2025 Southeastern Surgical Congress Presidential Address: Leadership and Innovation in Surgery: A Vision for the Future

Introduction

It has been a tremendous honor to serve as the President of the Southeastern Surgical Congress (SESC) for 2024-2025. The list of past-Presidents that have served the SESC, since its inception in 1930, is truly remarkable, and I am humbled to have joined that list. Today, I would like to speak with you about leadership and innovation in surgery. Surgeons have long been at the forefront of both leadership and innovation, driving advancements that shape the future of medicine. As leaders, we guide surgical teams, mentor the next generation, drive surgical care models within our organizations that impact our patients and more broadly influence health care policies that impact patient care on a global scale. As innovators, we push the boundaries of technology and technique, developing new procedures, refining surgical tools, and improving patient outcomes through research and creativity. Our dual role as leaders and innovators is essential to the continuous evolution of the field, ensuring that surgery remains a dynamic and ever-advancing discipline. Today, I would like to explore the integral relationship between surgical leadership and innovation. I will highlight individuals, including several past-presidents of the SESC, who have driven innovations that have transformed the practice of surgery over the years. I will then discuss some of the emerging technologies and innovations that will most certainly impact our field in the coming years. Finally, I will close with a call to action for our membership to become engaged and lead the next series of innovations that will shape our profession in the coming years.

Setting the Stage

Understanding a person’s background is critical to fully appreciate their accomplishments because it provides context for a person’s journey, challenges, and motivations. It also fosters a deeper appreciation for their achievements, showing how their personal and professional growth has been shaped by their previous circumstances and environment. With that in mind, I’d like to give you some background about my path and how that journey has brought me to this point as the 2024-2025 President of the SESC.

I was born and raised in Deerfield, Illinois which is a northern suburb along the North Shore of Chicago. Deerfield was a close knit, family-friendly community with outstanding public schools. At Deerfield High School, I excelled in academically and athletically and earned a scholarship to the University of Notre Dame to play Division I college football. My decision to attend Notre Dame was life altering and transformational. First, I had the chance to play Division I football for a program that epitomizes tradition, excellence and resilience. Contributing to the legacy of that institution was a tremendous honor. Second, I had the opportunity at a very young age, to learn leadership principles that would serve as the foundation for the leadership successes that I would have later in my career. My teammates were an ultra-talented, diverse group of student athletes from different parts of the country. Yet we were able to channel our diverse talents towards accomplishing one singular goal, victory. Learning how to drive performance in that paradigm was incredibly valuable. Third, I received a world-class education at Notre Dame. It laid the foundation for me to excel in medical school and beyond, and I honestly do not think I would be a surgeon today had I not made the decision to attend the University of Notre Dame. Fourth, and most importantly, it is where I met the love of my life, my wife Patty. Throughout my entire career, Patty has been with me and supported me. Together, we have seven amazing children. All seven were Division I student-athletes and are incredibly talented and successful young adults. Patty and I are truly blessed, and we can both honestly say that we have everything in life today because we both made the decision to attend the University of Notre Dame.

After graduating from the University of Notre Dame in December of 1983, I enrolled in medical school at Rush Medical College in Chicago in the summer of 1984. Founded in 1837, Rush is one of the oldest medical schools in the Midwest. It provided me with a supportive environment, where I was able to develop a strong foundation in the pre-clinical and clinical sciences. Rush also provided me the opportunity to develop the self-confidence necessary to succeed as a physician. Entering medical school was a bit of a culture shock for me. Because of the enormous time commitment required to excel athletically and academically at Notre Dame, when I wasn’t in the the classroom or studying, I was at practice, in meetings and in the film room preparing for each of our opponents during the fall season. And after the season was over, our attention was turned towards preparing for next year’s campaign. While my teammates to this day are some of the finest people I have ever been around, most of them were not interested in a career in medicine and were quite honestly nothing at all like the members of my medical school class. Because of the supportive environment at Rush, I developed the confidence that I had what it was going to take to be successful as a physician. It is also at Rush that I made the decision to pursue Surgery as a career. The pace of Surgery simply fit my personality, and I loved being a part of a multidisciplinary team.

