This post was authored by Robert A. Guyton, MD, FACC, treasurer of the ACC.

This week’s release of a special JAMA issue focused on professionalism couldn’t have been more timely. Your ACC leadership is in the midst of a major effort to develop new tools and explore new certification processes aimed at ensuring that members are best equipped to handle the rapid changes in health care delivery and education. Just recently I shared with my fellow Executive Committee members that I believe it is time to make a critical change in our thinking and our messaging.

Our stated and noble mission is to transform cardiovascular care and improve heart health. But, as Board of Governors (BOG) Immediate Past-Chair Michael Mansour, MD, FACC, in a recent address to the BOG asked: “Where is the member in our mission?”  I emphatically agree with this question – our efforts to realize the mission only float around in the iCloud without the daily actions of our members. Rather than a mission to transform cardiovascular care and improve heart health, we should have a mission of empowering our almost 50,000 members to transform cardiovascular care and improve heart health. This is where the rubber meets the road – one provider-patient interaction at a time. This is the intended site of implementation of the new discoveries from research, experience from registries, and assimilation of knowledge in guidelines and appropriate use criteria (AUC). Everything that’s in the iCloud comes to life when a provider and a patient come together to explore the new opportunities that arise from the explosion of knowledge in cardiovascular medicine.

Currently, our members feel battered under the assault of ever-changing bureaucratic billing requirements, unfunded quality mandates and decrees of recertification. We must re-empower them! A strong beginning to empowering our members is providing them, their practices and hospitals with registry data, as well as tools, to improve value and certify the level of quality/cost provided to patients. This improvement and this certification allow appropriate billing for outcomes/quality/value as mandated in three short years. Hence the ACC should have a major effort to develop those tools and certification processes to empower our members to navigate the reimbursement shift from volume to value. The College has the bandwidth, the economy of scale, the quality programs, the education programs, the substantial talents of volunteer members and staff, and the fiscal resources to tackle this formidable task. This is not a business venture for the College. It is a critical empowerment of members to allow them, fiscally, intellectually and operationally, to care for their patients in a manner consistent with our mission and consistent with the almost sacred contract made when patients put their lives in our hands.

Similarly, maintenance of certification is every bit as much an issue involving the need to empower our members. Recertification – or revalidation of competency as I prefer to call it – is part of transformed health care.  We either do it ourselves or it is done to us. Our registries, guidelines and AUC initiatives put us years ahead of others. We need to use our quality improvement and validation tools to efficiently and incisively evaluate member competency and facilitate member recertification as part of the same process that uses these tools for quality certification and improvement for practices and hospitals. This is legitimate revalidation of competency – evaluation of real outcomes with real patients. As a cardiac surgeon, a huge part of my recertification is submission of my last 200 cases with defined outcomes—an easy task if I participate in our database.

In summary, I propose an intentional realignment of our thinking and our message. The ACC’s new strategic plan aggressively creates the infrastructure to advance the mission. We need to leverage this infrastructure in a manner that delivers the research, the quality initiatives and the education to daily clinical practice. The realignment is the understanding that we deliver the goods primarily through our members. We need to crystallize the concept that empowerment of our 50,000 members to provide the best possible care to their patients is the essence of our utility to society.

ACC Note: The complex situation presented by the American Board of Internal Medicine’s changes in Maintenance of Certification (MOC) requirements continues to be top-of-mind for ACC leadership and most importantly for the ACC members affected by the changes. The ACC’s approach to addressing the changes over the past year has been careful and deliberate – looking for the best ways to help members and their patients in proceeding forward. In these matters headway has been made, and continues to be made, both in terms of working with ABIM to re-evaluate and change their requirements, and also in exploring alternative options to ABIM.

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