College of American Pathologists
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  President’s Desk Column


The energy within

April 2003
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 disperse.

There’s 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.

The Strategic 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.

The proposals 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 profession.
  • 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 executed well.