Next NKF Chief Outlines Objectives

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      34 Renal & Urology News                 OCTOBER 2009

      Next NKF Chief Outlines Objectives
                               A year from now—in October 2010—

                                                                                             Why are these goals of particular         controversies surrounding hemoglo-

       &                       Lynda Anne Szczech, MD, MSCE,
                                                                                             importance to you?
                                                                                             Dr. Szczech: I truly believe that we—
                                                                                             not just as physicians but as peo-
                                                                                                                                       bin targets and the results from the
                                                                                                                                       CHOIR [Correction of Hemoglobin
                                                                                                                                       and Outcomes in Renal Insufficiency],
                               a member of the Renal & Urology                               ple—have an ethical responsibility        CREATE [Cardiovascular Risk Re-
                                                                                             to make our world just a little better    duction by Early Anemia Treatment
      News editorial advisory board, will become the                                         than it was when we came into it. I       with Epoetin Beta], and TREAT
      first woman president of the National Kidney                                           want to add my piece of the puzzle        [Trial to Reduce Cardiovascular
                                                                                             in this way.                              Endpoints with Aranesp Therapy],
      Foundation (NKF), a post she will hold for two years.                                                                            trials. Our challenges are to fig-
                                                                                             In what areas do you hope to see          ure out how to apply these com-
      Already armed with a clear idea of what she would                                      rapid progress?                           plex messages for subgroups such
                                                                                             Dr. Szczech: In terms of research         as those with and without diabetes,
      like to accomplish during her tenure, Dr. Szczech                                      and clinical practice taken together,     and then to similarly “question base-
      [pronounced SEZ-ek] gave us a preview of her plans.                                    my hope is that we will see data          line assumptions” with the other
                                                                                             that will translate into policy regard-   easy-to-apply “threshold” bench-
      She will be focusing on issues surrounding national                                    ing how complex benchmarks of             marks of care.
                                                                                             care should and need to be. Clearly
      and international screening for kidney disease, new                                    outcomes for our patients have im-        What is your stance on Medicare’s
                                                                                             proved dramatically since the “know       proposed bundling of payments
      standards of care, and treatment benchmarks.                                           your number” campaign in the 1990s.       for dialysis-related services?
                                                                                             And to the credit of the renal com-       Dr. Szczech: The bundling of dialysis-
      What is your current position?              First, I am fascinated by how phy-         munity, this wasn’t due to a “pay for     related services is complex. And
      Dr. Szczech: I am the director of         sicians and all health-care providers        performance” model of care, but           by the time this article is published,
      nephrology research at the Duke           learn. I am always startled to see how       rather simply our desire to do the        there may be considerably more
      Clinical Research Institute [DCRI,        long it takes for a new finding or           very best for our patients. We iden-      available from CMS [Centers for
      at Duke University Medical Cen-           study to become adopted as a stan-           tified benchmarks to the best of          Medicare and Medicaid Services]
      ter in Durham, N.C.] I also direct        dard of care. This length of time has        our abilities and implemented them        on the rule for its implementation.
      the DCRI’s safety surveillance/           been estimated at more than 10 years         with lightning speed.                     My approach to this is focused on
      pharmacovigilance program. I am           and up to 17. I am truly impressed             But it is likely time to ask and an-    the patient perspective and moti-
      an associate editor for Kidney     
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