Get to Know Your Leaders: Patrick T. O’Gara, MD, FACC

Patrick O’Gara broke the family mold when he decided he wanted to be a physician. Of his eight siblings, he was the only one to go into medicine. O’Gara received his undergraduate degree from Yale and began his medical career at Northwestern University Medical School, graduating in 1978. From there he headed to Massachusetts General Hospital (MGH) where he completed his residency and chief residency in internal medicine (1984), as well as his cardiology fellowship (1983). He also served as a guest researcher in the Cardiology Branch of the National Heart, Lung, and Blood Institute (1986). O’Gara returned to MGH and ultimately landed at Brigham and Women’s Hospital (BWH) where he serves as director of clinical cardiology and professor of medicine at Harvard Medical School.

Patrick O’Gara
Patrick O’Gara, MD, FACC

O’Gara received his first committee appointment more than 25 years ago – and now, he is set to lead the College as president from 2014-2015. He will be the ACC’s 63rd president as of Convocation on Monday night during ACC.14 in Washington, DC, and follows in the footsteps of his predecessor John Gordon Harold, MD, MACC.

What are some of your goals for the College during your presidential year?

This year is an important one for the future of the ACC. Not only are we set to celebrate our 65th anniversary, but we are also poised to launch a revised College-wide strategic plan that has been in development for the past year.

The plan emphasizes the transformation of care that must take place to meet the expectations created by the Affordable Care Act (ACA), as well as our approaches to purposeful education, information and knowledge management, member value, population health, and patient and member advocacy. It is crucial for the College to address these thematic areas, particularly as health care transitions from a culture of volume to one of value, the implementation of the ACA proceeds, and the environments in which care is delivered and patient-centered outcomes are measured continue to evolve.

Our research and training missions are also challenged and will require collaborative initiatives to support the growth of our Fellows in Training (FITs), early career members, and cardiovascular care team. As ACC President, I look forward to the opportunity to work with colleagues to refine and execute strategies that will lead to effective solutions to these challenges.

We must continue to expand our membership across multiple constituencies. A more diverse member base will translate into a more impactful organization. As we increase the diversity of our membership– whether by gender, age, race, ethnicity, geography, training or sub-specialty – we will improve our ability to accomplish the goals we set and advocate more strongly for our patients and the cardiovascular community. This year, I hope to foster diversity at every opportunity.

We must also strengthen the many collaborative efforts initiated by my predecessors with other professional societies and organizations, both domestic and international, nonprofit, governmental and academic. This year, for example, will present a special opportunity to work with my BWH faculty colleague and past ACC Board of Trustees member, Elliott M. Antman, MD, MACC, who will be serving as president of the American Heart Association beginning in July 2014. One of the ACC’s core missions is the education of cardiovascular professionals. As president, I will continue to work with staff and the American Board of Internal Medicine to facilitate our members’ ability to meet Maintenance of Certification requirements and ensure that the process of recertification is both relevant and efficient. We will also continue to improve the College’s educational offerings through needs assessments, application of the principles of adult learning, and design of competency- based curricula focused on learner and patient outcomes. We will continue to work aggressively to distribute the College’s many learning activities through multiple distribution channels, including digital and print media, to engage our members in the learning styles they prefer. Integrating educational programming with NCDR quality activities designed to improve patient outcomes will constitute a new, national paradigm for learning and professionalism. Creating standards for the new world of team-based care is just one example of the work ahead. We also look forward to welcoming Valentin Fuster, MD, PhD, MACC, as the next editor-in-chief of the Journal of the American College of Cardiology. Fuster plans to incorporate educational messages regarding the clinical relevance of each of the Journal’s research articles.

Other important goals include helping to facilitate the practice guideline modernization process, restoring ACC’s career development awards and working with clinical trial experts to leverage ACC’s data registries as platforms for research, both in the U.S. and abroad. Forceful advocacy for patients, quality outcomes, value-based performance measurement, price transparency and payment reform will continue as a priority.

What are some of the biggest challenges you see facing the field of cardiology?

Our members, and their practices, are stressed. Uncertainty about near-to-intermediate term payment models, renegotiations with hospital and health system employers, patient access to quality care, scope of practice, rumored solutions to the sustainable growth rate “fix,” electronic health record transitions, and a cumulative sense of over-regulation are just some of the issues we must manage together. For our academic health centers, reductions in Medicare reimbursement and payments to safety-net hospitals, as well as significant declines in available research funding, could have serious downstream effects on resident and fellow training. The investigative careers of a generation of biomedical researchers are potentially at stake. I am also sensitive to the potential for a divided house of cardiology and the multiple, negative consequences that would result. We must work continuously to ensure the College is a leading force for cardiovascular professionals and their patients, and collaborate with other societies and professional organizations to advocate consistently and with one voice.

Are there ways you think the ACC can better help meet these challenges and help both patients and cardiovascular professionals?

The ACC exists specifically for this purpose and as long as we are able to focus, engage, communicate and advocate, we can overcome the challenges ahead. The strategic plan will help the College focus on mission and core values and allow us to prioritize programs in the near term to maximize our chances for success in reaching our shared goals. By engaging at the grassroots level through our domestic and international chapters, councils, sections, and committees, we can ensure open and dynamic lines of communication with the College’s Board of Governors, Board of Trustees, Officers and staff. Improving the means by which the College communicates, particularly through the digital platform, will be an important mechanism to address these challenges. We must also stay in touch with our patients and keep their interests foremost. The strategic plan emphasizes the College’s commitment to meeting the “triple aim” of modern health care; that is, improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care.

What attracted you to leadership positions at the ACC, particularly the presidency?

I have great respect for the ACC and have seen the tremendous impact it’s had on the field of cardiology, the lives of our patients and the aspirations of our members. I want to ensure the ACC remains the gold standard for professional cardiovascular societies. By assuming a leadership role, I have an opportunity to play a role in defining its mission and driving its future. This position will allow me to work with colleagues, mentors and staff on a range of issues and programs that affect practice, education, research, science, quality, professionalism and policy. I am thankful to be a part of this terrific organization as we continue to transform cardiovascular care and improve heart health. Excellence is the single word that most aptly describes our work.

What advice do you have for future leaders of the College?

Please remember that the ACC is a multi-faceted organization. To truly realize its reach and to understand its mission, value and potential, you must invest time, involve others, consult mentors, seek consensus, and promote the careers and aspiration of those who follow. Lead from your strengths – not from who you’d like to be or who others think you should be. Prioritize. Set personal goals wisely, but remember our leadership roles are of relatively short duration. We should do our best to leave behind something better than what we inherited. The College’s true strength lies in its membership and values.

Keywords: Electronic Health Records, Registries, Mentors, Cardiology, Knowledge Management, Patient Protection and Affordable Care Act, United States, Leadership, Consensus, Cardiology Magazine, ACC Publications

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