I received my surgery training at the University of South Florida (USF) from 1988-1995. My time there also included a 2-year Surgery-Immunology research fellowship. The clinical training at USF was amazing. Laparoscopic surgery was in its infancy and the faculty at USF embraced this new field. I learned laparoscopic surgery from the start of my career. My research fellowship was also instrumental. Not only did I learn the principles necessary to be successful in the lab, I also learned the practical skills about how to set up and run a lab. Most important of all though, was the sponsorship and mentorship I received from Dr. Alexander S. Rosemurgy (SESC President 2012-2013 and SESC Distinguished Service Award Recipient 2024) while in Tampa. He showed me how enjoyable and fulfilling a career in academic surgery could be and it changed my career trajectory.

After completing my training in Tampa in 1995, I joined the Department of Surgery at the University of Michigan, one of the great surgical departments in the United States. My senior partners on the General Surgery and Endocrine service at Michigan were Dr. Robert Bartlett and Dr. Norman Thompson, giants in Surgical Critical Care and Endocrine Surgery, respectively. Despite their international stature, they treated me with kindness and respect and were very supportive as mentors and sponsors. I was also successful in establishing an extramurally funded research program at Michigan in large part because of the skills that I had acquired from my research sabbatical at USF.

In 2001, I moved to Baylor College of Medicine to be a part of the DeBakey Department of Surgery. Cardiovascular surgery under Dr. DeBakey had been world renowned for decades. I thought it would be a tremendous opportunity to be a part of the team that would establish a robust General Surgery service at Baylor. Working in the Texas Medical Center also was an important experience. The Texas Medical Center is a very competitive environment. I learned first-hand how to develop successful clinical programs in that incredibly competitive environment. I also had the chance to meet one of my surgical heroes, Dr. Michael E. DeBakey, and learn some important lessons from him.

After six years at Baylor, I was recruited by Dr. William C. Wood (SESC President 2004-2005) to join the Department of Surgery at the Emory University School of Medicine. Dr. Wood recruited me to be the W. Dean Warren Professor and Chief of the Division of General and GI Surgery at Emory. Dr. Warren was the Chair of Surgery at Emory from 1971-1989. He also happened to be another of my surgical heroes. I served as Division Chief of General and GI Surgery from 2007 until 2013. In 2013, when Dr. Chris Larsen became Dean of the School of Medicine, he asked me to serve as interim-Chair of the Department Surgery and then two years later in 2015, I became the sixth Joseph Brown Whitehead Professor and Chair of the Department of Surgery at Emory.

The Surgeon as a Leader

Surgeons are inherently leaders, as their role demands decisiveness under pressure, adaptability, and exceptional problem-solving skills. In high-stakes environments, they must make split-second decisions that directly impact patient outcomes, demonstrating resilience and mental toughness in the face of uncertainty. Their high emotional intelligence allows them to navigate complex team dynamics, reassure patients, and manage surgical teams effectively. However, leadership in surgery also presents challenges. Due to our highly individualized training, surgeons may struggle with delegation, preferring to take control rather than distribute tasks. The hierarchical nature of surgery reinforces task-oriented behavior and a direct communication style, which, while efficient in the operating room, may not always foster collaborative leadership when dealing with other disciplines. Balancing these traits with the ability to empower and support team members is key to a surgeon’s success as a leader.

