PUBLIC POLICY

PUBLICPOLICY

// GOVERNORS' VANTAGE POINT INTRODUCING

NEW LEADERS

ACG’S BOARD OF GOVERNORS ELECTED NEIL H. STOLLMAN, MD, FACG, AS CHAIR AND

PATRICK E. YOUNG, MD, FACG, AS VICE CHAIR. The pair took the reins from Costas H. Kefalas, MD, MMM, FACG, Chair, and Douglas G. Adler, MD, FACG, Vice Chair. The ACG Governors are state and regional elected representatives whose role in the College is in part to serve as a conduit at a grassroots level for ACG members to share their needs and insights for clinical matters and other issues affecting the practice of medicine. ACG MAGAZINE invited Dr. Stollman and Dr. Young to introduce themselves and to share their vision for the work of the Governors going forward.

DR. NEIL H. STOLLMAN, CHAIR, ACG BOARD OF GOVERNORS

Tell us about your practice and clinical interests.

My GI career has been a bit, well, non-linear! After my GI Fellowship, my first job was at the Miami VA Medical Center. I loved working at the VA and still miss those Vets. I then came out to California to join the faculty at the University of California, San Francisco (UCSF) and to run the GI Division at San Francisco General, our county/teaching hospital. I’ve subsequently joined a single-specialty GI practice in Oakland where I now have a fulltime private practice. In addition, however, I still teach at UCSF and elsewhere, still take shifts and night call at our county facility, and have also maintained my academic interests and continue to do clinical research and 

writing in the C. difficile, fecal microbiota transplantation and diverticular disease spaces. Nothing unique or interesting about any one of those aspects of my work-life, really, although I think I’m somewhat of an outlier in that I’m still trying to do all three of those things full time despite the day apparently remaining only 24 hours long! On the plus side, I believe it allows me to have insight into many of the issues facing ACG members, in that I’m an active clinical practitioner, as well as an active teacher and researcher. My (now grown) teenage littleleaguer would say I’d make a good “utility infielder”—not an expert at any one thing, but able to fake it at most positions! And I can live with that…

How did you get involved in ACG?

My GI training was at the University of Miami, where I was fortunate enough to work with Jamie S. Barkin, MD, MACG, and my primary mentor, Arvey I. Rogers, MD, MACG, both of whom are ACG Past Presidents. They were both very kind and supportive at helping me to get involved, including a stint on the Educational Affairs Committee, among others. That experience cemented my connection to the College, and it has remained a main focus of my professional life since.

What’s your perspective on the role the Governors play in the life of the College? Why are the Governors relevant right now?

We’re all aware of the uniqueness of the Board of Governors, with elected colleagues providing a critical conduit from “the trenches” to the Board of Trustees and College officers. That’s always been of tremendous value to the College, but I believe more recently, as legislation and public policy issues have become far more important, having an “army” of Governors to work locally and nationally has been a key strength of the College’s efforts.

To me, the maintenance of certification (MOC) issue is one illustrative example of the effectiveness of the Governors. While the bigwigs were working with the other societies and the American Board of Internal Medicine (ABIM), the Governors were quietly working state by state on local initiatives. I firmly believe that the success of these local efforts was a major factor in bringing the ABIM folks to the negotiating table. That kind of effort would be impossible without our 70+ Governors working hard at the local level.

What is your vision for the year ahead for the Governors?

In the simplest sense, more of the same. Continue strong traditions established by the Governors of working with our local and national legislators on ACG priorities, including the colonoscopy “polypectomy” surprise, the increasing bureaucratic burdens of prior authorizations, mandatory “step care” with forced failure, and ongoing efforts to address widespread concerns with MOC in its current form. Two efforts that Immediate Past Chair Dr. Costas Kefalas started that I’d like to see us run with would be increased input from the Governors to assist with issues facing private practice GI clinicians—something we hear repeatedly— as well as increasing the representation of women on our Board of Governors.

The Governors host a fly-in to Washington DC each spring to visit legislators. What tips do you have for the Governors on effective advocacy on the Hill?

First off, comfy walking shoes and an umbrella! More seriously, lobbying and talking with legislators and their staff is not a skill set many physicians naturally possess or have been trained in. Some things I’ve learned from my six plus years of doing this include working to “know your audience.” Most of us are pretty good at reading people, but I try to think of how the best (i.e., most effective? least annoying?) pharma reps work, and I’ve realized that the good ones have excellent “radar” and a sense of their audience. Does this person have two minutes or 20? Are they interested in small talk and pleasantries, or are they all business? Don’t be focused on saying every talking point in every single meeting; it’s not possible, and we need to get good at picking out the highlights, the “two-minute elevator pitch.” I also try to personalize things when I feel that’s appropriate. Most of our contacts are young, but they have parents, many of whom have had colonoscopies, for example (and some of whom have had family members with colon cancer.) Often I simply refer to their constituents, but as people. Bills are boring…people are not!

Finally, when I leave a congressional office, I jot down literally one “note” on each contact, something personalized that I’ve noticed or we discussed (they’re a Warriors fan, their Mom had cancer, they just moved to DC, etc.), then I do follow-up emails to all, and make reference to that one “factoid” to remind them of who I am so the messages seems less like a copy-and-paste job.

