Before becoming the president of AMDA – The Society for Post-Acute and Long-Term Care Medicine, David Nace, MD, MPH, CMD, spoke with some of his predecessors about the role. “They told me about what was involved, and they said I would be perfectly fine. They lied,” he joked. Turning serious, he said, “We have been preparing for a possible pandemic, but never in our wildest dreams did we see one that would turn the world upside down and pose this level of challenge for all of us. And I certainly didn’t foresee it happening on the eve of my inauguration.”
However, not surprisingly, Dr. Nace and the Society reacted to the COVID-19 crisis without hesitation. They created a wealth of COVID-related resources, including a dedicated webpage with news and updates, guidance and best practices, videos, webinars, podcasts, and more. “This has been a herculean effort by members and staff. Everyone stepped up and pitched in to address the problems and challenges and said, ‘I’m here to help.’” More amazing, Dr. Nace noted, was that “our members did this while they were simultaneously doing everything possible to protect their own residents.” He added, “If we didn’t have AMDA and our members working so diligently, the death toll from COVID in long-term care would have been far worse.”
Members of the Society and its state chapters across the country have stepped forward and led the efforts. Dr. Nace said, “Our members have been passionate about PALTC as a specialty, and no doubt we’ve demonstrated that during this pandemic.”
The Virtual Victory
As if dealing with a burgeoning pandemic wasn’t enough, Dr. Nace had to gear up quickly for the Society’s first-ever Virtual Annual Conference in April. “The staff pulled it together in three weeks, and it was absolutely amazing,” he said.
He noted that the Society had recently invested in the Apex Learning Management System, a unified content and education platform for members. “We knew this would be valuable in a crisis and that it would pay for itself quickly, but we never guessed that those things would happen so quickly,” he said.
The conference’s glitches were few and far between, Dr. Nace recalled, and it was a learning experience for him in particular. “The glitches for me were mostly around learning to use the camera and audio controls. I have better, more reliable Wi-Fi now, so I won’t have to worry about the 2021 conference.” Another challenge, he said, was that “you a have Q&A box, a chat box, and other things going on while you’re speaking. It was so important to have moderators to help, or it could be overwhelming.”
The Society’s leadership and members quickly learned to appreciate the benefits of a virtual conference. “We realized that we can reach more people, and participants have the flexibility to attend more sessions.”
Nonetheless, despite the success of the Society’s virtual program during his tenure as president, Dr. Nace said, “Being able to meet in person and network is so critical to our leaders and members. That is one part that I’ve dearly missed this past year, but that will come back.” Looking forward, he suggested, “we’ll have to consider if we will do more hybrid programs.”
“The work that we’ve done as an organization on COVID has been amazing. It’s been very much needed and demonstrates that we are leaders in clinical expertise. We are the medical discipline that advocates for appropriate, quality care for residents. COVID has demonstrated this and planted the flag that we are a specialty,” Dr. Nace said.
However, Dr. Nace is perhaps most proud of the organization’s efforts to address racism, diversity, equity, and inclusion. “When you look at what’s happened over the past year, many events showed that racism is a systemic problem in our culture. COVID really brought that home.”
Under Dr. Nace’s leadership, the organization addressed this in a thoughtful, focused way. “We looked at where we can do better and where our blind spots are. In June, the Society’s Board of Directors released the “Statement on Racial Inequities” (https://bit.ly/36rnSpF
), which said, in part, “We are creating a workgroup to evaluate the issues of inequality, inclusion, and diversity within the Society. We will actively work to increase diversity among our membership, particularly in our national committee and senior leadership positions, and we will evaluate other areas within our organization where we can improve. We will also develop and promote educational offerings for our members that address race, equity, and diversity, both within the facilities we serve and within the practice of PALTC medicine.”
In addition to creating the workgroup to address these issues, the Society held a webinar, “Racism and Diversity in PALTC: A Conversation,” which featured Dr. Nace and Diane Sanders-Cepeda, DO, CMD. Racism and inequality also were addressed during November’s “Leadership, Ethics & PALTC Virtual Symposium.”
His year as the Society’s president has reaffirmed Dr. Nace’s optimism. He said, “AMDA has really done a phenomenal job. The time I’ve spent as president has given me hope for the future. It’s nothing short of a miracle that we’ve gone through this and survived. It’s really amazing.”
Looking into the future, he said, “There is good and bad coming. We will have a vaccine for COVID and other treatments that will become available. The downside is that we are still going through the worst of the pandemic, and we all need to be prepared for that.” He added, “We should continue to advocate for changes in the way we practice and finance long-term care services. We need to be the voice for reform.”
He further noted, “We can’t continue on the same road we’ve been on. We know a blame culture exists, and that needs to change.” He observed that more regulatory oversight is not the answer, and Dr. Nace said that he’s concerned about legislative initiatives that focus more on enforcement and less on improving quality of care and other pressing concerns. “We need to advocate for reform in PALTC and make sure it’s incorporated into the health care system as a whole.”
While Dr. Nace admitted that the pandemic is far from over, he said, “As we get through the rest of this COVID crisis, we have the momentum to push forward some reforms to improve quality and safety in this environment and improve satisfaction for frontline workers and others providing care to this vulnerable population.”
Reflecting on his presidency, Dr. Nace said, “I think it’s humbling that people thought I could do this; but, in reality, a lot of people in our organization are qualified to serve in this role. There’s nothing special about what I’ve done. It just takes making that first step.”
Senior contributing writer Joanne Kaldy is a freelance writer in Harrisburg, PA, and a communications consultant for the Society and other organizations.