Understanding the New World of Health Care

Abstract

This address introduces an informed new leader who demonstrates our specialty in action. As you read Paul Uhlig’s inspiring words, you will be proud of the spirit that is stirring in the wheatfields of Kansas and throughout the specialty. Like a cardiothoracic resident who learned transplantation immunology, Paul brought “the right stuff” to the right place. As the first Alley-Sheridan Scholar-in-Residence, he had a startling and stimulating impact on his fellow students and teachers at Harvard’s Kennedy School of Government. The “impact factor” of cardiothoracic surgeons, reflecting their unique combination of knowledge, judgment, problem-solving skill, and commitment to effective action, is sorely needed in the restructuring of health care. Former President of The Society of Thoracic Surgeons Ralph Alley showed how important strategic surgical thinking can be. As advisor to the New York State Department of Health, he introduced peer review of cardiac catheterization and cardiac surgery, using professionalism for quality improvement instead of government regulation. The skills required for effective action during the current health care revolution include a thorough understanding of policy development, health economics, government, and the political process. Paul’s writing reflects the broad population viewpoint we need to develop, while preserving a fundamental value of our specialty, exquisite sensitivity to the trust and care of the individual patient. We need more Alley-Sheridan Scholars. The Thoracic Surgery Foundation for Research and Education is promoting development of health policy skills in cardiothoracic surgeons as an important part of its mission. There is early evidence of progress. Three Society of Thoracic Surgeons presidents, the vice president, the treasurer, secretary, and chair and many members of the Government Relations Committee are among the 150 scholars who have completed the 10-day executive course. Their recent success in The Society of Thoracic Surgeons’ initiative to clarify thoracic practice expenses reflects the strengthened tactical skills and strategic thinking of our leaders.