This post was authored by Robert Shor, MD, FACC, governor of the Virginia Chapter of the ACC.

The question of where we are and where we need to go in terms of critical care cardiology has been at the forefront of my mind recently.  Has the train left the station? If so, what track is it on and can we redirect the direction of the train? I believe that we must make sure whatever policy is developed remains as inclusive as possible, meets the needs of our membership and allows us to remain advocates for our patients.  I believe more certification of docs and coronary care units is not the answer and would prefer to have individual procedures and programs meet certain standards, as has recently been done with transcatheter aortic valve replacement.

Furthermore, as a society, we often fail to take personal responsibility for our actions or circumstances. I have been struck by how those on Capitol Hill all too frequently view us and our concerns as House of Medicine in-fighting or motivated by greed. I may be a bit jaded as I live just outside of Washington, DC, but I think it is time to consider having our patients be aware of and take more responsibility for their care. I would consider addressing the taboo subject of getting patients to advocate for their care more. I understand this goes against the grain for many, but times and circumstances have changed. I also think CardioSmart can be a great tool to help patients become more informed about the changing realities of health care.

No matter what happens, whether we get to direct the train, be a passenger, or get run over, I think we need to feel that we have done whatever we can to make the system better. Fighting apathy, showing membership value and keeping us relevant is key. Identifying issues that resonate with our members and then showing them how their involvement can make a difference in the process are very essential elements in engaging our membership and for our collective future.

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