- Email: [email protected]
NKF Medical Advisory Board: Opportunities for Leadership and Community Service
Editorial NKF Medical Advisory Board: Opportunities for Leadership and Community Service Khaled Nashar, MD, was the Medical Advisory Board Distinguished Service Award recipient at the 2016 National Kidney Foundation Spring Clinical Meetings. This award was established to recognize an individual for educational activities and community service in promoting the mission of the National Kidney Foundation on a local level.
I
n 2015, the National Kidney Foundation (NKF) created the Medical Advisory Board (MAB) Distinguished Service Award to recognize physicians and individuals for their community service and commitment to programs aimed at promoting the NKF’s mission in fighting kidney disease. I feel honored to have received this recognition, and I view it less as a personal accolade and more as an opportunity to reflect on our work and the opportunities available within the NKF MABs. I also offer some strategies to help the MABs maximize their productivity. The anguish of Ada DeBold over the suffering of her son was the inspiration for the inception of the National Nephrosis Foundation in 1950, which later became the NKF.1 Since its founding, the NKF has been a leading organization in the United States and is dedicated to increasing awareness, prevention, and treatment of kidney disease. According to the Centers for Disease Control and Prevention, an estimated 1 in 3 adult Americans are currently at risk for developing kidney disease.2 Although there is no cure available for advanced kidney disease, if diagnosed early, it can be slowed, and early detection of kidney disease and referral to nephrology specialists are associated with improved outcomes.3,4 Many high-risk individuals are not receiving appropriate testing for kidney disease.5 Through programs like “KEEP Healthy,” patients with little or no health care access can receive diagnostic testing and resources for the treatment of hypertension and kidney disease.6 Such awareness programs are usually organized by a local NKF MAB. MABs are typically made up of physicians, scientists, and other health professionals. They guide the NKF’s patient, professional, and public education programs at the local level. They also provide medical oversight, support, and volunteer services and offer professionals in kidney-related disciplines an opportunity to exchange ideas and information. There are about 32 local offices within the NKF family in the United States, only 23 of which have active MABs. Programs organized and supported by MABs include KEEP Healthy, Kidney Disease Education, and professional education events.7 MAB members provide clinical consultations and assist in recruiting physicians and other volunteers for Am J Kidney Dis. 2017;69(2):169-171
these programs. MABs are expected to promote opportunities for professionals to exchange ideas and information and also assist in shaping local health policy to promote chronic kidney disease (CKD) awareness. Furthermore, MABs usually participate in raising funds in coordination with the NKF’s local leadership for programs and services in that region. Despite the valuable and rewarding experience these programs offer, physicians’ participation could be improved. Furthermore, MABs tend to mainly include physicians with academic backgrounds. However, multiple opportunities exist for the NKF chapters and their MABs to expand their roles and achieve the goal of increased awareness, prevention, and treatment of kidney disease. I offer 10 strategies to help MABs enhance their effectiveness. 1. Encourage nephrology fellows’ participation. Reach out to training programs to incorporate community service in the fellows’ training and into their educational activities. This sends the message to future nephrologists, whether academic or community based, that the NKF is a vital part of their mission to serve their patients. Furthermore, fellows will be more likely to participate after they become practicing nephrologists. 2. Provide venues for collaboration. In the times of competitive health care markets, the MAB can offer an excellent opportunity to bridge gaps between local medical institutions. At the same time, establishing solid collegial relationships fosters future engagement in MAB activities. In the Pittsburgh area, we were able to break barriers between 2 competing centers through collaborative programs and networking events. Our MAB launched a series of professional events in which nephrologists from all over the area get together on a quarterly basis to discuss important topics in nephrology. These include challenging cases, reimbursement models, and trends in practice.
