- Email: [email protected]
History of the North Pacific Surgical Association
PRESIDENTIAL ADDRESS
History of the North Pacific Surgical Association Philip C. Jolly,
he North Pacific Surgical Association has a unique heritage from which strong traditions have develT oped. The scientific program and the collegial atmosphere that this association has provided are what bring us together each fall, and have so for the past 78 years, with the exception of the two war years of 1944 and 1945. I would like to trace the history of this great organization pointing out important milestones, a few humorous anecdotes, and some suggestions for the future. The North Pacific Surgical Association is the oldest regional surgical society west of the Mississippi. Having been founded in 1912, it antedates the Pacific Coast Surgical Association by 13 years. By 19 12, the major centers of surgery in the Northwest were Portland, Tacoma, Seattle, Vancouver, Victoria, and Spokane. The highway and railroad networks in the region were advanced sufficiently to permit travel between cities. On March 9, 1912, Dr. Kenneth A.J. MacKenzie called together 23 of the leading surgeons from the 6 cities to an organizational meeting at the Arlington Club in Portland. At this meeting, Dr. MacKenzie was elected president and appointed a committee of three, including himself, to write the constitution. The bylaws were written by three Portland surgeons also appointed by Dr. MacKenzie. A second organizational meeting was held at the Arctic Club in Seattle on May 4, 1912. At this time, 20 of the charter members subscribed to the constitution. Charter membership was subsequently increased to 36. Each charter member signed the preamble to the constitution. Prominent in this preamble was a prohibition against fee-splitting. This paragraph was dropped from the constitution in 1960 because it was no longer needed after the American College of Surgeons had taken a strong stand against this practice. The Association’s stand on this issue far antedated the College’s position. Dr. Kenneth A.J. MacKenzie, the driving force behind the founding of the Association, was born in Saskatchewan and attended McGill Medical School where he studied under Osler. After graduation, he spent 16 months visiting the centers of medical excellence in Scotland and Europe. He was persuaded by his father, a high official in the Hudson Bay Company, to emigrate to Portland, Oregon in 1882, where a family friend lived. He established a successful practice and was active in the formation of the University of Oregon Medical School in 1887. He became Chief of Surgery at St. Vincent’s Hospital in 1907 and Dean of the Medical School in 1912. In addition to creating a regional organization with an From the Department of Surgery, The Virginia Mason Clinic, Seattle, Washington. Requests for reprints should be addressed to Philip C. Jolly, MD, The Virginia Mason Clinic, 1100 Ninth Avenue, Seattle, Washington 98101. Presented at the 77th Annual Meeting of the North Pacific Surgical Association, Seattle, Washington, November 9-10, 1990.
542
THE AMERICAN JOURNAL OF SURGERY
MD, Seattle, Washington
international flavor, Dr. MacKenzie and the other founding members wished to create an academic environment. One of the first amendments to the constitution in 1913 was the requirement that a surgeon must have published two papers in order to quality for membership. In order to retain his membership, a surgeon was required to attend as a minimum every third meeting and to present a paper before the society every third year. Subsequently this requirement has been modified to allow credit for submitting a paper, even though it might not be accepted, and the time interval was changed to every fourth year. Membership in the organization was restricted to surgeons practicing in the states of Oregon and Washington and in the province of British Columbia. Active members were limited to 60 in number. After 10 years of active membership, a surgeon was eligible for senior fellowship. An application to the Council was required; senior status was not conferred automatically. Since most members did not choose senior status, by the mid-l 920s the waiting list for active membership numbered 25, and senior status was made mandatory after 15 years as an active member or at age 60 in order to accommodate more new members. The first scientific meeting was held in Vancouver with Dr. MacKenzie, the Canadian from Portland, as president. Subsequent meetings have always been held in the president’s home city. After Dr. MacKenzie’s death in 1922, the Association donated $460 toward the cost of his memorial. In 1924, at the meeting in Portland, 45 of 55 active members