Karl W. Swann, MD, of Neurosurgical Associates of San Antonio, discusses the importance of physician leadership and how surgeons can become politically active today. Q: What are the opportunities for spine surgeons to grow into leaders today?
Dr. Karl Swann: There are so many ways spine surgeons can be leaders today, either within their own practice, the hospital where they work, university departments or within medical societies. It's also very important for us to cooperate with our colleagues and amongst ourselves. Our field includes both orthopedic spine and neurosurgeons, and communication between the two specialties is very important. We are also seeing surgeons take more of a lead in politics and economics as healthcare moves to the forefront of policy agenda.
Q: How can spine surgeons influence public policy?
KS: We need to get involved in both local and state politics. That doesn't necessarily mean running for office — some have in Texas, but you don't have to run to make a difference. You can get involved in campaigns and contribute to campaigns. Physicians have been reluctant to contribute to campaigns in the past, but we are getting beaten by other entities in terms of lobbying efforts. Other professionals place a greater emphasis on political involvement at all levels, and we need to focus more on that.
It's important for surgeons to form a relationship with politicians and hold fundraisers for them. In San Antonio, you'd be amazed at what happens for local politicians who start their offices here. We had a lawyer who specialized in medical malpractice who then ran to be a judge and then went to the Texas Supreme Court. He was eventually elected as the state Attorney General and is now a U.S. Senator from Texas.
His pathway illustrates how when you get involved in politics locally, sometimes you can follow politicians through their careers.
Q: How would you recommend surgeons start becoming politically involved?
KS: I'd recommend just starting; they should go to a fundraiser, figure out who organized that fundraiser and speak with members of the campaign. Surgeons would be very surprised to hear that their input is desired, and it's especially valuable if they are able to gather a significant number of physicians at a single fundraisers. Most campaigns are receptive to that.
Q: When surgeons want to voice their opinions to elective representatives, how is the best way to make sure they are communicating effectively?
KS: It's very important to be in the position to get your message across to politicians, but you have to take a balanced approach when dealing with them. You don't want to be perceived as a one-issue person. That has served me well in dealing with politicians. Take the approach that you want to make your point, but understand the other aspects of the issue and how the other constituents for that politician might be impacted by whatever it is you are discussing.
We had great success in Texas in 2003 with tort reform. We have one of the best malpractice reform laws in the country and it's largely because we had a governor, Rick Perry, who was willing to partner with physicians and other politicians to draw up legislation to pass tort reform. Governor Perry, along with physicians and his wife — who was a nurse — lobbied to help a constitutional amendment pass at the state level that really solidified the tort reform law.
Q: What advice do you have for surgeons just beginning to enter this arena?
KS: My advice would be to build the relationship gradually. Don't expect everything to happen all at once. Find politicians that you are very excited about supporting and chances are there is a good reason you are excited; that person is a good politician. Find someone you trust, someone who you think is upwardly mobile and has an interest in what is happening in medicine — in surgery in particular — and support them throughout their career.
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