PATRICK E. YOUNG, MD, FACG, VICE CHAIR, ACG BOARD OF GOVERNORS

Tell us about your practice and clinical interests.

I practice at Walter Reed Military Medical Center, a tertiary care teaching hospital for the Defense Health Agency. Clinically, I spend 40% of my time performing therapeutic endoscopy and 40% in general gastroenterology. Most of this time is also spent teaching fellows, which is one of the highlights of my work! The remainder of my

Photos: Dr. Patrick Young in his office. Dr. Neil Stollman during a past ACG Board of Governors Washington, DC Fly-in.

time is divided between formal teaching, administration and research. My research and professional interests include Barrett’s esophagus, colorectal cancer screening and prevention, therapeutic endoscopy, emotional intelligence in leadership, and ergonomics. I am also the Director of the Digestive Diseases Division at the Uniformed Services University of the Health Sciences.

How did you get involved in ACG?

I had the great fortune to have wonderful mentors early on, especially Brooks D. Cash, MD, FACG, Brian P. Mulhall, MD, and Roy K. Wong, MD, MACG. Seeing my passion for academic gastroenterology, they encouraged me to serve with the ACG. I started with the Educational Affairs Committee. There, I had the chance to work shoulder to shoulder with people I consider luminaries in the field. They treated me with collegiality and respect despite my junior status. The ACG staff was incredibly professional and helpful. The energy and enthusiasm of that group were fantastic, and I have been hooked ever since! Since then, I have had the privilege of serving on a number of committees including Training, Public Policy, Credentials, National Affairs and Membership. While each has a unique mission, I have learned much from each experience. I would highly encourage our members to get involved in the life of the ACG in this way. When I began, I had no particular vision for where things would lead. I simply knew that I believed in the College and its mission, and that I wanted to play some part in helping it to thrive in service of our patients and ourselves.

You have served as ACG’s Military Governor and now are making a transition to civilian life. What are the unique challenges facing GI physicians serving on active duty in the U.S. military?

(Full disclosure, since the incredibly capable Dr. Joseph Cheatham has succeeded me as the ACG Military Region Governor, he and I collaborated on this answer.) While some of the challenges—scope disinfection, documentation of quality assurance, etc. are the same, there are indeed unique aspects to military practice. Some challenges, such as the unexpected loss of personnel to deployment in support of our troops, are longstanding with time-tested management strategies. Others, such as the transition from service-specific medical centers to a single entity—the Defense Health Agency—are new. Like any widespread change in a large organization, many unknowns exist. How will career progression and assignments differ from the previous model? How will the roles and responsibilities of clinicians and clinical leaders change? Now more than ever, leaders in military GI must become facile in the management of both change and expectations. With folks like Dr. Cheatham at the helm, I have no doubt that they will successfully navigate these challenges.

The Young Physician Leadership Scholars will join the ACG Board of Governors at their Washington, DC Fly-In this spring. What are the goals for this collaboration?

Many of us have dedicated our careers to excellence in clinical care, research, etc. and have only come to advocacy relatively late in the game. Though earnest in intent and knowledgeable about the practice of gastroenterology, we often lack the fundamental skills necessary to be successful advocates before legislators and policymakers. By developing an interested cohort of young leaders, we can ensure that they have both the training and experience necessary to clearly elaborate the needs of gastroenterologists and their patients to our nation's congressional leaders and the key federal agencies. The Young Physician Leadership Scholars will benefit the ACG Governors as well. These young leaders will provide a fresh perspective to the meetings on the Hill, and legislators are often interested in hearing from younger individuals. The seasoned ACG leader and the young scholar will exchange stories and ideas from their different experiences and thus learn from each other.

How can ACG members get involved in supporting the College’s public policy priorities and the work of the Board of Governors?

ACG members should become familiar with the ACG’s Legislative Action Center. Through our Action Center, ACG maintains active track of both state and federal legislation relevant to your practice and patients, along with action alerts that allow you to reach out directly to your congressional leaders on important and urgent issues. Members are also encouraged to reach out to their respective ACG Governors for any state-specific questions you may have, if you wish to help introduce legislation in your state, or if there are any specific issues you feel that ACG should be advocating for on your behalf. The ACG Governor has been elected to be your voice and is eager to hear from you. ACG also keeps a list of the contact information for the state GI and medical societies for those who wish to become more directly involved at the local level.

“When I began, I had no particular vision for where things would lead. I simply knew that I believed in the College and its mission, and that I wanted to play some part in helping it to thrive in service of our patients and ourselves.”

—Patrick E. Young, MD, FACG, Vice Chair, ACG Board of Governors

RESOURCES

 ACG Legislative Action Center: bit.ly/ACGActionCenter  State and Federal Legislative Tracker on gi.org: bit.ly/ACGLegTracker  ACG “Action Alerts”: bit.ly/ACGActionCenter  Reach Your ACG Governor: gi.org/governors  List of State GI Societies: bit.ly/StateGISocieties

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