Adili: Welcome to a new episode of “Focus on Vessels”, the podcast of the German Society for Vascular Surgery and Vascular Medicine. My name is Farzin Adili; I am a vascular surgeon at Darmstadt Hospital and the current President of the DGG. This podcast is designed to offer you, our listeners, a platform to delve deeply into the topics that shape and advance our field. Together with our guests, we will explore the latest developments in surgical, endovascular and preventive vascular medicine and discuss current issues from the worlds of science, teaching, clinical practice and the clinic. True to our motto: “We take vascular medicine further”. My guest today is Professor Alexander Oberhuber, Director of the Department of Vascular and Endovascular Surgery at Münster University Hospital and current Vice-President of the DGG. So, dear Alex, you will be taking over the role of President from me in January 2027. A very warm welcome!
Oberhuber: Thank you very much for the invitation, Professor; I’m delighted to be here.
Adili: With today’s episode, just ahead of our professional association’s 41st anniversary on 7 December, we’d like to take a look behind the scenes at the DGG. Our professional association is the largest vascular surgery association in Europe and ranks among the largest in the world. I’d therefore like to start straight away with your personal DGG moment: what was your magical DGG moment? When did you decide to become a member and why?
Oberhuber: I simply decided early on to become a member. For me, it was always clear that I wanted to be part of a community. I am a vascular surgeon through and through, and for me that means being involved in the society. At the start, I was clearly just a standard member, and my moment back then – some time ago, as I said – was when you still needed two sponsors to become a member. Fortunately, that’s no longer the case today, but when my boss at the time, Professor Sundar Plassmann, a founding member of the DGG, said: ‘Mr Oberhuber, I think that’s a good idea’. He said, yes, my boss is in favour of it, so let’s go for it – now I’m going to become a member. I then applied accordingly, as it was called back then, and was very pleased to be accepted into what was, for me at the time, a very illustrious society.
Adili: In your view, what added value does DGG membership offer? In other words, what concrete benefits has it brought you?
Oberhuber: It’s been quite beneficial for me, because I’ve naturally worked my way through all the committees, and at some point I was also able to play an active part in the development of our field. I was able to have a say in decisions and work on committees; that’s been very rewarding for me. But of course, not everyone is actively at the forefront; we also have a great many members who hold the DGG in high regard but don’t necessarily play an active role. Yet even here, I believe, there is truly significant added value. We organise the annual conference, we have the Summer Academy, and we offer various formats for our colleagues, who naturally enjoy benefits when they are members. And what used to be the very smallest thing – nowadays the printed format is becoming less and less interesting – but back then, it was a real treat to hold our journal ‘Die Gefäßchirurgie’ in my hands and say: ‘As a member, I get this and I have the latest information here. I also have great studies, I have information, I have studies that are discussed, but I also have ‘announcements from the Executive Board’, which felt very distant to me at the start. That used to really excite me.
Adili: Yes, I actually felt much the same. Intrinsically, I didn’t really want to join the DGG that much, or rather, I had no idea what to expect. I was sort of steered into it by my boss at the time, Professor Schmitz-Rixen, who later became President and is now Secretary General of the DGCH. Above all, of course, to take part in the scientific programme, present our work there, and then also qualify for the prizes that the DGG awards. You can only do that as a DGG member. But I didn’t really grasp the actual scope of this work—the work of the association. Was it the same for you?
Oberhuber: Yes, well, as a young person – I was a junior doctor in my third year – you don’t really grasp all the tasks that an organisation like the DGG carries out. For me, it was the scientific society that organises the annual congress and, as you say, at uni it’s simply important to be able to say: ‘I’m standing up there, I’m giving a talk.’ And then, especially as a young person, to be allowed into the plenary session, into the main hall – that was a really, really great thing for me. And then being allowed to do other things too, eventually taking on a chairmanship when I was asked, really spurred me on to do more. We now have completely different formats that are much better, but as I said, the journal was simply one of the biggest things for me. Whenever you went into the big bosses’ offices or the libraries, there were those huge volumes and the complete works of vascular surgery and other journals, and suddenly I was allowed to hold a part of that in my own hands. I don’t know, what was it like for you with the journal? Well, for me it was really something quite, quite huge, holding my very first copy in my own hands, rather than having to ask the boss: ‘Can I have a look at that?’
