George S. M. Cowan, Jr.

1990-91 ASMBS President

Most Important Event

The NIH Consensus Conference, and the publication of Obesity Surgery journal – both of which impacted the field of bariatric surgery but in different time frames.

It is most interesting that ”most important” does not provide a time reference, i.e. then (being the year of my ASMBS Presidency) or NOW, the present. Therefore, please allow me to submit one for each of the two time-frames.

The most important event during the year of my ASBS (latterly ASMBS) Presidency actually consisted of TWO (2) “most important” events which are:

  1. The NIH Consensus Conference
  2. Publication of the Obesity Surgery journal

As I’m sure you will agree, these both are “most important” events; the order of importance is subjective although I imagine that you will likely support #1 which, during that year, was undoubtedly “most important.” However, the influence of #1 has been fading as it has become progressively outdated, while #2 is still going strong and is likely to persist, and to surpass #1, if it has not already, in its influence and importance internationally and nationally in decades to come. #2′s impressive, fairly consistent, ranking ahead of most other surgery journals over the years also attests to the importance of its establishment as of now.

To the best of my recollection, my year as ASBS President also included our calling the first formal meeting of the ASBS’s Allied Health Committee, first Chair Georgeann Mallory. As you know, it has developed into an outstanding and essential entity with superb contributions both to ASBS and our field. After Georgeann assumed her current position, Marylou Wallen became chair for years with her extremely fine contributions to development of the group, as stated, followed by a series of excellent chairs to the present as well.

Also, during the same year as President, recall calculating that our ASBS membership was about 95% private, 5% academic bariatric surgeons the latter of which only gradually increased with the years.

Until the founding of Obesity Surgery journal, there were some presentations which seemed to repeat themselves, or nearly so as to hardly notice a difference, at each ASBS annual meeting. After the authors’ presented papers were published, this, of course, stopped for obvious reasons, another, albeit somewhat more subtle, and decidedly laudable, benefit of the journal!

Since, unfortunately, our John Halverson is unable to contribute, I would suggest that you might want to include for his year, if you haven’t already, that he set up our having our first annual ASBS meeting OUTSIDE OF Iowa during his year as President. He proudly stated to me that it was “our coming of age and a declaration of independence” with considerable pride and justification. He qualified this by saying that he did not mean this statement as anything negative as to our Iowa origins or Ed Mason’s excellent, highly dedicated, work at founding our ASBS but, rather, a major step forward of, and one might say, a quite significant step in the maturation of our organization.

Our dear Father of Obesity Surgery Ed Mason remarked a number of times that our organization was primarily an educational one and NOT meant, in any way, even remotely, as regulatory. However, with time and some adverse occurrences with untrained general surgeons performing bariatric surgery, the IFSO produced the first what one could call regulatory document, the Cancun Statement. After bringing it to our first ASBS Executive Meeting, and taking a bit of heat for it, especially from John Kral, he and some others modified the Cancun Statement and produced our own somewhat similar ASBS one which, after adoption, to the best of my knowledge, like the Cancun Statement, still remains. Admittedly, it has been overtaken by events and essentially superseded but its principles still very much apply.

As our ASBS Founding was announced at our 1983 meeting, many (indeed most) of us were rather surprised and, of course, quite delighted; we all knew an organization was in the works but did not expect it for perhaps another year or so. It was, therefore, quite surprising and typical of the kindness and generosity of our Founder Ed Mason that he announced that we were ALL included as Founding Members of our ASBS, whether we had anything to do directly with the ASBS’ actual founding other than being at the founding meeting as an attendee.

Believe that it was during my year as President that the ASBS Executive developed the “doctrine” that we would try to seek to have an alternation of Private- and Academic -based nominees for ASBS President in order to assure an equitable support for each of our membership group’s needs/priorities.

Recall that Con Doherty’s year as ASBS President #4 was for one year instead of the previous two-year terms; this has continued to the present. There appear to have been some good reasons for this which seemed to at least include: (1) give more members a chance to be President; (2) most of major effort/changes/ideas seemed to come in the first of the two years as President; (3) two, as opposed to one, year of time distracted from one’s practice and personal life in leading the ASBS was a lot to ask/expect. Also, several years ago, an ASBS President calculated his number in Presidential succession as the difference between 1983 and the year of his Presidency, which, of course, was, to his surprise, too high due to the initial two-year ASBS Presidential terms of which he apparently was not aware.

I had the opportunity and pleasure to organize and direct a series of thirteen Masters Courses in Bariatric Surgery at our ASBS Annual Meetings; developed debates about aspects of bariatric surgery as part of many of these Courses, which were the first that continue to be held in our field by ASBS, IFSO and others.

George S. M. Cowan, Jr., MD