By Spencer B. King, III, MD

The long, hot summer in The Lower 48 has been stifling as usual, but for 3 marvelous days I had the chance to cool off in the Canadian Rockies. The ACC board chose to meet in Banff, Alberta, and the past presidents of our organization were asked to come and participate in some strategic planning. The hope, I think, was to enable our superannuated minds to be stimulated by the cool, rarefied Albertan air.

It was the first time so many past presidents had caucused together in my memory. We spanned decades from the latest PP (past president no longer on the presidential team) Fred Bove to Forrest Adams, who was president 41 years ago. At 94, he held his own hiking to the Columbia ice field glaciers, giving us all hope. About 20 past presidents spent a long morning discussing the state of the College and the direction in which it was going with our new CEO, Shal Jacobovitz. Bill Nelligan was also in attendance, and the "patron saint" of the ACC provided the gold standard for all staff leadership that has followed. The conversations were candid, and the elder statesmen supplied not only institutional memory but vision for the future. What will that future be?

Where Do We Go From Here?

Some say we have become too much of a guild, functioning primarily for the benefit of the members. The group assembled, however, still believes the College is not a guild but a professional society with the high purpose of preserving and improving the profession for the benefit of our patients and society in general. There is no doubt that the College has multiple roles to play, and those are now being influenced by the leveling of cardiovascular expertise around the world. When the College was chartered, World War II had just concluded. Europe and Asia were a shamble and rebuilding was just starting. The ACC, in its first 20 to 30 years, was, if not the only game, the main game in town. The certificate I received in 1972 confirmed that I was a board-certified cardiologist. The College promoted education as its primary mission, but that certificate itself made ACC membership worth it.

In the 65 years since the College was born, things have evolved. Dramatic advances in technology and therapy have transformed cardiology, and, in no little part through the College's efforts, that knowledge has spread all over the world. In the late 1990s, when I was president, we invited Lars Rydén, then president of the European Society of Cardiology (ESC), and Alan Howard, chief staff officer of the ESC, to visit Heart House and to observe and understand how these staff operated. We should be proud of any assistance this had as the ESC developed its own program.

Taking the ACC to the International Stage

Now another 15 years on, the College must, with the new strategic plan, determine its future. The ACC has long since stopped being a North American organization only. Forty thousand members, 10,000 of them from outside the United States and growing, speak to the global reach of the College. Whether one views the primary mission of the ACC as North American-centric or not, one cannot escape the necessity to be engaged in a major way with everything going on in our specialty. The journals are a good example. JACC remains, by a wide margin, the leading journal in cardiology with a readership of more than twice any other. The submissions to JACC, JACC: Cardiovascular Interventions, and JACC: Cardiovascular Imaging originate from outside the United States by a margin of 3:1 to 4:1. The global influence of our publications must be continued and enhanced.

I believe two recent actions by the ACC board confirmed the commitment to engage our organization on the world stage. Valentin Fuster was appointed as the new editor of JACC. There can be no more internationally engaged fellow of the College for this critical post. The commitment of Val and the editors of the sister journals is strong as we build on the shoulders of Tony DeMaria and his predecessors.

The other event is the selection of Shal Jacobovitz as the new CEO of the College. His energy, but even more his competence as a leader of organizations, is impressive. He has joint Canadian and US citizenship and has led companies while living outside North America. His global vision should provide important support for the leadership of the College.

Yes, we were founded primarily as an educational institution to improve the quality of our profession, and that mission continues. The College now, however, has become the standard-setting professional society with a powerful database to provide evidence to support those standards. The ACC, perhaps the most respected professional medical society, has a full plate, and our leadership will take fresh looks at the best use of our resources. The members of the College have much to offer to our profession in North America, not the least of which is to contribute to the building of an effective health system. But we also cannot fail to provide leadership on the world scene. As the bard said, "All the world's a stage."

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Spencer B. King, III, MD, is president of the Saint Joseph's Heart and Vascular Institute and Professor of Medicine Emeritus at Emory University School of Medicine in Atlanta. He is also editor-in-chief of JACC Cardiovascular Interventions. He has been a pioneer in interventional cardiology, directing the first trial of angioplasty versus surgery.

Keywords: Societies, Medical, Cardiology, Canada, Leadership

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