This year is an important one for the ACC – it's our 70th Birthday and Anniversary. Just 12 months ago, we were nearing completion of our last strategic plan, putting the finishing touches on our next, and looking ahead to this big year. During these times of transition and milestone anniversaries it's important and common to pause, and reflect on where we've been, who we are, and what we want to become. So, we did.

When we looked in the mirror, we saw the professional home of more than 52,000 women and men dedicated to improving the lives of cardiovascular patients around the world. We saw a College founded on Diversity and Inclusion and dedicated to continuing this legacy. We saw a "knowledge organization," built around the education of our members. We saw excellent governance, and strong leadership from our Boards, Committees, and our Chapters and Sections.

Advocacy, whether on Capitol Hill or around the world was strong. We are united around the message of "One College, One Voice." Quality remained a bedrock, with growing registries, accreditation services and expanded development of appropriate use criteria, clinical guidelines and decision pathways.

We saw our JACC Journals, led by the incomparable Valentin Fuster, MD, PhD, MACC, continue to rank among the most impactful in the world, while also growing. In addition to translated international editions, we were preparing to announce the addition of two new online, open-access journals this year. 

Education is on fire, with innovation and great science continuing to lead the way. Applications for [ACC.19] alone included eight new prevention trials, and many studies that will change guidelines and practice in rapid succession. Our international conferences, with partners in Latin America, Asia, and the Middle East, were providing new, innovative and – more importantly – localized education. 

Seventy years of innovation, knowledge, and growth … and so many reasons to be proud!

But not so fast! When we looked deeper into the mirror, we also saw many challenges. Our members, the foundation of the ACC, are not as diverse as the patients they serve. These same members are also struggling, not with patient care, but from the excess burden of regulations, electronic health records, maintenance of certification requirements and more.

A study from the Annals of Internal Medicine in 2016 revealed that cardiologists spend only 27 percent of their time face-to-face with their patients, and over twice that amount in computer entry and paperwork. Six to eight years of training to become transcriptionists and data entry clerks for health systems? We must be near the crisis point, when almost every major journal has an article on isolation and burnout.

Health systems, which now employ almost 80 percent of our members worldwide, are also struggling and confused. They see rising annual costs with no improvement in the quality of their care. They question registries and data, because the information piles up in C-Suite offices. They fail to engage the clinician leaders who can help them improve quality, lower costs and reach the Holy Grail of value. They don't have the tools to do so. We must help them.

And most importantly, our patients are suffering – suffering from lack of access to medication and treatments due to rising costs and prior authorization. They are angry when informed decision-making is difficult because clinicians are buried in their computers. And, they are dying. The 30-year decline in mortality from cardiovascular disease is now reversing with the growing epidemics of obesity and diabetes. This is troubling for our domestic patients, but also crippling for world health.

Statistics from Brazil and Egypt show just how severe the problem is. Uncontrolled risk factors of hypertension, smoking, obesity, and diabetes are at a critical level, and will overwhelm the resources of the developing world. Cardiovascular disease has no borders. Who will help?

So, when we looked in the mirror, and the image was not quite as attractive as we had hoped, what did we do? First, we asked for help – and more than 400 members and stakeholders volunteered to help us create new strategies for success. Dipti Itchhaporia, MD, FACC, and Richard J. Kovacs, MD, FACC, our incoming president, did a brilliant job of leading the process for our new Strategic Plan. We knew and loved our mission of many years – to transform cardiovascular care and improve heart health – but we wanted and needed a new and encompassing vision. The result: our vision of a world where innovation and knowledge optimize cardiovascular care and outcomes!

We also re-defined our core values. These new values – being patient-centered; teamwork and collaboration; and professionalism and excellence – were the basis for each strategy and decision that followed.