Originally published online November 14, 2016. Address correspondence to Khaled Nashar, MD, Allegheny Health Network, 320 E North Ave, South Tower, 7th Floor, Pittsburgh, PA 15212. E-mail: [email protected] Ó 2016 by the National Kidney Foundation, Inc. 0272-6386 http://dx.doi.org/10.1053/j.ajkd.2016.08.032 169
Khaled Nashar
3. Use “CKDinform” as another opportunity for collaboration within the community for the greater good of our patients. CKDinform is a collection of evidence-based resources for primary care practitioners created by the NKF.8-12 The MABs are expected to present the CKDinform materials at local symposia, grand rounds, or during collaborative education with their local primary care organizations. We suggest inviting speakers who represent local institutions and community physicians, including both nephrologists and primary care physicians. 4. Urge all MAB members to participate in events at which they mingle with patients. A perfect example of this is the Kidney Walk. Nephrologists can engage their entire patient care team, including office staff, nurses, and dialysis support staff, to form a walk team. This creates an opportunity for a friendly and nonthreatening competition among MAB members, as well as an opportunity to network in an environment outside of work. The Kidney Walk is a perfect venue for physicians to show their support for the NKF. 5. Extend MAB membership. The NKF chapters can encompass wide geographical areas. It is important to be inclusive and invite nephrologists in all areas of the NKF chapter to participate. We suggest developing a list of all nephrologists to reach out to for educational opportunities within their local communities, such as the CKD education programs for primary care, and to not rely solely on academic nephrologists or those in the main city hub for this role. Involving community nephrologists is vital. As a result, more regional nephrologists will become engaged in the other activities of an NKF chapter, including the kidney walk and kidney gala. 6. Partner with local medical societies, organizations, and major medical centers, for example, county or state medical societies, American College of Physicians chapters, and the PKD (Polycystic Kidney Disease) Foundation. These collaborations decrease cost, avoid redundancy in efforts, and help increase the target audience pool. 7. Diversify MAB’s membership to include professionals with various health care backgrounds. This includes nephrologists, family practitioners, social workers, nurses, internists, transplantation surgeons, dieticians working with patients with CKD, and public health professionals participating in prevention/risk identification programs. 8. Apply for educational grants to support professional activities. Coordinate with the NKF national office to ensure compliance with NKF regulations. 9. Review new medical literature, provide commentary reviews, and educate chapter staff. Ensure accuracy, validity, and the nonbiased nature of content. 10. Maximize use of NKF resources as needed. For example, the NKF offers excellent patient education 170
handouts. They are easy to read, are well illustrated, and provide accurate medical information written in lay terms. Consider compiling them in packets for patients to read after their office visit. We found these packets particularly useful for patients with newly diagnosed advanced CKD. This strategy alleviates patients’ anxiety, helps them understand their disease, and assists with learning about treatment options.13 To summarize, serving on the MAB is an immensely rewarding experience. There are numerous opportunities for physicians within the NKF and for the MABs to increase their effectiveness and maximize their impact. A philosophy based on creativity, inclusion, and active participation provides a path for success. I can think of no recognition of my interest and work in the field that would mean as much to me as this award. However, while this award is a wonderful thing, I am more grateful for being a nephrologist and being able to make a difference in my patients’ lives. Counseling and guiding patients from the diagnosis of CKD and during the transition to advanced CKD, renal replacement therapy options, and kidney transplantation is a true privilege. I can think of no more rewarding and intellectually stimulating field than nephrology. In an era of declining interest in careers in nephrology, opportunities for volunteer work and community services can enhance career satisfaction. In turn, nephrologists have the opportunity to be seen as true stewards of their communities. This may inspire residents and medical students to choose nephrology as a career. Khaled Nashar, MD Allegheny Heath Network Pittsburgh, Pennsylvania
ACKNOWLEDGEMENTS The author thanks Dr Barbara Clark for review of the manuscript and constructive suggestions that led to its improvement. Support: None. Financial Disclosure: The author declares that he has no relevant financial interests. Peer Review: Evaluated by Editor-in-Chief Levey.
REFERENCES 1. Brown WW. The history of the National Kidney Foundation. Am J Kidney Dis. 2000;35(suppl 1):S3-S18. 2. Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension Among Adults in the US: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief, No. 133. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Department of Health and Human Services; 2013. 3. National Kidney Foundation. Guidelines and commentaries. https://www.kidney.org/professionals/guidelines/guidelines_ commentaries. Accessed September 12, 2016. 4. Wouters OJ, O’Donoghue DJ, Ritchie J, Kanavos PG, Narva AS. Early chronic kidney disease: diagnosis, management and models of care. Nat Rev Nephrol. 2015;11(8):491-502. Am J Kidney Dis. 2017;69(2):169-171
Editorial 5. Brown WW, Collins A, Chen SC, et al. Identification of persons at high risk for kidney disease via targeted screening: the NKF Kidney Early Evaluation Program. Kidney Int Suppl. 2003;83:S50-S55. 6. National Kidney Foundation. KEEP Healthy: free kidney health checks. www.kidney.org/keephealthy. Accessed September 12, 2016. 7. National Kidney Foundation. Professional resources. https:// www.kidney.org/professionals/CAP/sub_resources. Accessed September 12, 2016. 8. National Kidney Foundation. CKDinform. www.kidney.org/ ckdinform. Accessed September 12, 2016.
Am J Kidney Dis. 2017;69(2):169-171
9. National Kidney Foundation. CKD intercept. www.kidney. org/ckdintercept. Accessed September 12, 2016. 10. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012;379(9811):165-180. 11. Thavarajah S, Knicely DH, Choi MJ. CKD for primary care practitioners: can we cut to the chase without too many shortcuts? Am J Kidney Dis. 2016;67(6):826-829. 12. Vassalotti JA, Centor R, Turner BJ, et al. Practical approach to detection and management of chronic kidney disease for the primary care clinician. Am J Med. 2016;129(2):153-162. 13. National Kidney Foundation. Patient resources. https:// www.kidney.org/patients. Accessed September 12, 2016.
