Thanks Ian for your kind introduction.
thought long and hard about what to say today. What could I possibly say
that would be meaningful, make an impact
and be remembered? I could discuss the finances and reorganization of
the AGA. But these things will be discussed tomorrow morning at the
business meeting which I hope you will attend. What about a capsule
summary of practice issues and what is going on in Washington but these
topics will be discussed Tuesday afternoon at a session which you can
attend. I could revisit the strategic plan but AGA’s annual report will
highlight organizational directions, committee activities and selected
programs in much more detail and more eloquently than I possibly could
So I asked my wife
Kristin what I should tell you about. She said don’t tell them anything
– talk to them about what it meant to be AGA president - what you
learned and experienced this past year. This is the last time you have a
captive audience - use the time to talk about what is important to you.
She also bet me that I couldn’t get through this plenary session without
crying – so many wonderful truly amazing things have happened to me this
past year. Since I always listen to Kristin, I’m going to talk to you
about something important to me- Time – A time of Need, A time of
Concern, and A time of Change.
First a Time of Need
presidential year I have traveled around the country and around the
world. I’m grateful for the warm reception I have received from
colleagues across the U.S. and from Asia, Europe, Mexico and Canada. No
matter where I travel I see that gastroenterologists everywhere place a
high value on professionalism, addressing the needs of our specialty.
Professionalism is addressing these needs by providing quality patient
care. It is advancing scientific understanding of digestive disease.
Professionalism is preparing the next generation of gastroenterologists,
as well as committing ourselves to lifelong learning and discovery.
I am proud that AGA
is working to institutionalize this commitment to professionalism - that
we are taking concrete steps to help clinicians, especially young
gastroenterologists, provide high-quality patient care- that we are
focusing on the future - that we are dedicated to move forward in a
thoughtful patient centered manner. To waiver from our commitment to
professionalism is to threaten our core ideals – those ideals that shape
us as individuals and as an association.
In this past year,
one of the areas in greatest need has been the Gulf Coast. My work as
president recently took me to New Orleans where I visited with
colleagues who are patching together their practices, their city, and
indeed their lives, after Hurricane Katrina. Despite incredible
pressures and hardship, the Gulf Coast medical community has a positive
spirit and patient first attitude. Later in the program we’ll hear from
two of our colleagues, Ian Taylor and Peter Traber who worked together
to attend to the critical needs of countless individuals in the days
after the storm. Their incredible story is a living illustration of
professionalism at its best.
In this time of
need, AGA offered relocation grant support to GI trainees affected by
the hurricane – I received letters from grant recipients describing the
frightening events that they and their families experienced during the
height of the storm and its aftermath and expressing their sincere
gratitude to the AGA for the financial assistance. These trainees, some
of whom were trapped in the hospital along with their patients,
personally experienced professionalism and this experience will
profoundly influence their lives.
When we think of
need, we often think of Philanthropy. You may recall I designated my
presidency as a Year of Philanthropy. Most of us have causes that we
believe in strongly enough to support with charitable gifts, and I’m
pleased to report that many of you from around the world chose to
support the AGA’s foundation. Thank you! Together, through member
contributions and planned gifts, we have been able to more than double
the size of our research endowment from 2.5-million dollars in 2004 to
more than 6-million dollars. This will allow us to fund more
researchers and provide larger grants than ever before. Foundation
grants are a concrete example of our commitment to the future of
gastroenterology and the next generation of GI researchers.
The foundation has
also received substantial support from industry, including a spectacular
multi-million dollar gift from Astra Zeneca - the largest unrestricted
gift to the Foundation and the single largest gift to gastroenterology
ever. AGA grant recipients are selected with no strings attached to our
industry donors. Such unrestricted support, which started with TAP
pharmaceutical’s major grant in 2005, is unprecedented and, along with
the commitment from our members, has been one of the most rewarding
aspects of my presidency.
This is also a time
of concern – concern about future teachers and scientists – concern
about research funding – concern about the viability of academic
medicine and medical centers – concern about the chronologically gifted
among us - what role will we continue to have as our number
participated in the Academic Skills workshop and was inspired by the
young men and women who I met there. I’m delighted that our ranks
include such impressive, bright young gastroenterologists. After the
workshop, I received a note from a trainee who thanked the AGA for our
commitment to the future of the specialty. This trainee expressed a
desire to return to the workshop in the future but as a mentor– you see
even at this early stage of his career he recognized the importance of
paying back- supporting future careers as we ourselves have benefited
from the guidance of others. In the hands of this fellow, and many
others like him, the future of gastroenterology is bright. We need to
help these individuals in every way possible. This is our obligation and
the right thing to do.
One concern that
affects me personally is the future role of older gastroenterologists.