of the Association attended the meeting for the dedication of the Kenneth A.J. MacKenzie Memorial at the University of Oregon Medical School. This was the largest attendance of any meeting and was a tribute to the high esteem with which Dr. MacKenzie was regarded by surgeons in the region. It was rumored that his middle initials stood for “Almost Jesus Christ.” The constitutional requirements for meeting attendance and presentation of papers have generally been enforced. There are numerous instances over the years of surgeons being dropped from the active roster because of failure to participate in the scientific program or to attend the meetings. In 1926, because of a perceived shortage of Canadian members, the constitutional requirement of two published papers for new members was temporarily suspended. The constitution has been amended over the years to increase gradually the number of active members to the current level of 135. The current order of rotation of the meeting sites between the six cities has been maintained since 1927. The 1923 meeting, which had been scheduled for Victoria, was moved to Seattle because there was only one active member from Victoria at the time. Although the constitution did not specify a set rotation between cities, this was apparently the intention of the founders from the beginning. There was a great furor caused by the change
VOLUME 161 MAY 1991
PRESIDENTIAL ADDRESS
in meeting site, and a proposal to limit the meeting places to the three major cities was defeated. In the early years, the fellows from each city often traveled to the meeting as a group by chartered railway car. During the war years of 1944 and 1945, meetings were not held. In 1942, a letter from Dr. Joel Baker to the secretary, Dr. William Wilson, stated that he could not prepare a paper because of the imminent departure of his partner, Dr. Cal Stone, for the Army, and because a shortage of residents had increased his duties. In the characteristic Baker postscript, he suggested that the meeting be cancelled. His advice was finally taken 2 years later. There was a feeling in the late 1920s that the scientific meetings had become too similar. A proposal was made that a $500 prize be given to the author of the best paper in the American or Canadian surgical literature each year, and that this person be invited to lecture before the organization in the year following. This proposal was defeated; however, in 1928 the Council was authorized to provide expenses for a guest speaker. This was initially called the North Pacific Surgical Association Lectureship, and Dr. Emmett Ricksford of San Francisco was invited as the first lecturer in 1929. In 1937, the guest speaker was first referred to as the Founders’ Lecturer, and this custom has continued. Astute financial management of its funds has usually been a hallmark of the Association. The annual dues were set originally in 19 12 at $10 a year and the initiation fee at $25. In 1917, there were surplus funds available and provisions were made for a financial trustee. The duty of this trustee was to invest surplus funds that were not needed for the operation of the organization and for the cost of meetings. The operational funds remained in the hands of the secretary-treasurer. Surplus funds were invested in interest-bearing notes and bonds. In 1929, a City of Antwerp, Belgium, General Obligation Bond was purchased for $995, which subsequently became almost worthless after Hitler’s invasion of Europe. Twenty shares of Marine Bank Corporation stock were obtained in 1934 for $665. This bank became the National Bank of Commerce, then the Rainier National Bank, and was finally acquired by a California bank, Security Pacific. The value of these shares increased over the years to $2,200 in 1960 and $4,650 in 1970. Half the shares were sold in 1986 for $14,328, and the money was invested in time deposits. The value of the remaining shares reached $28,800 last year and subsequently has declined to about $11,000. The financial councillor was dropped in 1948, and provisions were made for a Canadian councillor to collect the dues and initiation fees from Canadian members. These funds were to be used to defray meeting expenses held in Canada. Collection of dues by the Canadian councillor was discontinued in 1969, and the secretary-treasurer was asked to collect all dues. In 1950, a mandatory meeting registraion fee of $10 was imposed. Prior to this, the meetings had all been financed from the dues and investments of surplus funds. During the 1950s the reserves of the organization were gradually depleted, reTHE AMERICAN
Vancouver 54
Spokane 8
24%
I
3.5%
68
I
Figure 1. Distribution of papers by district, 1980 to 1989.
