In less than two weeks Mike Link of Stanford will be replacing me as President of our organization. He will do a great job: he is an honest, thoughtful, forthright physician whose intelligence and good sense, as well as his unique perspectives as a pediatric oncologist, will add much to our society’s efforts. I will ascend to what one of my predecessors, Rich Schilsky, has called “the best job in ASCO,” namely President Emeritus. Between now and then I still have much to do: the Board of Directors meeting, my Presidential Address (still wrapping it up!), lots of meetings with sister societies, joint sessions, and dinners and receptions galore.

But the end on my year as ASCO President is within hailing distance, so I thought I would share with you some things I’ve learned, in no particular order.

1. The Power of a Volunteer Organization.  Not every member of ASCO is an ASCO volunteer. Many join the organization for its real benefits: a JCO subscription, a break on meeting attendance fees, or access to its many online educational opportunities. Some join out of a sense of obligation to the profession that has nurtured their professional development, and which speaks for them and their patients. There is nothing wrong with any of these reasons for being a member, but it is not the same thing as being an ASCO volunteer. There is a significant core of members who devote enormous hours as well as significant wisdom and expertise. They have never disappointed me. ASCO Presidents tend to abuse their friends first, but I was regularly impressed by the willingness of those I had never met before to step up when called upon, often on very brief notice. We are a volunteer society, and should be proud of it.
2. The Importance of a Great Staff. You may be tired of hearing me talk about this, but it is true: we have an incredibly great staff. They are razor-sharp, hardworking, and believe in the mission of the organization. ASCO headquarters operates in the highly competitive Washington, DC marketplace. Other organizations regularly try and poach from us, because they know how high-quality a team we have. And yet we have very low turnover. Why is that? Great leadership, from Allen Lichter and his executive team, a great work environment, but also a great mission.  How great is the ASCO staff? Well, they put up with me for a year, which must count for something extra when they are standing in front of St. Peter.
3. The Value of Diversity. ASCO’s great strength is its diversity: we represent a lot of people who are working to solve the cancer problem.  As a group they have enormous smarts that we are able to call on. I never had any trouble finding expertise in any area. At our most recent Board of Directors meeting we brought in “outside” support in the areas of health information technology, guidelines development, and quality measurement to help us guide our discussions. Of course, “outside” was actually “inside”: several of the world’s experts in these areas were already actively involved in ASCO. There are of course dangers in being “all things to all people.” We do not have the laser-like focus of some organizations, something I was well aware of when we went up to Capitol Hill. We cannot make all of members happy all of the time, and I am sure that many of our members think that the subgroup they do not belong to gets more attention than is deserved. But I would not have it any other way for ASCO, any more than I would desire to live in a society where everyone looks like me or thinks like me. Oncologic purity has no more charms for me, and all of the disastrous flaws, of ethnic purity or religious conformity. Pretty much the only thing we all agree on is that our cancer patients come first and deserve our best. But that is enough to make us a respected and important voice in the world. Viva diversity!
4. I don’t have a clue whether I was successful as ASCO President. I mean this. I have worked really hard this year on ASCO’s behalf, but I don’t know how things will turn out, which I consider the true measure of success. We face lots of important issues as a Society and as a profession, and I have grappled at some time or another with all of them: funding of cancer care, our federally funded cooperative group system, electronic health records, guidelines development, quality measurements, issues related to healthcare reform, end-of-life care, drug shortages, conflict of interest issues and many others. We are working on important new initiatives, many related to our nascent Quality Department and the Rapid Learning System for Oncology. But it will be years before we know how all this will turn out, and as the great American philosopher Yogi Berra is supposed to have said, “Predictions are hard, especially about the future.” All I know for sure is that I had a fun ride and have tried my best.
5. We are in the middle of several simultaneous revolutions. I started the year as a breast cancer doctor, an academic sub-sub-specialist. I ended the year as much more of a generalist. What has fascinated me the most this past year has been the scientific revolution emerging from the mists. This is largely a series of digital revolutions, related to information technology and to the exploding area of cancer genomics. Watching it all from the 40,000-foot level, I see an emerging pattern that I suspect I would have missed had I been focused on my usual day job. For instance, things are moving very, very fast in cancer genomics and I cannot imagine that it will not have profound effects on all of us in the near future. Not to mention minor things like the Affordable Care Act.
6. I really enjoy blogging. I started blogging very shortly before I became ASCO President, at the request of ASCO staff. It was the first time in my life anyone ever suggested to me that they wanted me to pontificate regularly, after a lifetime of being told I talked too much. On average I have turned out a blog a week. Blogging gets easier the more you blog; you develop a rhythm as you go along. I have received many nice comments from those who read my blogs, and some that have gently chided me for statements made without careful enough thought. I do not know that I will keep up the same pace when I step down as President, but I am thankful to my readers, and (ASCO staff again) to Amy Fries. Amy is the Content Manager for ASCO Connection, and has thrown me many a lifeline in the last year. I am happy to have had this pulpit from which to opine on all sorts of things that interest me, and some of which I hope have interested you.
7. Knowing when to stop a blog is important. They can go on too long.