For surgeons to improve as leaders, structured leadership training focusing on decision-making, delegation, and effective communication should be integrated into our professional development. Emotional intelligence development is crucial. Helping surgeons enhance their self-awareness, empathy, and interpersonal skills will foster stronger team dynamics in the end. Encouraging collaboration through team-based training exercises and interdisciplinary teamwork can help surgeons shift from a purely task-oriented mindset to a more inclusive leadership approach. By combining technical excellence with strong leadership skills, surgeons can create more cohesive teams, improve patient outcomes, and drive meaningful change in health care. Additionally, defining one’s purpose as a leader—whether it’s mentoring the next generation, improving patient care, or advancing surgical innovation—provides clarity and motivation, guiding surgeons to lead with intention and impact.

Surgeons as Leaders of Innovation

Innovation in health care is the implementation of new or significantly improved ideas, products, or services that enhance the delivery of high quality, efficient, and effective health care. ¹ Health care innovation can lead to the earlier diagnosis and effective treatment of critical conditions, while at the same time reducing health care costs. In the end, health care innovation will contribute to healthier populations and more sustainable healthcare delivery systems.

Surgeons are positioned to be natural leaders of innovation because we are positioned at the intersection of clinical practice and technological advancement. Surgeons are inherently hands-on problem solvers, often the first to identify unmet needs as we encounter complex clinical challenges in real time. These experiences drive surgeons to develop novel therapeutic strategies to address complex surgical problems. Outside of the OR, surgeons are comfortable bringing together multidisciplinary teams to facilitate problem solving and innovation. Surgeons also persevere in the face of challenges that most other disciplines would bow to. All these characteristics uniquely position surgeons to be drivers of innovation.

Throughout my career I have been fortunate to learn from and be inspired by many remarkable surgeons. Among them, two stand out as true heroes—surgeons whose skill, vision, and leadership have impacted my approach to the field of surgery.

Michael E. DeBakey, MD

Michael E. DeBakey was a pioneering cardiovascular surgeon whose leadership and innovations revolutionized modern medicine. (Figure 1) Dr. DeBakey was born and raised in Lake Charles, Louisiana. He received his undergraduate and medical degrees from Tulane University. The first sign of his skill as an innovator emerged during medical school at Tulane, when he developed and patented a roller pump device to assist with blood transfusions. ² This roller pump ultimately was incorporated in the Heart-Lung Bypass Machine. As a visionary in surgical techniques, he developed groundbreaking procedures, including the first successful use of Dacron grafts to repair blood vessels and key advancements in coronary bypass surgery.^2,3 His leadership extended beyond the operating room, as he played a crucial role in establishing the Veterans Affairs Medical Center system and advising U.S. presidents on healthcare policy. ⁴ DeBakeys relentless pursuit of excellence and commitment to education shaped generations of surgeons, cementing his legacy as one of the most influential and innovative surgeons in medical history.

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Figure 1.

Dr. Michael E. DeBakey

W. Dean Warren

W. Dean Warren was a pioneering surgeon known for his leadership and innovative contributions to hepatobiliary and portal hypertension surgery. (Figure 2) He was born in Miami and raised in Lakeland, Florida. He received his medical degree from Johns Hopkins and ultimately completed his surgical training at Barnes Hospital in St. Louis, Missouri. He began his groundbreaking work on portal hypertension early in his career. He returned to Miami as Chair of Surgery, before being recruited to Emory to serve as the third Joseph Brown Whitehead Professor of Surgery from 1971 to 1989. As Chair at Emory, he fostered a culture of surgical excellence, mentorship, and research, influencing generations of surgeons. His leadership extended to major surgical organizations, where he advocated for advancements in patient care and surgical education. His long-term research efforts ultimately led to the development of the distal splenorenal shunt, known as “the Warren shunt,” which was a selective portocaval shunting procedure that significantly improved outcomes for patients with bleeding esophageal varices. ⁵ Yet, Dr. Warren was not rigidly attached to his own innovation. He recognized that liver transplantation would offer a more effective, durable and lifesaving solution to the clinical problem of portal hypertension secondary to end-stage liver disease. His openness to progress, illustrated by the creation of a world-class liver transplant service at Emory exemplified his commitment to improving patient care above all else.

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Figure 2.