Tacoma
9% Portland 25 5% 29.9
Vancouver 26.3
22%
Spokane 9.1 Victoria 4.2
8%
4
Seattle 32% 37.6
Figure2. Distribution of active members by district, 1980 to 1989.
quiring the first dues increase in 1960 to $20. In order to cover the increasing costs of meetings and publication of the papers, the dues were increased during the 1970s to $30 for senior members and $60 for active members. Senior members were first asked to pay dues in 1978. In 1990, the dues were set at $60 for senior members and $120 for active members. The distribution of membership between the six cities in Washington, Oregon, and British Columbia has always been a contentious issue for the Council. Candidates for membership were to be selected at the individual district meetings and submitted to the Council by the district councillor. In the old bylaws, the district councillor was never defined. No provision was made that there should be a councillor from each district, although this was the practice followed. The Council made the final nomination of candidates for membership, and election by the members occurred at the annual business meeting. The number of physicians in each of the six cities in the American Medical Association Directory was used as the reference point by the Council for many years. Seattle and Portland, each with about 30% of the membership in the region, would have a similar proportion of active members. The Council adhered closely to these quotas for several decades. Historically, and in recent years, most of the qualified candidates for membership have come from the three larger district cities of Vancouver, Seattle, and Portland. JOURNAL OF SURGERY
VOLUME
161
MAY 1991
543
These three cities have larger numbers of surgeons. In addition, more surgeons in these cities are likely to be qualified because of affiliation with medical schools. One way of judging the relative contributions of the six cities to the scientific program is to count the number of papers presented at the meeting from each district (Figure 1) and compare this number with the percentage of members from each district (Figure 2). By this criteria, 10% of the papers presented at the meetings over the past 10 years have come from the three smaller district cities, compared with 21% of the membership during this same period. Since each district is equally represented in the Council, it is usually easier for a minimally qualified surgeon from a smaller district to attain membership than for a more highly qualified candidate from a larger district. Many highly qualified surgeons from the larger cities have their membership delayed, whereas the smaller districts often have difficulty finding qualified and interested candidates. The Council continues to struggle with the issue of distribution of membership. Should the Council place an increased emphasis on academic qualifications and less emphasis on location of practice? The collegial relationship of the more academic surgeons from the medical schools and institutions in the larger cities with the less academically inclined, but clinically active, surgeons from the smaller cities may be one of the key ingredients of our success. New concepts of surgery such as laparoscopic cholecystectomy have been developed away from the academic centers. In addition, academic qualifications do not always equate with clinical excellence, Some of the pressure for membership coming from the larger districts has been alleviated by increasing the number of active members to 135. The major thrusts of our organization are the scientific program and the collegial relationships encouraged by the meeting format. We should enhance the scientific program by offering membership to academically qualified surgeons who will produce papers. It is important also to attract the best clinical surgeons from the region whether they come from large or small communities. Publication of papers presented at the scientific sessions has always been emphasized. The original bylaws of 19 12 made provision for a recorder. The talks were recorded by a stenographer. In the early years, the Association published its own transactions. The Western Journal of Surgery, Gynecology, and Obstetrics was designated as the official organ of publication in 1952. There was no requirement for publication, and members were not required to subscribe to the journal. In 1962, the bylaws were changed, requiring papers to be submitted in a form suitable for publication. Dr. Eric Sanderson was the surgical editor of the journal and sought to strengthen its ties to the Association. Despite his influence, only a few of the Association papers were published each year. The members of the Council were not satisfied with
544
THE AMERICAN JOURNAL OFSURGERY
