ASN President’s Column

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Raymond C. Harris, MD, FASN

Citation: Kidney News 8, 9

Nephrologists are leaders in medicine and science, but do we always define ourselves as such?

This “moment” in health care encompasses a huge amount of change, the kind of change nephrologists are incredibly well suited to lead. The skills that make us great nephrologists are the same skills that make us effectively pilot and implement new approaches to health care.

Changes in government policies that focus on quality measures and team care, and the rollout of bundled payment mandates mean that clinicians must adjust their practice patterns. Nephrology is already a leader in these areas; we understand how to provide the highest quality care in a bundled payment environment, and we excel at leading medical teams that provide high-quality care for a complex patient population.

In addition, medicine and science are at the cusp of harnessing massive amounts of information provided by electronic health records, by registries, and by the growing global interchange of data. Nephrologists excel at mastering data, and importantly, we understand how data should be interpreted and applied to improve treatment and advance scientific discovery.

However, if we are to really extend our leadership on a broad scale, we must also commit to training students—and ourselves—to lead. Some students are turned off by nephrology because they think it is “too hard and there is too much data.” We want the students who can appreciate the wonderful complexities of science and medicine in general, and the kidney specifically, but we must do a better job conveying to students that in learning to interpret this complex information, they will understand what energizes us as kidney professionals: the amazing gift of improving quality of life for our patients.

Unfortunately, we don’t tell that story well enough.

Are we enriching the training experience, advancing diversity, and educating trainees to lead? As Dr. Gibson and Dr. Wesson have noted, many of us are “accidental leaders.” We must reinvent training so that physicians and physician investigators are armed with the skills necessary to make the most of the leadership opportunities that will be offered them.

Finally, for those of us already working in kidney health, we must assure that in documenting our professional competence, we do not divert energy and time to efforts that do not actually promote professionalism or that impede our ability to make positive change in the lives of people with kidney diseases. We should take the lead in ensuring that lifelong learning appropriately reflects what we do, and we should make the most appropriate use of peer benchmarks, without taking valuable time from patient care or other leadership opportunities.

Administering health care in the future and mastering the data that will advance science and practice require the mindset of a nephrologist—someone who excels at understanding and applying knowledge that can promote positive change for the care of our patients. I challenge kidney professionals across the globe to take every opportunity offered to lead and to share the knowledge we have gained to improve science and medicine, health care, and policy.