ACC.17 Convocation Ceremony, March 19, 2017: ACC President Mary Norine Walsh, MD, FACC
To Past President Chazal and to our other past presidents, to the Board of Trustees and Board of Governors, to ACC’s CEO Shal Jacobovitz and all ACC staff, to the new Associates and Fellows of the College and to all College members, to our distinguished lecturers and awardees, and to the special guests, family members, and friends who are gathered here tonight. It is indeed the honor of my lifetime to serve the College as President and to address each of you tonight.
To the new Associates and Fellows of the College, I’d like to be the first to say, “Welcome to the team.” By pursuing the designation of AACC and FACC you have signaled your interest in engaging with the ACC in a new role and with a new level of involvement. Many of you have been ACC members for many years, some as Fellow-in-Training members, some as Cardiovascular Team members, some as Associate members; but today you have chosen to take that membership up a notch. You are signaling that you want to play a more integral part in the mission and activities of the College. Welcome to the team.
The delivery of cardiovascular care to our patients is becoming increasingly more complex every day. In my own field of advanced heart failure and transplantation, new treatment options and technologies and methods of care are advancing so rapidly that no one physician, surgeon or clinician can successfully care for our patients alone. It takes a team.
When I first began practice more than 25 years ago, cardiovascular care was often siloed. The model was pretty much: ‘one patient, one cardiologist.’ If you thought you needed an interventional cardiologist or a surgeon to help with the care of your patient, you became, in essence, a general contractor, farming out procedures as you would contract out plumbing or electrical work for home renovation. At that time, the talents of our nursing colleagues were often underutilized. Nurses frequently undertook administrative and scheduling tasks rather than the critical work of patient assessment and education.
But today we function differently. We work as a team. And we make sure that our patients are part of that team. Take interventional cardiology, structural and valve surgery for example. They have greatly evolved over the years. Teams of nurse educators, surgeons, imaging cardiologists and interventional cardiologists work together, not only to provide the best therapeutic options for our patients with valvular disease, but those teams also increasingly embrace the patient as a pivotal member of the team. They engage the patient in shared decision making that is needed before choosing a specific therapy or pathway.
Look around you. New FACCs look across the aisle to your left. These are your teammates looking back at you. They are nurses, nurse practitioners, physicians’ assistants, pharmacologists and other talented clinicians. New AACCs look across the aisle to your right. These are your teammates looking back at you. Some of them are cardiologists just getting their feet wet in practice. They need your expertise to help them deliver excellent, multidisciplinary cardiovascular care. Remember what your teammates look like. Make sure that in your practice and/or at your home institution, you recognize each other for the talents you each bring to the team.
Be a highly functioning team. Do what you do best. Expect your teammates to do the same. And don’t forget the cardiovascular administrators on your team. Many of them are here tonight as well. For those of you just starting out in practice, make sure you know your administrative teammates. Introduce yourself to the CV administrator, the director of nursing, and the CEO of your organization, and understand each of their roles. Knowing and understanding their goals and priorities will help you be a better teammate in the provision of excellent patient care and quality improvement.
Working in health care teams is perhaps more important now than it has ever been. Health care laws are changing and are moving reimbursement models from a volume-driven system to a value-driven one. Teams are no longer optional in this new health care landscape.
As we begin to assume the cardiovascular care needs for groups and populations of patients, we will be held accountable for and paid for quality outcomes. No longer will we bill a fee for every clinical service or test provided for each patient. And it will be crucial for us to move beyond the concept of ‘my patient’ to ‘our patient’ once and for all. It will no longer behoove the cardiologist to see a stable patient with coronary artery disease as a type of ‘well baby visit’ when that patients’ needs are better served by a pharmacist helping with medication reconciliation and a nurse practitioner providing education about medication adherence, diet and lifestyle changes. Each member of the team working up to the top of his or her license will be crucial to deliver the right care to the right patient at the right time.
Team-based care may not be comfortable to all. Those who have practiced for many years in more traditional caregiver roles will need education, coaching and transition time to learn new ways to partner with other clinicians. We will need to continue to be sensitive to the preferences of our patients who may have concerns of abandonment in this new model, rather than feeling the embrace of the team.
