Harold on History | The Legacy of James T. Dove, MD, MACC, and Health Care Reform

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The 27th annual ACC Legislative Conference, held this month in Washington, DC, brings together ACC members from across the country to advocate for the cardiovascular care team and their patients. Key among the discussions expected to take place with lawmakers: how to ensure cardiovascular professionals can continue to provide the most appropriate care for their patients in an evolving health care environment focused on value vs. volume.

Nearly a decade since the passage of initial health care reform legislation, we can have these discussions and be heard thanks to the visionary leadership of former ACC President (2007-2008) and health reform pioneer James T. Dove, MD, MACC.

Dove was the founding partner of Prairie Cardiovascular Consultants of Springfield, IL, in 1979. This pioneering medical group, based around providing “quality, compassionate, personal care,” was on the forefront of electronic health record adoption, quality improvement and integrated, team-based care.

In addition to his work at Prairie Cardiovascular Consultants, Dove was actively involved in ACC leadership, including chairing the Board of Governors and several major operating committees, as well as serving as secretary, treasurer, vice president and ultimately president. As talk of reforming the U.S. health care system began to take shape, Dove’s experience at Prairie and his leadership roles within the ACC helped to give the College a seat at the table.

“Jim had unique qualities that enabled him to be an ideal leader for ACC’s growth in advocacy and health care reform,” says current ACC President C. Michael Valentine, MD, FACC. “As the developer of a large, progressive practice, he brought experience, credibility and strategic vision to the table.

More importantly, his warm personality, patience and kindness made him trustworthy to even the toughest opponents. He was able to advocate effectively for international growth and expansion, inclusion of the cardiovascular team as members of the College, leadership development and health care reform through his Blue Ribbon Task Force. Jim lived the mission of the College and inspired so many to do so as well.”

The ACC launched its Quality First health care reform campaign back in 2008. The first order of business: a Health Reform Summit that brought together more than 100 stakeholders to gain a better understanding of the perspectives of patients, seniors, labor unions, economists, government and other medical societies in guiding health care reform. Dove chaired this summit, highlighting the current state of health care, barriers to reform, system redesign and payment reform to support the redesign.

"Silence is not an option,” he said. “We must be there to defend our patients and our members. Our position cannot be self-serving but must be based on access to appropriate quality care. We also have an obligation to control costs in every way that we can… We must be one of the leaders in the debate on health care reform...”

The Summit set the stage for ACC’s role in health system reform over the next three years. A core set of principles developed from the Summit discussions encouraged health care providers to act on their professional responsibility to transform health care from the inside out. Physicians, nurses and other health care professionals on the front lines of care delivery were felt to be ideally positioned to ferret out waste and unnecessary or inappropriate care to focus instead on improving quality of care and empowering patients.

Fast forward to today. The spirit of the early principles remains, particularly as they relate to collaboration, team-based care and patient access to cost-effective, quality care. A new set of updated principles were released last year to reflect where we are today and continue to make sure any new or updated policies and provisions protect patient access to quality, cost-effective care and ensure continued investment in cardiovascular research, prevention and health care workforce development. These principles are:

  1. Expand access to and prevent loss of health care coverage through public and private programs.
  2. Guarantee access to affordable coverage options for patients with cardiovascular disease or other pre-existing medical conditions.
  3. Improve access to and coverage of preventive care and expand the nation’s investment in research, prevention, public health and disease surveillance.
  4. Continue and build upon policies to promote usability and interoperability of health information technology to improve patient care and outcomes.
  5. Maintain commitment to patient-centered, evidence-based care and reverse the trends toward decreased personal contact between the patient and the physician/care team.
  6. Emphasize professionalism, transparency and the collaborative clinician-patient relationship to improve quality and promote better outcomes.
  7. Foster collaborative development, testing and expansion of models that promote and reward value, team-based care and shared decision-making through the Center for Medicare and Medicaid Innovation and other entities.
  8. Minimize barriers to the delivery of efficient, high-quality cardiovascular care in all practice settings.

Inspired by Dove’s legacy, the College in conjunction with the entire cardiovascular care team continues to be recognized as a credible resource both on the Hill and off. As a result, we continue to be effective advocates in terms of both transforming and optimizing cardiovascular care and patient outcomes.

Keywords: ACC Publications, Cardiology Magazine, Health Care Reform, Leadership, Quality Improvement, Delivery of Health Care, Quality of Health Care, Electronic Health Records, Acute Coronary Syndrome, United States Food and Drug Administration

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