Author + information
- Marvin A. Konstam, MD⁎ (, )
- Mariell Jessup, MD,
- Gary S. Francis, MD,
- Douglas L. Mann, MD and
- Barry Greenberg, MD
- ↵⁎Tufts Medical Center, The Cardiovascular Center, 750 Washington Street, Box 108, Boston, Massachusetts 02111-1526
We thank Dr. Jordan for his thoughtful remarks in response to our commentary (1). In our article, we describe the need for certification of the secondary subspecialty of advanced heart failure and transplant cardiology and the competency requirements that have been enumerated by the American Board of Internal Medicine (ABIM). In his letter, Dr. Jordan challenges the inclusion of technical competencies, including management of patients undergoing cardiac transplant, and raises concerns that these requirements will preclude recognition of competency in heart failure management within the community.
We wish to reaffirm the focus of the Heart Failure Society of America on the cognitive aspects of heart failure patient care and placement of the patient with heart failure at the center of all heart failure management competencies. We favor development of opportunities for recognition of practice competencies in heart failure, short of ABIM secondary subspecialty certification and without requirements for technical competencies. However, the consensus that evolved around the need for secondary subspecialty certification included the necessity of mastering the technical aspects of contemporary advanced heart failure management, including managing patients undergoing transplantation and ventricular assist device placement. We and our colleagues across the cardiology and internal medicine communities believe that competencies in these areas represent key elements that set apart the subspecialist in advanced heart failure from the highly competent cardiologists and internists who will continue to provide the vast majority of care to patients with heart failure.
We do not anticipate that the advanced heart failure and transplant cardiologist will limit his or her care to the transplant center. Many who gain these special competencies will practice within the nontransplant center and community hospital setting. The nature of the technical procedures offered to advanced heart failure patients will evolve in the coming years. As it does, increasing numbers of patients undergoing these procedures will return to the community and will require care from subspecialists with expertise in their management. The certified advanced heart failure and transplant cardiologist will have recognized expertise in the full range of treatment options available to the patient with advanced heart failure and be fully qualified to care for patients receiving these treatments as they return to the community. We believe that recipients of certification in advanced heart failure and transplant cardiology, having demonstrated their competencies in all aspects of advanced heart failure management, will provide a vital function both in the advanced heart failure center and within the health care community at large.
- American College of Cardiology Foundation