HOW I FOUND MY RHYTHM WHEN THE MUSIC STOPPED

At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.

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THE MAN IN A BLUE SARONG

I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.

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PATIENT “OWNERSHIP”

I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.

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issue or a conflict. Taking the best of both sides of the debate, and putting them together collaboratively is an imperative for me. I am simply the facilitator of the activity, not the decider of the outcome.


As that leader however, I recognize that people can’t read my mind and playing “What am I thinking?” doesn’t work. Being assertive but kind and generous goes a long way. Learning to engender trust is powerful and learning to be analytical and responsive is an absolute. Having a sense of humor helps but recognize that what you think is humorous may in fact be an insult to others, particularly if they come from a different background or culture. I am convinced that in many situations, by simply empowering those with whom I am working, I will earn their respect and trust and in turn they serve and contribute in significant and meaningful ways.


I can’t stress how important communication is in accomplishing your goal. During the year that I served as Chair of the AMA Board of Trustees, I was reminded over and over again why it is so important to clarify and make transparent to your members, your partners in a practice or any governing body the work that is being attempted and why. I learned as I traveled around the country meeting with physicians in many venues, the value of articulating the challenge, the methods to manage the challenge and the hoped for outcomes. Is it easy? No. Is it necessary? Yes.


As President of the AMA, I was honored to be able to represent the AMA testifying before members of Congress, in the media, in the states, at national organizations and internationally at the World Medical Association. The respect that physicians receive in the US and across the world is powerful yet humbling because of the responsibilities that we must carry. Being the spokesperson for the AMA is an amazing opportunity for which I am very grateful.


As a President of the AMA I served as an official representative from the United States to the World Medical Association. The WMA is an organization of representatives from 112 countries representing millions of physicians. The WMA was formed in 1947 following World War II and was created to ensure the independence of physicians and to work for the highest standards of ethical behavior by physicians and the care that they provide. Today, the WMA is recognized as the authority in speaking for the doctors of the world on international affairs. The WMA is governed by a Council which is made up of elected representatives from each of the six major regions of the world (Africa, Europe, Latin America, North America and the Pacific). The Council elects its Chair, the position in which I am now serving.


So what do we do? The WMA constitutes a free and open forum for frank discussions of issues related to medical ethics, medical education and the practice of medicine. Our deliberations then provide the evidence and recommendations for physicians to utilize in their own countries. Consider recent debates on the Declaration of Helsinki (research on human subjects), protecting healthcare workers in areas of conflict so that they can provide care to anyone regardless of their politics, and the need to protect data in bio-banks and other research entities, which are just a few of the recent topics on our agenda.


The challenges in leading an organization such as the WMA are significant but nonetheless very gratifying. Different languages, cultures, economies, variability in education and types of practice coupled with procedural knowledge differences add to the extent of the work and the expertise that is required.


Nonetheless, the opportunities are immense and I recognize that there is much to be learned when we share our knowledge and our experiences.


In answering the second part of the question, Yes, I do enjoy the work. It requires commitment and a willingness to be part of an organization that has great potential to make change and make a difference.


I encourage you to take a chance, volunteer to be part of the team and be a part of change.

It is not uncommon for me to be asked “Why do you do this and do you enjoy it?” At the onset of my career in medicine, the idea of being President of the American Medical Association or Chair of Council of the World Medical Association was never a consideration. In fact in those early years, I had very little knowledge about these organizations or what they could accomplish. It was not until the AIDS epidemic and the impact it had on patients and my practice did I recognize that part of my responsibility as a physician was to be engaged in health care in a different way. Through organized medicine I would soon learn that working collaboratively with colleagues of like mind, much could be accomplished. What I learned in the examination room with my patients would eventually propel me to take action to improve health care and the practice of medicine. Assuming a role of advocacy on behalf of patients and medicine is something of great importance and sorely needed in the changing environment of health care today. This is why I do this important work.


In organizations such as the Lexington Medical Society, the Kentucky Medical Association and the American Medical Association, we learn from mentors and learn to appreciate the work of those who have gone before us. The challenges can be many including the time required away from a busy practice or the family, learning to respect the diversity of opinion and recognizing that as a leader you will not have all of the answers. Dealing with variable levels of knowledge about process and procedure, and being challenged along the way by the “politics” of a situation can be stressful. . But I have learned that despite

BY ARDIS D. HOVEN, MD

the challenges, physicians can and do come together to make the right decision, doing what is best for patients, their doctors and the practice of medicine.


Leadership is both a learned and earned opportunity. We all learn by doing and by being engaged in the process where decisions are made and goals identified. Making mistakes is expected and strong mentors who teach and guide are invaluable. Humility is a valued commodity and flexibility is needed when attempting to engage a variety of personalities, many of whom have very strong opinions on a subject. Being respectful, no matter what is proposed or debated, is mandatory, and providing a level playing field for the participants is essential in order to achieve a good result. Congeniality helps as well.


As chair of the AMA Board of Trustees during the year following the passage of The Affordable Care Act, I quickly understood what my position would require in addition to setting agendas and making sure the work of the AMA progressed appropriately. It was during that time that physicians, both inside and outside of the AMA, had become splintered regarding their support or lack thereof of the ACA in which political opinions dominated conversations. I have always believed that diverse and opposing ideas are good for the evaluation and management of an

ARDIS D. HOVEN, MD