Temporal Resolution in the New Decade

      I once asked an old friend what his resolution was for the new year. He said “This time it will be different. I'm going to smoke, drink, eat out, and watch more TV.” I stared in disbelief. Noting my reaction, he went on to add, “Since my new year resolutions never work, I decided to try something different. A sort of reverse psychology!” I was visibly relieved that my friend wasn't headed on a path of self-destruction. However, I realized that embedded in his unique strategy was the phenomenon we are all experience often – managing change is hard. It is probably the reason why we all struggle with abrupt change, and often resist the forces that attempt to push us in a different direction. Even a professional society like ASE isn't exempt from this phenomenon. We are comprised of people, after all. However, change and evolution are necessary, and what better time to affect change than the dawn of a new decade.
      Our Society was founded in 1975 by a passionate group of echo enthusiasts, who tried to coalesce echocardiographers under one umbrella to enhance the field, advance the science, advocate for the profession, and eventually improve care of patients with heart disease. It is a testament to their vision that 45 years later, our goals remain the same. Those times were, however, different. Early records indicate that ASE had a little over 3,000 members in 1987 with little international representation. Today, ASE embraces more than 17,000 members with almost 20% residing outside the United States. We have become a truly global and diverse Society representing the best of echocardiography. From education to advocacy and innovation to humanitarian outreach, we have achieved much, and while the numbers are impressive, there is much more to do.
      In 2008, ASE leaders created a strategic plan with “big audacious goals” that lasted for more than 10 years. Our strategic plan has undergone modifications and revisions, but the foundation has remained largely the same. One may ask why haven't we undergone repeated transformations in the last 11 years? Is it because we are resistant to change? Or was our strategic plan so powerfully robust that it accounted for strategic shifts along the way? The answer perhaps is a bit of both. The new question now is whether we need a new strategy that will enable ASE to thrive and grow over the next 15 years.
      Over the last 45 years, our world has changed a great deal, and so has the world of echocardiography. Once the exclusive domain of cardiovascular professionals in academic institutions that had access to sonography machines capable of filling a small room to only perform M-mode imaging, to the smartphone-enabled transducers that can fit into anyone's pocket, innovation has broken down barriers. Technology has allowed echocardiography to cross geographic and specialty boundaries. New uses and new users have emerged together bringing with them both opportunities and challenges. The constant evolution of healthcare regulation challenges our practitioners to create fiscally viable solutions to allow continuous growth and maintain our quality of care. ASE stands at the intersection of our changing echo landscape. How we embrace this change will likely define our relevance in the future.
      In November of 2019, ASE's leaders convened in Durham, North Carolina, to chart a new strategic plan that captures our collective vision, mission, and goals to continue our trajectory of growth in the new decade. It wasn't easy. Change rarely is. We began by noting our rich history to provide us with both inspiration and guidance in preparing for the future. Next came a review of our successes and failures. Celebrating the former and learning from the latter. Then came the hard part – envisioning the future. “It is hard to make predictions. Especially about the future.” While the exact quote has uncertain attribution (likely Danish physicist, Niels Bohr), it applies well to our work. A careful analysis of our strengths, weaknesses, opportunities, and threats helped shape our strategy. Education, advocacy, member engagement, research, technology innovation, and strategic alliances were all tackled with a view to create an enduring vision for the Society in the coming years. The plan will undergo more scrutiny and change before it firmly defines our path for the new decade. Once the vision and strategic goals are adopted, our committees and task forces will develop tactical plans to achieve our goals.
      We fear what we can't predict and find safety in what we know and understand. Change is inevitable and our natural resistance to its force is understandable. As a Society, we are fortunate to have members who are passionate about what they do, and leaders who are ready to prepare the Society to embrace change. It may not be an easy transition to our next strategic plan, and the uncertainty of the future may make for an uneasy experience.
      Unlike my friend, who hoped that the strategy of a fatalistic new year's resolution would likely fail, I hypothesize that ASE's resolution of a renewed strategic plan will succeed and usher the Society into a new era of growth. That change is certain.Madhav Swaminathan, MD, MMCi, FASE, is a tenured Professor and Vice Chair for Faculty Development in the Department of Anesthesiology at Duke University Health System in Durham, North Carolina. He has worked as a cardiac anesthesiologist and intensivist at Duke since 2000 and is serving as ASE's President.