 Dr. Warren Cole |
 Dr. Robert Turell |
 Dr. John Waugh |
The history of the SSAT begins in 1957 when Dr. Robert Turell dreamed "of launching a new surgical organization oriented to the problems of the alimentary tract and of creating a research or educational foundation. "(1) He discussed the possibility of a new society with many prominent surgeons and many discouraged him, but he found substantial support from Dr. Warren Cole, who agreed to help under the condition that Dr. John Waugh would assist in the formation of the society. The three met in Rochester, Minnesota, at which time Dr. Waugh confessed that he had been entertaining similar thoughts for a society devoted to the advancement of alimentary surgery.
The Society was incorporated on March 30, 1960, and was initially named the Association for Colon Surgery. The founding membership consisted of authors who had contributed papers to six issues of the Surgical Clinics of North America edited by Dr. Turell and the authors of the chapters in his textbook Diseases of the Colon and Anorectum. In the beginning it was thought advisable to limit the Society's interest to surgery of the colon, but Dr. Cole proposed that the name be changed to The Society for Surgery of the Alimentary Tract to reflect wide interest in abdominal surgery. Dr. Robert Zollinger, the Society's third president, gave a convincing address entitled "Justifying our Existence. "(2) He noted that papers related to the alimentary tract made up less than half of the programs of other societies including the American College of Surgeons Clinical Congress, and that SSAT was the only North American organization focused on surgical problems of the entire alimentary tract, a situation which still exists today.
The requirements for membership in the Society have been a matter of frequent debate since its inception. In 1965, five years after the founding of the society, the Board of Trustees directed that the membership should be enlarged rather than restricted to a small group. The first constitution of the Society was approved that same year. The requirements for membership were:
Initially, the number of published papers was flexible, but by 1981, sixteen years later, the requirement for at least 10 publications became the law of the membership committee. As a result, the society's growth flattened.
In 1984, the Board of Trustees became concerned over the lack of growth and again decided that the publication requirement should be liberalized. Dr. James Thompson, Chairman of the Board, noted that "the ascendancy of our collegial organization, the American Gastroenterological Association (AGA), to a position of great importance, many believe, dates from its adoption of the recommendation of Dr. Mort Grossman that it be an egalitarian and not an elitist organization. Dr. Thompson urged the membership to identify surgeons practicing alimentary surgery in their community and propose them for membership. At this time, the only membership criteria were certification by the American Board of Surgery or its equivalent, membership in the American College of Surgeons or its equivalent, and an interest in gastrointestinal surgery.
In 1993, President-Elect Dr. Bernard Langer set an agenda that focused on three important issues facing the Society: first, the creation of advanced training programs in gastrointestinal surgery; second, the need to increase substantially the membership of the Society to include the vast majority of surgeons practicing alimentary tract surgery in North America; and third, an assessment of starting the Society's own journal of gastrointestinal surgery. "During his presidency, Dr. Langer convened a task force that recommended to the Board a campaign to aggressively recruit members, a change in the membership process to one of direct application, and the creation of a trainee membership. The proposed criteria for membership were:
The result of these changes has been a substantial increase in the membership of the Society in recent years.
The development of the Society's own journal took many years. The founders of the organization wished to live in harmony with the already established surgical organizations, which precluded consideration of an independent journal. After the first annual meeting, several existing journals expressed interest in publishing the Society's papers the publication of the papers presented at the first annual meeting. Ultimately, a decision was made to publish in the American Journal of Surgery, edited by Dr. Zollinger; that journal subsequently published the papers presented at the Society for the next ten years. Only once during that period, in 1965, the Society reviewed the possibility of publishing its own journal, but thought it not to be desirable at the time. In 1970, the American Journal of Surgery became the official journal of the Society, with all members subscribing to the journal as part of their membership.
The issue resurfaced again in 1993 as one of Dr. Langer's three important decisions facing the Society. The issue became part of the agenda of the special task force convened during his presidency. In response to the report of the task force, the Board appointed a Publication Committee, chaired by Dr. Keith Kelly, to study the issue. At its October, 1995 meeting, the Board accepted the recommendation of the Publication Committee to proceed with establishing an SSAT journal. The name selected was the Journal of Gastrointestinal Surgery. Most importantly, the journal was to be owned and copyrighted by the Society. The Board made the decision to have dual editors and appointed Drs. Keith Kelly and John Cameron to the position.
