Cardiology Magazine — March-April 2011
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Education
Richard Nishimura M.D., F.A.C.C

Academic Medical Centers Not Immune to Changes in Health Care Delivery

Cardiologists in academic medical centers (AMCs) have traditionally been shielded from changes in health care and payment systems. They have been able to continue to be involved in their research and education through support from their medical center as well as grants from industry and the National Institutes of Health (NIH). There has also always been a steady stream of patients referred directly to AMCs for complex problems from the practice community.

However, cardiovascular professionals in the AMC environment are now facing challenges on several fronts. For one, funding from both external and internal sources is decreasing dramatically for cardiovascular research because of financial constraints and regulatory requirements. These changes are forcing many investigators to look elsewh

AMCs are also increasingly counting on income from patient care. This means stricter work hours for residents and fellows, increasing faculty clinical work hours and expectations, and the need to meet American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) requirements. Such a rigorous schedule detracts from a physician’s ability to pursue education and research opportunities.

Despite the need to rely more and more on income from patient care, the higher cost of care in a teaching insti Institution is leading to a decline in patient volume at many AMCs, with some payers not having the AMC hospitals in their networks. There also has been a decline in referrals for tertiary care as private practice groups have become significantly more specialized. Patients are instead going to practices where comparable, less expensive and covered services are available.

Finally, it is the inherent responsibility of the AMC cardiologist to provide updated knowledge to colleagues in the field. However, the explosion of knowledge and new science in the field of cardiovascular diseases makes it difficult for cardiologists to stay current on the latest information. There are more than 1,500 new original publications every day in the library of medicine, and less than one percent is pertinent to practice. Thus, much more is now involved in simply staying abreast of the new science in one’s own practice, let alone continuing to educate others.

To navigate through these challenges and changes, cardiologists

In AMCs need to adapt. They need to establish independent funding at the earliest stages and seek alternative methods of funding for their research – perhaps in new partnerships with outside innovative companies. Novel business opportunities must be pursued in the future, while conflicts of interest must still be avoided.

Cardiologists in AMCs must also

Finally, it is the inherent responsibility of the AMC cardiologist to provide updated knowledge to colleagues in the field. However, the explosion of knowledge and new science in the field of cardiovascular diseases makes it difficult for cardiologists to stay current on the latest information. There are more than 1,500 new original publications every day in the library of medicine, and less than one percent is pertinent to practice. Thus, much more is now involved in simply staying abreast of the new science in one’s own practice, let alone continuing to educate others.

To navigate through these challenges and changes, cardiologists

Learn how to best provide high-quality, patient-centered care, using a team approach and all available resources in the most efficient manner. This is not only necessary for the future, but residents and fellows need to be taught these things now, since they will be responsible for providing care after graduation.

The AMC cardiologist will also need to transform education. New models of educating residents and fellows need to be put in place to adapt to the work hour regulations, including the creation of competency-based requirements, rather than depending upon duration of rotations and number of procedures. Education for cardi- Ology professionals needs to develop into a learner-centric model rather than teacher-centric. Education should also incorporate American College of Cardiology (ACC) tools to supplement live lectures with more web-based resources.

In addition to its online tools, the ACC needs to continue to offer leadership programs to help both practicing physicians and those in AMCs adapt to these changes. Career development programs and organizational leadership programs are already available through the Cardiovascular Leadership Institute. In addition, the ACC has supported the Teaching Skills Workshop for Emerging Faculty to assist young promising academic cardiologists in their educational endeavors. In addition to its online tools, the ACC needs to continue to offer leadership programs to help both practicing physicians and those in AMCs adapt to these changes. Career development programs and organizational leadership programs are already available through the Cardiovascular Leadership Institute. In addition, the ACC has supported the Teaching Skills Workshop for Emerging Faculty to assist young promising academic cardiologists in their educational endeavors.

Developing this new talent will ensure that the College maintains its reputation for educational excellence in meeting The learning needs of all members.

The future paradigm of education will be to provide ACC-vetted information at the point of care through CardioSource.org. The learning should then be stored so that the individual can show the certification boards and patients that they remain highly competent.

Furthermore, there has been much time, effort and resources put into the creation of the ACC/AHA guidelines and other clinical documents. However, it has been difficult for a busy practicing cardiologist to access pertinent information from these well-written but voluminous documents when confronted with a patient care question.
Furthermore, there has been much time, effort and resources put into the creation of the ACC/AHA guidelines and other clinical documents. However, it has been difficult for a busy practicing cardiologist to access pertinent information from these well-written but voluminous documents when confronted with a patient care question.

The development of new technology will allow enhanced search capabilities of all College-vetted documents so that there can be ready access to clinically relevant information. The ACC’s Lifelong Learning Portfolio will allow members to continuously documentThe development of new technology will allow enhanced search capabilities of all College-vetted documents so that there can be ready access to clinically relevant information. The ACC’s Lifelong Learning Portfolio will allow members to continuously document

Achievement of their competencies, and the College is working hand-in-hand with the ABIM to facilitate MOC.

cardiologists join an AMC is to promote the science and

Education of cardiovascular diseases – a concept that we should never forget. Despite all of the transitions and changes occurring around us, it is essential that the mission of the AMC cardiologist remains the pursuit of the science and education of our colleagues.

