Dr. Zipes said physicians must reaffirm their identities as “healers,” building on the traditions of the doctor–patient relationship.

“Those who have the calling must be healers by conviction, not simply by virtue of a medical degree,” he said. “We become healers when the identifiable purpose of our lives is forever bound up with the relief of suffering. We become healers when the relationship between our patients and us is a covenant of faith, not a business contract; an article of trust, not simply a fee for an exchange of services.”

Because physicians tend to see people when they are at their most vulnerable, Dr. Zipes said physicians become more than just caregivers, but protectors of their patients’ health.

“We see people when they are undressed in every way—physically, emotionally, and spiritually,” he said. “And it is this vulnerability that endows the physician with stunning privilege, and an equally stunning responsibility. For it is our privilege to shield our patients when they are bare and without defenses.”

Dr. Zipes said these ideals transcend international boundaries and should be promoted, supported, and applied to health care worldwide.

“In the months following Sept. 11, we now know that our concerns can no longer be limited to a personal agenda, to a national interest, or to any single corner of any particular market. It has become blindingly clear that our concerns must encompass the relief of misery wherever we find it.” Dr. Zipes said. “For if we did not know it before, we now know that when a single child in Peru goes to sleep hungry, then the entire planet is malnourished. When oceans of the homeless drift through the streets of Calcutta, then the equanimity of all good people becomes profoundly disturbed. And when a heart stops beating in Afghanistan, the silence that follows envelops the world.”

Dr. Zipes believes that the keys to global outreach are communication and education—the exchange of ideas, knowledge, and information. With the launch this week of ACCardio, the College’s new online professional education resource, the College now offers an important tool to facilitate that exchange.

“With the development of ACCardio, we are building a system that will be the premier digital source of knowledge and information for physicians and other health care professionals who treat patients with cardiovascular disease,” he said. “But, more than anything else, ACCardio transforms the College into an international source of knowledge and, in so doing, into an international organization as well.”

Another tool the College hopes will assist in training and education, both at home and abroad, is new medical simulation technology that uses mannequins and computers in place of real patients to help physicians learn new procedures.

“I like to call it a ‘patient in a box,’ and it is designed to teach physicians at all stages of their careers how to use new medical devices and perform new procedures,” Dr. Zipes said. “In the near future, from the first venopuncture that a medical student performs to a complex angioplasty in the last year of cardiology fellowship training, procedures will be taught in such virtual reality settings. I submit to you that this technology is an unquestionable part of our educational future, and it is a means through which we can spread knowledge all over the world.”

Efforts to reach across borders must, however, begin at home, he said.

“At the same time, if our voice is to be heard across geographic boundaries and political borders, it first must be heard in the health policy arena of our own country,” Dr. Zipes said. “Toward that end, the College is expanding its advocacy efforts.”

Part of that expansion includes the establishment of a political action committee and an increased emphasis on state and federal activities at the grassroots level.

“Clearly, these are two closely related initiatives, intricately interwoven and interdependent,” he said. “They are part of the movement to make the voice of cardiology echo in the halls of Capitol Hill and in state legislatures across the country. They are vital components of the College’s plan to improve the treatment of cardiovascular disease in this country and, in time, all over the world.”

An important component of that plan is the development and dissemination of practice guidelines.

“These guidelines are irreplaceable tools for practicing physicians, who cannot possibly find the time to synthesize the mass of evidence that is derived from population-based studies in order to apply that knowledge to individual patients,” Dr. Zipes said.

He pointed to the Guidelines Applies in Practice (GAP) Program as another example of the effort that the College is making to address clinical needs at the point of care.

“Our goals with the GAP Program are twofold,” Dr. Zipes said. “First, is to improve communication between patients and their health care teams. And, second, GAP will improve the quality of patient care by taking the guidelines off the shelf and putting them to work in daily practice.”

While the College has invested considerable time and resources to develop these and other tools to help physicians learn and practice state-of-the-art medicine and to share these resources with the rest of the world, they are meaningless without the concern and commitment of individual physicians.

“It has nothing to do with national borders, with ethnicity, or with religious affiliation,” he said. “It has everything to do with the framework of humankind that needs our constant support, not just as physicians but as men and women of sensibility and conscience. It has everything to do with the exportation of excellence and it has everything to do with the Hippocratic oath.