Author + information
- David R. Holmes Jr., MD, FACC⁎ ()
- ↵⁎Address correspondence to:
David R. Holmes, Jr., MD, FACC, American College of Cardiology, 2400 N Street NW, Washington, DC 20037
Hands are the most unique attributes among primates, with particular significance for humans. They feed us, clothe us, allow us to communicate by written language (or keyboard), and allow us to express intimacy. Some of the most captured images are of newborn infants' hands resting on their mothers' breasts while nursing, or tiny hands grasping a parent's finger. Photos of adolescents holding hands in societally-accepted public displays of affection are also common, as are images of older couples holding hands comfortably while waiting in a hospital setting for what is to come.
Societies may also hold hands. The American College of Cardiology (ACC) holds hands with many societies, ranging from smaller cardiovascular specialty societies to other medical specialty organizations, on a number of programs and projects. This hand-holding offers several great advantages. Not only does it provide a united front, but it also allows partners to optimize the use of their individual resources, whether structural, financial, personal, or creative. The recent collaboration between the ACC, Society of Thoracic Surgeons, American Association for Thoracic Surgery, and the Society for Cardiovascular Angiography and Interventions for transcatheter valve therapy (TVT) highlights the advantages of hand-holding.
All 4 societies bring unique perspectives and talents to this endeavor. These attributes were highlighted at a Food and Drug Administration advisory committee panel meeting in July. Representatives from these societies—either principal investigators of the PARTNER (Placement of Aortic Transcatheter Valve) trial or leaders of the societies—testified before the panel, lending their experience, scientific knowledge, and visions for the future of TVT. One of the most important potential hand-holding partnerships that came from the panel meeting was the idea of a national aortic valvular heart disease registry, in which modular information about the short- and longer-term outcomes of all TVT procedures would be recorded. This clinical information could then be combined with administrative/claims databases. Such a registry was proposed by Society of Thoracic Surgeons President, Michael Mack, MD, FACC, and your ACC with the goal of working with the regulatory agencies to answer questions about selecting specific therapeutic strategies (medical therapy, surgery, or TVT) from robust data collected on short- and longer-term outcomes. Holding hands and working together in collaboration in this manner opens up great opportunities for optimizing patient care.
Many of us remember our first date, our first lecture, or our first examination, when our palms were sweaty as if global warming had arrived at center stage. Questions contributed to the sweating, such as: How will it turn out? Will it work? Can I trust the other party? Will they try to take advantage of me? Those questions or variations of them may be present in every hand-holding adventure, whether it is a first date or it is surgeons, interventionalists, and primary cardiologists working together on a registry or developing a guideline. Sweaty palms are part of the collaboration and trust-building process. What does it take to get over sweaty palms? It takes building trust, the desire to make things work, chemistry, and success.
As you approach small towns in the Midwest, grain silos can be seen standing apart, rigid and unyielding with hidden content. A fundamental problem with silos is that we cannot hold hands with one another or with the people in the other silos. If we cannot break through the barriers, we can never reach the full potential of holding hands and making things happen collaboratively.
Building relationships between cardiovascular surgeons and interventional cardiologists offers the chance to improve care for patients. Building this relationship can serve as a model for future collaborations between different groups in the large tent of the ACC and other subspecialties and societies. As Robert Fulghum writes, “When you go out into the world, watch out for traffic, hold hands and stick together” (1).
From the ACC to you!
- American College of Cardiology Foundation
- Fulghum R.