Essential nonclinical competencies for cardiovascular specialists imperatives for training.

C. Richard (Dick) Conti was a pioneer in innovation…not only in clinical and academic fields, but also in the exposure of academicians, clinicians, and trainees to various environments for expansion of their knowledge base…and world view. In an evolving environment of systems of medical care, engagement in management and planning by physicians and all members of the care team is essential to ensure quality for patients and to develop processes that work effectively for practitioners. This is particularly true in cardiovascular disease, where the majority of physicians are now part of integrated healthcare systems. Such integration can have advantages, but can also lead to a perceived and real loss of professional control over the practice of medicine. As health systems grow, even those practitioners who remain "independent" require the ability to actively engage in system programs, processes, and planning. Tools to effectively contribute to such skill sets are not commonly part of formal training. This communication describes the needs for training in nonclinical competencies, some current resources, and a model for formal integration of such instruction into cardiology fellowship training. An approach such as this honors the memory of Dick Conti, as an educator and leader who continuously looked for avenues to improve the practice of cardiovascular medicine.