HISTORY OF THE AVAS

Until World War II the Veterans Administration was mostly concerned with pensions, old soldiers’ homes and cemeteries. In 1946 the VA created its Department of Medicine and Surgery to retain, retrain and give research opportunities to physicians leaving military service. Surgeons who took these opportunities found VA hospitals to be ideal settings for controlled, collaborative clinical trials. Collaborators in studies became close friends, inspired one another, and achieved the scientific credibility that drew medical schools to affiliate with VA hospitals in the mid 1950's.

Leading the movement for affiliation and for part-time appointment of faculty was General Carl Hughes. Leading VA research were Drs. John A. Kennedy, Lyndon Lee, Raymond Postlethwait (peptic ulcer studies), Mark Wolcott (coronary artery surgery), Francis Jackson (varices) and George Higgins (cancer chemotherapy). Through their leadership the VA became vital to American medical education and the world’s largest provider and investigator of high- quality hospital care.

In 1964 a group of VA surgeons met for a testimonial dinner on the retirement of Dr. Kennedy. Their enthusiasm led to reunions at Clinical Congresses of the American College of Surgeons, and in 1967 sixty-eight surgeons founded the Association of Veterans Administrations Surgeons. Its purpose then was simply to “Improve patient care, medical education and research in surgery in the Veterans Administration.” Its first president, Dr. Lloyd Rogers, faithfully and lovingly attended and blessed subsequent meetings for over 32 years.

Since 1977 Annual Surgical Symposia have been hosted by urban, university-affiliated VA medical centers. In two-day meetings, VA surgeons or their residents present 30 to 40 scientific papers selected from abstracts submitted to the Program Committee. For ten years papers and discussions were published by the A.M.A. Archives of Surgery. In 1992, because most papers described basic research, publication was moved to the Journal of Surgical Research. At each meeting prizes are given to residents for the best clinical or the best research papers. A Distinguished Service Award is often given to a VA surgeon, and thirteen eminent American Surgeons supportive of the VA have been elected Honorary Members.

Members of the Association continue to design or participate in authoritative cooperative studies, such as those of ascites, reflux esophagitis, heart valves, carotid stenosis and small abdominal aneurysms. A very important study has been of surgical risk assessment that led to the National Surgical Quality Improvement Program in which all VA surgical services participate. Studies such as this are possible only in the VA. They have helped sustain surgical excellence during years in which funding for basic research declined and the Department of Veterans Affairs shifted its priority from hospital to ambulatory, preventive care.

The AVAS is a non-profit, non-political educational organization. It refrains from lobbying Congress, but its opinions on managing the VA are communicated to Central Office or headquarters by its members of the Surgical Field Advisory Group. Thus to its constitutional objective has been added “to provide a forum for discussion of issues of concern to the membership and formulation of an organized representation of them.” Discussions are sometimes long and heated but never so hopeless as to outweigh the optimism of the scientific program or the encouraging companionship of idealistic VA surgeons.

Hunter McGuire, M.D., Archivist
Richmond, VA