ACC president: ‘Antidote to burnout’ is engagement
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NEW ORLEANS — The cardiology community has faced great challenges in recent years, but continuing to engage can help overcome them, American College of Cardiology President Edward T. A. Fry, MD, FACC, FSCAI, said in opening remarks here.
“The challenges ahead are many, but as we will see at this meeting and in years to come, the opportunities are boundless,” Fry, who is also chairman of the Ascension Health Cardiovascular Service Line at Ascension Medical Group, Indianapolis, said during his presentation to open the ACC Scientific Session, held in conjunction with the World Heart Federation’s (WHF) World Congress of Cardiology. “There is only one thing that can stand in our way: not engaging [and] not participating in leading the process of transformation. Engagement is the essential characteristic of professionalism and agency. It is the antidote to burnout. Engaging takes effort but reaps tremendous rewards. It is the essential ingredient for success.”
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The state of the fight against CVD after enduring the COVID-19 pandemic “is like a twist on Charles Dickens: It was the worst of times, it was the best of times,” Fry said. “Many challenges facing cardiovascular medicine had their origin before the pandemic, but over the past year, we have seen an accelerated attrition of physicians and care team members as part of the Great Resignation or ‘quiet quitting.’ At the same time, the complexity and prevalence of all forms of heart disease are steadily increasing.”
This has led to the economic failure of many hospitals, and, for the first time in 80 years, a drop in U.S. life expectancy in 2 consecutive years, he said. Although the pandemic and the opioid crisis have contributed to that, it is also driven by “increasing mortality from cardiovascular disease, especially among the poor and minorities, reflecting the disparities of care and the threats to health equity.”
Those factors plus bureaucratic barriers to optimizing health care “distract from clinician wellness, and from attracting young people to careers in cardiovascular medicine,” Fry said. “Economic instability and declining support combined with unintended consequences of ineffective regulation have resulted in additional barriers to meeting these goals [of the ACC’s Quadruple Aim] for patients and clinicians in our communities. Increasingly, these challenges ... have led to a sense of futility, compounding clinician wellness and fueling the epidemic of burnout across the team.”
A purpose of the meeting, however, is to show how the cardiology community is in the best of times, he said. “ACC and WHF have had to be nimble and creative to meet these sorts of challenges while also moving the fields of cardiovascular medicine and education forward.”
Modernization of guidelines, registries, education, publications, advocacy and care delivery have been part of these efforts, Fry said.
“One positive that has come out of COVID has been the increase in accessibility of cardiovascular education through an array of in-person and virtual options, making access to current medical knowledge easy, affordable, flexible and customizable,” he said.
Another positive development has been more research and publications on maternal CV health, spurred by awareness of the problem of maternal mortality, he said, noting the ACC’s board of trustees has established a clinical section on reproductive health and cardio-obstetrics.
An important challenge for the future, Fry said, is “to focus on the efforts upstream to tackle social determinants, public health policy, health care funding and primordial prevention.”
To prepare for the future, the ACC “is addressing the composition of our cardiovascular workforce, to ensure that professionals reflect the diversity of the communities we live in and serve in,” Fry said. “We are doing this through initiatives like the ACC Young Scholars Program for high school and college students. In addition, efforts like the new ACC Internal Medicine Residency Program aim to attract residents from diverse backgrounds to pursue careers in cardiology. Leadership development programs also foster equitable opportunity for the underrepresented to lead our profession.”
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Fry ETA. ACC.23/WCC Opening Showcase. Presented at: American College of Cardiology Scientific Session; March 4-6, 2023; New Orleans (hybrid meeting).
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