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- W Bruce, MD, MA, FACC, President, American College of Cardiology*
- ↵*Reprint requests and correspondence:
W. Bruce Fye, MD, MA, FACC, Mayo Clinic, Division of Cardiovascular Diseases, 200 First Street, SW, West 16A, Rochester, Minnesota 55905-0001, USA.
The American College of Cardiology (ACC) is the world’s leader when it comes to innovative and high-quality continuing education programs and products that focus on the cardiovascular system. But it’s much more than that! The College is an articulate and authoritative voice that speaks out on behalf of cardiovascular specialists and persons with cardiovascular disease. Although the ACC’s primary purpose has been and will remain continuing education, current circumstances compel us to focus more resources and energy on advocacy. Fortunately, our concerns are being heard in Washington. That was never more evident to me than during a meeting Dr. Doug Zipes and I had last July with President George W. Bush, Health and Human Services (HHS) Secretary Tommy Thompson, and Labor Secretary Elaine Chou. As president and president-elect of the ACC, Doug and I—along with representatives of 11 other specialty societies—had the opportunity to share our thoughts with them about the “Patients’ Bill of Rights.”
President Bush was quite familiar with the ACC. Just three months earlier, he had spoken at the College’s 50th Annual Scientific Session in Orlando, Florida. Now, in Washington, he wanted to hear our thoughts about the challenges patients with cardiovascular disease sometimes confront in this era of managed care. The President listened carefully as Doug recounted compelling stories of patients who needed specific tests and treatments but couldn’t always get them. I described how some for-profit managed care organizations had developed guidelines that put patients at risk rather than putting them first. It was evident that the President was very interested in the discussion and was concerned about the issues we raised. An aide urged him repeatedly to end our meeting so he could start a major press conference on the “Patients’ Bill of Rights.” But President Bush was engaged, and he wanted to continue talking with us. Our scheduled 20-minute visit lasted three-quarters of an hour.
I mention this unique meeting because it reflects the College’s credibility and clout. This enviable situation, where the ACC has access to—and influence with—top government leaders, was not achieved overnight or by accident. This status has been earned as a result of years of hard work by many talented, energetic, and informed College staff members and fellows whose efforts have focused on government relations, reimbursement, and the quality of care. To have an impact in Washington, contacts and credibility are crucial. The ACC has plenty of both. I’ve seen this firsthand, not just with President Bush, but with many other health care leaders in the U.S. As chair of the ACC’s Government Relations Committee during the mid-1990s and, more recently, as an officer, I’ve had the privilege of representing the College in meetings with the President, cabinet officers, the Surgeon General, members of Congress, and leaders of the National Institutes of Health, Centers for Disease Control and Prevention, and Federal Drug Administration. These key policy and decision-makers know about the ACC—and they respect our opinions. Indeed, as our meeting with President Bush demonstrated, they actively seek our input.
Education is the College’s main mission, and it blends seamlessly into our advocacy activities. Just as we educate ourselves and other health care professionals, we must also inform policy makers on new advances in diagnosis and treatment—innovations that help us care for patients. But cardiovascular specialists are also deeply committed to prevention, a tradition that dates back to the birth of our specialty in this country. The College actively supports public health efforts aimed at preventing cardiovascular disease. Just a few weeks ago, during National Heart Month, HHS Secretary Tommy Thompson publicly congratulated the ACC and our members for our dedication to reducing the societal and economic burden of cardiovascular disease. Secretary Thompson’s thanks came during a national press conference on the greatly increased cardiovascular risks persons with diabetes face. The Secretary told the reporters present and the television audience that the U.S. is in the midst of twin epidemics of obesity and diabetes. He applauded the “Make the Link!” program cosponsored by the ACC and the American Diabetes Association. This new educational program seeks to enhance awareness of the critical importance of cardiovascular risk factor modification in persons with diabetes.
There are several reasons that policymakers and legislators turn to the ACC for information and advice. The College has represented the nation’s cardiovascular specialists for more than 50 years. During that time, it has worked hard to improve the quality and length of life of persons with cardiovascular disease through continuing education. Our members turn to the ACC when they want timely and clinically relevant information to help them care for patients. Increasingly, our members also look to the College for advocacy. When they do, they discover what health policy analysts and government officials have long known. The ACC has a superb advocacy staff that brings great expertise and rich experience to bear on a wide variety of issues that affect the delivery of cardiovascular care. These professionals, partnering with our members who serve on advocacy work groups, task forces, and committees, have done a great job developing key relationships with lawmakers and regulators. These contacts provide the College with many opportunities to showcase the medical expertise of our members and broadcast our policy positions.
Some organizations might be content pointing to past successes, but the ACC is an ambitious, forward-looking professional society. Reflecting the growing importance of advocacy—to our members and to persons with cardiovascular disease—the College acted recently to enhance our ability to articulate our perspectives and our concerns. We just created a 501(c)(6) entity to complement our traditional 501(c)(3) organization. This innovation means that we can devote more funds to advocacy, can form a Political Action Committee (PAC), and can partner more effectively with our chapters. These important changes have come at the right time. As cardiovascular specialists, we’re dealing with dramatic cuts in Medicare reimbursement, skyrocketing liability insurance rates, and a multitude of other challenges that have a direct impact on how we practice and provide care. And it doesn’t matter what context we’re in; we’re all affected.
Cardiovascular specialists are generally optimistic. This positive attitude reflects our ability to help patients today and our shared vision of a future filled with promise. But innovation and invention are only part of the equation. Practitioner and academic cardiologists share very real concerns about how to provide high-quality and technologically sophisticated care in the face of unrelenting cuts in Medicare reimbursement. Their once clear vision of the future is clouded by the practical implications of continuing fee cuts. I want to assure you that the ACC is responding aggressively to this stressful situation. My next President’s Page will focus on Medicare reimbursement and reform as well as other specific advocacy issues that the ACC is addressing.
Change doesn’t come quickly in Washington, and patience and persistence are essential. One point cannot be overstated: more ACC members must get involved in the process. As busy cardiovascular specialists, it’s easy to rationalize that someone else is addressing our concerns or that our College is focusing on them. We are, but we need your help. The ACC is an organization of 28,000 members, and every voice that joins the chorus amplifies the advocacy message—especially when Congress is involved. Members of Congress listen to their constituents; they listen to you. If we hope to succeed in advocacy as we have in education, we must work together—and work as individuals.
Whether we are educating each other, developing clinical practice guidelines, or advocating for fair and logical reimbursement policy, we need the insights and energy of our members. If you want to influence health care policy and reimbursement philosophy, get involved. There are many opportunities: become a “key contact” that links the College with your elected national representatives, make a contribution to our new PAC, or get involved with your ACC chapter. Better yet, do each of these things. As a professional society and as individual physicians, we can make a difference. How much of a difference depends on the commitment each College member makes to helping us achieve our ambitious advocacy goals.
I thank Carmen Phillips for his valuable contribution to this essay.
- American College of Cardiology Foundation