Dr. O'Gara, distinguished guests on the dais, awardees, ACC Past Presidents, Board of Trustees, Board of Governors, International leaders, new Fellows and Associates of the College, ACC staff, my Rush University colleagues, members, guests, families and friends — Thank you all for being here this evening.
Before I begin, I want to acknowledge and thank my wife Dr. Amy Williams, my mom who couldn't be here tonight, my children and kids-in-law. I am so proud of each of you. You have made it your daily mission to help people, whether through business, law, our U.S. Marine Corps, or the five of you who are in medicine. You inspire me every day.
I want to acknowledge and thank my career mentors, many of whom have passed on — J. Willis Hurst, Leon Resenkov, Rory Childers, Mort Arnsdorf, Jim Ryan, Bob Schlant, Jim Dove — to name but a few; and there are some who continue to inspire us all every day, such as Nanette Wenger, Richard Allen Williams, Doug Weaver, Fred Bove, Ralph Brindis, David Holmes, Bill Zoghbi, Pam Douglas and Mike Wolk. Each of you has left a legacy of leadership that inspires us all.
I also want to thank my AMA Cardiovascular Section Council colleagues, especially Jerry Kennett, Sam Wann, Suma Thomas, Joe Babb and Gene Sherman. We've been through many battles together trying to make the house of medicine a better place for our colleagues and for our patients.
I have been struck in my career how circular mentorship can be. I've learned so much from the faculty with whom I have served at University of Chicago, Wayne State and Rush University; yet I've also learned from the myriad of talented students, interns, residents and fellows whose education has been entrusted to us as academic faculty. To each of you — thank you!
I'd like to recognize the members of our ACC Executive Committee for their leadership and strategic thinking. I want to especially recognize the members of presidential team this past year. It has truly been a privilege to be a part of this amazing group. John Harold has a vision and passion for the College's future that builds upon an already rich and vibrant history. Rich Chazal is a true Master of the College, with more time on the executive committee than so many of our leaders.
And then there's Patrick O'Gara, a most articulate, kind and erudite gentleman; a master teacher, a master clinician and a master leader. He and I have shared a lot of ACC experiences, but we also share a geographic connection to Chicagoland. Pat is from the north and I'm from the south side. Our Chicago backgrounds have helped mold our vantage points today — Pat is a master educator, while my career has focused on patient access and elimination of disparities, and yet we share each other's passions. Thank you, Pat, Rick and John, and thanks to our Board of Governors leadership, David May, Mike Mansour and Bob Shor, for your leadership, your expertise and your friendship.
So many of you, my colleagues, have asked: "What are you going to do as ACC President?" Each president has the privilege of inheriting the foundation of past leaders. Following on Pat's year of ensuring continued focus on educational funding and research, I hope to focus on increasing our ongoing effectiveness as advocates for patient access to the best cardiovascular care possible, regardless of age, race, ethnicity, gender, income or geography. I hope to focus on advocacy for patient access and continued strides in quality improvement. And I hope to focus on the transformation of care, from volume to value, a place where the stakes are high and the College can have an impact that few other medical societies can deliver.
But enough about me! Tonight, we are here to celebrate each of YOU. As members, YOU are the College. As young members, YOU are also the future of the College. YOU and the care of your patients are the core of our mission. Your guidance and mentoring of the next generation and your pursuit of science are the reason that the ACC exists.
Our guidelines and appropriate use criteria; our educational products; scientific programs like the one we've just experienced here in San Diego; our member sections and Chapters around the globe; our JACC journals; our health policy and advocacy efforts–are all designed to help YOU, as a cardiovascular specialist, provide the best possible care for your patients throughout your career.
So I urge you. Take advantage of this opportunity! Get involved. How will YOU shape the ACC of the future? We talk a lot about our goal of taking down heart disease from being the #1 killer, a position it has held in the U.S. since the Spanish Flu epidemic of 1918. We talk about the 75 percent decrease in heart disease deaths since 1968 in this country, with the advent of modern cardiology and cardiac surgical interventions.