the limited, regional circulation of the Western Journal and asked the recorder, Dr. Earl Lasher, to arrange a publication agreement with a journal of national scope. Negotiations with the American Journal of Surgery were unsuccessful. Finally, in 1964 Dr. Lasher was able to negotiate an agreement with Dr. Arlie Mansperger for publication of the association’s papers in the American Surgeon. Early dissatisfactions with the editorial policies of the journal were assuaged by naming Dr. Lasher as an associate editor responsible for reviewing the association papers. The American Surgeon remained the official publishing organ for 15 years. Senior and active fellows received subscriptions to the Journal paid by the association. Despite the efforts of Dr. Leonard Fratkin, the Recorder, to improve relationships with the American Surgeon, many were not satisfied and believed that an agreement should be secured with a journal of wider circulation. Many papers were being presented elsewhere in order that publication would occur in journals with a larger circulation. In 1980, Dr. Mark Vetto, the Recorder, reached an agreement with Dr. Robert Zollinger specifying that the association papers would be published in The American Journal of Surgery. Dr. Hiram Polk became editor in 1985 and has maintained a close relationship with our association through the efforts of our able Recorders, Dr. William Fletcher and Dr. Richard Anderson. The American College of Surgeons was petitioned in 1964 for a Governor to represent the Association. This request was granted in 1965. Three members were nominated, as is the custom, and the college selected Dr. Eric Sanderson as the first governor. A number of positive moves were made by the Council during the decade of the 1980s that in my opinion have greatly strengthened our association. The first was the agreement with The American Journal of Surgery for publication of the association papers after an editorial review including our Recorder. A second key move was the first extensive revision of the constitution and bylaws to accurately reflect the traditional manner in which the Association had operated for over 70 years and to provide for legal incorporation in 1985. We are indebted to Dr. Richard Anderson, with the assistance of Stan Tuell and Ed Kanar, for this effort. Next, we are indebted to Dr. William Fletcher for developing a properly organized, formal program committee. Early publication of a preliminary program has been an offshoot of this effort. The proper marriage of tradition and change is difficult for any institution to achieve. I believe our organization is achieving this goal of blending tradition with appropriate change. It is well positioned to continue its leadership role as the premier surgical organization in the Northwest. I am confident that the programs are in place that will lead us into the next century. Those who follow in the leadership of our association will find new ways to strengthen the organization while maintaining its academic excellence and collegial atmosphere.
VOLUME 161
MAY 1991
History of the North Pacific Surgical Association Philip C. Jolly,
he North Pacific Surgical Association has a unique heritage from which strong traditions have develT oped. The scientific program and the collegial atmosphere that this association has provided are what bring us together each fall, and have so for the past 78 years, with the exception of the two war years of 1944 and 1945. I would like to trace the history of this great organization pointing out important milestones, a few humorous anecdotes, and some suggestions for the future. The North Pacific Surgical Association is the oldest regional surgical society west of the Mississippi. Having been founded in 1912, it antedates the Pacific Coast Surgical Association by 13 years. By 19 12, the major centers of surgery in the Northwest were Portland, Tacoma, Seattle, Vancouver, Victoria, and Spokane. The highway and railroad networks in the region were advanced sufficiently to permit travel between cities. On March 9, 1912, Dr. Kenneth A.J. MacKenzie called together 23 of the leading surgeons from the 6 cities to an organizational meeting at the Arlington Club in Portland. At this meeting, Dr. MacKenzie was elected president and appointed a committee of three, including himself, to write the constitution. The bylaws were written by three Portland surgeons also appointed by Dr. MacKenzie. A second organizational meeting was held at the Arctic Club in Seattle on May 4, 1912. At this time, 20 of the charter members subscribed to the constitution. Charter membership was subsequently increased to 36. Each charter member signed the preamble to the constitution. Prominent in this preamble was a prohibition against fee-splitting. This paragraph was dropped from the constitution in 1960 because it was no longer needed after the American College of Surgeons had taken a strong stand against this practice. The Association’s stand on this issue far antedated the College’s position. Dr. Kenneth A.J. MacKenzie, the driving force behind the founding of the Association, was born in Saskatchewan and attended McGill Medical School where he studied under Osler. After graduation, he spent 16 months visiting the centers of medical excellence in Scotland and Europe. He was persuaded by his father, a high official in the Hudson Bay Company, to emigrate to Portland, Oregon in 1882, where a family friend lived. He established a successful practice and was active in the formation of the University of Oregon Medical School in 1887. He became Chief of Surgery at St. Vincent’s Hospital in 1907 and Dean of the Medical School in 1912. In addition to creating a regional organization with an From the Department of Surgery, The Virginia Mason Clinic, Seattle, Washington. Requests for reprints should be addressed to Philip C. Jolly, MD, The Virginia Mason Clinic, 1100 Ninth Avenue, Seattle, Washington 98101. Presented at the 77th Annual Meeting of the North Pacific Surgical Association, Seattle, Washington, November 9-10, 1990.
