Concomitantly, heads of divisions of vascular surgery in universities as well as community practice hospitals can no longer rely on the largesse of chairpersons of general or cardiothoracic surgery since most will not have clinical vascular experience. Accordingly, these vascular surgeons must have complete autonomy with titles and positions elevated to chairs of a department rather than a division.
Vascular surgeons should also acknowledge that they can no longer claim total control of vascular patients. Vascular internists, cardiologists, interventional radiologists and even interventional nephrologists are all involved. An attempt to block further inroads will alienate these other specialties who in turn will attempt to deny us independent specialty designation. We need to work in conjunction, while remaining the only specialty that can offer all forms of therapy. By providing quality care vascular surgeons will gain the respect of government, insurance agencies and our patients and thus support for our independent status.
Although our small specialty of probably no more than 3000 active vascular surgeons is still represented by many differing societies, the SVS has now become the de facto union of vascular surgeons. It has the ability to bring together all factions and it has the finances, the manpower and the organizational structure to represent all vascular surgeons on the national and international level. As such it is already recognized by governmental and commercial agencies as the authoritative voice of vascular surgeons. The SVS, which has built a strong relationship with the APDVS, is also in a strong position to support and facilitate the undergraduate and postgraduate training of vascular surgeons and strengthen all aspects of an independent specialty of vascular surgery. Although there may still be disagreements about whether vascular surgery should be an independent specialty, the SVS should be the organization that serves as “convener” and ultimately implements the decision of the majority of vascular surgeons. It may be appropriate that the SVS Executive Committee authorizes one more survey of its membership to determine whether we continue to seek independent specialty designation and to approve it as a binding membership referendum.
The plusses and minuses should be carefully defined and much thought given to how the questions in the opinion poll are defined. Whatever the results, they should stand, and be implemented.
Finally, as a practicing vascular surgeon and not necessarily in my role as medical editor of the Vascular Specialist I would like to thank Dr. Timothy M. Sullivan and the Annals of Vascular Surgery for publication of this review and Drs. Stanley and Veith for providing us with the gift of historical perspective. Now our goal should not be to repeat history, but rather to learn from our past experiences. I am sure most will commend Drs. Stanley and Veith and all the other vascular surgeons who dedicated so much of their time in the pursuit of an independent vascular specialty.
However, we should not demonize those that held a contrary view, for most were a product of their times. As recent Nobel Laureate Bob Dylan has written, “ The times they are a’changing ,” and they are changing in our favor. ■