Innovation in vascular surgery goes beyond new devices and procedures. It also requires new approaches to advocacy in a health care system increasingly shaped by consolidation, workforce shortages and shifting employment models.
That was the central message from Margaret Tracci, MD, JD, during a session at VAM 2026, where she argued that vascular surgeons need to pursue coordinated advocacy and engage more aggressively at all levels. “There is cacophony in D.C.,” she said. “We talk constantly about disunity among physicians, a house divided. These result in disengagement and a general lack of leverage.”
Tracci said the rapid growth of physician employment by large health systems has changed the advocacy landscape. As consolidation reduces the number of independent practices, more physicians become eligible for collective bargaining, creating opportunities to rethink how they advocate for resources.
She highlighted efforts by organizations such as the American College of Surgeons to develop standards defining the institutional support vascular surgeons need. “This is innovation and advocacy in a way that’s intended to make us feel better where we live and work,” she said.
She also pointed to recent state-level victories as evidence that coordinated physician advocacy can influence policy. In Virginia, lawmakers approved legislation restricting noncompete agreements after physicians turned out in large numbers to testify before legislators. “The legislators said, ‘We knew the hospitals would be here, but we’ve never had physicians lined up to testify,’” Tracci recalled.
Tracci said addressing workforce shortages, payment challenges and physician autonomy will require a broader advocacy strategy that unites surgeons across specialties. “We need to broaden that fight on all fronts — federal, state and local,” she said. “We need to unite and engage and we need to find leverage everywhere we can and use novel approaches to bargaining power.”
