Lisa M. Hollier, MD, MPH, FACOG, became ACOG’s 69th president Sunday morning during the Presidential Inauguration and Convocation. Here is her speech from the inauguration.
Good morning Fellows, Junior Fellows, medical students, distinguished guests, family and friends. Thank you for joining us here today.
Thank you Dr. Brown for leading such an outstanding meeting. Your friendship over the last 15 years has meant so much.
Allow me to introduce my escorts. Mary Behneman is special to me. She is the person who answered my first phone call to ACOG and with such kindness and efficiency, she connected me with the pathway to leadership. We are fortunate that she has chosen to devote her career to ACOG—she is a tremendous resource for all of us.
Dr. James N. Martin, ACOG past president. Jim has been a mentor to me for many years. I called on him often for advice about leadership struggles or how to balance my responsibilities of clinical care and ACOG and he always answered with patience and insight.
Dr. Gerald Joseph, ACOG past president, became my mentor when I was a medical student. Throughout my career, he believed in me and provided me with opportunities and skills that allowed me to lead. I am forever in his debt.
Pam Promecene has been my dearest friend and running partner for more than 20 years. She is an amazing, thoughtful, and intelligent woman, and I am grateful to have her in my life.
I am appreciative to have my family and friends in the audience today. Please stand as I call your names. My husband, Larry. I am fortunate to have such a caring and supportive spouse. Despite all his own professional accomplishments and responsibilities, he has always made extra time for me. He is an incredible father, and we are blessed to have a son who is also quite accomplished. Pierce is not here with us because he is a nationally ranked debater and is competing in the High School Debate Tournament of Champions today. My father, Reynold Ericksen, has always been an incredible inspiration. When I was a little girl, he always encouraged me that I could do anything or be anything that I wanted to be. My in-laws, Diana and Dr. Larry Hollier, are here today. Dr. Erica Giwa and Dr. Faunda Armstrong are here today along with many of the physicians in the Center for Children and Women. I could not be here without their support! A special thank you to Mr. Lou Fragoso, president of our Health Plan, for supporting me in this incredible opportunity.
My first official action as your new president is to formally thank our now past president, Dr. Haywood Brown, would you please return to the podium?
Haywood, Thank you for all you have done and will continue to do for ACOG.
Please wear this past president’s medallion as a token of our appreciation.
Dr. Brown, thank you for all your years of service, your forward thinking, and your guidance.
You will be missed.
Bienvenedos! Bienvenue! Welcome! It is an honor to welcome our new members of the American College of Obstetricians and Gynecologists. Over the next year, it will be my privilege to work with you and our 58,000 members to achieve the mission of our College: The advancement of women’s health care and the professional and socioeconomic interests of our members through continuing medical education, practice, research, and advocacy. ACOG is a strong organization because of you. Our collective energy, particularly when combined across women’s health organizations, means we can meet challenges head on and drive to meaningful solutions!
I remember sitting in the audience just as you are today, filled with excitement and promise. You have chosen a most amazing field. Our specialty has the opportunity for lifelong care of women. Each day, women come to us in their most vulnerable moments, and each day, we alleviate their suffering. With our knowledge and our dedication, we can and we do change women’s lives everyday.
Just six years ago in London, Professor Mahmoud Fathalla, a past FIGO President, addressed a crowd gathered for the 25th anniversary of the launch of the International Safe Motherhood Initiative. He recounted the past and the tremendous progress that had been made, but felt that the agenda was unfinished. He spoke about one challenge, which remains—a challenge to investment, in investing in what it takes to eliminate the tragedy of maternal deaths. “The tragedy of maternal mortality”, he said, “is now a question of how much the life of a mother and a woman is considered worth. Mothers are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.”
While he was speaking primarily of developing nations, recent trends in the United States point to a broader concern.
After hundreds of years of declining maternal mortality, rates in the United States are rising again, with the frequency of severe maternal complications increasing in parallel.
Dramatic disparities in access and outcomes are widening, too. African American women are 2-4 times more likely to die of causes related to pregnancy than are Caucasian women.
Maternal mortality rates among our indigenous women are higher: Native American and Pacific Islander in the United States, First Nation and Inuit women in Canada, and indigenous women throughout Mexico—all are at higher risk.
Before we can reduce maternal mortality, before we can achieve meaningful improvements in women’s health outcomes, our societies must decide that women’s lives are worth saving. Women’s lives MUST be a priority.
In the last century, the United States has experienced dramatic improvements in health care services: Advanced imaging techniques, genomic-based diagnosis, and minimally invasive surgery.
The average life expectancy of an American woman is now 81 years, compared to 48 years in 1900.
However, the prevalence of diabetes and obesity in American women increased 150 percent since 1988.
Depression and drug overdose are taking women’s lives with alarming frequency.
Cardiovascular disease is the leading cause of death in women, with rates increasing most among the youngest women, women under 50.
With all our advanced technology, how does this happen?
All too often, women are unseen, and their voices go unheard.
We must change this.
To achieve our full potential not just as women but as a country, and as a global community, the health of women MUST be a priority.
To state the obvious: The best health care in the world is meaningless without access to it.
Women are dying from preventable causes like obstetrical hemorrhage, cervical cancer, and myocardial infarction—here in the United States— often because of barriers to accessing the health care they need.
Throughout my career, I have dreamed of a day when ALL women would have access to high quality healthcare throughout their life. I know this is your desire, too.
To achieve healthy pregnancies and safe deliveries, women need access to appropriate health care.
The Affordable Care Act enabled women—many for the first time—to access preventive health services, including maternity care.