Adili: Yes, well, for me, that wasn’t really a deciding factor. I had access to the journal through the clinic, via the reference library, which they still had in the individual clinics back then. That… didn’t really play such a decisive role for me, as I could always get hold of it. To be honest, I have to say quite honestly, I didn’t really know what to expect from the DGG. What would you say: when is the right time to become a member for someone who works in vascular surgery or wants to work in it, or does it not matter at all?
Oberhuber: There’s no wrong time, no wrong age to join. I always tell my junior doctors: ‘Become members; you’ll get so many benefits, you’ll gain so much, and you’ll become part of the community.’ I believe that, now more than ever, networking is crucial – connecting with people. This is ideally possible, whether at the annual conference or at other events, to find out what’s happening in vascular surgery in Germany. That’s why my recommendation is to join as early as possible, but even if you’re already experienced – a senior registrar, senior consultant, or in a leadership role – it’s never too late to join.
Adili: What opportunities do our members have to contribute to the DGG or work within the DGG? We do, after all, have 21 committees and sections. Could you briefly explain: what a committee is, what a section is, why we distinguish between them at all, and what opportunities there actually are to get involved in the DGG?
Oberhuber: Well, first of all, we distinguish between the committees, which are directly managed by the DGG and represent the individual sub-fields, or as I might quote you: “This is the driving force behind our professional society and we try to steer it.” These are the ones where a lot of committee work is done, where many questions are answered and ideas are developed further. Then we have the sections: sections are assigned to the private academy, which are not just for strategic and conceptual matters, but mostly also deal with very specific tasks. For example: the Endovascular Techniques Section is responsible for the curriculum for endovascular surgeons and endovascular specialists; the summer academy; the courses are organised; the exams are held; and there’s something for everyone, as you say. There are 21 committees and sections you can get involved with; there’s a specific focus on diversity and variety for everyone – we have ultrasound committees, open techniques, endovascular techniques, sound committees, trauma and a wide range of other topics. So, I think there’s something for everyone, and if anyone says: “I’d like to get involved, I’d like to help shape the work, I’d like to contribute ideas, I’d like to get involved personally,” then you’re welcome to do so at any time. In every committee or section, we have a chairperson whom you can contact, or if I know anyone else, or even directly via the office through us board members – so no matter how you get in touch, people who are willing to get involved are always very welcome, and we can actually find a role for everyone.
Adili: Yes, the committees and sections are quite easy to find on our website; they’re listed there, and if you click on them, you’ll also see the membership details, and then you can actually contact any of us easily and get involved. Which committee role was actually your personal entry point into the DGG? So, through which committee or channel were you, so to speak, welcomed into the inner circle?
Oberhuber: A committee that didn’t exist yet. As I said, I got in touch relatively early on; my former boss, Prof. Ohrendt, came to me with a note: ‘You’ve got to go!’ There was a meeting in Heidelberg.
Adili: You’ll have to translate that again – not everyone’s familiar with what’s that, Old Swabian or what?
Oberhuber: No, it’s deep Bavarian, and he meant: “Oh, you’ve got to go there.” There was a meeting, organised by Professor Böckler, back then at the former Heidelberger Reisen, where research assistants and junior doctors were supposed to meet to set up a young researchers’ organisation. And we ended up with a really great forum where we gave our own talks and, well, actually started networking a bit for the first time. It was a long, long time ago, and we then founded the Young Forum back then. Actually, even before it was an official commission of the DGG, we got together and said: “It would be great if we could get involved there, if we could also become part of the DGG.”“ That was well received by the Executive Board at the time; they said: ‘Great, great idea. Go ahead, become a commission.’ And so we officially founded the Young Forum as an official commission, with various working groups at the time. And that’s how I got involved in this committee work, and had my first contact with the Executive Board and the relevant people in the secretariat. It became clear to me relatively quickly: I think this is great; you can get involved, you can put ideas into practice. It was clear that I wanted to continue at that level.
