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President's page: Upon convocation: Dream big, love big FREE

Pamela S. Douglas, MD, FACC
[+] Author Information

Address correspondence to: Pamela S. Douglas, MD, FACC, American College of Cardiology, 9111 Old Georgetown Road, Bethesda, Maryland 20814-1699

American College of Cardiology Foundation

J Am Coll Cardiol. 2005;45(7):1142-1143. doi:10.1016/j.jacc.2005.02.031
Published online
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I come before you, humbled and honored. In part, this is because of the wealth of knowledge, experience, and friendship the American College of Cardiology (ACC) has brought into my life. In part, it is because of something very simple: as only the second woman to serve as president of the College, I simply do not look like most of the past presidents.

You may not look like a past president of the College either. However, I am personally committed to making sure you look like a future president of the College. You are a beautiful bundle of potential for your community and for the College. Your enthusiasm and energy will be most welcome throughout the College, from our committees to our state-based chapters.

I am sure you expect your new FACC credential will bring you great professional acclaim and success. As president and chief custodian of the College's value for members for the next year, I assure you it will.

But if my own experience is any guide, your new FACC credential will bring you much, much more. That extra benefit comes from something we rarely acknowledge: the personal, in-your-own-heart meaning behind our profession that entrusts you with the care of another human being.

What really counts, after we get past the science and the training and the late nights on call, are our collective dreams, passion, and love. Although I have yet to meet you, we have something very special in common. We have chosen to realize our dreams through cardiovascular medicine. Although many people share a dream to make the world a better place, you and I share a deep and abiding passion for cardiology and a love for humanity.

People like us believe medicine is our calling, our reason for being. I know I did when I was a new Fellow of the College. I still do. The mix of the science and the art of medicine; the opportunity to create something of value and to serve others; the challenge of leading our world toward better cardiovascular care … these are unique. To me, they are the elixir of life. I honestly cannot imagine a different profession because nothing else could possibly be as fulfilling. This is the kind of bone-deep commitment I hope you will always feel as a cardiovascular professional.

The College is dedicated to nurturing you and your practice throughout your professional life. There is simply no better way to keep our profession strong, vital, and contributing to the greater good that we pledged in our Hippocratic oath.

You trained long and hard to earn the designation of Fellow of the American College of Cardiology. All of us have willingly sacrificed family, friends, and community for the sake of our profession. This commitment is reflected in our passion for cardiovascular medicine and in our dreams for a better tomorrow.

Much of the value in our profession is generated by those for whom getting the job done is their primary motivation. Many of us carve time from our busy practices to teach or to volunteer, or we forgo higher salaries by choosing an academic career. We all strive to be Super Doctor, squeezing yet another impossible hour out of every day.

Why do we do this? Perhaps, like me, you are drawn to the magical mix of research, education, and clinical care. Or, you are intrigued by the challenge of working in a fast-paced practice. Whatever the nominal reason, we are passionate about cardiology, and we believe in caring for people. The College shares this core belief, unconditionally.

One of the College's primary missions is education. There have been many changes in the ACC's educational efforts in the last few years, but the goal remains firm: to improve patient care by rapidly moving cardiovascular research and knowledge into practice.

The College has a history of innovation—the first ski meeting, the first board review CD—and more is yet to come. The ACC is currently building a refreshed collection of conventional programs and products, exploring innovative educational activities, and training future educators. The College thoroughly understands our plight of trying to absorb yet another 300-page guideline while rendering care every 20 minutes. What we need are the tools to translate those guidelines into practice, and the College is working feverishly to produce the tools.

All of us who treat patients are operating under a tightening financial noose—the squeeze between declining physician reimbursements and rising costs of doing business, such as malpractice premiums. The College constantly advocates on your behalf on these and other issues—on the Hill and in the halls of regulatory agencies—and our staff are among the best in the business.

But, we also need visionary doctors like you to personally talk to legislators, regulators, payers, and patients. We need you to talk about the critical role you play in improving our nation's cardiovascular health. Your voice speaks louder, your experience counts for more, and your position as a key constituent cannot be overestimated.

I encourage you to personally volunteer for the ACC at a local and national level and to contribute to our Political Action Committee. The College is only as good as its members and that, my dear Fellow, would be us!

Right now there is a great controversy around cardiovascular imaging. Our right to provide the full range of imaging services to our patients is being questioned. We may, in fact, be excluded from developing exciting new techniques, such as magnetic resonance imaging and computed tomographic angiography, and from continuing our current work in nuclear cardiology.

In response, the College seeks to take the high road by advocating for quality. In imaging, this includes describing technical standards, participating in accreditation and certification, outlining ethical and appropriate use, and defining competency on the part of those interpreting studies, regardless of specialty.

The trained eye of a cardiologist will always provide better value because only a patient's personal physician can deliver continuity of care and an understanding of the person within the patient. We will fiercely protect our patients' right to have their own cardiologist perform the life-saving tests they need!

But cardiology is fundamentally about heart. Passion is about excitement, fire, satisfying one's own needs, making one's self happy. Love is about having a heart for others. In medicine, this means going beyond merely treating our patients or delivering medical care, to caring truly and deeply about our patients' well being.

As cardiovascular practitioners, we ascribe to the highest aspirations of professionalism. What is professionalism? As the American Board of Internal Medicine (ABIM) states: “Professionalism in medicine requires the physician to serve the interests of the patient above his or her self interest” (1).

Our obligation to our patients and to humankind is to love them so much that we demand only the best of ourselves on their behalf. Accordingly, perhaps the College's most important effort is ensuring the best cardiovascular practice by helping its members deliver the highest quality, evidence-based care.

Our dream is to create a universe in which all patients receive equally marvelous care. Unfortunately, such is not the case. Women, elders, and minorities still do not receive the care they should, and that cannot be tolerated. The College has been a leader in developing tools to measure and improve the quality of our practice. These include the National Cardiovascular Data Registry, which is rapidly becoming the standard of care. As we scientists know all too well, it is by measuring that we improve.

Measurement is here to stay. Pay-for-performance is a reality for hospitals today, and similar programs are planned for physicians. Rather than fear this change, think how wonderful it will be to be paid extra to do what has been right all along for our patients!

A passion for medicine is about the joy of practicing cardiology; loving your patient is about healing. Dreaming is about envisioning a healthy world and our central role in making this a reality. We must incorporate all of these elements in everything we do as cardiovascular practitioners.

As teachers, we must have a passion for education and for being an expert, but our love for teaching means making sure our students are actually learning. As scientists, we must have a passion for discovery, but our love of new knowledge is about making sure society benefits from it. As cardiologists, we must have a passion to expertly deploy exactly the right therapy at the right time, but our love for our patients is about making sure the therapy is both wanted and beneficial.

You will face many challenges in your career, and the future surely holds changes for our profession and our College. The core of cardiology will remain constant, however. It will be the one-to-one interaction between a patient and a physician, together seeking relief from disease or the path to greater health.

To be true to our core requires a passion that will not be ignored, a love that will not be shaken, and a dream that will not fade. Nothing else any of us will ever do is more important. As you launch your career, remember this: be passionate, love big, and dream in color.

References

American Board of Internal Medicine. Project Professionalism. Philadelphia, PA: American Board of Internal Medicine, 2001:9.

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References

American Board of Internal Medicine. Project Professionalism. Philadelphia, PA: American Board of Internal Medicine, 2001:9.

Correspondence

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