ASN President Sharon M. Moe, MD, FASN, Reflects on Year’s Accomplishments

Sharon M. Moe

What has ASN accomplished this year?

It has been a busy year, and I have been honored to work with ASN’s councilors, committees, and advisory groups on many important projects.

The ASN has aggressively worked to identify barriers to interest in nephrology and to overcome those barriers through multiple initiatives targeting medical students and residents. The Workforce Committee, led by Mark Parker, MD, has implemented new programs to combat misconceptions about, and promote the many rewards of, nephrology careers. These programs will be visible at ASN Kidney Week 2014, and I encourage every ASN member to spend time with students, residents, and fellows discussing their research, their careers, and why they became passionate about kidney health. We are our own best advocates for nephrology!

The Training Program Directors Executive Committee, chaired by Nancy Adams, MD, has developed nephrology fellowship milestones for the new United States trainee evaluation criteria. This amazing feat was accomplished in a very short time, and I am grateful for their contributions. These milestones align evaluations across the country and will allow better characterization of training programs and ensure that the fellows master critical skills.

Research advocacy remains an important mission for ASN, especially in the current scientific funding environment. In the United States, kidney disease is disproportionately underfunded, given the high prevalence of, and high cost of care for, kidney disease. ASN’s aggressive research strategic plan emphasizes these two important points to congressional leaders.

The ASN worked with the congressional kidney caucus to request a formal Government Accountability Office report to substantiate the imbalance between prevalence and cost of kidney disease versus research funding to find a cure for kidney disease. Caring for patients with ESRD is a major cost for health care systems everywhere. Research is needed to identify the causes of kidney diseases, to characterize why some patients progress and others do not, and to determine how some of the identified genes in minority populations increase progression. Clearly, we have a lot to learn, and research is necessary if we hope to improve lives and contain the costs of caring for this population in the future.

The ASN is also advocating for innovation in dialysis delivery because current modalities have not significantly changed in the past 30 years. I was honored to testify before the House Science Subcommittee on Research and Technology about this lack of innovation and the need for better therapies. This testimony, and subsequent meetings with Congress and regulatory agencies, raised awareness about the importance of fostering new therapies to give patients receiving dialysis a better quality of life at a lower cost.

Other fields have made such advances, and I know that nephrology investigators are equally talented. Real innovation is in the foreseeable future, but it requires harnessing the immense talent within the nephrology community and collaborating with investigators and bioengineers beyond the traditional kidney research sphere. The increased impact factor of our journals and the high quality of published research are just one indication that scientists are paying attention to our specialty.

The ASN continues to advocate within the Centers for Medicare & Medicaid Services to ensure that health care delivery to our patients is optimized and reimbursed appropriately. We support high-quality care, but we also want to ensure that the metrics that measure quality reflect improved outcomes. Health care delivery models are changing rapidly, and, as usual, nephrology has been ahead of other medical specialties in the United States, implementing the first-ever disease-specific Accountable Care Organization program in Medicare. ASN worked closely with Medicare and others in the kidney community to ensure the success of this novel care delivery model. As we move forward we need to protect our profession and continue to provide high-quality continuity of care across the spectrum of kidney diseases and the many health care delivery settings.

Such dynamic changes require building new paths to improve patient care and working with teams of caregivers in multiple settings. These teams must be diverse and well trained, and ASN is dedicated to ensuring that both of these goals are met. ASN Diversity Champion Eddie Greene, MD, will provide an external review of ongoing ASN efforts to diversify our membership and leadership. A series of summits has helped identify barriers to engagement, areas for improvement, and future opportunities.

What did you like best about being ASN president?

It has been a pleasure to work with the outstanding ASN staff and to help set the society’s priorities for this and coming years as we initiated ASN’s new five-year strategic planning efforts. These are challenging times, with shifts in health care delivery, reduced research funding, and changing educational requirements. Each poses a threat to nephrology, and we must continue to be proactive in turning these challenges into opportunities. I have been honored to lead these efforts.

What surprised you about being ASN president?

What surprised me most is the importance of short conversations with members of Congress, their staffs, and other government officials. I wasn’t expecting to meet so many stakeholders, but it has been exciting to do so. These interactions raise awareness about kidney disease, the importance of research, and the need for innovations in all aspects of kidney care.

What advice do you have for others in the nephrology community?

We need to be proactive and positive in promoting nephrology to the public, students, politicians, and government. Nephrology offers physicians a rewarding career that combines the excitement of science and physiology, continuity of care and lasting relationships, and the opportunity to improve our patients’ lives. We are detail-oriented by necessity, but sometimes this attention to detail can become unnecessarily negative. I encourage everyone to think positively and embrace collaboration in research, innovation, education, and health care delivery across the kidney health spectrum. The ultimate goal is to improve the care of those with kidney disease. ASN Kidney Week is a great forum for expanding and initiating collaborations with colleagues from around the world. Together we can make a difference, but we need to embrace change, rise to the challenges before us, and encourage one another.

What will you not miss once you are past president?

I won’t miss the frequent trips to Washington, DC. I have the times for all the direct flights memorized!

What other question should we have asked you?

I would like to thank ASN’s staff, especially executive director Tod Ibrahim. These amazing groups of talented and hard-working individuals believe that kidney disease can be cured, and their enthusiasm is infectious. I also thank my husband, John, and daughter, Michelle, for their patience and support this year. Finally, I thank ASN’s members for the honor of serving as your president.