Message From the President, Michael F. Rotondo, MD
A Time for Action
We have spent the last several months as a nation mourning the loss of our children from a rash of senseless school shootings. The heart of the country has been grabbed by a passionate group of student survivors who, as fierce advocates, have drawn stunning attention to the problem of gun violence. While our organization’s message immediately after the Parkland, Florida, event expressed our sympathy and outrage, it was also a call to action. Under the leadership of president-elect Dr. Martin Croce, a special task force of the Board of Managers has crafted a thoughtful, balanced, and comprehensive statement calling for specific interventions and legislative measures to reduce firearm injury. In it, we articulate explicit steps intended to reduce death, disability, and injury from guns. The statement has been endorsed by the Board of Managers and is soon to be widely disseminated. It is important that through cooperative advocacy efforts, we each take responsibility to work cohesively with our local, regional, and national lawmakers and urge them to take specific and decisive action.
In this same vein, this year’s Annual Meeting in September in San Diego will include several important presentations related to firearm injures. Moreover, I have had the honor and privilege of inviting my mentor and past AAST President, C. William Schwab, MD, FACS; to deliver the Fitts Oration. I invited Dr. Schwab not because of our long-standing association, but rather due to his 25+-year track record of investigation of, and advocacy for, firearm injury reduction. In the early 1990s, he delivered a landmark presidential address on the topic at the Eastern Association for the Surgery of Trauma, and thereafter, established the Firearm Injury Center at Penn (FICAP), which has been continuously funded for many years. I can think of no one more qualified to deliver this important oration on a timelier topic. For us to move from words to action requires a balanced approach to bring our polarized country together around issues upon which we agree. We must do so in an atmosphere of civility and respect for our differences while maintaining our collective focus on measures that will prevent these horrific acts in the future. It will take perseverance, collaboration, and cohesion across a broad societal spectrum for us to make progress. We must have a significant role as advocates for this cause and consider this a public health problem that is ours to solve.
Two Meetings in One
Preparations for the 77th Annual Meeting of the AAST in September are fully underway. The Program Committee, under the leadership of Dr. Pat Reilly, has reviewed more than 520 abstract submissions—a near record number—and the committee is in the midst of considering options for podium presentations, quick shots, posters, and lunch sessions. The quality of the science has never been better, and the breadth of topics has never been more expansive.
This meeting will be unique in that it also coincides with the 4th World Trauma Congress (WTC). An integrated program, rife with outstanding contributions from our international colleagues, the WTC will enrich our experience and promote collaboration with our international colleagues. In this regard, I have asked two internationally renowned surgeons to deliver our AAST Master Surgeon lectures. They are Professor Ian Donald Shepard Civil, BSc, MBChB, FRACS from the University of Auckland and Trauma Chief at Auckland City Hospital in New Zealand; and Professor Christine Gaardner, MD, PhD, Chief of the Department of Traumatology at Oslo University Hospital in Norway. Both are recognized international leaders and accomplished master surgeons. It is a great privilege to have the opportunity to enlist their teaching skills and abilities to enhance our scientific sessions.
The program will also feature an important plenary session on Healthcare Economics in Acute Care Surgery, which will highlight the work of a newly formed committee led by Drs. Kristan Staudemeyer and Joe Minei. This group has produced a comprehensive review of the current economic terrain in American healthcare in relation to acute care surgery. They examine macroeconomic trends, reimbursement sensitivity, workforce and branding issues, as well as the economic interdependencies of trauma, emergency general surgery, and surgical critical care. I firmly believe that their work will be vital to informing our strategic thinking regarding the positioning of acute care surgery within the landscape of American surgery.
Overall, the meeting promises to be an outstanding opportunity to exchange the latest scientific advances in acute care surgery, to bolster CME credits, and enjoy the fellowship of the association.
Doing Our Work
Our committees remain fully engaged in driving acute care surgery to the next level as we Execute on the Vision set forth in the association’s strategic retreat initiatives last year. Their work is expansive, dynamic, and highly productive, and just as important, real and tangible progress is being made.
In a collaborative arrangement with the American College of Surgeons, AAST Immediate Past-President, Dr. Raul Coimbra, and ACS Executive Director, Dr. David Hoyt, convened a meeting consisting of a broad range of constituents, across a number of surgical organizations, to begin vetting standards for the care of the emergency general surgery patient. The “Optimal Resources for Care of Emergency General Surgery Patients” paper, drafted by the AAST under the leadership of Drs. Marie Crandall and Shahid Shafi, promises to mark an important advance in emergency surgery patient care. It is our intention to utilize a collaborative approach to develop standards, and ultimately, to use those standards, along with data, to promote infrastructure development to support the care of these patients. Similar to the approach we have used for decades to advocate for optimal care of the trauma patient, we are now applying those same principals to the emergency general surgery patient. The work will be arduous but certainly worthwhile.
The established committees are also hard at work. Of note, the Acute Care Surgery Committee has conducted a comprehensive review of the fellowships with an eye toward future development and curriculum reform. The Patient Outcomes and Assessment Committee is in the process of indexing all of the currently existing clinical practice guidelines, creating new guidelines that are related to emergency general surgery, and continuing to develop scoring systems for both injury and acute surgical illness. The Multi-Institutional Trials Committee currently has a wide range of studies in progress, and it is steadily building collaborative relationships across academic societies to promote research. The Communications Committee is devising new ways to disseminate information and keep our members informed and engaged. It is impossible in a brief such as this to highlight all of the activities of the AAST committees but I must say, across the board, the committees are highly productive on behalf of our organization.
Additional creative work is in the offing. The Board of Managers has recently endorsed a proposal for a new Ad Hoc Committee on Palliative Care. The purpose of forming this committee is to explore opportunities to integrate the principles of surgical palliative care throughout the appropriate elements of acute care surgery. This could well influence palliative care education for AAST members, become part of the acute care surgery fellowship curriculum, foster the conduct of relevant, multi-institu-tional trials to increase the evidence base and inform implementation; and further establish and disseminate best practices. The long-term intent: to improve the physical and psychosocial outcomes for acute care surgical patients and their families. I believe that this is the beginning of a seminal movement within the AAST, which will fundamentally strengthen the fabric of our specialty.
The Journal of Trauma and Acute Care Surgery has an ever-increasing impact factor under the strong leadership of our Editor-in-Chief, Dr. Gene Moore. And Trauma Surgery and Acute Care Open’s Editor, Dr. Tim Fabian, recently informed us that our open-access journal will now be included in the expansive PubMed listings; quite an achievement for such a young journal!
In closing, it remains an incredible privilege to serve as your President. The summer months will soon be upon us signaling the final season of my term. You can be certain that I will hold the time I have left to serve with great respect for the organization, its members, and its mission “as the premier scholarlyorganizationforsurgeonsdedicated to the field oftraumaand the care of critically illsurgicalpatients.”