AmSECT has al­ways taken a proactive role in identifying the critical issues facing perfusionists and determining how to best  address them. AmSECT’s history is full of success stories where the Society, and its volunteers, diligently identified and addressed challenges that faced the profession. Some of the achievements in the ‘60s and ‘70s included support of the formal organization of educational programs which began developing both in university and hospital locations. Soon thereafter, AmSECT helped in establishment of the accrediting committee on perfusion education as well as the Perfusion Program Directors Council. AmSECT identified the need for a formal certification process, which led to the creation of the American Board of Cardiovascular Perfusion. The growth of cardiac surgery in the 1980s saw a shift in the Society’s past efforts to support a multidisciplinary clinician (dialysis, cell salvage) to that of a primary focus on the heart-lung machine; and the future looked brightest. In the ‘90s, the tremendous need for perfusionists became evident with other specialties beginning to encroach upon our responsibilities. This led to AmSECT adjusting its focus and, for the first time, at least on a national scale, perfusionists became familiar with the legislative process while legislatures became aware of perfusionists. The Society placed significant resources in the area of licensure and established the Government Relations Committee, which served as the guiding force behind the drive towards formal recognition of perfusionists. Indeed, anyone who uses the abbreviation ‘LCP’ after their name can thank AmSECT, and its hardworking vol­unteers, for this designation. So where are we today and what is the legacy that the current decade will leave in the wake of AmSECT’s efforts?

Without a doubt, the first five years of 2000 served as a wake-up call for the profession. A number of sentinel events occurred that roused the emotions of even the most stalwart of perfusionists. The decline in cardiac case numbers was the most prominent event that resulted in a reduction in staffing needs at various hospitals and in some service-providing organizations. The fallout was far reaching and included a reduction in individuals considering perfusion, as a profession as evidenced by a decline in applicants to perfusion educational programs. In fact, in the past decade, we have seen 15 educational programs close, represent­ing a net loss of 43% of all American perfusion schools. It is not difficult to imagine that the over­all feeling by the majority of perfusionists is that of concern, with many feeling that these are the ‘dark days’ of the profession. So, the questions of where we are, and what  AmSECT is doing about this ‘crisis’ rise to the forefront.

The most immediate need is to refocus, or to use the buzzword of the ‘90s, shift the paradigm of perfusion service, to one of perfu­sion expansion. AmSECT has addressed this through two important initiatives. The first, and most obvious, was to reevaluate the perfusion Scope of Practice. To this charge a committee was established and chaired by Cody Trow­bridge, MPS, CCP. This committee was given a fast track assignment and asked to complete their task with a one-year deadline. I am happy to announce that this highly motivated group has completed their charge, the efforts of which will be presented in April 2007 at the 45th International Conference in Atlanta. To no one’s surprise, there will be a move towards two expanding patient need areas: heart failure and blood management.

It is easy to say that we, as a profession, need to focus on these areas since anyone who has read the scientific literature, or picked up a newsstand periodical, knows of the need for improving care to this challenging patient population. AmSECT has taken the initiative and established an educational course in the area of ventricular assistance to be presented in Atlanta on April 25, 2007, and then regularly thereafter.  This one-day course will be focused entirely on the biology of heart failure and the technology of ventricular assist devices. Individuals taking the class will be given a certificate of completion that may be of value and recognized by regulatory organizations. Because of the intense nature of this course, a separate registration will be required for participation.

The area of blood management has also been a major charge of the Society. AmSECT’s Symposium on New Advances in Blood Management (NABM) is in its 15th year and is a phenomenal resource for those interested in this clinical specialty. The meeting has grown signifi­cantly and attracts several hundred participants to venues in locations such as Jackson Hole, Wyoming and Kansas City, Missouri. However, a more formal and intensive need for the study of blood management became evident.  To this end, AmSECT established a Perioperative Blood Management Taskforce, which has a goal of developing a plan for this specialty. The Task­force has been in existence for just over a year and has developed a strategic plan for the field including the creation of a new clinical specialist (Perioperative Blood Management Specialist - PBMS). They are also going to evaluate the need for expanding the continuing education process with the hope of providing certification as a PBMS. This year the American Association of Blood Banks has invited AmSECT to share its directive at the annual meeting in March of 2007. AmSECT is working to establish close relationships with other organizations whose mission is consistent in this high growth and specialized area. One necessity is the sharing of these initiatives with colleagues throughout the world, which, on a global scale, is without precedent in the history of our profession. This will occur through intra-society communication and the sharing of ideas. Such thinking without boundaries is a strong motivating factor for the advancement of the profession.

There are few things that stand out as clear mandates when one tries to prepare for the future. The advice our parents gave us, and perhaps now shared with our own children, is that education is the best foundation for any structure that one wishes to build. AmSECT’s proactive stance in addressing these needs is based upon action more so than reaction, which has been, and hopefully always will be, a prevail­ing trait that helps guide the profession.