Dr. W. Dean Warren

SESC Presidents as Leaders of Innovation

Including a section highlighting several past-Presidents of the Southeastern Surgical Congress, who have made significant contributions to innovation, highlights the enduring legacy of leadership within our organization. I apologize in advance to individuals that I may have inadvertently left off this list. Having said that, these individuals not only guided the SESC during their tenure as President but also advanced the field of surgery through groundbreaking research, novel surgical techniques, transformative educational efforts or important public policy initiatives. This section honors the spirit of innovation that defines the SESC and hopefully will inspire the next generations of SESC leaders to continue pushing the boundaries of surgical innovation.

Alton Ochsner, MD

Dr. Alton Ochsner played a major role in American surgery. (Figure 3) He served as Chair of Surgery at Tulane University and was President of the Southeastern Surgical Congress from 1945 to 1946. In 1939, alongside Dr. Michael DeBakey, he was among the first to suggest a link between cigarette smoking and lung cancer—a groundbreaking observation that preceded widespread public awareness by decades. ⁶ Beyond this important contribution to public health, Dr. Ochsner was a pioneer in cardiothoracic and vascular surgery, helping to advance surgical techniques and training in these complex fields. He also played a key role in founding the Ochsner Clinic, which became a model for group practice and multidisciplinary patient care and remains a leading institution to this day.

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Figure 3.

Dr. Alton Ochsner

J. Alex Haller, MD

Dr. J. Alex Haller, Jr. served as President of the SESC from 1976-1977 (Figure 4). He is widely regarded as one of the founding figures in pediatric surgery and played a pivotal role in the development of pediatric trauma care systems. He advocated for structured, child-specific protocols that have since become national standards. Among his many contributions, he introduced the Haller index, which is a radiographic measurement that is still used today to assess the severity of pectus excavatum before surgical intervention. ⁷

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Figure 4.

Dr. J. Alex Haller

Hiram C. Polk, MD

Dr. Hiram C. Polk served as President of the Southeastern Surgical Congress from 1995-1996 (Figure 5). Dr. Polk was a pioneer in the use of surgical antibiotics, playing a major role in shaping infection control practices that are now foundational to modern surgical care. ⁸ He made important contributions to surgical oncology that helped advance the treatment of complex cancers. He has mentored and trained generations of surgeons during his long tenure as Chair of the Department of Surgery at the University of Louisville. Ultimately, his career reflects a long and deep commitment to innovation, education and the advancement of the surgical sciences.

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Figure 5.

Dr. Hiram C. Polk

L.D. Britt, MD

Dr. L.D. Britt, who served as the President of the SESC from 2007 to 2008, is widely recognized as a transformative leader and pioneer in the field of Acute Care Surgery (Figure 6). His visionary work helped formalize and advance the specialty, shaping how emergency surgical care is delivered nationwide. ⁹ Beyond his clinical innovations, Dr. Britt has been a leader in surgical education, mentoring countless trainees and junior faculty, while at the same time pushing them to academic excellence. He has also been a tireless advocate for health equity and access dedicating his career to ensuring that all patients in the US, receive high quality surgical care.

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Figure 6.

Dr. L.D. Britt

Kirby I. Bland, MD

Dr. Kirby I Bland, who served as President of the SESC from 2009 to 2009, is recognized for significant contributions to surgical oncology, particularly in the management of breast cancer (Figure 7). His research has focused on targeted therapies for Breast cancer, aiming to advance innovation and translational science in clinical trials for breast cancer. ¹⁰ Dr. Bland has played a pivotal role in surgical oncology training programs mentoring numerous residents and fellows.

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Figure 7.