Many of us are facing a difficult career choice - how to wind down but
not wind out. We have never faced such a large scale maturing in our
profession and it’s clear we can not afford to lose this precious
resource. How can we best capture their unique wisdom, experience, and
knowledge? I challenge the AGA to ensure the lifelong vitality,
relevance and value of a gastroenterology career. As we develop
resources to enhance early GI careers– let’s not forget late career
Many concerns of
gastroenterologists center on issues under the control of federal
policymakers. Biomedical research funding, Medicare reimbursement are
medical liability are matters affecting us all whether we’re scientists
or practitioners. If we don’t speak up for the issues that concern us
and our patients, no one else will do it for us. The AGA formed a
political action committee or PAC to augment our advocacy efforts and
visibility among key leaders in Washington. Join me and get involved
with AGA PAC and make your concerns heard.
This is also a time
of change. Some view change as a threat – successful people and
successful organizations, like the AGA, view change as an opportunity. I
began my GI career in the BC ERA – before cimetidine – when
gastroenterologists took care of ulcer patients and measured acid
secretion. Endoscopy was in its infancy and we learned to do upper GI
studies and barium enemas during. As a gastroenterology Luddite, I could
have resisted change, remained an ulcer doctor, and continued to do
barium studies. Along comes Barry Marshall - so much for my chosen
career. Who in their right mind would have suggested bacteria cause
ulcers in the BC era?
Barry’s out of the
box thinking was recognized this year with the Nobel Prize for Medicine
or Physiology. Kristin and I were thrilled to accept Barry’s and
Adrienne’s invitation to attend the week long festivities honoring one
of our closest friends. It took years for the gastroenterology
community and the world to recognize the value of his discovery. Nobel
prizes typically go to scientists engaged in basic research, but Barry
has shown that simple clinical observation can lead to revolutionary
findings that fundamentally change a specialty. His discovery
underscores the importance of listening to our patients, keeping an open
mind and questioning established facts. Later this morning, we will
honor gastroenterology’s Nobel Laureate by awarding him the AGA’s
William Beaumont Prize.
Does anyone here
believe that change in gastroenterology will stop with H. pylori? There
was another BC era in our specialty, before colonoscopy – hard to
believe when today more than half of a Gastroenterologist’s time is
spent with a colonoscope in hand! Endoscopic Luddites will continue to
oppose non invasive GI imaging and alternative diagnostics. During this
time of change organized gastroenterology must do what is right not what
is expedient. I am proud that AGA is not tied to the present, but rather
looking to the future and is willing to loudly articulate and advocate
for opportunities that accompany change. What AGA says may not always be
what you want to hear but we must say it and will continue to say it
because to do otherwise would be to betray you our members.
The AGA is so
committed to change that we flexed our advocacy muscles to secure a
National Commission on Digestive Diseases at NIH. Selected commissioners
include an AGA past president, our incoming Vice President and a number
of prominent AGA members. With their input, we expect the commission
will reshape the future of GI research at the NIH.
Only one individual
annually is privileged to be president of the AGA but many share the
honor since one individual can’t achieve the office alone. As my
presidency ends I want to thank friends and colleagues from around the
world for their hospitality, their support and for sharing their
thoughts and concerns. I learned a lot during my travels and this
knowledge allowed me to be a better informed advocate for the issues
that are important to you.
John, Jack and Rob,
presidents of our sister societies, this year we have cooperated
effectively in many important areas yet when we have not agreed on
issues, we have respected each others opinions and remained collegial.
Thank you and I hope our societies can continue to build on our
successful communication and collaboration.
I want to recognize
my colleagues and fellows from the University of Virginia who were so
understanding and helpful this year. With out their cooperation it would
have been impossible for me to carry out my AGA presidential, academic
and clinical duties.
To my mentors, many
sitting in the audience, who have over the years unselfishly given me
advice and guided my career, I hope I have represented you well this
year. What a wonderful gift you have given to me and to so many others.
Thanks to the
volunteers who serve AGA developing and implementing our many programs.
Special thanks to the governing board and officers. You are talented,
insightful, dedicated leaders - a blessing to the AGA. I have enjoyed
working with and learning from each of you.
I am particularly
appreciative of the AGA staff without whose guidance and patience I
could never have kept up with day to day issues nor been able to
understand the big picture. Imagine each year a new president comes
along with different ideas and different style and it is their job to
make it work.
The one regret I
have is that my parents are not alive to celebrate with me today. They
instilled in me a respect for life, an understanding that hard work
leads to success, a commitment to honesty and a deep belief and reliance
To my daughter
Jessica, son Brian and daughter-in-law Jennifer thank you for being here
for your dad. Your mother and I are very proud of you for your many
accomplishments. As Grammie always said “remember where you came from”.
To my bride of 37
years, Kristin thank you for always being there for me, listening to me,
offering me advice, sharing me with the AGA, and reminding me why I
became a doctor. I love you!
Mark, the AGA is a
precious diamond- take care of it, polish it and let its beauty sparkle
for the whole world to see!
Good Luck, be careful out there and may God bless
each of you.