Starting Off: ASCO as Agora

Starting Off: ASCO as Agora

George W. Sledge, MD, FASCO

May 25, 2010

I’ve made community/connectivity/communications (different words circling around a common theme) one focus of my tenure as President of ASCO. ASCO is a large organization, with a diverse membership, and that membership has many needs and interests. These needs and interests may or may not intersect (e.g., cancer care delivery in the developing world and the average sales price of a new monoclonal antibody in the United States), and in rare cases they may even conflict.

Like all large organizations that attempt to be “all things to all people,” there is the danger that ASCO will fail to satisfy any fully. Many organizations that were once powerful in their own domain have either atomized into smaller groups or dwindled into irrelevance. For those of you who, as I do, love our Society for what it represents and what it does, this is devoutly to be avoided.

We accomplish this by remembering who we are and by deciding where we want to go. The “remembering who we are” part should be straightforward:  we are the professionals who stand up for patients with cancer. We strive to maintain (and, in some cases, create) the infrastructure of cancer care.  We educate the next generation of cancer caregivers and keep the current one up-to-date. We support access to high-quality care for all. We foster prevention. We communicate the role of modern science in furthering cancer care to physicians, to patients, and to the wider society. We forcefully deliver our views to all who will listen.

Deciding “where we want to go” is a joint enterprise, and one which I need your aid in accomplishing. As a profession we face many challenges: challenges to our autonomy as caregivers, a health care system in hyper-evolution, dramatic changes in medical and information technology, and the ever-present financial pressures. We want to be ahead of the curve, not reactive; but to be ahead of the curve you need a clear vision of where you want to go. I’m a bottom-up rather than a top-down guy. I believe that in a civil society the more voices that are heard, the better the decisions that we make: our vision of where we want to go should be a mutual one. 

I’ve been enthralled for quite some time with the ancient Greek agora.The agora was an open-air marketplace that served as a meeting ground for the activities of the polis. It, rather than the Parthenon, was the center of the Athenian democratic experience. ASCO’s headquarters building is not ASCO any more than the Parthenon was the agora: beautiful buildings at best reflect rather than create a society. I believe that if our Society is to continue to thrive and survive, we need to build our own agora, our marketplace of ideas. We need to foster our community by encouraging all to participate. Pericles, the greatest of the Athenian statesmen, said something that resonates: “We do not say that a man who takes no part in public affairs is minding his own business. We say that he has no business here at all.”

There has been a huge increase in communication channels in recent years: new technology, new software, new online communities pop up with amazing frequency. ASCO needs to harness these new channels, but use them in ways that foster our community--or our “community of communities,” perhaps a better way of looking at what we are.

I’ve heard more than one friend lament that their kids will sit next to each other at the dinner table and tweet rather than talk.  Is that amusing or sad? Whatever it is, connectivity isn’t exactly the same thing as community. Creating a community without being a Luddite strikes me as an important part of where we are going. We are working on this, but we need your thoughts.


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Michael Jordan Fisch, MD, MPH, FASCO

Jul, 04 2010 1:38 PM

Deciding "where we want to go" is a great place to focus our attention. We do face many challenges, and I would add to the list the challenge of managing our time. We want our connections and information on a "just-in-time" basis so that we can apply information readily in our daily work. But at the same time many of us our ambivalent about the "price" of connectivity. We deal with the daily influx of so many emails, faxes, pings, etc. that being connected itself can seem overwhelming. My kids keep asking me to join Facebook, but I am holding off, based on my sense that it might heap upon me one more set of tasks that I do not relish (friend requests from distant relatives, Little League parents, long lost pals from elementary school or whatever). I look forward to working together to create an efficient and useful Agora (or set of Agoras) for our benefit and the benefit of our patients.

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