ASN President-Elect Jonathan Himmelfarb, MD, FASN, Looks to the Year Ahead

ASN President-Elect Jonathan Himmelfarb, MD, FASN, Looks to the Year Ahead
What issues do you anticipate being big in the coming year as ASN President?

Without a doubt the coming year will present many exciting opportunities and challenges for nephrology, and I anticipate that ASN will be right in the middle of the action. There will continue to be volatility with respect to the reorganization of health care delivery, and nephrology always seems to be front and center in the assessment of quality metrics, in the bundling of payments for cost control, and in demonstrating value in comprehensive, team-based specialty care.

The strong trend in health care is toward integrated care models, which will likely result in more and more consolidation among hospital networks, and perhaps dialysis providers. In this rapidly changing environment, ASN will be working hard to emphasize the value of nephrology care to patients and to health care systems. Over time nephrology may shift from the traditional hospital- and clinic-centric approach, which is essentially passive, episodic, and disease oriented (waiting for the patient), toward more technology-enabled, population management strategies. Our goal is for ASN to help make the case that kidney care provides essential value within these increasingly integrated care models.

On the education and communications fronts, ASN will continue to develop innovative products that meet members’ needs, including new self-assessment tools that make it easier to maintain certification. As an example, ASN plans to roll out KSAP (Kidney Self-Assessment Program), an exciting addition to materials that help nephrologists prepare for board exams.

The kidney community is also observing seismic shifts in the research landscape. Having been active in a wide variety of clinical and translational research efforts over the past 25 years, I see the coming era as providing the opportunity for true breakthroughs that can substantively change outcomes for people living with kidney disease. Yet at the same time, we are experiencing funding challenges that threaten to stall or even prevent progress. Despite many serious funding problems, especially for young investigators, the research tools available are unprecedented, and as a research community we are learning how best to use them, especially through collaborative, multidisciplinary, and often multi-institutional approaches. The scientific enterprise is now truly global, a trend that will likely accelerate in the coming year.

What do you particularly look forward to doing?

I am very excited about what ASN can do to develop tools and resources to support nephrologists and kidney scientists in every stage of their careers. I particularly want to find ways to help younger nephrologists navigate the landscape of clinical practice, learn to become great educators, and become successful researchers who will change the future practice of nephrology. We need to implement strategies to strengthen the pipeline of future leaders in our field.

Most of all, I am excited that ASN has begun a journey to become a more diverse, open, and inclusive organization. ASN has embarked on an initiative to increase diversity and inclusion at all levels of the organization, including (but certainly not limited to) gender, racial, and ethnic diversity. We need to take advantage of all the talent in our field to maintain our successes. This is especially critical given the patient population we serve. We need for our entire community to feel valued and capable of participating in the work of ASN. This can only make ASN a stronger and better organization. Membership also must be inclusive, and as part of this effort we need to reach out to each member of the care delivery team who contributes to kidney disease care.

Are there any parts of the job you are dreading?

To be honest, because I really care deeply about ASN, I look forward to taking on this leadership role with almost no reservations. Over the past three decades I have been involved in almost all aspects of the ASN core missions, including education, communications, public policy, and research activities. So I feel as though I understand the organization well and am well aware of the change dynamic within the society and the broader kidney community. Yet at the same time I do realize the level of required time commitment for this role. If there is anything I dread it is the required travel, especially the frequent trips from Seattle to the East Coast and beyond. This year I achieved diamond status for frequent flier miles (not something to be proud of), and I suspect next year will be worse.

You have significant policy experience. How will that experience influence your year as ASN president?

As the inaugural Chair of ASN’s Public Policy Board before becoming a Councilor, I learned a lot about how best to collaborate with organizations external to ASN, to help further ASN’s mission and goals. This collaboration is essential, given the high prevalence and complexity of kidney disease, which touches so many individuals and organizations.

Policy informs many of the daily activities within ASN. As an example, ASN will continue to dialogue with and reach out to the many patient advocacy organizations that care about kidney disease in order to increase our community’s effectiveness in getting the word out about the importance of kidney disease to public health in North America and worldwide.

Patients are our partners in spreading the word about the need for optimal clinical care and for innovation through research that can change clinical care for the better. An outstanding recent example is the Kidney Health Initiative (KHI), an effort led by ASN in partnership with the FDA. Now comprised of 68 member organizations, KHI works to remove barriers to innovation in developing new safe, effective medical products for treatment of kidney disease.

Being involved in policy has taught me that ASN must be proactive in trying to solve problems, and ASN must understand the political, legislative, and regulatory environment to be an effective organization.