Adili: So at some point you started taking on responsibility as well. Did that happen on your own initiative, or to what extent is some form of mentoring actually needed within the DGG? Do you need someone to help you, or can you manage just fine on your own?
Oberhuber: Yes, as always, you can make progress on your own, but it’s harder. If you’re guided a bit, get some help and have suitable mentors. In my case, it just happened that way: I was a working group leader, then deputy spokesperson for the Young Forum, and things just progressed like that until I stepped down, because at some point I became a senior registrar and we decided: ‘OK, at some stage this won’t fit in with the Young Forum anymore.’ But I was then introduced to it a bit through my former senior consultant colleague, Professor Kai Balzer, who was a board member at the time. He said: “Hey, don’t you want to? What do you say? Look, we’ll do this and that...” and so I joined the board via that route, and also through the Young Forum, where I naturally still had good contacts. Or rather, I was elected to the Executive Board at the time as a representative in a subordinate position, that is, the representative of the junior doctors and senior doctors. And so, step by step, you just move forward, and what Kai Balzer always said to me had a huge impact on me, but also helped me. Like, what the board actually does, what it’s all about, and whether you can get involved or not, and whether you’re even welcome as a young senior registrar back then. That really helped me, which is why I believe mentoring is simply always a very, very important and significant part of such a process.
Adili: Why don’t you take us along to one of those board meetings for a moment. What actually happens there? Who’s there and how does it actually work? How should we picture it?
Oberhuber: Yes, it goes like any other meeting. There are various participants; in this case, the President – currently you – and the Vice-President – me. We still have the Past President, who previously ran the organisation. Then there are others depending on the association’s structure. In our case, we also have the treasurer present. Then there’s the secretary, who always holds a very important position. Then we have the representative of the so-called ‘dependent’ position, which I used to hold myself. We also have a representative of the ‘established’ members, which is very important because the other members are mostly employees, primarily in hospitals. So they always have the self-employed members as well. And then we have the representative of the university staff, and we also have an assessor who is present. So we are not a large group, but a fairly manageable group that is involved. Whoever is present is, of course, our managing director, who is not officially part of the executive committee, but who is, of course, extremely important for our committee work. We meet several times a year. We hold various meetings either at other events, such as the annual conference or the summer academy, and we actually always have a relatively tight agenda to work through, with various items on the agenda that are then presented by a single person or, in most cases, primarily by me as President. Then we discuss and vote on matters: How do we do this? How do we further develop the professional association? In which direction are we heading? Where do we want to get involved? Where do we not want to get involved? In exchanges, interdisciplinary work with other professional societies: when do we do this? How do we do this? All these matters need to be discussed, debated and ultimately approved. Of course, there are always the finances, which we keep an eye on for our members, and what is increasingly taking up more and more time are all the professional policy issues. Everyone has heard of the ‘State Hospital Plan’, the ‘Hospital Care Improvement Act’ and all the rest. There’s always a fair bit of work involved where the DGG Executive Board, acting as the DGG’s internal representative body, has to get involved and set the course for the future.
Adili: How would you describe the atmosphere? Is it always peace, joy and sunshine? Are there any tense moments in a board meeting like that? Do you ever really clash, or is it just a friendly round of discussions?
Oberhuber: Well, I wouldn’t say ‘heated’. We discuss things; we don’t always agree, but I think whenever there’s more than one person in the room, you’re not always going to see eye to eye, which isn’t a bad thing. But we get on quite well; ultimately, we can always channel our differing opinions into something productive, and I haven’t experienced anything truly heated. I mean, where people might behave inappropriately or something like that. We discuss it, ultimately we vote and the majority wins – that’s how democracy works. But I can also say that the vast majority of decisions we make unanimously; in other words, there are no dissenting votes – we’re essentially a single voice on the board.