542
THE AMERICAN JOURNAL OF SURGERY
MD, Seattle, Washington
international flavor, Dr. MacKenzie and the other founding members wished to create an academic environment. One of the first amendments to the constitution in 1913 was the requirement that a surgeon must have published two papers in order to quality for membership. In order to retain his membership, a surgeon was required to attend as a minimum every third meeting and to present a paper before the society every third year. Subsequently this requirement has been modified to allow credit for submitting a paper, even though it might not be accepted, and the time interval was changed to every fourth year. Membership in the organization was restricted to surgeons practicing in the states of Oregon and Washington and in the province of British Columbia. Active members were limited to 60 in number. After 10 years of active membership, a surgeon was eligible for senior fellowship. An application to the Council was required; senior status was not conferred automatically. Since most members did not choose senior status, by the mid-l 920s the waiting list for active membership numbered 25, and senior status was made mandatory after 15 years as an active member or at age 60 in order to accommodate more new members. The first scientific meeting was held in Vancouver with Dr. MacKenzie, the Canadian from Portland, as president. Subsequent meetings have always been held in the president’s home city. After Dr. MacKenzie’s death in 1922, the Association donated $460 toward the cost of his memorial. In 1924, at the meeting in Portland, 45 of 55 active members of the Association attended the meeting for the dedication of the Kenneth A.J. MacKenzie Memorial at the University of Oregon Medical School. This was the largest attendance of any meeting and was a tribute to the high esteem with which Dr. MacKenzie was regarded by surgeons in the region. It was rumored that his middle initials stood for “Almost Jesus Christ.” The constitutional requirements for meeting attendance and presentation of papers have generally been enforced. There are numerous instances over the years of surgeons being dropped from the active roster because of failure to participate in the scientific program or to attend the meetings. In 1926, because of a perceived shortage of Canadian members, the constitutional requirement of two published papers for new members was temporarily suspended. The constitution has been amended over the years to increase gradually the number of active members to the current level of 135. The current order of rotation of the meeting sites between the six cities has been maintained since 1927. The 1923 meeting, which had been scheduled for Victoria, was moved to Seattle because there was only one active member from Victoria at the time. Although the constitution did not specify a set rotation between cities, this was apparently the intention of the founders from the beginning. There was a great furor caused by the change
VOLUME 161 MAY 1991
PRESIDENTIAL ADDRESS
in meeting site, and a proposal to limit the meeting places to the three major cities was defeated. In the early years, the fellows from each city often traveled to the meeting as a group by chartered railway car. During the war years of 1944 and 1945, meetings were not held. In 1942, a letter from Dr. Joel Baker to the secretary, Dr. William Wilson, stated that he could not prepare a paper because of the imminent departure of his partner, Dr. Cal Stone, for the Army, and because a shortage of residents had increased his duties. In the characteristic Baker postscript, he suggested that the meeting be cancelled. His advice was finally taken 2 years later. There was a feeling in the late 1920s that the scientific meetings had become too similar. A proposal was made that a $500 prize be given to the author of the best paper in the American or Canadian surgical literature each year, and that this person be invited to lecture before the organization in the year following. This proposal was defeated; however, in 1928 the Council was authorized to provide expenses for a guest speaker. This was initially called the North Pacific Surgical Association Lectureship, and Dr. Emmett Ricksford of San Francisco was invited as the first lecturer in 1929. In 1937, the guest speaker was first referred to as the Founders’ Lecturer, and this custom has continued. Astute financial management of its funds has usually been a hallmark of the Association. The annual dues were set originally in 19 12 at $10 a year and the initiation fee at $25. In 1917, there were surplus funds available and provisions were made for a financial trustee. The duty of this trustee was to invest surplus