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J Thorac Cardiovasc Surg 2009;138:1053-1059
© 2009 The American Association for Thoracic Surgery

Presidential Address

The quality conundrum

Division of Cardiothoracic Surgery, Alice Langdon Warner Endowed Chair in Pediatric Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA

Received for publication June 18, 2009; accepted for publication July 14, 2009.

^_* Address for reprints: Thomas L. Spray, MD, Chief, Division of Cardiothoracic Surgery, Alice Langdon Warner Endowed Chair in Pediatric Cardiothoracic Surgery, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Suite 12NW10, Philadelphia, PA 19104. (Email: spray@email.chop.edu).

The first 300 words of the full text of this article appear below.

Anyone who is elected to this office, after the immediate elation, begins to recognize with increasing trepidation that he has to come up with a presidential address. The difficulty of thinking of something of any interest to say to several thousand cardiothoracic surgeon colleagues is stressful to say the least. Usually it seems the first step is to go back and read the presidential addresses of the past presidents to try to get some guidance. Unfortunately, in most cases, this process simply leads to the recognition that someone much more erudite and eloquent has previously discussed most of the important topics. It is inevitable that the presidential addresses tend to focus on the major issues in our field. These challenges include the necessity of change and the imperative of innovation, the difficulty in residency training and attracting qualified young surgeons into our area of specialty expertise, the challenges of the health care system in the United States and its continual pressures on reimbursement and yet increasing requirements for administrative activities, and the responsibilities of our profession to underserved populations around the world. Ultimately, all of these topics share the common challenge of defining, attaining, and maintaining quality in cardiothoracic surgery.

As medicine evolves in the United States, there is an increasing quest for quality outcomes that provide value for dollar spent. The mantra of quality has been taken up by political leaders and major players in the entire health care field. Quality is the new buzzword in health care policy. A search of 3 major journals in our field (Journal of Thoracic and Cardiovascular Surgery, The Annals of Thoracic Surgery, and European Journal of Cardio-Thoracic Surgery) since 2000 reveals over 500 articles with quality as a keyword. The difficulty in providing quality is perhaps not so . . . [Full Text of this Article]