But we can no longer just look inward about this epidemic. Cardiovascular disease is now a leading killer globally. Yet have more than 51,000 members in the ACC, including our 34 international chapters. We know that we are stronger together than when we are apart. We need to embrace the fact that in today's world of cardiovascular disease, there is no "us and them," there is only "us".
Achieving our goal is well within our grasp if we are dedicated to the task. We have to work together to rebuild public trust in our efforts, building outreach and opportunities to improve both quality of care and access to it.
One recurring issue for us is TRUST. I'd like to talk a little bit about trust tonight. You've all heard of, or maybe even witnessed, physicians whose priorities are not driven by quality and access. Actually, so have our patients.
This past October the New England Journal of Medicine published a survey quantifying the declining standing of U.S. physician leaders in the public eye since the 1960s. In 1966, 75 percent of Americans surveyed had great confidence in physicians, but by 2012 only 34 percent shared this outlook. This lack of trust places the U.S. well behind other developed countries like Turkey, France, Great Britain, Switzerland and many others.
These authors from the Harvard School of Public Health suggested that this lack of trust may diminish the influence of physicians in decision-making around the next stages of health system reform, as we try to influence lawmakers on the conversion of volume to value based payments. I also suspect that it impairs doctor-patient relationships in a real and tangible way, such as adherence to medication, coming in for follow-up appointments and participation in shared decision-making.
As ACC members we have an opportunity to improve this trust. We need to hold each other accountable for providing appropriate, evidence-based care. We need to utilize our registry data like NCDR to find gaps in care and improve patient outcomes. We must stand up and own our actions — both good and bad — and be visible to the public and our patients in positive ways that impact their lives.
That same Harvard study showed that poorer people in the United States have a substantially lower level of trust in the entire health care system. Adults from families earning less than $30,000 per year were less trusting of their physicians, and less satisfied with their own medical care. We can change this. We can measure it, and we can manage it. We can use registries to promote quality and close gaps in care, reducing door-to-balloon times in hospitals around the globe and reducing hospital readmissions. We can partner with community groups and other specialty societies and work closely with our own cardiac care team members. We can offer outreach and patient education.
Our CardioSmart initiative and live programs can target under-served communities. We need to expand these efforts, by working with our state and international Chapters and members on the ground to translate resources and make our programs and tools culturally relevant.
We can rebuild trust.
William Butler Yeats is often quoted as saying: "Education is not the filling of a pail, but the lighting of a fire." So let's light a fire! Let's educate our lawmakers, regulators, payers, professional certification boards, our patients, their families and the media about what we do. We have a lot to be proud of — continued declines in mortality from cardiovascular disease; transformational new research; innovative global partnerships that are harnessing the power of data; and new digital technologies to reduce disparities in care and provide widespread, easy access to helpful tools and resources for patients and clinicians. The list goes on. We need to do a better job touting these successes.
We also need to tout what it means to be FACCs and AACCs. We are best positioned to show by our actions and our words that these four letters demonstrate a commitment to providing the best possible care to patients — and we should be trusted because of them.
Finally, we need to focus on prevention. It is said that "the best physicians prevent disease, not just treat disease." Maybe you've seen the cartoon with the two doctors, stethoscopes dangling, feverishly mopping up the bathroom floor, while the sink in the corner continues to overflow. We have opportunities within the College with our new strategic plan's Population Health initiative to focus on prevention as never before. We will need to become prevent-driven, not just event-driven. We should promote and exemplify healthy lifestyles — such as diet, exercise and not smoking — while continuing to amass the research that will help us codify best practices to lower the burden of risk factors that contribute to the epidemic of heart disease we are in.
To our new FACC's and AACC's, congratulations! My tennis hero, Arthur Ashe often said, "From what you get, you can make a living, but from what you give you, can make a life." Each of us is here today because we have made "giving" our profession — our life choice. We have made a commitment to give back to the communities where we live and work — and we are giving back lives. The College and its leadership are here for you each step of your journey. Use us. Take advantage of our tools and resources. Get involved in ACC committees, sections and councils, chapters and advocacy. Each of us separately is a spark, but together we are a fire. Let's make cardiovascular disease #2 together.
And then? Let's widen the gap.
Blessings to you all, safe travels home. And may God bless the American College of Cardiology.
Thank you very much.