Article first published online: 4 MAR 2010
© 2010 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 12, Issue 4, pages 295–297, April 2010
How to Cite
Black, H. R. (2010), Leadership Message. The Journal of Clinical Hypertension, 12: 295–297. doi: 10.1111/j.1751-7176.2010.00280.x
- Issue published online: 5 APR 2010
- Article first published online: 4 MAR 2010
25 Years of the American Society of Hypertension—Where We Have Been and Where Should We Be Going
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- 25 Years of the American Society of Hypertension—Where We Have Been and Where Should We Be Going
Now that the American Society of Hypertension, Inc (ASH) is about to celebrate its 25th anniversary and I am completing my 2 years as President, I feel it is fitting that I reflect on how ASH has grown and changed and what challenges face us for our next 25 years.
Societies such as ours come in two basic flavors—membership-oriented societies, perhaps exemplified by the American College of Cardiology; or disease-oriented societies, such as the American Heart Association or American Cancer Society—or a hybrid of both. Membership-oriented societies focus on providing services for their members, while disease-oriented societies concentrate on issues related to the disease or diseases of interest in a broader context.
ASH began as a membership-oriented society. Initially—beginning in 1986—we met once a year in the spring, and provided a forum for the presentation and discussion of subjects to our members and others whose primary clinical and/or research interest was hypertension. Our primary focus and mission then, and, perhaps, now, is the education of our peers and constituents. To that end, in 1995, ASH became an Accreditation Council for Continuing Medical Education (ACCME) approved provider of continuing medical education, enabling us to offer Continuing Medical Education credits to those who attended our annual meeting. We have now expanded this activity to include sponsorship of programs at meetings of other organizations as well. We developed and revised a Core Curriculum for Hypertension, endorsed educational programs of partner organizations with similar goals, and developed and hosted a Clinical Hypertension Review Course for those whose primary clinical and/or research interest was hypertension and related disorders.
We supplemented these efforts with an independent but related journal where none existed before. We have since designated 2 journals as official journals of the Society: The Journal of Clinical Hypertension (JCH), which became an official ASH journal in 2006, and a new journal, The Journal of the American Society of Hypertension (JASH), established in 2006. In 2009, we expanded the benefits to our members by including the Journal of the CardioMetabolic Syndrome with JCH, reflecting our interest and commitment to conditions related to hypertension.
We are still very much a membership-oriented society, but the scope of services has expanded. In 1999, we established the ASH Specialist Program Inc., a separate organization whose responsibility was to identify and designate specialists in clinical hypertension. In collaboration with the ASH Specialist Program, the Society is currently attempting to obtain a taxonomy code and a specialty code for designated specialists in clinical hypertension in order to provide for appropriate local and national recognition and reimbursement. We are also working to formulate criteria to designate qualified institutions or practices as Hypertension Centers. In 2001, so we could continue our programs between meetings and in areas remote from the site of our Annual Meeting, the Society established Regional Chapters and now has 8 Chapters encompassing 24 states and the District of Columbia.
Our Annual Scientific Meeting still focuses on cutting-edge science, new clinical trials and, earlier this decade, we added a new program, Hypertension Highlights, featuring topics the Program Committee thinks that a Hypertension Specialist should want to know about. We have completed and published 5 American Society of Hypertension Position Papers and have several more soon to be completed. These statements are dedicated to providing our membership (and others) with the Society’s position on critical clinical issues relating to hypertension and related disorders, from the perspective of the specialist in hypertension. We deliberately avoided preparing a “Guideline,” although we hope those who are doing so will take advantage of our expertise and opinions. And we are doing still more for our members by offering the designation of Fellow of the American Society of Hypertension (FASH), a program introduced in January 2010, whereby we will certify that certain individuals have reached a level of expertise and recognition to have earned this designation. Next year we will also offer another honorific title, Master of the American Society of Hypertension, a designation we are reserving for only a very special few, much as the American College of Physicians has done for decades.
But we have also become a disease-oriented society. We have expanded our activities in 2 different, distinct, and complementary ways. We have still maintained our focus on education and have warmly welcomed specialists in related areas, primary care physicians, pharmacists, nurse practitioners, physician’s assistants, and others, so we can include the growing number of clinicians and scientists who share our appreciation of the need to stem the tide of the growing cardiovascular epidemic, but whose primary interest is not hypertension. In collaboration with our members who are primary care physicians, we have supplemented the curriculum at our Annual Meeting and devoted our educational resources to a Primary Care Track. In this portion of the Annual Meeting, we have focused on the clinical problems in hypertension and related disorders that face a primary care clinician and we have enlisted primary care clinicians as faculty to deliver these talks. We have expanded our educational activities both online with the ASH Educational Alliance with WebMD, and with enduring materials, such as the Hypertension Accreditation Program developed in 2009, and we plan to export and host segments of our Annual Meeting on a regional basis and offer them to primary care clinicians whose primary interest is not hypertension and related disorders.
