Conversations With Cardiologists: Richard A. Chazal, MD, FACC

December 14, 2016 | Richard A. Chazal, MD, FACC

In an interview with Poonam Velagapudi, MD, MS, an interventional cardiology fellow in training (FIT) at Brown University in Providence, Rhode Island, and a member of the FIT Section Leadership Council, ACC President Richard A. Chazal, MD, FACC, discusses his presidency, hot advocacy topics and more.

Poonam Velagapudi: Dr. Chazal, thank you for talking with us and sharing your views and advice to FITs on various topics of interest to trainees. We are grateful to the College and your leadership for encouraging FITs to participate in all levels at the ACC. With the increasing subspecialization of trainees and the growth of specialty societies, what is the role you envision for ACC membership for cardiologists who specialize in interventional cardiology, electrophysiology or various imaging modalities?

Richard A. Chazal: The College is the professional home for all cardiovascular specialists, and as such, provides the essential opportunity for all of us to jointly participate in teams designed to further the best care of our patients. The interaction between interventionalists, imagers, heart failure specialists, electrophysiologists, congenital experts and generalists is essential to this process. The ACC has the bandwidth and resources to provide education in not only clinical areas, but in essential non-clinical areas needed to be successful. The participation of ACC, through its members, in advocacy is essential. This drives legislation to some extent, but even more importantly, it drives proper implementation of programs such as those embedded in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The journals of the ACC continue to be without peer in the cardiovascular space, including the number one cardiology journal in the world, JACC.

PV: What has been your major focus during your tenure as president of ACC?

RC: Every year, it is the job of the ACC President to focus on the Strategic Plan of the College and help the Board oversee implementation. This year, there are four major issues at the forefront of this implementation: Maintenance of Certification (MOC), MACRA, Governance Transformation and expansion of accreditation services. These are the areas that are of greatest focus for me and for the Board of Trustees.

PV: What sessions are you most excited for during ACC.17? What advice can you give to FITs or first time attendees who may feel overwhelmed by the tremendous amount of programming?

RC: Once again this year, there will be the very popular FIT Jeopardy competition (Battle of the State Chapters), which generated tremendous interest last year ... among ALL attendees (not just FITs!). The international presentations include terrific topics and allow all of us to expand our understanding of how problems are approached around the world. I'm also very excited about expansion of MOC to virtually all of ACC.17.

For FITs or first time attendees, I have several suggestions: 1) Take time to plan your itinerary ahead of the meeting to ensure efficiency; 2) Be sure to attend at least one Late Breaking Clinical Trial session and at least one session on a topic new to you; 3) Leave a little wiggle room in your schedule; you never know when you'll come upon a session that you really want to attend but wasn't on your initial agenda ... or a colleague with whom you wish to network!

PV: Despite a lot of focus from the College on MACRA, there is still much confusion about what exactly MACRA is and what it means for cardiologists. Any tips on how to get more acquainted with MACRA and changes in health care legislation as it applies to cardiologists?

RC: More sessions on health care reform, including MACRA, will be available at ACC.17, or you can get the graduate level course at the annual CV Summit in January! For most members, I suggest four simple approaches to MACRA:

  1. Be aware of the general direction and requirements.
  2. You don't have to be an expert on MACRA ... but someone in your institution does need to be an expert and the champion for implementation. Identify who that person is and make certain he/she exists!
  3. Know your own data! Become comfortable with your NCDR data, QRUR, Crimson or whatever data is available to you. If you have none, that's a problem that must be remedied.
  4. Begin earnest efforts to move from volume to value. It is the basis of health care reform and it is not going away ... and is part of the ACC Strategic Plan.

PV: What changes in health care do you anticipate when the new administration assumes the White House?

RC: We all expect some changes in the Affordable Care Act (ACA; "Obamacare"), although the scope and details are still unclear. This legislation focuses on access and impacts our patients greatly. While some changes in implementation/style related to health care reform may occur, we do not foresee any abandonment of this process. It's useful to recall that MACRA (which is separate from ACA) passed with broad-based, bipartisan support; it has to do with economics and quality ... not politics.

PV: How have career prospects for graduating FITs changed since you trained? There appears to a shift towards hospital-owned practices and hybrid practices.

RC: When I completed training, the options were essentially private/clinical practice or an academic career. Currently, academicians are often pursuing vibrant clinical practice, while many "private" cardiovascular specialists are heavily engaged in clinical research and teaching; there is some degree of melding of the career paths. The shift toward large practices, often institutionally based, offers new opportunities for engagement of administrative aspects of practice (academic and non-academic) that widen the potential scope of opportunity to serve community and patients.

PV: What is the most fun aspect of being president of ACC? How do you like to spend your free time?

RC: The opportunity to learn from and interact with so many gifted professionals domestically and internationally is the opportunity of a lifetime! What free time??? (I still love to chase fish, when able!)

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