Hail to the Chief: Dr. James Chang
American Society for Surgery of the Hand
May 15, 2020
This article is the first in a series of interviews with Stanford Surgery faculty who were, are, or will be presidents of surgical societies. Dr. James Chang is Chief of the Division of Plastic and Reconstructive Surgery at Stanford University. He was president of the American Society for Surgery of the Hand (ASSH) from September 2017 to September 2018.
Rachel Baker: Why did you decide to become President of the ASSH?
James Chang: I feel extremely lucky to have filled that role. I think that is a misunderstanding some people have. You don’t decide to become president. Instead, you volunteer for a national organization in committees and boards for years and eventually, if that is noticed, you hopefully reach the level of president.
There are many great reasons to get involved with a national organization. These include learning from colleagues around the country, getting involved in academics by leading conferences, impacting health policies within your specialty, and offering your expertise to surgeons in training.
If you wish to pursue this experience, it is important to start early in your career. Find the organization that you are most passionate about and then continue concentrating on that one organization. As a junior faculty member, it is helpful to ask more senior members how and why they got involved.
Once you join committees, dig in and do the work. I say that because in any committee there are complainers—people who complain about the status quo but don’t have anything beyond that—there are sitters, who passively sit without contributing, and then there are fixers—people who come up with innovations to solve issues. Once you are known to be a fixer and have solutions, you will be quickly volunteered more committees and more work!
RB: How do you prepare to be President of a society?
JC: First, I served on many different committees over 12 years, so I knew the ASSH organization very well. I was Research Director for three years and then Treasurer for three years, when I learned a lot about finances and investments. Beyond that, I served as Vice President and President-elect before becoming President.
I took notes along the way on how I could make an impact at that time for hand surgery in general, and I began to pick projects and causes that I thought I could reasonably get done during my time in office with the resources available—similar to a platform. I had to think about what I was passionate about, and tangible ways to make things better for patients, trainees and fellow hand surgeons. Then I spent a lot of time building consensus. One thing you learn is that all the people you are working within a national organization are volunteers and peers, so building common goals is critical.
RB: What was your platform?
1) Global hand surgery: We have a lot of hand society members who want to volunteer overseas to deliver and teach hand surgery, but they don’t have the organizational structure to do that. I established a $5M endowment to organize and support this volunteer work.
2) Integrated Fellowship Application Platform: Every year I would see my residents apply for hand fellowships. It was an arcane system—all on hard copy—that they’d have to mail. The staff at the programs would have to open those packets and make multiple copies or scan them for the faculty to review. I led the initiative to host the application online, making the process simple for busy residents.
3) Surgical simulation: We established a simulation curriculum for the fellows to practice hand surgery—procedures like arthroscopy, microsurgery, bone fixation, and tendon repair. It will hopefully make the early months of fellowship better for the fellow, faculty, and most importantly, the patients!
4) Maintenance of Certification Reform: A lot of our ASSH members complained about the cost and stress of maintenance of certification (MOC). We advocated with the boards to make MOC more reasonable and stress-free for the members. This has led to great member satisfaction, without sacrificing the quality of re-certification.
5) Hand Surgeon burnout: Obviously, this is a crisis facing all medical specialties. Our survey showed that hand surgeons—consisting of plastic surgeons, orthopedic surgeons, and general surgeons—ranked amongst the highest impacted. I made this the focus of my presidential lecture and other initiatives.
RB: What do you do after you're the president (in the society and beyond)?
JC: You take satisfaction in a job successfully accomplished. Hopefully you feel have you made an impact. You cherish the colleagues and friends you have made, and you move on to the next fun project to do. I just finished writing a textbook, and I am pivoting to do more global reconstructive surgery work. Now is my time to cheer on others like our Stanford faculty, Dr. Paige Fox and Dr. Catherine Curtin, who are very involved in with ASSH. I would love to see them become ASSH president someday!
RB: What advice would you give to other presidents and people looking to have the job?
JC: Past presidents should only be heard when asked.
Upon request, I have been giving advice to the current ASSH president, who is a really good friend of mine. I have been commiserating with him because he may not be able to convene the Annual Meeting in October. The Annual Meeting in 2018 was a career highlight for me: I gave the presidential lecture, and we had 1500 seats to Fenway Park for the members, including the international guests. (There is nothing better than to skip a formal reception in favor of a night in the ballpark!)
During times like this, we have to remember that we work for the membership. We need to provide resources for the members who are dealing with this crisis like how to protect your patients and your practice and how to educate using virtual training platforms. We also need to provide some comfort. Leaders can provide common sense advice but should also be able to grieve with the members and trainees about the uncertainties of the future.
RB: Any other advice?
JC: Yes, and that is to not to forget the work back home. It is important to take care of patients and faculty at your home institution. Also, to get to that stage in your career takes a lot of time away from family—that needs to be acknowledged. There were council meetings three times a year and committee phone calls late at night almost every week. It’s not for everyone, but if you want to make an impact nationally it’s so much fun. I enjoyed every minute of it.