This post, originally in the BOG Update newsletter, was authored by Geetha Raghuveer, MBBS, FACC, Governor of the ACC Missouri Chapter.

From planning and moderating educational sessions, to serving as program chair for State and Regional ACC Annual Meetings and as Chapter President and member of Board of Governors (BOG), my involvement with the ACC and Missouri Chapter has been quite a ride. Over 90 percent of cardiologists within Missouri are ACC members, verifying that there is great value in belonging to the ACC. Even for a pediatric cardiologist like myself, there is a lot that the ACC offers.

Our region's cardiac related issues follow the national trend of increasing lifestyle and obesity associated chronic disease burdens. Missouri has the nation's lowest cigarette taxation and one of the highest rates for cigarette smoking, especially in poor, rural areas, which we have not been able to significantly influence to date. About 20 percent of the children I see in my clinic are exposed to tobacco smoke. Having grown up in India, I often reflect on the "paradox of poverty," in India the poor were emaciated, a stark contrast to the American poverty, strongly associated with obesity. There is no calorie scarcity in this country, though there is nutrient scarcity. I also wonder about the appropriate amount of government intrusion when seeking to solve these issues. How much is too much, and how little too little? It is a fine balance, but just as we all cherish our personal freedoms, we benefit from society, and hence owe something back. Personal responsibility and societal solutions can coexist; there is a middle ground.

Physicians in my state are just as stressed facing the burdens of the changing practice landscape, insurance issues, hospital regulations, MOC requirements, as they are about the major public health trends in our state, and some of these mandates and regulatory burdens are not even remotely relevant to quality patient care. I believe that cardiologists across all backgrounds and specialties, who belong or do not belong to the ACC, face common problems. The politics and business of medicine is changing rapidly for all of us, and it is best that we direct our own change. This task is likely easier when working alongside luminaries in the state ACC chapter, on the BOG, Board of Trustees and ACC leadership.

The ACC is the only professional cardiovascular care organization with the brain and muscle power that can speak for the entire cardiovascular community. The ACC has the means to play a pivotal role in advocating for all cardiac patients and care providers. The causes ACC champions – quality, outcomes, registries, reimbursement, advocacy and appropriate use criteria – are worthy of our time and effort as volunteers of the ACC, and if we continue to work together, the ACC will become what we want it to be.