First Neurologist President of AHA Now President of AAN

Deborah Brauser

May 11, 2017

The first neurologist to become president of the American Heart Association (AHA), back in 2010, is now the first former AHA president to become president of the American Academy of Neurology (AAN).

Ralph L. Sacco, MD, Miller School of Medicine at the University of Miami, Florida, became the organization's 35th president at the recent AAN 2017 Annual Meeting, where he accepted the ceremonial gavel from immediate past president Terrence L. Cascino, MD, Mayo Clinic College of Medicine, Rochester, Minnesota.

"Like the presidents before me, I am dedicated to expanding the reach of the AAN, and demonstrating the immense value of neurology," said Dr Sacco in a statement.

Dr Ralph Sacco accepts gavel from immediate past president, Dr Terrence L. Cascino

"Our mission is to enhance patient-centered neurologic care and help our members practice neurology," he added to Medscape Medical News. "So we have a number of task forces that have now been moved into the implementation phase."

This includes focusing on ways to help individual members deal with burnout in the AAN's task force on wellness, continuing to look into strategies for expanding the budget of the National Institutes of Health (NIH), and helping to "grow the pipeline" of future neurologists.

"There are many different subspecialties that are all under the umbrella of the Academy, and we can do so much more now for multiple sclerosis, Parkinson's disease and movement disorders, epilepsy, migraine, and critical care," he said. "It's just a really exciting time in neurology."

Dr Ralph Sacco

Unifying Different Groups

At the University of Miami, Dr Sacco is the chair of the Department of Neurology and the Olemberg Family Chair in Neurological Disorders. And at Jackson Memorial Hospital in Miami, he is the executive director of the Evelyn McKnight Brain Institute and chief of the Neurology Service.

In addition, he is the principal investigator of the Northern Manhattan Study and the Florida Puerto Rico Collaboration to Reduce Stroke Disparities. Dr Sacco has also been a "career-long member" of the AAN and has served on its board of directors; as well, he is a past chair of the American Stroke Association Advisory Committee.

When Dr Sacco became president-elect of the AHA in 2009, he told Medscape Medical News at the time that that organization may have started with a focus on the heart but "has grown over the years to now involve so many people…from basic scientists to translational researchers, to cardiologists, cardiac surgeons, hypertension experts, endocrinologists, neurologists, and neurosurgeons."

Looking back now, he said he was "very fortunate" to have been elected president of AHA, and some of the principles he used there, such as strategic planning and uniting multidisciplinary groups, will be applicable during his stint with the AAN.

The latter group "is much more focused on the profession of neurology and has a different mission. But there are also things we can do together. And that's part of my platform: how can we work across organizations, across professional societies, across patient-centered groups, and even across nations to unify voices, advocate together, and build programs?

"As a stroke neurologist, I've treated stroke patients for many years, but I'm wearing a wider and broader brim of my hat these days," he said.

Hurdles in the Field

Dr Sacco noted that several hurdles currently affect the field of neurology, but the AAN is trying to meet each one head on. "There is plenty to do," he said.

For example, the success of new translational discoveries over the past few years is "really at the brink of new opportunities to improve care for our patients," said Dr Sacco. "But only through enhancing the funding of NIH research for neurologic disorders can we bring some of these discoveries into the clinic."

He also noted the worry about meeting the high demands for this type of care — now and in the future.

"Our population is aging and we need to make sure there are enough professionals providing care for neurological disorders in this country," said Dr Sacco, adding that approximately 1 in 6 Americans may have a condition that needs to be seen by a neurologist. "But there are just not enough of them."

In fact, only about 2.6% of medical students choose careers in neurology, he said. "So there are a number of things we're trying to do to excite more students." Also, the organization is trying to improve programs to advance access through telemedicine and is looking into reimbursement that will improve telemedicine consultations.

"And we're trying to expand advanced practice providers, who are one of the fastest-growing groups in our organization," said Dr Sacco. "How can they help us? And how can we meet their needs as members and as partners in providing care for the growing number of neurological disorders?"

He added that he's also interested in more "patient care teams" that cross specialties and include healthcare providers of different backgrounds.

"That's important to be thinking about, and we need new models to encourage multidisciplinary collaboration."

Optimism Toward the Future

Dr Sacco noted that there is also currently a lot of optimism in the field of neurology, especially in its subspecialties.

"We are making many more inroads into treating neurological conditions. In fact, one of the areas that we're trying to emphasize is what I call 'expanding the scope of neurology practice.' In the future, neurologists will be in charge of caring for populations of people, and that may mean those at risk for neurological disease as well as those with the conditions."

He added that the organization also wants to expand the idea of neurology to embrace the areas of intervention, prevention, and regeneration.  

"There are many exciting ways we can intervene to treat these people." For example, he noted that stroke has made major breakthroughs with use of stent retriever catheters, and there are now deep-brain stimulation approaches for Parkinson's disease and surgery that can be curative for patients with intractable epilepsy.

For preventive neurology, "there are many conditions that we can detect and treat earlier to prevent stroke and even prevent dementia nowadays," said Dr Sacco.

"And I think regenerative neurology is the future: stem cells and other advanced biologics and medications that help us to regenerate neurons in the nervous system to improve care of our patients," he added.

Overall, he said that he is blessed to be taking on the opportunity to act as president of the AAN. "It is a big task but I believe strongly in distributed leadership and teamwork. And I want our members to know they're in good hands with our great board and many outstanding volunteers leading committees to advance our mission."

Dr Sacco's term will continue until 2019, when he'll be succeeded by the current president-elect, James C. Stevens, MD, neurologist and specialist in sleep disorders at the Fort Wayne Neurological Center in Indiana.

Follow Deborah Brauser on Twitter: @MedscapeDeb. For more Medscape Neurology news, join us on Facebook and Twitter.

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