Reasserting the Value of Nephrology

David L. White
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Nephrology faces challenges. Clinically, other internal medicine specialties increasingly are managing diseases traditionally considered in the domain of the nephrologist. Funding for kidney research is less per patient than every other major disease, such as cancer, cardiovascular disease, and diabetes. And the next generation is less interested in nephrology careers than any previous generation.

The American Society of Nephrology (ASN) is committed to working with every member of the kidney community—particularly the society’s more than 20,000 members—to overcome these challenges, assert the value of nephrology, and articulate a positive, bold vision for the specialty’s future. The question is no longer should ASN attempt to accomplish these goals, but how.

The current ASN Strategic Plan is in its third year, and the ASN leadership and staff are focused on the plan’s fifth goal to “Assert the value of nephrology to health and science professionals, health care systems, and other stakeholders to ensure high-quality care for patients” by:

  • Defining the scope of nephrology practice and articulating a vision for nephrology in the future.

  • Facilitating improvements in kidney care, research, and education by using all available data sources to produce recurring reports about the state of nephrology.

  • Demonstrating that the specialty of nephrology adds unique value to health care delivery that results in better outcomes for the millions of people with kidney diseases.

By conducting research, evaluating current trends in nephrology and other specialties, and studying the approaches peer societies have employed to increase interest in their specialty, ASN is beginning to finalize a strategy to assert the value of nephrology. During the last two years, ASN has interviewed leaders in medicine, both in nephrology and other specialties, the society’s members, and representatives from peer societies.

The ASN leadership met twice during summer 2018 to distill these insights, ideas, and suggestions into an action plan. These sessions resulted in a draft outline that was reviewed during the fall by each of ASN’s eight mission-based committees:

  1. Career Advancement Committee

  2. Continuous Professional Development Committee

  3. Diversity and Inclusion Committee

  4. Media and Communications Committee

  5. Policy and Advocacy Committee

  6. Publications Committee

  7. Quality Committee

  8. Workforce and Training Committee

To incorporate considerable feedback from the committees, ASN leaders and staff revised the draft outline and presented it in several forums at ASN Kidney Week 2018, including the joint meeting between the division chiefs and nephrology fellowship training program directors. Several thematic questions emerged during these productive discussions, including what is core to nephrology, should nephrologists further specialize, and what is best for people with kidney diseases?

Entering 2019 and the fourth year of its five-year strategic plan (2016–2020), ASN has identified several levers available to the society and the rest of the kidney community to execute a positive, bold vision for the future of nephrology, such as:

  1. Delivering the message: Time to cure kidney diseases.

  2. Fostering innovation and therapeutic developments.

  3. Reinvigorating the educational continuum for nephrologists, particularly fellowship training.

  4. Aligning certification and recertification (assessing lifelong competence) with the specialty.

  5. Outlining the financial case to demonstrate that nephrologists add value to health systems.

  6. Cultivating strong leaders.

  7. Encouraging work-life balance and controlling burnout.

  8. Advocating for greater reimbursement.

To finalize a plan for achieving the fifth goal of its strategic plan, ASN is simultaneously building upon the continued success of its ongoing initiatives such as Kidney Week, the ASN Foundation for Kidney Research, the Kidney Health Initiative (KHI), Nephrologists Transforming Dialysis Safety (NTDS), KidneyX, JASN, and CJASN. ASN is also continuing to focus on increasing interest in nephrology careers via programs like Kidney STARS as well as addressing policy and advocacy issues that affect nephrologists and their patients.

Later this year, ASN will invite the society’s members and the broader kidney community to comment on a draft version of the plan for reasserting the value of nephrology. In the meantime, please contact ASN Policy and Advocacy Specialist David L. White at, if you would like to suggest ways ASN can be of most value to you.