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I
n 2015, the National Kidney Foundation (NKF) created the Medical Advisory Board (MAB) Distinguished Service Award to recognize physicians and individuals for their community service and commitment to programs aimed at promoting the NKF’s mission in fighting kidney disease. I feel honored to have received this recognition, and I view it less as a personal accolade and more as an opportunity to reflect on our work and the opportunities available within the NKF MABs. I also offer some strategies to help the MABs maximize their productivity. The anguish of Ada DeBold over the suffering of her son was the inspiration for the inception of the National Nephrosis Foundation in 1950, which later became the NKF.1 Since its founding, the NKF has been a leading organization in the United States and is dedicated to increasing awareness, prevention, and treatment of kidney disease. According to the Centers for Disease Control and Prevention, an estimated 1 in 3 adult Americans are currently at risk for developing kidney disease.2 Although there is no cure available for advanced kidney disease, if diagnosed early, it can be slowed, and early detection of kidney disease and referral to nephrology specialists are associated with improved outcomes.3,4 Many high-risk individuals are not receiving appropriate testing for kidney disease.5 Through programs like “KEEP Healthy,” patients with little or no health care access can receive diagnostic testing and resources for the treatment of hypertension and kidney disease.6 Such awareness programs are usually organized by a local NKF MAB. MABs are typically made up of physicians, scientists, and other health professionals. They guide the NKF’s patient, professional, and public education programs at the local level. They also provide medical oversight, support, and volunteer services and offer professionals in kidney-related disciplines an opportunity to exchange ideas and information. There are about 32 local offices within the NKF family in the United States, only 23 of which have active MABs. Programs organized and supported by MABs include KEEP Healthy, Kidney Disease Education, and professional education events.7 MAB members provide clinical consultations and assist in recruiting physicians and other volunteers for Am J Kidney Dis. 2017;69(2):169-171
these programs. MABs are expected to promote opportunities for professionals to exchange ideas and information and also assist in shaping local health policy to promote chronic kidney disease (CKD) awareness. Furthermore, MABs usually participate in raising funds in coordination with the NKF’s local leadership for programs and services in that region. Despite the valuable and rewarding experience these programs offer, physicians’ participation could be improved. Furthermore, MABs tend to mainly include physicians with academic backgrounds. However, multiple opportunities exist for the NKF chapters and their MABs to expand their roles and achieve the goal of increased awareness, prevention, and treatment of kidney disease. I offer 10 strategies to help MABs enhance their effectiveness. 1. Encourage nephrology fellows’ participation. Reach out to training programs to incorporate community service in the fellows’ training and into their educational activities. This sends the message to future nephrologists, whether academic or community based, that the NKF is a vital part of their mission to serve their patients. Furthermore, fellows will be more likely to participate after they become practicing nephrologists. 2. Provide venues for collaboration. In the times of competitive health care markets, the MAB can offer an excellent opportunity to bridge gaps between local medical institutions. At the same time, establishing solid collegial relationships fosters future engagement in MAB activities. In the Pittsburgh area, we were able to break barriers between 2 competing centers through collaborative programs and networking events. Our MAB launched a series of professional events in which nephrologists from all over the area get together on a quarterly basis to discuss important topics in nephrology. These include challenging cases, reimbursement models, and trends in practice.
