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Cardiology’s Future at Rush and Beyond

Kim Williams, MD, is the director of the Division of Cardiology at Rush University Medical Center in ChicagoKim Williams, MD, has big plans not only for the Rush Division of Cardiology — whose helm he took Nov. 1 — but also for the future of cardiac care in the United States.

"We have to be more integrative with other disciplines," he says. "Primary care, oncology, nephrology, radiology — cardiologists need to work closely with people in all of these areas."

Coming from Williams, these words are more than wishful rhetoric. Now vice president of the American College of Cardiology, he will become the organization's president-elect in March 2014; in 2015, he will serve as president. These leadership positions give Williams an unusual amount of influence over the direction of the discipline.

His plans for Rush and beyond provide a map of where he wants to take it.

New Services at Rush

In the coming months, Williams plans to establish a cardio-oncology clinic at Rush in collaboration with the Division of Hematology, Oncology and Cell Therapy. The clinic would provide care for two distinct groups of patients: those whose chemotherapy regimens put them at high risk for heart disease and those who have both cancer and heart disease.

"In the coming years, cancer will overtake heart disease as the No. 1 killer of Americans," Williams points out. "But with the incidence of heart disease being what it is, there will be a lot of overlap between the two. And patients who have both conditions need specialized management."

He hopes to add or expand services at Rush for several other groups of patients who need ongoing management: adults with congenital heart disease, patients with heart and renal problems, and patients with heart and metabolic conditions.

Cardiology's Changing Role

Williams also plans to continue promoting collaboration between cardiologists and primary care physicians across the United States.

"Cardiology has always been event-driven rather than prevent-driven," he says. "That's something we have to change."

He hopes to help organize workshops and sessions on preventive cardiology at the meetings of the major general internal medicine associations. He also plans to invite internists to speak about preventive care at the American College of Cardiology meetings.

A Focus on Appropriate Use

Another of his goals for the discipline is to continue issuing new appropriate use guidelines in all areas of cardiology.

A nuclear cardiologist, Williams played a major role in the American Society of Nuclear Cardiology's overhaul of its appropriate use criteria in 2009. And he continues to conduct research in this area.

In May, he testified in front of the U.S. House Ways and Means Committee about possible methods of linking Medicare reimbursement for imaging procedures with performance on quality measures. Such methods, he argues, would do a better job than the fee-for-service system of promoting — and rewarding — a focus on quality.

"We will continue to issue appropriate use guidelines," Williams says. "If we get the ear of Congress — and they seemed receptive when I testified — then down the road we should have reimbursement more closely tied to how well a provider meets quality measures we have established, including appropriate use criteria. It all comes down to giving the right care at the right time."

Rush Physician November/December 2013


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