Does the Past Dictate the Future? Responsible Stewardship From the Youngest Among Us

'Pearls of Wisdom' for Early Career Members from the members of the Senior Cardiology Work Group

"Like so many Americans, I am concerned about the economy and our war on terrorism both at home and abroad. National polls indicate that jobs and the economy consistently rank high among voter priorities, but health care is not far behind. And when it comes to health care, the issues facing the President and Congress are indeed daunting."

"Appropriate cardiovascular care used to be solely in the head of the beholder. Before the advent of cardiovascular diagnostic breakthroughs, physicians relied on intuition and last case result to sort out individual treatment. Universal-based practice based on the evidence was a dream. But now we have developed excellent cardiovascular care pathways, guidelines, performance measures and appropriate use criteria, in the belief that we can learn from each other without stumbling through the rocks ourselves."

Both statements come from President Pages that I wrote in 2004, well over 13 years ago. What are the lessons learned?

As to my concern regarding the national challenges our country faces, we are no further along addressing the dyad of the economy and terrorism. Distinct progress has been made for adequate access to health care as a human right, although as we speak even that is in jeopardy. The political system has been paralyzed and polarized for years, a situation that will sadly affect my grandchildren and your children. There always are opportunities even in the face of what appear to be insurmountable challenges. Take advantage of these. If you are passionate about the future of health care, participate in College committees such as the Health Affairs Committee. Get involved in the process! You can educate a local representative in your home district, participate in the ACC Legislative Conference and, even as an increasing number of physicians have successfully done, run for public office. Help improve the health of our most valuable commodity, our patients.

In the latter instance, we are fortunate that in the golden era of cardiology, the ACC and American Heart Association were both wise enough to assemble clinical and research experts to spend countless hours reviewing the literature to determine the evidence base that permitted us to learn from each other and practice "value-based care" well before this term became popularized with the Affordable Care Act, also known as Obamacare. Kudos to the foresight of both organizations and the sub-specialty societies, who over last 30 years, began assembling the science for optimizing patient care.

In one of my favorite books, the wonderful and wise The Little Prince, author Antoine de Saint-Exupery reveals an important secret of life: "One sees clearly only with the heart" the little prince learns. "Anything essential is invisible to the eyes." Always follow the passions within your heart!


This article was authored by Michael Wolk, MD, MACC, past president of the ACC.