Reflecting upon his year as ACC President, Kim Allan Williams Sr., MD, FACC, considers his top presidential priorities, looks back on his most cherished memories, and contemplates what the future holds for the practice of cardiovascular medicine and care.

What were the top priorities during your presidency?

During my tenure as ACC President, the top priorities for the College have been advocacy for payment reform, transformation of care and population health. These three focus points have been intimately interrelated throughout the past year. Four weeks into my presidential year, the College's long-term advocacy for payment reform bore fruit. The flawed sustainable growth rate (SGR) formula was removed legislatively, resulting in a 21 percent cut in Medicare fees being averted and the scheduling of Medicare payments to reward quality rather than volume of care. This meant that the focus on transformation of care from volume to value, often touted as “five years away and always will be,” was upon us, and we needed to galvanize College resources to craft the value proposition facing our members and their patients. It logically followed that we would take a deeper dive into population health – adopting the principles laid out in our array of prevention guidelines, and committing to promulgating, updating and refining them.

What do you describe as the College’s greatest strengths over the past year?

One of the greatest strengths of the College is its unrelenting focus on quality – in practice, education and research. We have registries, training guidelines, appropriate use criteria and practice guidelines. We are now moving further into accreditation and quality assurance, leveraging the organizational skills of ACC staff with the expertise of our members and leadership. Equally acute for the ACC is the focus on population health and prevention, both in the U.S. and internationally. We have asked our members to buy into the concept of “turning off the faucet instead of just mopping up the floor.” We are great at the treatment of heart disease, but everyone would benefit from less need for treatment through the implementation of healthier lifestyles and early recognition and treatment of cardiac risk factors. This gives our patients hope and our government confidence in our partnership. Cardiologists are willing to “put themselves out of business,” so to speak, by stopping impending disease before expensive treatments are needed.

What is the biggest challenge currently being faced by the College?

Currently, the greatest challenge facing the College is the implementation of the new governance model. The ACC Board of Trustees, with the intent of becoming more nimble and responsive, and improving governance of the College, voted to reorganize College leadership. The new model will focus on maintaining centralized authority, while decentralizing decision-making by increasing the involvement of the talented experts on our committees and councils. The most visible change will be the reduction from 31 board members presently sitting, to 11 by 2018. It takes courage, selflessness, vision and true belief in the mission of the College to vote oneself out of office, but that is exactly what has taken place with our luminary leadership. The implementation of this new model will be challenging, but we will roll it out carefully and meticulously, aiming to avoid any disruption in College functions, innovations or impact.

What are the biggest challenges being faced by the cardiovascular care community as a whole?

Escalating costs of drugs and devices that are life-saving but expensive threaten to widen disparities in care by exploiting socioeconomic strata. The “haves and the have nots” have been reshaped into “affords and afford nots.” The exponential increase in the cost of some generic drugs has been an active advocacy issue for the College in recent years. “Pay or pain” and “buy or die” policies should not exist. Congress, the ACC and the American Medical Association have called for close scrutiny and accountability regarding this issue. The generic drug industry, in many ways, is a public trust. They can harm or they can help, and perhaps they need legislative encouragement to do the latter.

Could you share with us one of your favorite moments from the past year?

Reflecting upon this question, two notable memories come to mind. Following the SGR signing celebration, the ACC was called to the White House to be recognized for our hard work in pushing for SGR reform. I was thrilled to represent the College at the White House, to meet the President of the United States, and to engage in discussion with leaders from several other medical societies. My second most cherished memory occurred during our annual Legislative Conference this past year. The conference boasted record attendance of Fellows in Training. It was heartwarming to see this level of participation from our emerging leaders. Their dedication and involvement reaffirmed my confidence that ACC’s future is in good hands.

What issues and innovations have you focused on that you hope will continue to be important to the College’s growth?

I am incredibly passionate about the prevention of heart disease through a healthy lifestyle – diet, exercise, medication adherence and access to care. The imprimatur of the College as an active force in preventive cardiology has been far reaching. The White House, the U.S. Department of Health and Human Services, the U.S. Department of Agriculture, the U.S. Food and Drug Administration, the Centers for Medicare and Medicaid Services, legislators, academia, payers and patients have all taken note of ACC leadership in this arena, and the College must continue to expand upon existing progress.

What advice do you have for future ACC leaders?

Love what you do, do what you love, and prepare for a rapidly changing cardiovascular disease landscape and treatment environment in which you will be asked to lead from the front. The College does not exist for its own sake, but rather as a convener of medical science, technology and humanity, all aimed at improving heart health and transforming cardiovascular care.

What would you like your legacy as ACC President to be?

Folks have expressed that my legacy will be defined by being the first African American ACC President (or the first vegan/former tennis professional), but I hope I will be remembered as the “president who wanted to be number two.” I frequently talk about how heart disease has been the number one killer of Americans since the Spanish Flu epidemic of 1918-1920, and it is now number one throughout the world. I want to see heart disease move to number two on that list before my career is complete. So much of our cardiovascular disease is preventable, and once these preventative measures are put into place, death from cardiovascular disease is avoidable. The ACC has the structure in place to promote prevention and treatment strategies, and we have developed key partnerships with global and domestic medical societies that can turn this epidemic around. We can turn attention to health care outcomes and disparities, which often costs lives, productivity and resources far too early. We have the science, we have the will and we have the implementation strategies. Let’s do this!

Keywords: Cardiology Magazine, ACC Publications, Accreditation, Cardiology, Cardiovascular Diseases, Centers for Medicare and Medicaid Services, U.S., Heart Diseases, Medicaid, Medicare, Medication Adherence, Pharmaceutical Preparations, Pharmaceutical Preparations, Dental, Registries, Societies, Medical, United States Food and Drug Administration

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