What happened next? We hired ACC's dynamic new CEO, Timothy W. Attebery, DSc, MBA, FACHE, who has had experience in every level of cardiovascular care, from practice manager, to service line executive, to hospital CEO. We then completed the Strategic Plan, in which you'll see strong emphasis on the quadruple aim and clinician wellness, diversity, inclusion, and leadership development for our next generation. We are going to need a Campaign to support these areas—and I challenge you to support us as we do.

We then used our core values of collaboration and teamwork to renew partnerships with our subspecialty organizations. There is no clearer example than our new ACCSAP, CathSap and EP SAP products. We could not have completed these without the help from the leaders of HRS, SCAI, and HFSA—and the entire SAP Editorial team, led by Patrick T. O'Gara, MD, MACC.

I'm also very excited to announce that the American Board of Internal Medicine and the ACC have signed an agreement for a new Collaborative Maintenance Pathway (CMP) option for certified cardiologists who wish to maintain their board certification. A CMP using ACCSAP for both formative engagement in learning and the demonstration of currency with an annual performance assessment will be available to each of you in 2019. We owe a huge debt of gratitude to William Oetgen, MD; Richard A. Chazal, MD, MACC; and Rick Battaglia, MD, along with their tremendous teams, for their work in co-creating this innovative new assessment option for cardiologists. They, together with our subspecialty partners, will be available to answer questions about this new pathway at 1 pm today in a special Heart-to-Heart Stage presentation.

Nearly two years the ago, separate task forces created by the Board of Trustees set out to develop a CV Enterprise and Health Systems Strategy. Led by Cathie Biga, MSN, RN, and Paul N. Casale, MD, MPH, FACC, the groups made important recommendations that were incorporated into our Strategic Plan. We are already starting to deliver on some of these [recommendations]!

Just last month, the College acquired MedAxiom, a cardiovascular services and consulting firm, known for offering successful process improvement solutions for every practice setting – from private practice to large integrated practices and academic centers. With so many members saying they feel a lack of control over the quality of care, efficiency, cost, and outcomes, MedAxiom offers tools to navigate the changing environment. MedAxiom staff and leadership is also here this week to answer questions and work with anyone who needs help.

Last, but certainly not least, I am very proud of the College's Membership Committee, which recently undertook the Herculean task of creating an international stakeholder round table, to advise us in our efforts to improve cardiovascular care around the world. This has resulted in a comprehensive plan to advance and accelerate our global strategy. We will work even more closely with members and chapters to eradicate cardiovascular disease and to improve heart health, including hosting the World Congress of Cardiology at ACC.20 in Chicago. Our mission, and our vision have no borders either.

Up next, you will hear an inspiring international message of hope from Roberto Canessa, MD. But I want to leave you now with some personal inspiration I received just two weeks ago, while visiting our partners in Egypt. There, I was privileged to spend a day with Sir Magdi H. Yacoub, MB, BCH, FACC, a renowned cardiovascular surgeon and icon in his field.

Dr. Yacoub was raised in Egypt but practiced in England for over 40 years. He has performed more cardiac transplants than any other surgeon and could be retired in the luxury of the English countryside. Instead, he returned to Egypt nine years ago and started the Magdi Yacoub Heart Foundation, creating one of the most impressive cardiovascular centers in the world.

He developed this system on donations alone, and it serves a huge populace that is poor and has very little access to care. There is no charge to patients who can't pay and the center has engaged the entire city of Aswan and the nation. While we were sharing lunch at one point in the trip, Dr. Yacoub was approached by parents who said: 'Bless you professor, you saved our child."

When I asked him why he did all of this at age 83, and what advice he would give to us today, he replied: "I am just doing my job. We are the fortunate ones, and we were sent here to serve. We truly have a remarkable opportunity. Please tell them to smile often, and …. just do their jobs."

I would like for us all to think of this as we go about this meeting – and when we head back to our practices and medical centers. When obstacles seem insurmountable and burnout approaches, remember how fortunate we are, and the opportunities before us. And please, don't forget to smile.

Thank you and welcome to ACC.19!

Keywords: ACC19, ACC Annual Scientific Session

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