The energy within
Paul A. Raslavicus, MD
The movement to
reinvigorate the CAPHouse of Delegates reminds me of the law of
thermodynamics, which asserts that while energy cannot be created
or destroyed, it can be transformed. A useful corollary adds that
when energy is not directed or contained, it will spontaneously
a great deal of potential energy that awaits catalysis in the CAP
House of Delegates. Many of our colleagues within the College have,
or could assume, responsibilities in the House. But the opportunities
outnumber those who are interested: Of the 222 seats in the House,
175 are held by a delegate or delegation chair, and only 66 delegates
and alternates were seated at the House of Delegates meeting last
month. The picture was better for the fall 2002 meeting because
it was held in conjunction with the CAP annual meeting. At that
meeting, 178 of the 233 seats were held by a delegate or delegation
chair, and 115 delegates and alternates were seated. The potential
energy in our House has clearly been permitted to disperse.
This would be
less bothersome were it not so inconsistent with everything else
we do. The College enjoys the benefit of many gifted and hardworking
volunteers who participate in dozens of ways. Members donate countless
days to laboratory accreditation, to council and committee work,
and to advocacy within the AMA and in Washington. There are more
candidates for committee assignments than there are vacancies. Yet
our House of Delegates meetings are poorly attended. The meeting
agendas are all too brief. In such a vigorous organization, competition
for a seat in the House should be fierce. We should hear heated
debate, host numerous reference committees, and sort through hours
of impassioned testimony. But we don’t. With the newly curtailed
House meeting schedule, reducing meeting time to less than a day,
we seem to have given up the fight.
The House of Delegates
is where the action should be, the place where new ideas percolate,
and where communication between the leadership and the grassroots
is facilitated. Membership in the House suggests creativity, credibility,
and being a leader in pathology; it should be coveted. There ought
to be a long list of members waiting their turns to become delegates.
But there’s not.
Planning Committee that I chaired from 1999 to 2001 addressed the
untapped potential in the House. The Steering Committee of the House
thereafter discussed it formally. The Steering Committee’s
document “Strategic Tactics for Revitalization” was
debated for half a day at the House meeting last month in Washington.
presented for House debate included:
- Changing the culture of the House of Delegates Steering Committee so that
it would become a high-profile proactive body that critically analyzes actions
of the Board and the councils, creates ad hoc House committees to address
identified issues, and develops relevant resolutions for House consideration.
- Increasing CAP member interest in the House of Delegates by making it a
more communicative body and using the CAP Web site and other information modalities
to get members more involved and to encourage them to raise issues that concern
them. Delegates need to know what their constituents are thinking, and members
need to know what the councils and committees are doing.
- Enhancing the
role of the House in setting and reviewing College policy. The
vitality of the House bears relationship to the members’
perception of its importance within our association and to our
- Reducing the
size of the House and restoring the elections process. As our
specialty has grown in numbers, and as work pressures have increased,
it is difficult to find the delegates to fill the available slots.
A leaner, trimmer House could become a more vigorous and nimble
component of the College.
- Investigating the expansion of the House of Delegates base to include representatives
from selected national pathology organizations.
- Increasing the attendance and participation at House meetings. One mechanism
could be a stipend for each seated geographic delegate or alternate and a
strict attendance requirement for all delegates. Also, returning to a multi-day
format for House meetings should be considered, so that sufficient time is
given to deliberate the issues at hand.
With these topics
on the House floor, the delegates clearly showed that they are by
far not moribund. There was lively debate on many issues. Some said
the model of a periodic face-to-face meeting no longer works in
a 21st century information society. Some suggested that we initiate
regional meetings to get closer to where the action is. A resolution
to establish a House of Delegates list server was passed after vigorous
discussion. Others think it is time to modify the longstanding geographic
model of representation to give voice to organizations of pathologists
that are not state oriented but instead represent other scientific
or subspecialty societies.
Some feel that
if attendance were funded to some extent, as it is for committee
work, participation would improve. Some believe the House would
be more vigorous if it had more power in defining College policy;
others point out that the House even now can establish policy, with
the concurrence of the Board.
To me it is clear
that the Board takes all the actions of the House seriously, and
it is charged to report back on its positions and the reasons for
its decisions. To ensure that the voice of the delegates is heard,
the Board has proactively caused a bylaws change that gives the
principal officers of the House, the speaker and vice speaker, full
voting rights within the Board. Our bylaws also give significant
power to the House in the elections of governors and officers whenever
the vote of the membership fails to elect an individual by absolute
majority of the votes cast.
Our entire membership
would be well served if a healthy dynamic evolved within the House
that made it an exciting place to be. In the final analysis, the
effectiveness of the House and the degree to which it affects and
effects College policy will be related directly to the vigorousness,
timeliness, and wisdom of its actions and how well it mobilizes
and represents the interests of all pathologists.
In my address
to the House I said the vigorous discussion at the meeting is a
sign that the House can be a strong voice for pathology. It can
recreate itself into a dynamic forum where strategies are honed
and tactics developed for energizing our specialty for many years
to come. The time may be near when it can transform itself into
our national “House of Pathologists.”
The kinetic energy
is on the move. It is up to us, working together, to see that the
energy doesn’t disperse before it is directed, and that the
ideas that come from this energy are channeled appropriately and