Asserting the value of nephrology

Physician productivity and compensation

Financial support of educational effort

Recruitment, retention, diversity and inclusion

Ensuring that Nephrology fellowship programs provide quality training in all aspects of kidney care

These topics are of primary interest to kidney professionals concerned about the future of nephrology. The interest of students and residents in pursuing careers in nephrology has waned over the past decade. With the increasing population of patients with kidney diseases, now approaching 40 million in the United States, these issues must be addressed immediately, in order to sustain a sufficient workforce to care for patients with kidney diseases. Furthermore, the success of exciting programs such as KidneyX and Advancing American Kidney Health, which are designed to catalyze innovation and transform patient care, depends upon establishing a robust pipeline of talented young physicians and scientists in nephrology. Key among the groups of leaders who regularly address issues concerning the field of nephrology are nephrology division chiefs and training program directors (TPDs). Whereas TPDs have successfully addressed many training program issues, there was a need to engage division chiefs to address other issues that extend beyond the purview of TPDs. Therefore, in 2018, the American Society of Nephrology convened a small group of division chiefs to discuss these issues in depth and design a blueprint on how ASN might work with division chiefs to promote positive advances.

This group met several times with ASN leaders, and the group proposed a larger in-person meeting as a first step to greater engagement to understand regional, local, and practice setting (academic vs practice) forces that represent barriers to advancement.

In June 2019, ASN hosted the first Nephrology Division Chiefs Conference in Dallas, TX. More than 45 adult and pediatric nephrology division chiefs from around the country and four ASN Councilors including ASN President Mark E. Rosenberg, MD, FASN, Past-President Mark D. Okusa, MD, FASN, and Councilors Susan E. Quaggin, MD, FASN, and David H. Ellison, MD, FASN attended.

The meeting was opened with a keynote presentation from Donald E. Wesson, MD, MBA, who was formerly the S.C. Arnett Professor of Medicine and Chairman of the Department of Internal Medicine and Physiology at Texas Tech University and Professor of Medicine and Vice Dean of Texas A&M University College of Medicine. Dr. Wesson currently serves as President of the Baylor Scott & White Health and Wellness Center at Juanita J. Craft Recreation Center, as well as Senior Vice President of Baylor Scott & White Weight Management Services and is a former ASN Secretary Treasurer. He is a thought-leader in academic medicine and an internationally recognized researcher in kidney acidifying mechanisms.

 Dr. Wesson’s presentation focused on improving the health of communities through focused, data-driven population health initiatives. He challenged conference participants to think creatively about cost-effective solutions for improving the field that center around promoting high quality patient care.

The rest of the program consisted of a half day of small breakout groups, each focused on one of the five topics, followed by a full day of larger group discussions. During the large group discussions on the second day, the small groups shared a summary of their sessions and led the room in brainstorming concrete short- and long-term recommendations for ASN Council.

The ASN Council reviewed the discussions and recommendations from this conference at their meeting in July 2019. A white paper summarizing the recommendations and recommending next steps from the conference is currently being drafted. Additionally, the ASN Data Analytics Team led by Kurtis Pivert, ASN Data Science Officer, will work to gather data on national benchmarking data on work RVU productivity and compensation productivity. Many participants feel that asserting the value of nephrology is a critical first step to addressing the other issues discussed in this conference.

The conference was well received, with attendees enthusiastically endorsing the value of future meetings. Many commented that they appreciated the opportunity to connect with peers and share knowledge across programs. As a result, ASN plans to expand the meeting, opening it to all Nephrology Division Chiefs in 2020. The ASN Council and ASN staff will use these meetings, coupled with recent high-profile events in the kidney space, to help them develop a bold vision of Nephrology in the 21^st century. This vision will help catapult nephrology back to the front of medicine subspecialties.