From the beginning, SSAT has shown an interest in integrating with other professional organizations. It all started in 1964, when Dr. Helger Jenkins urged that a committee be appointed to work out a joint membership with gastroenterologists. Apparently in response to his request, a Liaison Committee to the AGA was appointed by the Board around 1966. Dr. Lloyd Nyhus chaired the committee. Their charge was to explore possible ways of bringing the two societies interested in gastrointestinal diseases into closer relationship. The committee found it impossible to schedule a joint meeting with the AGA and the whole issue would have been dropped if it was not for the death of a prominent individual in Minneapolis from ulcerative colitis. The family of the deceased individual established the Digestive Disease Foundation of Minneapolis for the purpose of funding research in the broad scope of digestive diseases. In February, 1967 Dr. Nyhus, still attempting to make contact with the AGA, attended a conference on Digestive Disease as a National Problem. This conference was sponsored by the Digestive Disease Foundation of Minneapolis, the National Institute of Arthritis and Metabolic Diseases and the AGA. The purpose of the conference was to stress to the federal government the overall importance of digestive disease on the American public. Details regarding the prominence of the problem, the need for continued research, the needs for manpower and a plan to provide for these needs in the future were presented. As a direct result of the conference, the National Institute of Arthritis and Metabolic Disease identified the problem of gastrointestinal disease for in-depth study.
The following year, Dr. Nyhus reported to the Society that the AGA had taken an interest in our Society because of the desire to have surgeons involved in discussions about digestive disease with governmental agencies. This provided an opportunity for the two societies to discuss a variety of issues, including the possibility of a joint annual meeting. At that time, the SSAT's annual meeting was held in conjunction with the AMA meeting, and it was suggested that SSAT change its meeting dates to coincide with the AGA.
The AGA, in moving towards its goal of obtaining research dollars, formed both a Federation of Digestive Disease Societies and a Digestive Disease Foundation. Dr. Morton Grossman addressed the SSAT's Board of Trustees at its 1970 meeting, explaining that the goal of the Federation and Foundation was to develop a National Digestive Disease Institute similar to the National Cancer Institute. The purpose of the Institute would be to support research, education of the lay public, unify public relations and initiate legislation regarding digestive diseases. He expressed the hope that our Society would join both organizations. There was considerable discussion of Dr. Grossman's presentation, and the decision was made to join both the Federation and Foundation.
When the action of the Board was reported at the Society's annual business meeting, Dr. Ward Griffen took the issue of integration with the AGA one step further and recommended that the membership be polled regarding moving the meeting of our Society to coincide with the AGA meeting.
At the 1972 meeting, Dr. Nyhus reported that the poll of the membership showed that eighty percent were strongly in favor of changing the date and location of the meeting to coincide with the AGA in a so-called Digestive Disease Week; accordingly, arrangements for a combined meeting in New York were set for May, 1973.
The combined meeting went exceedingly well and most members enthusiastically supported the motion to continue the arrangement. In October, 1974, six months after the annual meeting, Dr. Robert Zeppa and Dr. Frank Moody were authorized to attend the newly formed Digestive Disease Week Council as representatives of our Society. So it was that Digestive Disease Week came into being.
Four years later, in his presidential address entitled "Cooperation to Meet the Challenges, "(3) Dr. Zeppa reviewed the Society's decision to join Digestive Disease Week Council. He noted that financial benefit and stability came to each of the four societies, namely the AGA, the American Association for the Study of Liver Diseases (AASLD), the American Society for Gastrointestinal Endoscopy (ASGE) and the SSAT; second, attendance at our meeting increased; third, the quality of our program improved; fourth, the educational benefits for our members expanded by the diversity of programs available; and fifth, there was increased accessibility for dialogue, formal and informal, with our medical colleagues. He concluded that the membership was to be congratulated for its wise decision.
More recently we have furthered our relationship with the component societies of DDW by contributing to combined clinical symposiums, organizing a yearly consensus conference, and integrating appropriate oral and poster presentations of our papers into AGA focused research sections and the president's plenary poster session.
The Society's founder, Dr. Robert Turell, in his presidential address, spoke of his dream of creating a research and educational foundation for alimentary surgery. In practical terms, creating a research and educational foundation required the development of an enduring source of funding. The first move in realizing this dream occurred at the Board of Trustees meeting in October, 1985. Dr. Bernard Jaffe, Chairman of the Ad Hoc Committee on Research and Education, recommended that the Board issue a policy statement supporting the development of a two year program for post-residency experience in research and clinical surgery of the digestive tract for the purpose of providing leadership for the discipline in the future. The committee further recommended that the Society sponsor a Career Development Award to support individuals involved in this advanced experience.
The next year, the Society used its share of DDW profits to fund the fellowship. Drs. David Nahrwold and Jaffe worked out the process of application and selection with the understanding that the first award would be given in 1987. The annual award was subsequently increased step wise to its current level of $50,000 per year. The majority of its recipients currently have University appointments and many have ongoing NIH funding. The program has been a tremendous success.
Five decades after Dr. Turell's initial imaginings, the SSAT is a strong organization with a growing membership, strong ties to other disciplines in medicine involved in the study and treatment of digestive diseases, and a commitment to support the next generation of alimentary tract surgeons.
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References
* This history of SSAT was excerpted from the Presidential Address of Tom DeMeester at the 38th Annual Meeting in Washington DC by Richard Bell. The full text can be found in - DeMeester TR. Change, Relationships, and Accountability: Marks of a Vibrant Society. J Gastrointest Surg 1998;2:2-10.
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