In the last year, though, how many times did we hear that maternity coverage doesn’t need to be included in health insurance plans?
Last year, Medicaid paid for 43 percent of births nationwide.
Yet each new legislative proposal reduced funding—or creates new barriers in the Medicaid program. All of which reduce access for women in need.
Small hospitals, particularly in rural areas, are important access points for maternity care. In fact, 60 percent of hospital births in the United States occur in hospitals with fewer than 1,000 annual deliveries.
Unfortunately, across the country, we are seeing more of these small or rural hospitals stop their obstetric services, or close entirely.
The closure of hospitals that disproportionately serve women of color can exacerbate racial disparities in health outcomes and contribute to higher rates of maternal mortality.
Prioritizing women’s health means more than access to maternity care.
Contraception—one of the top ten public health achievements of the past century—changes women’s lives.
Unfortunately, many women STILL lack access to the safest and most effective methods of contraception.
The need for contraception around the globe is significant—more than 214 million women need modern contraception but are unable to access it.
The health benefits would be substantial. An estimated 76,000 maternal deaths worldwide could be prevented by assuring access to modern contraception.
We MUST prioritize access to the SPECTRUM of high quality women’s healthcare—women’s health MUST be a priority.
This is our challenge. A challenge I am confident we can meet because of all you, our Fellows and Junior Fellows of The American College of Obstetricians and Gynecologists.
Looking out over this room, I see many of you who answered Past President Tom Gellhaus’ call to be “All in for Advocacy”.
After his campaign, the number of messages to Congress from ob-gyns increased 300 percent, to over 17,000 in 2017.
We have increased the attendance at ACOG’s Annual congressional leadership conference by nearly 70 percent to over 630 this year, our largest conference ever.
Advocacy is a part of life for our young physicians.
At their request, CREOG developed educational objectives for residency programs specific to advocacy, preparing all ob-gyns to advocate for our patients and our profession.
These young doctors are leading our advocacy on Instagram and Twitter, too
With all the advancements we’ve made and all the national momentum, now is the time to renew our commitment—we must ensure that women’s health is a priority.
To achieve this, together, (arm gesture!)
as organizations and individuals leading women’s health care, we MUST advocate for:
- Policies that ensure access and availability of essential health care services.
- Programs that promote the health and well-being of women and girls.
- Research that improves women’s health and health care.
- Resources and Infrastructure that SUPPORT these policies, programs and research.
- Empowerment of women to advocate for their OWN healthcare.
As we work to ensure that women’s health is a priority, we will continue our advocacy at home and abroad. Contraception has enabled women to achieve their educational, professional, and economic goals.
ACOG will continue to advocate for access to contraception and the full range of reproductive health services.
ACOG will continue to lead global initiatives in Zambia, Uganda, and Ethiopia to improve the quality of care, and increase access to women’s health care services.
What we learn from these efforts can help reduce maternal morbidity and mortality right here at home.
My three presidential initiatives focus on reducing preventable maternal mortality.
First, ACOG will continue its strong advocacy for state and federal legislation to establish maternal mortality reviews.
These state-based reviews are the best opportunity to comprehensively assess and characterize each maternal death, to understand the causes and contributing factors, and identify strategies to prevent women from dying.
Second, ACOG will continue to improve patient outcomes by promoting a culture of safety.
The Alliance for Innovation on Maternal Health, known as AIM, is a national data-driven maternal safety and quality improvement initiative to reduce maternal mortality and severe morbidity.
Sets of evidence-based practices or bundles, when implemented together and reliably, reduce complications and improve women’s outcomes.
And third, we’re going to help solve the critical problem of cardiac contributors to maternal morbidity and mortality.
Cardiovascular disease is the number one cause of death in women in the United States—400,000 deaths annually.
Cardiovascular events and cardiomyopathy are the leading causes of maternal mortality in the United States, now accounting for nearly 25 percent of deaths.
Women with complications like preeclampsia, gestational diabetes, and growth restricted babies have three times the risk of later cardiovascular events compared to women without these complications.
ACOG will partner with other professional organizations including the American College of Cardiology to create a multidisciplinary task force addressing cardiac contributors to mortality and morbidity during pregnancy. We will concentrate on the creation of evidence-based best practice guidelines addressing screening, diagnosis, and management of cardiovascular disease in women, before, during and after pregnancy.
It will also address the pregnancy-related contributions to lifelong cardiovascular risk by evaluating the evidence, making recommendations and prioritizing research to help us deliver better care.
To ensure these health care services are available, physicians MUST be accessible, and we MUST have the infrastructure, technology and tools that support us.
As women’s health care physicians, we have the opportunity to drive the development and implementation of technology solutions.
Solutions that allow us to provide the highest quality care, while connecting in a meaningful way with our patients.
ACOG’s 2020 strategic plan is exploring and implementing ways to harness technology to benefit you and your practices. ACOG will continue to produce the educational content that you value and is developing the technology to put that information at your fingertips in the day-to-day care of your patients.
Our new innovations will simplify your work in clinic and reduce the time you spend after office hours completing medical records. Won’t that be a welcome relief!
My dream—our dream—of all women having access to the spectrum of high quality healthcare has a plan.
Now is the time for us to focus on our common goals.
Women’s lives are worth saving.
With women’s health as our priority, we’ll make lasting change.
Look at everyone around you. You’re looking at leaders like you.
This is our moment. My charge to you, our new ACOG Fellows, and to all our members is this:
Together, we will lead and make the health of women a priority across our nation and across the globe.