March 12, 2019

#ACGME2019 Days 3 and 4 Round-Up

The third day of the conference featured a morning of inspiring talks, including the President’s Plenary with ACGME President and Chief Executive Officer Thomas J. Nasca, MD, MACP, and a special fireside chat, “Rediscovering Meaning in Medicine” with Marvin R. Dunn Keynote Speaker Vivek H. Murthy, MD, MBA, 19th surgeon general of the United States.

President’s Plenary: What Will the Medical Workforce of the Future Look Like?
“We need to be proactive in planning the education of our future physicians,” Dr. Nasca said in his opening remarks this morning. “Part of our mission, our reason for being here, is to prepare the next generation of physicians to serve the public and meet their needs.”

Dr. Nasca explained the scenario-planning exercises the ACGME uses for strategic planning to help predict what social, political, and environmental factors may influence how medicine functions in the future, and how it uses those factors to guide development of requirements and other organizational priorities.

He noted that in all scenarios devised for the organization’s current strategic planning exercises, the data indicated the number of physicians need not increase, but the function must evolve. The field as a whole has to recommit itself to be more than the sum of its bureaucratic and administrative parts.

“Medicine writ large cannot survive in the absence of an enduring commitment to professionalism,” Dr. Nasca said.

To thrive in this uncertain future, Dr. Nasca encouraged the room to develop ways to be responsive, forward-facing, and outcomes-oriented, and to promote interprofessional, team-based care, and most importantly, to stay true to our core values.

Do not strive for the past, Dr. Nasca said, but look to the future of treatment, of prevention, and of care equity in communities. “Our job is to prepare physicians to seek the horizon.”

2019 Marvin R. Dunn Keynote Address: Rediscovering Meaning in Medicine
In a highly personal, inspirational, 90-minute fireside chat, Dr. Nasca interviewed Dr. Murthy, who explored the role that courage plays in academic medicine, how to address the pathology of loneliness in the United States, and the commitment to connection physicians owe not only to their patients, but to each other.

Dr. Murthy said having values and principles isn’t enough, insisting that, “we have to live by those principles and values.” This, he said, is courage.

Dr. Murthy noted that courage is not always convenient, and that it is, in fact, a resource “that has to be continuously renewed.”

The world needs more courage, he said, and this is where physicians can make a difference. Since the general public overwhelmingly trusts physicians, it affords them the unique opportunity to be courageous, to stand up for what is right, and to advocate not only for their patients but for themselves and their colleagues.

Collegial support and the idea of “having someone’s back” were also important messages Dr. Murthy relayed to the audience.

“The joy you get from patients is important,” he said, “but we also need the joy we get from colleagues who see us for who we are.” The care of patients and caring for each other, he stressed, need to be equal priorities.

Dr. Murthy transitioned, and began discussing an “epidemic of loneliness” he said he began to recognize during his tenure as Surgeon General. One of the most common threads among people he met, he realized, was a profound sense of loneliness and isolation, which studies show have significant negative effects on health.

People who are lonely live shorter lives, he said, adding that loneliness has been found to have the same impact on people’s health and lifespan as smoking 15 cigarettes a day for many years.

This disconnection affects those in medicine who suffer from burnout, depression, and suicidal ideation. Connection and joy are crucial to professional and personal well-being. Again, Dr. Murthy pointed to the public’s inherent trust in clinicians as an opportunity.

“If we as a profession could become a model for how to live a connected life, then we can build a model that is worthy of the entire nation paying attention,” Dr. Murthy said. This, he said, would be a tremendous service to society.

As the session concluded, Dr. Murthy pivoted one last time, to talk about the role of love in medicine.

“Our ability to live with love is what is going to create a better world for my son and my daughter and for your children as well,” he said. “I cannot think of a better group of people than all of you, members of our profession, to fill that gap, to provide the moral leadership that this nation needs.”

Beyond the Plenaries
Other sessions Saturday covered more important information and hot-button issues. Topics included bullying, harassment, discrimination, and sexual harassment; resident well-being data; clinical learning environments for team-based care; addressing unprofessional behaviors without instilling shame; improving gender equity; and much more.

Sunday Morning's Conversations with the CEO
The final day of the conference wrapped up Sunday morning with “Conversations with the CEO,” at which Dr. Nasca responded to questions posted throughout the conference on one of the Conversation Boards in the Exhibit Hall. Questions covered a range of topics, including well-being, the future of medicine and GME, patient care quality, role modeling, health care in rural and other underserved populations, and more.

"They're not learning what you say, they're learning what you do," Dr. Nasca told attendees of their role in shaping the physicians of the future.