Adili: We’re always guided by the desire simply to help vascular surgery and our members, and we always strive for a broad professional consensus – which isn’t always achievable, but largely is.
What has your work on the board actually brought you personally, or what have you gained from it, for yourself personally, but perhaps also in terms of your own career? Was it somehow meaningful, or do you tell yourself, ‘I’m in this now and I have a role to play, and it’s more stress, more work and less fun’?
Oberhuber: Well, let’s put it this way: it’s naturally more work. I think that’s clear to anyone who volunteers anywhere. That’s the case, but ultimately it’s also fun again, because I enjoy setting the course and driving things forward. If you stop and think, ‘What has it done for me personally?’, then naturally everyone thinks, ‘Well, you make decisions on the board that mean you can perform more operations in your own clinic or gain some advantage.’ That’s not the case, but it does bring you something, and anyone who has taken on or wishes to take on a position – a senior position – in the clinic must, of course, be clear about what sets them apart from other competitors. Yes, it’s the technical expertise, of course, and in the university setting, the scientific aspect, but one mustn’t completely forget: one should have a certain level of networking, one should have a certain level of recognition, and one should also have already held a certain level of leadership roles. When you say: ‘I’m on the board, I hold this position here,’ then that is certainly an advantage. And of course it also benefits you in everyday life, as you’ve already said: we try to reach a consensus, try to see the bigger picture, the whole picture, even if it might not be the ideal decision for everyone; we try to see the bigger picture, and that’s what we also have to achieve in everyday clinical practice with other disciplines and other colleagues. We don’t always see eye to eye; we don’t always agree with other disciplines when it comes to treating our patients either. But ultimately we need this consensus; we need a clear decision on how we treat patients or how we handle a particular matter, and that is always beneficial in such committees. This means both sides benefit: if you already have experience, it’s good to be able to contribute it, but of course you also learn to reach a consensus for the greater good.
Adili: Apart from the technical aspects, such as guideline work, and the scientific exchange, I think it is above all the networking – connecting with one another, engaging in conversation and getting to know each other. There are hardly any vascular surgeons in Germany whom I don’t know, haven’t heard of, or whom I don’t even address informally; and on the other hand, of course, there is also the opportunity to play a creative role. I mean, outside, shall we say, our hospitals and institutions, we are rarely involved in strategic considerations regarding health policy or social policy, and the DGG enables us to do so or provides a platform to do so, and then to influence the wider political sphere or stakeholders, thereby improving the conditions under which we can practise our profession. I’m thinking, for example, of the G-BA guideline, where we lobbied to ensure that the specialist training requirements for intensive care could be reduced accordingly. I’m thinking of the quality assurance guideline for outpatient interventions, where we’ve finally been able to establish vascular surgery as well, rather than leaving the field solely to radiologists. So there are actually a whole host of things that can be achieved practically through the DGG within the DGG. The guidelines, our daily practice – things are really moving forward there… it’s actually quite satisfying, really. That’s how I’ve always seen it.
Oberhuber: Absolutely. I’d say I enjoy helping to develop things, and it’s not always just the decisive factor, but there are many developments, as you say; a lot has happened in terms of professional policy, and that’s now a big part of it too. But what I think I really enjoy, in my view, are all the scientific aspects. As already mentioned, guidelines – I was actually involved in leading the development of two guidelines – and that’s basically: How do I treat a patient? With what kind of therapy? In what form? And what’s the aim? That’s laid down in the guidelines. Here too, I have to reach a consensus on many things, but I find that extremely enjoyable. And the annual congress is also a brilliant event, where we exchange ideas and present the latest data. There’s one thing we haven’t discussed yet, but I think it’s one of the most important things: passing on our discipline to the next generation. We’re very much involved with the next generation through the Summer Academy, as well as other formats; we train them further and run continuing professional development courses to explore: what’s important in our field, which direction it’s heading in, and what’s particularly relevant for each individual? But what we mustn’t quite forget – and this is sometimes overlooked – is that the training regulations are also co-determined by the DIG. Yes, within the framework that involves doctors and the German Medical Association, but we do have a say in the content, so we do have a significant influence on these matters. I was also able to take part in the last WBO under your leadership. It’s actually quite fun.
