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Dr. Steven Stack could become the first EP elected president of the AMA. Has our specialty finally found its champion?

Steven Stack, MD, an emergency physician from Kentucky,  was recently re-elected to his second term on the AMA Board of Trustees. After this unprecedented, unopposed election, many emergency physicians are wondering the same thing: will Steve “Stack” up to our expectations or just be another great physician sucked into the wheels of bureaucracy, forgetting his heritage? Is he, in the immortal words of Morpheus in The Matrix, “The One”? I think Steve may very well be the one – the one to effectively represent emergency medicine in the house of medicine while still being a good fiduciary to all physicians in all specialties. One thing Steve has going for himself is that he’s still a physician in the trenches, just like the rest of us.

alt“I will always identify with emergency physicians,” says Stack. “I’m a medical director of a busy ED and I worked 160 hours last month.”  In short, Stack, at 38 years of age, is just beginning to peak in his emergency medicine career. He’s certainly not fading away, simply seeking a desk job with the AMA or aspiring to hang out with the ophthalmologists.

Steve and I had a long talk about where he came from and where he’s going. He completed his residency training in emergency medicine at Ohio State University.  He currently is the ED medical director at St. Joseph’s Hospital East in Lexington, Kentucky.  His road to the AMA Board of Trustees is littered with accolades and accomplishments. “I went to my first AMA meeting in December, 1995. It was in Washington, DC, and I was a second-year medical student at Ohio State. Eighteen months later I was elected Speaker of the Medical Student Section Assembly. That was the start. I’ve only missed one AMA annual or interim meeting in the 14 and a half years since.” Although very humble by nature, Steve is a sleeping giant, possessing the strength to command respect with the eloquence to tame a wild surgeon and make him think it was all his idea. All kidding aside, Steve’s leadership skills and style are well known and appreciated by those who work with him.  He recalls one hospital administrator’s comments, regarding his approach to difficult situations,  “He possesses the unique ability to let go of defensiveness and pre-conceived notions, while working to find the truth and create a plan to make things better.”  

Steve does talk the talk, and his repose would rival that of any good politician.  What’s different about this “politician?” Five minutes with him and I guarantee you’ll be taken by his sincerity and commitment to our specialty and medicine in general. For that matter, you’ll probably hand him a check for your AMA dues.

So, what’s so unique about this medical messiah? Will he actually be the first EP to become the AMA President?  I’d put good money on it. Dr. Stack’s history with the AMA is nothing short of extraordinary.  

“Leadership positions are a ticket to sit at the table,” says Stack. “What you do with those opportunities is very important.” He won’t tell you without a little prodding, but he was the first AMA Young Physicians’ Section (YPS) member to be re-elected for a 2nd term to the Board of Trustees.  He is the fourth YPS member to sit on the Board of Trustees, the first being Dr. Regina Benjamin, our current Surgeon General.  He is the first emergency physician ever to sit on the Board of Trustees and the youngest post-residency Board member noted in modern history.

I asked Dr. Stack why he has aspired to AMA leadership. “I think we all have an obligation to try our best to make things better, to try to at least manage, if not solve, some of our enduring challenges taking us all to a better place. How we provide care to an entire nation in an effective and sustainable manner is a persistent and nettlesome task. We can do a lot better than we do now.  Every emergency physician knows and sees this each shift they work.”

When asked if he would pursue the AMA Presidency, he simply stated, “I have never held fascination with titles. There was no road map and no intentional goal to become the AMA President.” However, he did concede that those who are successful navigating the “life cycle” of positions on AMA governing councils tend to aspire to future leadership roles.

“Seriously? My principle driving aspiration is to ensure that the AMA is healthy and strong so it can serve our profession and help us to serve patients. Titles sometimes facilitate or afford leadership opportunities. But, to paraphrase a quote I recently read, ‘true leadership is influence – nothing more, nothing less.’ I have the privilege to be an AMA Trustee and, currently, to be the Secretary of the AMA. The larger privilege and obligation, though, is to work through whatever channels I can to improve and sustain the AMA. Time will tell if my pursuit of these goals take me to be Chair or President of the AMA.”  His next logical move seems to be a run for Chair of the AMA Board of Trustees or the AMA President-Elect position.  His ultimate path has yet to be determined or disclosed.

So, you might be asking, “What has the AMA done for me lately?”  Many physicians, present company included, have been fairly skeptical about the value of AMA membership and the effectiveness of the AMA in representing emergency physicians.  I asked Steve to make his case.

“I think the AMA is serving medicine very well,” he started, “but I’m not naïve,  and I’m saddened that physicians carry so much misplaced frustration and disappointment and deliver it at the AMA’s doorstep. As doctors, we are so fragmented by our specialization. We think of ourselves as emergency docs first and, maybe, as physicians second. ‘Proceduralists’ and ‘Cognitives’ are deeply divided by the reimbursement system. Then, we are split based on Democratic or Republican ideologies.”  Dr. Stack went on to highlight some notable AMA benefits:

  • The Journal of the American Medical Association (JAMA), along with the New England Journal of Medicine and Lancet, is one of the most highly regarded peer reviewed publications in all of medicine.
  • Although Congress gets the “Front page,” the AMA’s DC office of 100 or so staff sets the stage and impacts the political process on a daily basis.
  • The AMA assists all medical schools.  
  • The AMA writes the code of medical ethics, with each specialty represented.  
  • With private section advocacy, the AMA attempts to right wrongs, such as with insurance companies.   The $350 million settlement obtained from United HealthCare, on behalf of physicians, is just one of many examples.   


“We can’t solve the problems we face if we can’t speak the language of other specialties,” says Stack. In other words, we are much more likely to shape healthcare cooperatively with the AMA than without.  So, where is the AMA on health care reform?  Many physicians felt the AMA simply didn’t do enough.  Steve agreed that many physicians are frustrated about the reform package and tend to vent those frustrations toward the AMA.  However, some of those frustrations have arisen due to certain individual, legislative concerns of physicians not being addressed.  He reminded me that much of these decisions were made by the legislature with little input from physicians, and although the AMA is deeply concerned about them, cannot take responsibility for things which they do not control.  Nonetheless, Stack ultimately said, “It was still the right thing to do to help the patients,” referring to the adoption of the Patient Protection and Affordable Care Act (PPACA).  

“I like the comprehensive lens on healthcare through which the AMA views issues,” he continued. “Health care is big, and it’s complex. It touches every person in the country and consumes nearly a fifth of our nation’s entire economic output. That’s massive. Additionally, a small change here can have a big impact in unexpected ways. One person’s solution is another person’s ruin. I take that challenge seriously. In fact, I’d steal that line from the movie, The American President, and say that ‘We face serious problems and they require serious leaders to solve them.’ Sensationalism and over-simplification are not options and are, instead, irresponsible and terribly harmful.”

We do face serious problems, and we do need serious leaders. My take is that while Dr. Stack is truly a consensus builder, he doesn’t seem to be a “Yes man.” He seems to be one of those serious leaders with the skills necessary to influence and make positive change.

Steve, you have my confidence, and have re-instilled my trust in the AMA. Check your mailbox – I’m sending you my membership renewal check.



 

 

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