of the Ohio Chapter from all the major academic centers that championed the cause for high-quality cancer care in every community in Ohio. Residents trained by these champions then went on to work in smaller Ohio hospitals and became cancer care champions in their own facilities.
The same goes for trauma care and the influence of the Ohio Committee on Trauma (COT). Ohio has 54 verified trauma centers, including 28 Level III centers. The last I checked, that is one of the highest numbers of community trauma centers in the country.
In the 1980s and 1990s, Ohio COT Chair Jay Johannigman, MD, FACS, and others were true champions for encouraging smaller facilities in Ohio to raise their level of trauma care and become verified. Dr. Johannigman was instrumental in the process at my own facility. None of this happens without academic and community surgeons building trust and mutual respect while breaking bread or sharing experiences over a cocktail at an Ohio Chapter meeting.
As a young surgeon, during my introduction to the Ohio Chapter, I was impressed and encouraged to see the extensive involvement of women surgeons in the chapter, including women like our current President Dr. McDonald and President-Elect Alisha D. Reiss, MD, FACS.
While many state chapters may have been just an extension of the “old boys’ network” that existed in many surgical organizations, the Ohio Chapter has always had women surgeons at the forefront of our leadership and our activities and initiatives.
Ohio has a rich heritage of women in surgical leadership positions. Olga Jonasson, MD, FACS, was the first woman chair of an academic department at The Ohio State University in Columbus, and the first female Regent of the College. The Ohio Chapter touts many other female academic and College leaders, including Mary C. McCarthy, MD, FACS, Margaret M. Dunn, MD, MBA, FACS, and Nancy L. Gantt, MD, FACS.
I was fortunate to have ACS First Vice-President-Elect Carol E. H. Scott-Conner, MD, PhD, MBA, FACS, as a mentor at my training program before she was appointed the chair of the Department of Surgery at the University of Iowa Carver College of Medicine in Iowa City, and I still consider her a close friend. My work on the ACS Advisory Council for Rural Surgery opened doors to close friendships with influential woman leaders like Sharmila Dissanaike, MD, FACS, Karen Deveney, MD, FACS, Amy L. Halverson, MD, FACS, and current ACS Executive Director and CEO Patricia L. Turner, MD, MBA, FACS.
The Ohio Chapter, because of its inclusiveness and respect for all members—even those with little power or influence from tiny rural communities—truly facilitated and championed my opportunity to be a national spokesperson on the subject of rural surgery.
The Ohio Chapter offers membership status to all Ohio surgeons but the next step for each Fellow is to actually participate. Volunteerism and service make the world a much better place. Ohio Chapter members have played key advocacy roles in legislation on state trauma care, narcotic prescription exemptions for surgical and palliative care patients, prevention of legislative mandates on breast cancer care, colon cancer screening rules, nurse anesthetist autonomy, and many others. Frequently, our chapter leaders have had to change their clinical schedules on very short notice to run to the statehouse to testify when important matters arise. These are all examples of service above self.
Accepting even a small role in state chapter leadership as a young surgeon can eventually lead to a position as ACS Governor, which opens doors to opportunities at the College on a national level. The Ohio Chapter serves as an incredible incubator for ACS leadership positions at the highest level, due to the tradition of service of its members. Whenever there are breakout sessions for governors or cancer liaison physicians at national meetings, the Ohio crowd always takes up two tables and is one of the most boisterous and productive of the gathering.
Many of our Ohio Chapter members have been committee chairs, members of the executive council, Advisory Council Chairs, ACS Officers, and ACS Regents. Mark A. Malangoni, MD, FACS, received the 2022 ACS Distinguished Service Award—the highest honor bestowed by the College for his long-term service. Michael J. Sutherland, MD, FACS, is now the ACS Director of Member Services, and we are all very proud of Dr. Ellison, the 2022–2023 Past-President. These members are only a small fraction of Ohio Chapter members who have held national positions at the College, and I apologize for the many not included.
The smallest act of service can lead to amazing opportunities. As a new Governor, I volunteered to participate in a medical student career roundtable. This event occurs at the end of the medical student program. They break out beer and wine and set up tables for almost every surgical specialty. The students engage, speed-date style, every 20 or 30 minutes with gray-haired surgeons who talk about their specialties and answer questions. I happened to be at the rural surgery table with a small-town surgeon from Kansas named Tyler G. Hughes, MD, FACS, who also was volunteering his time.
We struck up a conversation that resulted in a wonderful and enduring friendship, and it led to a membership position on the very first Advisory Council for Rural Surgery. I served two terms as Chair of the Advisory Council for Rural Surgery, and in that role, I was invited to represent rural surgeons at surgical conferences in multiple states, Canada, and Australia. The simplest acts of volunteerism provide a valuable service and can open doors to amazing opportunities.
I will forever be proud and honored to be a part of this organization. Ohio Chapter members epitomize the ACS motto “To Heal All with Skill and Trust.” Thank you all for the opportunity to address the Ohio Chapter of the American College of Surgeons.