Originally published online November 14, 2016. Address correspondence to Khaled Nashar, MD, Allegheny Health Network, 320 E North Ave, South Tower, 7th Floor, Pittsburgh, PA 15212. E-mail: [email protected] Ó 2016 by the National Kidney Foundation, Inc. 0272-6386 http://dx.doi.org/10.1053/j.ajkd.2016.08.032 169
Khaled Nashar
3. Use “CKDinform” as another opportunity for collaboration within the community for the greater good of our patients. CKDinform is a collection of evidence-based resources for primary care practitioners created by the NKF.8-12 The MABs are expected to present the CKDinform materials at local symposia, grand rounds, or during collaborative education with their local primary care organizations. We suggest inviting speakers who represent local institutions and community physicians, including both nephrologists and primary care physicians. 4. Urge all MAB members to participate in events at which they mingle with patients. A perfect example of this is the Kidney Walk. Nephrologists can engage their entire patient care team, including office staff, nurses, and dialysis support staff, to form a walk team. This creates an opportunity for a friendly and nonthreatening competition among MAB members, as well as an opportunity to network in an environment outside of work. The Kidney Walk is a perfect venue for physicians to show their support for the NKF. 5. Extend MAB membership. The NKF chapters can encompass wide geographical areas. It is important to be inclusive and invite nephrologists in all areas of the NKF chapter to participate. We suggest developing a list of all nephrologists to reach out to for educational opportunities within their local communities, such as the CKD education programs for primary care, and to not rely solely on academic nephrologists or those in the main city hub for this role. Involving community nephrologists is vital. As a result, more regional nephrologists will become engaged in the other activities of an NKF chapter, including the kidney walk and kidney gala. 6. Partner with local medical societies, organizations, and major medical centers, for example, county or state medical societies, American College of Physicians chapters, and the PKD (Polycystic Kidney Disease) Foundation. These collaborations decrease cost, avoid redundancy in efforts, and help increase the target audience pool. 7. Diversify MAB’s membership to include professionals with various health care backgrounds. This includes nephrologists, family practitioners, social workers, nurses, internists, transplantation surgeons, dieticians working with patients with CKD, and public health professionals participating in prevention/risk identification programs. 8. Apply for educational grants to support professional activities. Coordinate with the NKF national office to ensure compliance with NKF regulations. 9. Review new medical literature, provide commentary reviews, and educate chapter staff. Ensure accuracy, validity, and the nonbiased nature of content. 10. Maximize use of NKF resources as needed. For example, the NKF offers excellent patient education 170
handouts. They are easy to read, are well illustrated, and provide accurate medical information written in lay terms. Consider compiling them in packets for patients to read after their office visit. We found these packets particularly useful for patients with newly diagnosed advanced CKD. This strategy alleviates patients’ anxiety, helps them understand their disease, and assists with learning about treatment options.13 To summarize, serving on the MAB is an immensely rewarding experience. There are numerous opportunities for physicians within the NKF and for the MABs to increase their effectiveness and maximize their impact. A philosophy based on creativity, inclusion, and active participation provides a path for success. I can think of no recognition of my interest and work in the field that would mean as much to me as this award. However, while this award is a wonderful thing, I am more grateful for being a nephrologist and being able to make a difference in my patients’ lives. Counseling and guiding patients from the diagnosis of CKD and during the transition to advanced CKD, renal replacement therapy options, and kidney transplantation is a true privilege. I can think of no more rewarding and intellectually stimulating field than nephrology. In an era of declining interest in careers in nephrology, opportunities for volunteer work and community services can enhance career satisfaction. In turn, nephrologists have the opportunity to be seen as true stewards of their communities. This may inspire residents and medical students to choose nephrology as a career. Khaled Nashar, MD Allegheny Heath Network Pittsburgh, Pennsylvania
ACKNOWLEDGEMENTS The author thanks Dr Barbara Clark for review of the manuscript and constructive suggestions that led to its improvement. Support: None. Financial Disclosure: The author declares that he has no relevant financial interests. Peer Review: Evaluated by Editor-in-Chief Levey.
REFERENCES 1. Brown WW. The history of the National Kidney Foundation. Am J Kidney Dis. 2000;35(suppl 1):S3-S18. 2. Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension Among Adults in the US: National Health and Nutrition Examination Survey, 2011-2012. NCHS Data Brief, No. 133. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention, US Department of Health and Human Services; 2013. 3. National Kidney Foundation. Guidelines and commentaries. https://www.kidney.org/professionals/guidelines/guidelines_ commentaries. Accessed September 12, 2016. 4. Wouters OJ, O’Donoghue DJ, Ritchie J, Kanavos PG, Narva AS. Early chronic kidney disease: diagnosis, management and models of care. Nat Rev Nephrol. 2015;11(8):491-502. Am J Kidney Dis. 2017;69(2):169-171
Editorial 5. Brown WW, Collins A, Chen SC, et al. Identification of persons at high risk for kidney disease via targeted screening: the NKF Kidney Early Evaluation Program. Kidney Int Suppl. 2003;83:S50-S55. 6. National Kidney Foundation. KEEP Healthy: free kidney health checks. www.kidney.org/keephealthy. Accessed September 12, 2016. 7. National Kidney Foundation. Professional resources. https:// www.kidney.org/professionals/CAP/sub_resources. Accessed September 12, 2016. 8. National Kidney Foundation. CKDinform. www.kidney.org/ ckdinform. Accessed September 12, 2016.
Am J Kidney Dis. 2017;69(2):169-171
9. National Kidney Foundation. CKD intercept. www.kidney. org/ckdintercept. Accessed September 12, 2016. 10. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012;379(9811):165-180. 11. Thavarajah S, Knicely DH, Choi MJ. CKD for primary care practitioners: can we cut to the chase without too many shortcuts? Am J Kidney Dis. 2016;67(6):826-829. 12. Vassalotti JA, Centor R, Turner BJ, et al. Practical approach to detection and management of chronic kidney disease for the primary care clinician. Am J Med. 2016;129(2):153-162. 13. National Kidney Foundation. Patient resources. https:// www.kidney.org/patients. Accessed September 12, 2016.
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