funds that were not needed for the operation of the organization and for the cost of meetings. The operational funds remained in the hands of the secretary-treasurer. Surplus funds were invested in interest-bearing notes and bonds. In 1929, a City of Antwerp, Belgium, General Obligation Bond was purchased for $995, which subsequently became almost worthless after Hitler’s invasion of Europe. Twenty shares of Marine Bank Corporation stock were obtained in 1934 for $665. This bank became the National Bank of Commerce, then the Rainier National Bank, and was finally acquired by a California bank, Security Pacific. The value of these shares increased over the years to $2,200 in 1960 and $4,650 in 1970. Half the shares were sold in 1986 for $14,328, and the money was invested in time deposits. The value of the remaining shares reached $28,800 last year and subsequently has declined to about $11,000. The financial councillor was dropped in 1948, and provisions were made for a Canadian councillor to collect the dues and initiation fees from Canadian members. These funds were to be used to defray meeting expenses held in Canada. Collection of dues by the Canadian councillor was discontinued in 1969, and the secretary-treasurer was asked to collect all dues. In 1950, a mandatory meeting registraion fee of $10 was imposed. Prior to this, the meetings had all been financed from the dues and investments of surplus funds. During the 1950s the reserves of the organization were gradually depleted, reTHE AMERICAN
Vancouver 54
Spokane 8
24%
I
3.5%
68
I
Figure 1. Distribution of papers by district, 1980 to 1989.
Tacoma
9% Portland 25 5% 29.9
Vancouver 26.3
22%
Spokane 9.1 Victoria 4.2
8%
4
Seattle 32% 37.6
Figure2. Distribution of active members by district, 1980 to 1989.
quiring the first dues increase in 1960 to $20. In order to cover the increasing costs of meetings and publication of the papers, the dues were increased during the 1970s to $30 for senior members and $60 for active members. Senior members were first asked to pay dues in 1978. In 1990, the dues were set at $60 for senior members and $120 for active members. The distribution of membership between the six cities in Washington, Oregon, and British Columbia has always been a contentious issue for the Council. Candidates for membership were to be selected at the individual district meetings and submitted to the Council by the district councillor. In the old bylaws, the district councillor was never defined. No provision was made that there should be a councillor from each district, although this was the practice followed. The Council made the final nomination of candidates for membership, and election by the members occurred at the annual business meeting. The number of physicians in each of the six cities in the American Medical Association Directory was used as the reference point by the Council for many years. Seattle and Portland, each with about 30% of the membership in the region, would have a similar proportion of active members. The Council adhered closely to these quotas for several decades. Historically, and in recent years, most of the qualified candidates for membership have come from the three larger district cities of Vancouver, Seattle, and Portland. JOURNAL OF SURGERY
VOLUME
161
MAY 1991
543
These three cities have larger numbers of surgeons. In addition, more surgeons in these cities are likely to be qualified because of affiliation with medical schools. One way of judging the relative contributions of the six cities to the scientific program is to count the number of papers presented at the meeting from each district (Figure 1) and compare this number with the percentage of members from each district (Figure 2). By this criteria, 10% of the papers presented at the meetings over the past 10 years have come from the three smaller district cities, compared with 21% of the membership during this same period. Since each district is equally represented in the Council, it is usually easier for a minimally qualified surgeon from a smaller district to attain membership than for a more highly qualified candidate from a larger district. Many highly qualified surgeons from the larger cities have their membership delayed, whereas the smaller districts often have difficulty finding qualified and interested candidates. The Council continues to struggle with the issue of distribution of membership. Should the Council place an increased emphasis on academic qualifications and less emphasis on location of practice? The collegial relationship of the more academic surgeons from the medical schools and institutions in the larger cities with the less academically inclined, but clinically active, surgeons from the