The following is an interview with the 2002-2003 AACVPR President, John Porcari, PhD, FACSM, FAACVPR. I have had the pleasure of working with John for a few years now and have great regard for his work, his commitment to his field, and the joy he gets out of life. I also admire his ability to inject humor when the situation desperately needs it. I am in hope that this interview allow the readers who don't know John to have a glimpse of the man I have seen in the years that I have know him.
TMW: So John, tell our readers a bit about yourself ...
JP: I am married with two children, Casey and Elizabeth. I love the outdoors. I like to hunt and fish. We spend a lot of time on Mississippi-"death tubing" and water skiing, jet skiing, you name it. My current passion is coaching my son's baseball team. Casey is also a hockey player and Elizabeth a figure skater. Being an Italian, I also love to cook...and unfortunately I love to eat what I cook. That was never a problem, until I hit 40.
TMW: How did you get started in cardiac rehab?
JP: By accident. In the back of my mind I had always wanted to be a cardiologist, but I didn't want to go to school for that long. When I was at Springfield College I took a class from Chris Higgins, who was in the first Adult Fitness/Cardiac Rehab masters program at LaCrosse. It really got me interested in the field, thinking that cardiac rehab would be a great compromise. I don't remember how and why I even applied, but it snow balled from there. And...I ended up going to school for 13 years anyway!
TMW: What are your goals for your term as President?
JP: The first major goal is to enhance communication. The executive board, board of directors, and the various committees put in countless hours on behalf of the organization. Unfortunately I don't think the membership realizes all of the projects we get done or the successes we have had. I would like the membership to understand the key issues the organization faces and what the board actually does and accomplishes. Another area of communication that needs work is the relationship between national and the state societies. The states are not out on an island; AACVPR and the Board of Director's have not done a good job of working with the state and regional societies and keeping them informed of key issues. Another major goal would be to continue to try to solidify the financial foundation of AACVPR by attaining external funding so that the society costs are not placed solely upon the membership.
TMW: I've actually had a number of your students as interns. They are very complimentary of you as a professor. What do you think is important when teaching or mentoring individuals new to the field?
JP: Looks like we keep fooling them. First of all, teaching in our program is more of a team approach. Carl Foster, Kristi Cadwell, Anne Rollings, and myself are constantly working on the curriculum so that the material covered in one class dovetails and builds on what they are learning in other classes. That makes us all look good. We try to focus on the practical knowledge and skills that are needed for the job market. We try to focus on mechanisms; why something happens as opposed to rote memorization, which I think allows them to be better teachers to their participants. We also try to teach the students about how to be a professional and how to enjoy themselves in their chosen field. Ninety percent of what we do is social. I try to guide the student in how they need to interact with participants, and fellow staff. It's all about relationships.
TMW: You've worked in cardiac rehabilitation for quite a few years now, what are the most significant changes you've seen through your career? What bearing do you think they have had on where we are today?
JP: Change in technology/procedures and reimbursement policies and their impact in length of stay and recovery time. Patient recovery is so much quicker. In that sense it reaffirms the need to stay current with technology, practice guidelines, and reimbursement trends. And, the best way to stay current is through membership in your state and national organizations.
TMW: In your opinion, what are the most important issues facing cardiac and pulmonary rehabilitation?
JP: Reimbursement, reimbursement, reimbursement and gaining recognition for what we do. We perceive what we do is invaluable and patients see us as invaluable. Payers and physicians often neglect us. What we do is never going to be more important, people are getting fatter, less active and the incidence of diabetes continues to increase...we are in the best position to combat this. We need to find ways to increase payers and physicians awareness of how we can be a vital, cost effective part of the treatment team.
TMW: Where do you see our field going?
JP: Toward more comprehensive risk factor management. We have run excellent exercise programs for a long time; evidence shows that we need to be more than that. Because we are going to see less and less reimbursement and reimbursement for fewer and fewer sessions, we are going to need to develop innovative self-pay programs of some sort.
TMW: What advice would you give a person entering the field today?
JP: Never stop learning. The field is changing so fast in regard to interventions, medications, etc. Stay current! Also, if you don't like what you do, find another field, because we certainly don't do this work for the money.
TMW: What is the most important piece of advice you have for us "old-timers"?
JP: The day you consider this "work" is the day you need to move on. Do what you love.
JP: One final thing I'd like to say is that people need to realize that we are a relatively small organization in the big scheme of things, with very few physician members. Despite all of our efforts, and we have been working very hard at it, that makes it tough to make changes in healthcare policy and influence legislation. Professionals in this field really need to step up to the plate and be members of the National association and their state/regional affiliates. It is the only way we are going to get anything done. Being a multi-disciplinary organization, I realize that it is difficult to for people to pay membership dues for another organization. But people need to be committed to this field and to AACVPR. I encourage people to support AACVPR and help be part of the solution.
TMW: Thanks for your candor, John, and best wishes for a very successful and rewarding term!