Looking forward – July 2014

David B. Hoyt, MD, FACS

For 35 years, the American College of Surgeons (ACS) has had a growing presence in Washington, DC. This spring, the College’s ability to speak for surgeons and surgical patients and to influence health policy got an added boost with the successful recruitment of two Medical Directors to help lead the Division of Advocacy and Health Policy (DAHP). Frank G. Opelka, MD, FACS, will serve as Medical Director of Quality and Health Policy, and Patrick V. Bailey, MD, FACS, will serve as Medical Director of Advocacy. Christian Shalgian continues to serve as Director of the Washington, DC, legislative, regulatory/quality, and state affairs teams.

The College’s Washington presence

Since the establishment of the Medicare and Medicaid programs in 1965, the federal government has had a significant impact on how surgery is practiced in the U.S. In response to this trend and with the belief that surgery needed an independent voice and presence in Washington, DC, then-ACS Director C. Rollins Hanlon, MD, FACS, and the Board of Regents opened the College’s Washington Office in March 1979.

Initially, the Washington Office was viewed as a branch of the College’s Department of Surgical Practice, which was established in 1974 and based at the ACS headquarters in Chicago, IL. The Washington Office originally had a two-person staff, no lobbyists, and a budget of less than that of many small specialty societies.* The focus at the time was on regulatory issues, rather than legislation, although the College did respond to requests to offer testimony before congressional committees, which was presented by ACS Fellows, Officers, and Executive Staff.

Shortly after the Washington Office’s establishment, Dr. Hanlon wrote, “…the importance of our Washington presence, as a part of our enforced interest in socioeconomics, can be expected to increase significantly in the future.” He was absolutely right. The Washington Office now has six regulatory staff, six congressional affairs staff, three state affairs staff, and three administrative staff, in addition to Mr. Shalgian. Most of these individuals are registered lobbyists.

Furthermore, in 2002 and under the leadership of then-ACS Executive Director Thomas R. Russell, MD, FACS, the College established the American College of Surgeons Professional Association (ACSPA). The ACSPA is an arm of the College, which, because it has a different tax-exempt status than the ACS, was able to form a political action committee (ACSPA-SurgeonsPAC). The PAC disburses campaign contributions to political candidates who are supportive of surgery’s legislative agenda.

A dynamic duo

Dr. Opelka

Dr. Opelka

Dr. Bailey

Dr. Bailey

To help the College’s advocacy and regulatory affairs staff speak with greater gravitas on how legislation and regulation affect surgical patient care, the organization’s leadership determined three years ago that surgeons should be on staff in Washington. On March 25, 2011, we hired Don E. Detmer, MD, FACS, to serve as Medical Director of the ACS DAHP. Dr. Detmer has a strong background in health policy leadership and was an important member of the ACS leadership team. However, approximately a year ago, he left the College to pursue his academic interests.

During Dr. Detmer’s term as Medical Director, Dr. Opelka served as Associate Medical Director for Quality, a role that has helped him become eminently qualified to assume the position of ACS Medical Director of Quality and Health Policy. In addition, Dr. Opelka chairs the Surgical Quality Alliance, established by the ACS, and the American Medical Association Physician Consortium for Performance Improvement. He also plays a leading role on the National Quality Forum’s Consensus Standards Approval Committee and Measure Applications Partnership.

He has served for a number of years as the executive vice-president of health care and medical redesign at the Louisiana State University (LSU) Health System, Baton Rouge. Dr. Opelka spearheaded the redesign of Louisiana’s health care delivery system in the aftermath of Hurricane Katrina, an effort that involved the privatization of a large public hospital system. Furthermore, he fostered the development of a clinical data warehouse at LSU, which expanded service to a range of national specialty society registries.

Dr. Bailey comes to the position of ACS Medical Director of Advocacy armed with the experience he has gained as Vice-Chair of the ACSPA-SurgeonsPAC and as a member of the ACS Health Policy and Advocacy Group. He has served as chief of pediatric surgery at Maricopa Medical Center, Phoenix, AZ, and is completing his work toward a master of legal studies degree at Arizona State University’s Sandra Day O’Connor College of Law. He is a Captain in the U.S. Navy Reserve.

I believe the addition of these two individuals to our Advocacy and Health Policy leadership team will strengthen our presence and influence in Washington, DC. I look forward to working with them as we work to confront the challenges ahead on the changing landscape of health care delivery in the U.S. and around the globe.

Piece of the puzzle

I would also like to remind the Fellows as a whole that if the College is going to successfully build upon its legacy and become a more prominent contributor to the future of surgical practice, we need you to get involved as well. A strong, full-time team in the Washington Office is just part of the puzzle. Your talents, knowledge, and commitment to quality patient care are the true keys to our level of influence in Washington.

I encourage you to reach out to Dr. Opelka and Dr. Bailey to let them know how you can help them be effective in their new roles at the College. Working together, we can have a profound impact on the quality of care and ensure that all surgeons have the tools, training, and compensation needed to best serve their patients.

The ACS Washington, DC, Office.

The ACS Washington, DC, Office.

*Nahrwold DL, Kernahan PJ. The College Wakes Up. A Century of Surgeons and Surgery: The American College of Surgeons, 1913–2012. Chicago, IL; 2012:277-294.
Hanlon CR. Director’s memo. Bull Am Coll Surg. 1979;64(11):1.

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