UNDERSTANDING THE NEW-WORLD OF HEALTH-CARE

This address introduces an informed new leader who demonstrates our sp ecialty in action. As you read Paul Uhlig's inspiring words, you will be proud of the spirit that is stirring in the wheatfields of Kansas a nd throughout the specialty. Like a cardiothoracic resident who learne d transplantation immunology, Paul brought ''the right stuff'' to the right place. As the first Alley-Sheridan Scholar-in-Residence, he had a startling and stimulating impact on his fellow students and teachers at Harvard's Kennedy School of Government. The ''impact factor'' of c ardiothoracic surgeons, reflecting their unique combination of knowled ge, judgment, problem-solving skill, and commitment to effective actio n, is sorely needed in the restructuring of health care. Former Presid ent of The Society of Thoracic Surgeons Ralph Alley showed how importa nt strategic surgical thinking can be. As advisor to the New York Stat e Department of Health, he introduced peer review of cardiac catheteri zation and cardiac surgery, using professionalism for quality improvem ent instead of government regulation. The skills required for effectiv e action during the current health care revolution include a thorough understanding of policy development, health economics, government, and the political process. Paul's writing reflects the broad population v iewpoint we need to develop, while preserving a fundamental value of o ur specialty, exquisite sensitivity to the trust and care of the indiv idual patient. We need more Alley-Sheridan Scholars. The Thoracic Surg ery Foundation for Research and Education is promoting development of health policy skills in cardiothoracic surgeons as an important part o f its mission. There is early evidence of progress. Three Society of T horacic Surgeons presidents, the vice president, the treasurer, secret ary, and chair and many members of the Government Relations Committee are among the 150 scholars who have completed the 10-day executive cou rse. Their recent success in The Society of Thoracic Surgeons' initiat ive to clarify thoracic practice expenses reflects the strengthened ta ctical skills and strategic thinking of our leaders.