Adili: You just briefly mentioned the guidelines – which guidelines have you worked on?
Oberhuber: Well, I was recently given the lead role in drafting the guideline on renal artery stenosis – or whatever it’s called now, arteriosclerotic renal artery stenosis. I actually ended up in that role a bit by chance, back when I was on the board.
Adili: So you weren’t a recognised renal artery interventionalist or renal bypass surgeon, but they placed their trust in you?
Oberhuber: Well, it was like this: I said they were still looking for someone to support Thomas Hupp at the time, who had published a lot on the subject back then and had written the guideline – the latest version. I’d already been heavily involved, was able to support him, and then coordinated it, so to speak, as an official partner of the AWMF, and was now allowed to do the same with the new guideline. And of course, we’re now doing much more than I did back then. That’s just how I got into this field, and I’ve really enjoyed it. Analysing evidence-based literature, making recommendations for people, and what I’ve done most recently was the Type B aortic dissection guideline, which I believe is is, I believe, a very, very important guideline, because patients do come to us with their Type B dissection; even if it isn’t quite as common as, say, peripheral arterial disease, it is still a very, very difficult and complex clinical picture. I think the guideline has turned out rather well as a result; we’ve made many, many new recommendations.
Adili: Yes, so take heart, don’t be afraid to get involved. It’s all that – it’s not as bad as it seems. If you’re interested in contributing to guidelines like these, just get in touch.
Oberhuber: Absolutely. As I said, I got involved in this quite spontaneously. You don’t have to be the greatest specialist. The willingness to get involved, to work in an interdisciplinary way in this case, to coordinate within such a guideline process, is a really, really great thing, because you learn a lot more about the condition, but also the structured process of developing a guideline is fantastic; it’s extremely enjoyable from a scientific perspective and I can only recommend it to everyone.
Adili: And the younger generation often brings their own perspective to the table, which we older members might not even be able to bring into the discussion, or which we simply don’t have the perspective on. I’m not thinking so much about the guideline right now, but when I think of our new Diversity and Integration Commission, even at the socio-political level, there are many ideas we could gain from our younger members. What would you like to see from our members who are currently practising vascular surgery out there, who support the DGG with goodwill but haven’t quite dared to make the transition from passive to active membership yet?
Oberhuber: More courage. I think there are plenty who’d like to get involved but don’t dare, because many believe it’s a closed shop. We’re such a close-knit community that you can’t get into, where they might not be welcome, and if I say now that I might just come from my little hospital – we don’t operate that much anyway – none of that matters. This is about vascular surgery in general, and it’s not about this one operation or that one; whether I use this wire or those scissors is completely irrelevant. Anyone who wants to get involved and is committed to it is very welcome and more than happy to join us. So, be brave, get in touch – we don’t bite.
Adili: That’s a wonderful closing remark: we don’t bite, we just cut. Yes, dear Alex, time has really flown by. That was a truly interesting and wonderful look back with you at the history of the DGG, but also at our work as a professional association. Thank you very much for that.
Oberhuber: You’re welcome.
Adili: Yes, and to you too, dear listeners, thank you very much for joining us again. If you have any questions or would like to share your feedback with us, please feel free to write to us at podcasts@medizinkommunikation.org, and if you listen on Spotify, you can also leave us a review. I’m already looking forward to the next episode of “Gefäße im Fokus” and, until then, I wish you all a peaceful festive season and a happy New Year. Stay curious and, above all, stay healthy.
