The defining moment during my 2001-2002 Presidency of the AS(M)BS had nothing to do directly with medicine or surgery, but everything to do with our re-examination of who we were, where we were going, the risks of getting there, and the benefits of our destination and completed journey. 9/11/2001 had a profound effect on ALL of us in this respect. The St. Paul insurance company as well as several others shut down the med/mal section of their business leaving many (including me) without coverage. What to do? Go bare? Pay 20-40% of our gross income for coverage to a Caribbean carrier? Quit? All this consternation and upheaval came during the initial years of what has become a quantum leap in the general surgical philosophy of abdominal access. Industry seized the day, and weekend quickie courses sprung up everywhere, aimed at practicing surgeons who thought they could go home and do bariatric surgery laparoscopically, resulting in a plaintiff attorney hay day. This “perfect storm” of paucity in med/mal insurance coverage opportunities and the practicing surgeons’ “learning curve” produced a near disaster for our sub-specialty. Fortunately, the open and lap preceptorship program was already established and well under way, and most general surgery training programs had been teaching laparoscopic techniques for quite some time. We also saw that we needed to change our ASBS mission from a teaching society and add a credentialing arm. Fortunately, lap technology fellowships began to incorporate bariatric surgery into their programs which added further experience for recently graduated surgery residents.
I looked at my Presidential address of 11 years ago, and I noted that we were indeed at a crossroads, in that it was a time of transition for lots of issues far beyond lap techniques and affordable med/mal insurance. We were continuing to prop up the idea that we could do an operation to change one’s metabolism and favorably influence their longevity and quality of life. This was years before Walter Pories popularized this notion, which effectively changed the name of our society and markedly enhanced the perceived legitimacy of our surgery. It was a time when many of the public as well as our medical colleagues considered us as little more than charlatans with a profit motive and little else. Indeed, after the JI bypass, the original loop GBP, and Horizontal Gastroplasty, who could blame them? After all, human nature has a greater tendency to remember the disasters of a few, never hearing of or paying any attention to the overwhelming successes of the vast majority. In spite of all this adversity, we have continued to weather one storm after another, have survived, thrived, and have achieved the status of a major general surgical sub-specialty.
If I made any contribution to bariatric surgery and the ASMBS, I think it was to be in the Bully Pulpit during part of this time of transition to emphasize and support the continued close surveillance of this natural evolution, insuring the surgical competency and proficiency of our members. I take little credit for bringing about this absolutely necessary change in bariatric surgical thought, but at the time, I was indeed its biggest supporter and cheer leader.
Thanks again to all our membership for allowing me to be your President for a brief period of time. It was truly the greatest honor of my professional career and it has been a very positive influence in so many other phases of my life in my pursuit of being a better physician, surgeon, and person.
Kenneth B. Jones, Jr., MD