The ACC recognized the importance of the team early on. Until 2003, the ACC was a professional organization composed almost exclusively of cardiologists. It was under the leadership of our outstanding past president Dr. Jim Dove, that opening College membership to non-cardiologists was first proposed. Though there was some resistance early on, the College leadership quickly grew to understand the need for our organization’s membership to reflect the way in which we now practice: in teams. The Cardiac Care Associate membership category was approved and by the end of 2003, the College boasted a membership of more than 400 registered nurses, clinical nurse specialists, nurse practitioners and physician assistants. Later, due to interest from other cardiovascular clinicians, Cardiac Care Associate membership was extended to pharmacists, technologists, cardiac rehabilitation specialists and other professionals. All of whom are members of the team. There are now more than 4,500 members of the Cardiovascular Team Section of the College. These members have enriched the work of the College, bringing unique perspectives to our work in quality, education, advocacy and professional development.
Our cardiovascular team is not limited to those practicing in the United States. I ask you to look at those on the Dais. Dr. Allen Seals has introduced to you the leaders of some of the most important cardiovascular societies in the world. They, too, are on our team. Cardiovascular care, research and innovation is now a global enterprise. Our success in stemming the tide of death and morbidity from cardiovascular disease will depend on us working together to share knowledge and best practices.
Through our Assembly of International Governors, the ACC partners with many of the major cardiovascular societies in the world to form our International chapters. I’ve had the privilege over the past two years to attend and participate in the scientific congresses of many of our partners and I’ve seen some extraordinary care delivery by cardiologists and surgeons around the world. One such example is that of a talented transplant surgeon in India who has made primary cardiac transplantation a reality for more than 70 patients in his hospital over the past year. In his region, placement of ventricular assist devices is an impossible strategy. The progress he has made is incredible and his story is not unlike many other outstanding members of the cardiovascular care team making a difference around the globe. The ACC is committed to global outreach in education and innovation and it is my hope that going forward each of you will have an opportunity to meet our global partners and teammates.
Also on the dais are the several named lecturers and Distinguished ACC Awardees who tonight were honored for their work. Each of these leaders has made great contributions to our team, whether in their work in basic and translational science, clinical investigation or outcomes research. Those of you who are early in your career development could do no better than to familiarize yourself with their scientific work and accomplishments and aim to emulate them.
Last, it is my hope that beginning tomorrow, you will seek to involve yourself in the important work of the College. In the audience tonight are future chairs of committees, board review course directors, chapter governors and trustees– and so many other future leaders of the ACC. Join a member section in an area of your interest and once there, volunteer for a work group or task force to which you might contribute. Later this year, there will be a call for committee nominations. Volunteer! Roll up your sleeves and work together with other College members and be an active member of our team. I can assure you that volunteering for the College is incredibly rewarding.
A time like this offers one an opportunity to acknowledge and thank those who have helped along the way. I’ve had many fellow travelers on my journey to this day – people who have encouraged me, shared my vision, guided me when paths diverged, and supported my career.
I’ve been a part of many important teams and I’d like to acknowledge them tonight. First and foremost is the team I was born into. My parents, aunts and uncles are here tonight along with all my brothers and sisters and their families. I owe them thanks for supporting me in my dream of pursuing medicine from early in my childhood and sustaining me along the way with loans, food, music and always love.
Thanks also go to my academic mentors, Drs. Donald Seldin, Burt Sobel, Steve Bergmann and Mark Josephson, honored here earlier tonight. Under their leadership, I developed first as a clinician and then as a clinical scientist. I owe them each a great debt.
I’ve spent the last almost quarter century in the practice of cardiovascular medicine at St. Vincent in Indianapolis. I owe a debt of gratitude to the founders of that practice and the leaders who have shaped both it and my career. Under the leadership of Drs. Skip Hallam, Eric Prystowsky, Rich Fogel and Ed Fry among others, our practice has served as a hotbed for leadership development and I am the better for it.
I also must acknowledge all the members of ‘Team T:’ the cardiologists, surgeons, nurse practitioners and nurses with whom I work caring for our heart failure and transplant patients. I am inspired daily by your talents and commitment to excellence.
As all the women in the room know, we do better with the support of other women. And I have benefitted greatly from the support of many other women in cardiology along the way. Like other prominent women, many will be recognizable to you by one name. My thanks for support on my journey go to: Mariell, Nanette, Noel, Athena, Pam, Janet, Leslee, Jennifer, JoAnn and Felicia among many others. Less recognizable to this audience, but equally dear to me: thanks to my running ladies in Indianapolis, for keeping me healthy, running and fully caffeinated along the way.
Last, and most importantly, to my home team: my husband Bob, my son Gil and my daughter Hanna. You guys are my rock. Thanks for your unceasing support and love.
Congratulations again to the new Associates and Fellows of the College. I welcome you to your new roles in the College and look forward to working with you in the years to come. Our team will be better for your participation and involvement.
Keywords: ACC17, ACC Annual Scientific Session, ACC Scientific Session Newspaper, ACC History
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