<International Circulation>:  In that same speech you mentioned that the membership was going to have to “adjust its sails.”  What does that mean?

   《国际循环》：你在就职演讲中还提到，成员将 需要“调整销售。”这是什么意思？

     Prof. Brindis:  One of the hallmarks of a true cardiovascular professional is to be able to be listened to is not only to understand all the science and be up-to-date with all that is going on scientifically， but also to be flexible enough to adapt in these changing times.  As we have discussed， the healthcare transition as we move from a payment for quantity to a payment for quality requires significant adaptation for the healthcare system in general and for the way that physicians and clinicians think.  One of the issues that have come up particularly this year is the issue of potential overuse of PCI.  This is a big issue in states like Maryland， Missouri， and Pennsylvania.  I would suspect that in this coming year the issue of inappropriate angioplasty would be even more on the forefront.  The professional societies have adapted to this in a good way.  The ACC has come up with an appropriate use criteria related to coronary revascularization.  Our national cardiovascular data registry has developed ways of reporting appropriateness that are benchmarked and that feed back to clinicians and hospitals so they can understand how they are performing.  We have developed a partnership with SCAI the ACE Initiative， an accreditation of cath labs in excellence as a way of helping hospitals and clinicians to an sure that we are performing high quality of care in cat labs and to do so with a high degree of appropriateness.  I think a professional is in the best position to be able to assess this and， if we don’t do this， others may come