smaller cities may be one of the key ingredients of our success. New concepts of surgery such as laparoscopic cholecystectomy have been developed away from the academic centers. In addition, academic qualifications do not always equate with clinical excellence, Some of the pressure for membership coming from the larger districts has been alleviated by increasing the number of active members to 135. The major thrusts of our organization are the scientific program and the collegial relationships encouraged by the meeting format. We should enhance the scientific program by offering membership to academically qualified surgeons who will produce papers. It is important also to attract the best clinical surgeons from the region whether they come from large or small communities. Publication of papers presented at the scientific sessions has always been emphasized. The original bylaws of 19 12 made provision for a recorder. The talks were recorded by a stenographer. In the early years, the Association published its own transactions. The Western Journal of Surgery, Gynecology, and Obstetrics was designated as the official organ of publication in 1952. There was no requirement for publication, and members were not required to subscribe to the journal. In 1962, the bylaws were changed, requiring papers to be submitted in a form suitable for publication. Dr. Eric Sanderson was the surgical editor of the journal and sought to strengthen its ties to the Association. Despite his influence, only a few of the Association papers were published each year. The members of the Council were not satisfied with
544
THE AMERICAN JOURNAL OFSURGERY
the limited, regional circulation of the Western Journal and asked the recorder, Dr. Earl Lasher, to arrange a publication agreement with a journal of national scope. Negotiations with the American Journal of Surgery were unsuccessful. Finally, in 1964 Dr. Lasher was able to negotiate an agreement with Dr. Arlie Mansperger for publication of the association’s papers in the American Surgeon. Early dissatisfactions with the editorial policies of the journal were assuaged by naming Dr. Lasher as an associate editor responsible for reviewing the association papers. The American Surgeon remained the official publishing organ for 15 years. Senior and active fellows received subscriptions to the Journal paid by the association. Despite the efforts of Dr. Leonard Fratkin, the Recorder, to improve relationships with the American Surgeon, many were not satisfied and believed that an agreement should be secured with a journal of wider circulation. Many papers were being presented elsewhere in order that publication would occur in journals with a larger circulation. In 1980, Dr. Mark Vetto, the Recorder, reached an agreement with Dr. Robert Zollinger specifying that the association papers would be published in The American Journal of Surgery. Dr. Hiram Polk became editor in 1985 and has maintained a close relationship with our association through the efforts of our able Recorders, Dr. William Fletcher and Dr. Richard Anderson. The American College of Surgeons was petitioned in 1964 for a Governor to represent the Association. This request was granted in 1965. Three members were nominated, as is the custom, and the college selected Dr. Eric Sanderson as the first governor. A number of positive moves were made by the Council during the decade of the 1980s that in my opinion have greatly strengthened our association. The first was the agreement with The American Journal of Surgery for publication of the association papers after an editorial review including our Recorder. A second key move was the first extensive revision of the constitution and bylaws to accurately reflect the traditional manner in which the Association had operated for over 70 years and to provide for legal incorporation in 1985. We are indebted to Dr. Richard Anderson, with the assistance of Stan Tuell and Ed Kanar, for this effort. Next, we are indebted to Dr. William Fletcher for developing a properly organized, formal program committee. Early publication of a preliminary program has been an offshoot of this effort. The proper marriage of tradition and change is difficult for any institution to achieve. I believe our organization is achieving this goal of blending tradition with appropriate change. It is well positioned to continue its leadership role as the premier surgical organization in the Northwest. I am confident that the programs are in place that will lead us into the next century. Those who follow in the leadership of our association will find new ways to strengthen the organization while maintaining its academic excellence and collegial atmosphere.
VOLUME 161
MAY 1991