AHA 2008 New Orleans-Will Change Come?

   Will a nation sleepy from the long celebration of a newly elected president pay much attention to our upcoming American Heart Association meeting developments?  I do believe that in this troubled economic environment, as American physicians,  we are more willing than ever to listen to what our colleagues in other countries have been telling us for years : "An organized approach to AMI therapy is effective and necessary" and "a new focus on personal responsiblity" from the patient perspective  will be required   to balance the strain of a country whose medical budget is bust,  against the needs of  an aging population writhe with obesity, tobacco use and a sedentary lifestyle.  We can no longer "rob Peter to pay Paul" because Peter is bankrupt  and uninsured.  Peter probably smokes if he's from the deep south and  he's obese just about anywhere else  we look  in America.  For some, the Peter they know, through no fault of their own is saddled with medical bills that can never be paid and face the daily decision of either  purchasing food or medication.   Change is long overdue and maybe,  just maybe,  some of the results of the late breaking clinical trials will be implemented in such a way that both  "Peter and Paul " can have a brighter and healthier future.     

   One would hope that the long anticipated  birth  of "change" in America will reach into our offices, our homes and the lives of our patients. Perhaps after this year's AHA meeting, we can look forward to a better understanding of why women aren't responsive to certain primary prevention measures and why for  the first time in a long time we just might have real hope with regard to that issue. Are we studying women too early or too late?   Might we look forward to finally implementing home INR monitoring that when placed in the hands of certain  individuals might save billions in the cost of bleeding and thrombotic complications?  Will CRP enjoy a resurgence in popularity  on the wings of JUPITER or remain an orphaned lab parameter with no real feel for its best application?  Will the FIT trial change our family mechanics such that we no longer spend our evenings in front of the television or computer screens munching on carbs and instead spend a few  quality moments trying to insure that we can meet our grandchildren? Will new drugs with new applications make their way into our daily prescribing regimens?  Will Ibersartan really help those with normal EF's but the lable of "heart failure"?  So many questions will be answered this week and most certainly  will give rise to even more questions to be answered in future meetings. Anyway you slice it, this year's AHA seems to be lining up to be an exciting week indeed.   

  The most important question is "Will change really come to this nation?"  or will it be more empty rhetoric? My daughter, with just a tinge of excitement in her voice called us after the election last evening.  She and her boyfriend  rushed down to Grant park  just to see if she could hear Obama's victory speech.  If she made it onto the grounds, she heard him say  "there are many who won't  agree with every decision or policy I make as president, and we know the government can't solve every problem.  But I will always be honest with you about the challenges we face".   

  Mr. President-elect Obama, I'm being honest with YOU about the challenges we face.  I hope that in this week in all the aftermath and hustle and bustle of your victory schedule that you will take the time to hear about the problems we face in America with the delivery of optimal Cardiac care to our citizens.  Perhaps you will hear our voices all the way from New Orleans and all across the nation from this year's  AHA where we  will surely outline some of those issues.   But our own  organizations, the AHA and the ACC  will  have to acknowledge  the specifics of the challenges that we face in order to make real progress.  First and fore most, we must be honest with ourselves.  Only then will "change" finally come.

Melissa      

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