The SVS is currently soliciting nominations for election to the positions of VP, Treasurer, and Secretary. Because this is an election year in the USA, I wonder how the current crop of Republican and Democratic candidates would campaign if they were vascular surgeons running for an Executive position in the SVS. As a corollary, I also question how they would be elected President of the nation if we use the format the SVS uses to elect its Executive. The following examples of what I think their platforms would be implies no resemblance to any current or past executive member. Rather, I use these candidates’ personalities to identify issues that may be of concern to the SVS and its members.
Dr. Bernie Sanders is horrified that most Medicare payments go to “the top 1%” of doctors, most of whom are doing unnecessary procedures like venous ablations for spider veins or angioplasties for 15-block claudication. He would support a move to a single payer “Medicare for all” to make sure that all vascular surgeons were compensated equitably for what they do, regardless of their form of employment. As someone who wants to limit wars, he would not get involved in any turf battles with cardiologists or interventional radiologists.
While Dr. Hilary Clinton has held many high office positions in the SVS, she would emphasize that there has been only one prior female President, Dr. Julie Freischlag, and so she would claim that it is certainly time for another woman to lead the organization. As a pragmatist, she would try to follow the leadership principles of past President Perler. However, Dr. Clinton has been accused of taking money from the Super PACS, such as the device manufacturers, and so would be indebted to Industry.
Dr. Martin O’Malley, a busy community practice vascular surgeon would have to drop out of the race. Unfortunately, because none of the voters had any idea what a vascular surgeon does, he would get very few votes. Most of the voters in his constituency think that cardiologists take care of vascular conditions so they would cast their vote for anyone other than a vascular surgeon.
Dr. Donald Trump, on the other hand, is a very rich private practice vascular surgeon who had his own medical show on national television. Accordingly, while he had achieved notoriety, he would probably be envied by academic vascular surgeons. Having accumulated so much money investing in angiosuites and medical real estate he even had his own plane to fly between hospitals (which he also owned!). His penchant for hiring only the most beautiful nurses is common knowledge. A drawback is that he had never served on any committee of the SVS exposing his lack of understanding of the organization’s function. But this shortcoming would not bother him as he would lead “by hiring really smart people.” He proclaimed, without substantive explanation, that he would make the SVS “great again.” His popularity would be based on his promise to “build a wall” to keep other specialists from being able to treat vascular patients.
Dr. Jeb Bush was well regarded by the established Executive, some of whom considered him “part of the family.” However, he would not acknowledge any relationship with these “relatives.” He would use his success as President of the Florida Vascular Society to support his candidacy. However, Dr. Marco Rubio, who had trained under him at Florida State Medical School in Tallahassee, would suggest that he had not done such a good job after all.
Dr. Marco Rubio, even as a young resident, had his sights set on the Presidency. However, although he succeeded in getting elected to many positions, even the Board, he had never really achieved anything substantial. He had not authored any major research or excelled in clinical practice. His campaign would consist of repeating derogatory remarks about the current President and Dr. Jeb Bush.
Dr. Ted Cruz had served on the Board but was not well liked. His views were very conservative. He was adamantly against a separate Board of Vascular Surgery. Therefore, he would solicit the votes of the “Evangelicals” consisting of older surgeons, many of whom still did General Surgery. He was also the most academic candidate having completed his fellowship at Harvard. He would insist that only academics with a strong conservative viewpoint deserve to be elected.
Dr. Chris Christie, on the other hand, favors splitting vascular surgery from general surgery. He will belligerently state that if a bridge is built to maintain the relationship he would make sure his officers make it impassable.
Dr. Carly Fiorina believes her prior experience running a major academic institution makes her the most qualified. However, the other candidates would be quick to point out that she had been fired! Like some other academics, she had been forced to take many positions around the country and so she did not have a local constituency to support her. On the other hand, having lectured all over the world she would have many international contacts including “knowing Vladimir Putin.” Of course, no one would know what that would offer the SVS.
Dr. Rand Paul, a Vascular Surgeon with a strong interest in Amaurosis Fugax, wants the SVS to save its money and not do anything. In fact, he thinks it should not be involved in any aspect of vascular surgery, leaving everything up to the individual practitioner or other specialties. His views are also held to a large degree by Dr. Ben Carson. As a retired pediatric neurosurgeon from Johns Hopkins, he would try to follow in the highly respected footsteps of presidents Perler and Freischlag, also from Hopkins. Since he believes brain surgeons are the smartest, he would claim that he could be the President of the SVS even with his eyes closed. To prove this, he would give most of his speeches with closed eyes.
Dr. Kasich was the President of the Ohio Vascular Society. He would argue that if voters only paid attention to what he has accomplished in Ohio, he would get everyone’s vote. But he would be concerned that since he had never published his results in any national journal, no one would respect him.
Well, that’s perhaps how the candidates would do their electioneering. But what if our national election were to be held in the manner we elect our SVS Executives? Rather than allowing the public to hear all the candidates express their viewpoints over and over in a multitude of televised debates, a small group would determine who should be nominated. According to the bylaws of the SVS, they would be the last two surviving ex-presidents (Bush and Clinton) as well one Governor elected by all the Governors, one Senator elected by the Senate and one person elected by the nation. This nominating committee would then invite the entire voting public to a luncheon on the Washington Mall, where the attendees would accept their recommendations voting by acclamation. Of course, most voters would not attend since it would be too inconvenient and expensive to make the trip to this luncheon.
After all, they would have to take time away from their jobs. As a result the vast majority of the “voting” public would in essence be excluded from the electoral process. Not very democratic – but certainly efficient. Further, who better to assess the candidates’ potential than these esteemed members of the nominating committee? But is it efficiency that we really need? Should we not rather have a fully open election in which potential candidates can express their goals for the SVS? This could be achieved by publishing their platforms in this Newspaper. This would enfranchise all of our members to participate in the election of candidates that represent their own goals for the Society.
To tell the truth, I am ambivalent as to which method is preferable, but it is at least worth discussion. Why don’t you use the “Letters to the Editor” section of this, our official newspaper, to make your viewpoint heard? If that is not possible in your schedule, then take a few minutes and click this link to take our poll and place your vote for the option you prefer.
Dr. Russell H. Samson is a physician in the practice of Samson, Showalter, Lepore, and Nair, and clinical professor of surgery, Florida State University, Tallahassee. He is also the medical editor of Vascular Specialist.