Avoiding the ‘tragedy of the unprepared’

Jan 03, 2021

By Shahram Aarabi, MD and Kenneth Madsen, MD

At the conclusion of a challenging 2020, we at the Society for Vascular Surgery (SVS) have a clear mission ahead: We must work with the U.S. Congress to avoid what military experts refer to as a “tragedy of the unprepared.”

We all know too well as surgeons the critical importance of preparedness. Our success hinges on removing or controlling as many known variables as possible. The critical importance of preparation, mobilization and response is key in health policy.

In “The Art of War,” Sun Tzu noted: “Now the general who wins a battle makes many calculations in his temple before the battle is fought. The general who loses a battle makes but few calculations beforehand. Thus do many calculations lead to victory, and few calculations to defeat. It is by attention to this point that I can foresee who is likely to win or lose.” The message here is that the majority of SVS members (93%, to be exact) and nearly all elected political officials are either uneducated, and/or misinformed about the coming Centers for Medicare & Medicaid Services (CMS) cuts to Medicare. Few vascular surgeons (or politicians) seemed to realize that a 7–10% loss of revenue was due to begin Jan. 1. At this juncture—writing in the middle of December—the situation truly looks to be a “tragedy of the unprepared” waiting to become a reality. The PAC is spending the final weeks of the year urging SVS members and lawmakers to support a bill to prevent cuts to all specialties. To the 7% of the SVS membership supporting the PAC, we thank you. To the remainder of our colleagues, please consider the impact your participation could have for our profession. The charge, “I am responsible for protecting the specialty” is a call for us all to engage in this battle to reverse the CMS cuts, protect our specialty—and to avoid our own tragedy of the unprepared!

Shahram Aarabi and Kenneth Madsen are members of the SVS PAC Steering Committee.

Related Articles