In addition, as part of our expanded focus, we have become active in the public health arena. The ASH Outreach Program, introduced in New Orleans and reprised in San Francisco, is now an established part of our activities. Our plans for New York are complete and we expect to again provide important services to those in need. We have embraced public health and advocacy issues considered vital to the care of hypertensive patients, such as being a participant in the National Salt Reduction Initiative and by actively contributing to the ACCF/AHA/ACP 2009 Competence and Training Statement.1
But we all need to understand that the funding landscape has changed, not only for ASH, but also for all organizations like ours. Since our founding a quarter century ago, we have had a fruitful and mutually beneficial relationship with the pharmaceutical industry and medical device makers. The lion’s share of our funding has come from these industries and is related to what is presented at our Annual Meeting. The content of our meeting is carefully controlled, regulated, and scrutinized as a result of ASH being an approved and accredited provider of continuing medical education. Our relationship with industry has allowed us to keep our dues low and to offer an outstanding Annual Scientific Session at a modest cost. It has allowed us to provide travel grants so we can bring young and eager scientists to our meeting. Without such support, interested young people would likely stay home and the leaders of the future wouldn’t be exposed to the exciting science presented at our meeting and the networking opportunities available.
Regrettably, the public and Congress have become increasingly distressed and alarmed by their perception of the relationship between academics/academically-oriented societies and industry. They perceive us to be in conflict with what they expect health care providers to do and this “conflict of interest” has been difficult to combat, although we are making some inroads.2
So it is time for ASH to address important questions for the future:
- 1What is the primary role(s) of the Society?
- 2Should we revert to being a membership society or should we remain a hybrid? If a hybrid, what percentage of our energy and resources should be devoted to providing services to our membership, and what percentage to helping combat hypertension and related disease(s)?
- 3Should we work even more closely with the Hypertension Specialist Program, now that it has expanded from simply a testing organization to one that is working to advocate for new reimbursement levels and center designations for Hypertension Specialists, recognizing at last that these individuals and institutions and practices have special expertise in managing hypertension and related disorders?
- 4Should we expand our advocacy and lobbying efforts at a public health level, and leave it to the Hypertension Specialist Program to focus its advocacy efforts on ways to benefit our members?
- 5How much of our fundraising efforts should be oriented to the pharmaceutical and medical device makers and how much toward other industries or other sources of funding? If so, which ones?
- 6Should we include a membership category for interested members of the public?
- 7Should we more aggressively support research? Training?
- 8Is our organizational structure with Regional Chapters and multiple Committees appropriate and effective for our current and future mission(s)?
These and other questions will face the leadership and membership of ASH in the next decade. Dr Daniel Lackland and our Membership Committee recently surveyed our members about these and other issues. For the most part, our members were satisfied with our efforts, but I feel we need even more input. Let us know what you are thinking, so ASH can serve our members and the public in the best way we can.
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- 25 Years of the American Society of Hypertension—Where We Have Been and Where Should We Be Going
- 1for the American College of Cardiology Foundation; American Heart Association; American College of Physicians Task Force on Competence and Training (Writing Committee to Develop a Competence and Training Statement on Prevention of Cardiovascular Disease); American Academy of Neurology; American Association of Cardiovascular and Pulmonary Rehabilitation; American College of Preventive Medicine; American Diabetes Association; American Society of Hypertension; Association of Black Cardiologists; National Lipid Association; Preventive Cardiovascular Nurses Association. ACCF/AHA/ACP 2009 competence and training statement: a curriculum on prevention of cardiovascular disease: a report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Competence and Training (Writing Committee to Develop a Competence and Training Statement on Prevention of Cardiovascular Disease): developed in collaboration with the American Academy of Neurology; American Association of Cardiovascular and Pulmonary Rehabilitation; American College of Preventive Medicine; American College of Sports Medicine; American Diabetes Association; American Society of Hypertension; Association of Black Cardiologists; Centers for Disease Control and Prevention; National Heart, Lung, and Blood Institute; National Lipid Association; and Preventive Cardiovascular Nurses Association. J Am Coll Cardiol. 2009;54:1336–1363., , , et al