Dr. Kirby I Bland

Grace S. Rozycki, MD

Dr. Grace S. Rozycki served as President of the SESC from 2011 to 2012 (Figure 8). She is recognized as a pioneer in surgeon-performed ultrasound in trauma care (Focused Assessment using Sonography in Trauma:FAST) enhancing the rapid assessment and management of critically injured patients. ¹¹ Her leadership in trauma surgery has been instrumental in advancing surgical education. She has mentored numerous trainees, and she has been a tireless advocate for women in surgery, inspiring many to pursue careers in surgery and excel in the field.

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Figure 8.

Dr. Grace Rozycki

Frederick L. Greene, MD

Dr. Frederick L. Greene served as the President of the Southeastern Surgical Congress from 2013 to 2014 (Figure 9). He has made significant contributions to the field of surgical oncology, particularly in the advancement of cancer staging methodologies. His work has been critical in standardizing cancer classifications, thereby enhancing diagnostic precision and treatment planning. ¹² He has been an advocate for comprehensive cancer data management, emphasizing the importance of accurate data collection and analysis to inform patient care and research.

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Figure 9.

Dr. Frederick L. Greene

Challenges of Implementing Innovation in Surgery

Innovation has been a critical driving force behind progress in surgery, continually reshaping the way we provide care for patients. One of the most significant transformations has been the evolution from maximally invasive procedures to minimally invasive techniques, reducing recovery times, complications, and improving outcomes. Today, we stand on the cusp of a new era of innovation in surgery, defined by emerging technologies such as surgical robotics, artificial intelligence, and augmented reality. Each of these innovations carries the promise of enhanced precision, safety, and efficiency in the operating room. Personalized surgical strategies, informed by genomics and biomarkers, will pave the way for more targeted patient-specific interventions. The promise of telemedicine and remote surgery will also increase access to expert surgical consultations, breaking down geographic barriers to care. These advancements collectively promise to redefine the future of surgery, providing surgeons with tools that will make us even more effective for our patients.

While innovation in surgery holds immense promise, its implementation comes with significant challenges. The high cost of these emerging technologies, such as robotic platforms, AI platforms, and advanced imaging tools, can be a barrier to adoption, particularly for institutions that are resource limited. Funding limitations functionally limit widespread access and slow the pace of integration into routine clinical practice. Another barrier to uptake of these technologies that must be overcome is the complex regulatory pathways to ensure safety and efficacy, a process that is time consuming and expensive. There are also practical considerations, including the need to seamlessly integrate these new tools with existing hospital infrastructure and electronic medical records. Ensuring that surgical teams are properly trained in these new technologies and that workflows are adapted to accommodate the new tools and technologies further complicates uptake. Addressing these challenges will be essential to ensure that the benefits of these new innovations are equitably realized by all patients.

Additionally, as surgical technology becomes more complex, particularly with the potential integration of robotics and AI driven decision-making, the implementation of advanced surgical innovations brings important human and ethical considerations. Questions will arise about the role of the surgeon, patient autonomy and accountability for outcomes. Ensuring patient safety in this ever changing landscape will require thoughtful oversight in order to protect patients but also allow for the advancement of our specialty. Clear protocols for managing technology-related errors or malfunctions must be developed and implemented to protect our patients. Ethical concerns also arise as it relates to access to these new technologies. We must guard against propagating a two-tiered system where there are barriers to receiving the benefits of these new technologies for certain populations The increased reliance on digital systems also heightens risks around data privacy and cybersecurity. Safeguarding protected health information and maintaining patient trust are critical, especially as patient data is increasingly stored, shared, and analyzed across interconnected platforms. These issues must be addressed proactively to ensure that these innovations enhance rather than complicate our ability to take care of patients.

Call to Action

As members of the Southeastern Surgical Congress, we are uniquely positioned and indeed called, to lead the next wave of innovation in surgical care. Our rich legacy of clinical excellence, research, and education provides the foundation upon which we can influence the future of surgery. We must embrace the potential of these emerging technologies, all the while ensuring that these innovations positively serve our patients in an equitable fashion. We must lead with a commitment to advancing our field with integrity and vision, rising to the challenge of adopting innovation in a responsible manner.