To learn more about the ACC’s commitment to science and education, visit CardioSource.org.

ACC.11 CardioSmart Health Fair Offers LA Patients Free Screenings, Education

The American College of Cardiology (ACC), and the Mississippi and Louisiana chapters of the ACC, are co-sponsoring the CardioSmart Health Fair at ACC.11 Saturday, April 2 from 9 a.m. through 3 p.m. at Kingsley House, 1600 Constance St.

The fair will offer patients in New Orleans a chance to meet cardiologists and gain valuable information about healthy lifestyle choices through free cardiovascular health screenings and education. The primary goal will be to engage the underserved and underinsured populations in the city, said Thad M. Waites, M.D., F.A.C.C., co-chair of the health fair. He said the fair will be a significant event for the New Orleans community, and holding it at Kingsley House, which has been in operation since 1896, adds even more meaning to the event.

“The fair will be a significant event for the New Orleans community. Kingsley House is a United Way Community Impact Partner and currently serves nearly 7,000 people annually throughout Southeast Louisiana in a wide variety of nationally accredited and state certified capacity building programs.

“Kingsley House is nationally renowned as the oldest Settlement House in the South, has served more than half a million people since it was founded in 1896,” said Waites. “The venue itself can be a great example to the patients and the community pursuing health, on recovery and on survival.”

Highlights of the health fair include:

• Health screenings,

• Blood pressure management,

• Smoking cessation,

• Weight loss/management,

• Fitness/exercise,

• Nutrition, and

• Medication education.

With help from the New Orleans Health Department and local health clinics, each of the areas will have presentations by experts and will offer educational handouts on the simple steps people can take to improve their heart health. Free screenings include blood glucose, total cholesterol, body mass index (BMI), waist circumference and blood pressure. Patients will also have the option of speaking one-on-one with a cardiac care team member once they receive their test results. There will also be a special CardioSmart program for children. ACC.11 attendees are invited and strongly encouraged to actively participate in the Health Fair.

“The Health Fair will bring to the community an exciting day of education regarding heart and general health and a fun day with many exciting events,” said Waites. “The participants will leave with new data about their own health and education on how to improve their health.

The CardioSmart Health Fair is part of the ACC’s CardioSmart National Care Initiative. Sponsors include the Coca-Cola, Colgate-Palmolive, General Mills and SUBWAY.

For more information, CardioSmart 5K in Honor of Dr. Henry McIntosh

Special 5K Fun Run/Walk in honor of ACC past President Henry D. McIntosh, M.D.,

M. A.C.C., will be held on Monday, April 4 at 5:45 a.m. Runners will meet in front of the World Trade Center building at the intersection of Canal St. and Convention Center Blvd.

Monday, April 4

5K Fun Run/Walk in honor of Henry D. McIntosh, M.D,, M.A.C.C.

Runners and walkers must sign in when registering for ACC.11 for an accurate headcount, to sign a waiver and select a t-shirt size. Those not yet registered for ACC.11 and/or i2 Summit 2011 can sign in for the Fun Run/ Walk during the registration process. For those already registered, go to your registration confirmation and select the “Changes/Cancellation” button and log into the registration website. Once logged in, select the “Add/ Remove Social Tickets” button and add “CardioSmart Fun Run/Walk” to your registration.

For questions or assistance, contact the ACC Registration and Housing Center at accregistration@jspargo.com.

Don’t Miss the 60th Annual Convocation

The ACC’s 60th Annual Convocation, presided over by President Ralph

G. Brindis, M.D., M.P.H., F.A.C.C., is one of the most exciting and prestigious events to take place during ACC.11. A hallowed tradition of the College, Convocation confers fellowship on newly elected fellows of the College. It also honors awardees, including the 2011 recipients of the ACC Distinguished Awards, ACC Foundation (ACCF)/ Merck Research Fellowships, the ACCF/GE Healthcare Career Development Awards, the ACCF/William F. Keating, Esq. Endowment Award, the Young Author Achievement Awards for JACC: Cardiovascular Cardiovascular Interventions and JACC: Cardiovascular Imaging and the ACCF Young Investigator Awards.

New this year, the first class of Cardiac Care Associates will advance to “Associates of the American College of Cardiology” (A.A.C.C.) during Convocation. This designation recognizes nurse practitioners, clinical nurse specialists, registered nurses, clinical pharmacists and physician assistants, who – through advanced education, training and professional development – have dedicated themselves to providing the highest level of cardiovascular care. In addition, David R. Holmes, Jr., M.D., F.A.C.C., will be installed as president of the College.

Do not miss this exciting evening! For a complete list of Distinguished Awardees and Young Investigator award winners, visit CardioSource.org/ CardiologyMagazine.
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