Articles
Governor Reflections
Posted on 04/25/2025 12:00 am / April 2025
ACC's State Chapters play a pivotal role in fulfilling the College's Mission to transform cardiovascular (CV) care and improve heart health for all. Their on-the-ground efforts to foster community, develop new leaders, ensure equitable access to cardiovascular care, share the latest science and best practices, and advocate for health policies, are critical to the ACC's ability to deliver on its Strategic Pillars and major initiatives.
Led by Governors who also serve as Chapter Presidents, the state chapter serve as the voice of the Cardiovascular community at the local level. Notably, Governors are the only elected leaders in the ACC.
The editorial team of the MO ACC Connect had the privilege of interviewing outgoing MO ACC Governor Dr. Gabriel E. Soto MD PhD FACC (2022–2025) and incoming MO ACC Governor Dr. Toniya Singh MD FACC (2025–2028).
Interview with Dr. Gabriel E. Soto: Triumphs and Opportunities for the Missouri ACC Chapter
- Dr. Soto, Congratulations on the completion of a successful term! What inspired you to serve as the Missouri ACC Governor?
I’m a strong proponent of advocacy, and serving as governor provides an opportunity to bring the needs and concerns of our state members to the national level at the ACC. For example, the ACC’s response to Restrictive Covenants and push for a new Cardiovascular Board were in direct response to hearing the needs of members being adversely impacted by non-competes in employment contracts, and by the time and costs associated with Maintenance of Certification, or MOC. In addition, serving as governor offers the opportunity to learn from other leaders across the country and beyond, allowing for the sharing of ideas as to how we can continue as a chapter to improve upon the value we bring to our members.
- As you reflect on your term, what are your most memorable moments and triumphs?
One of my favorite moments was our Annual Meeting in the Fall of 2022. After the preceding 2 years of COVID which had shut down most in-person meetings and turned most of us into “Zoom Zombies”, it was great to be able to get together with colleagues from across the state an re-establish those important face-to-face connections.
In terms of triumphs, I am especially proud of the work the Chapter did in collaboration with the MO-ACC Foundation, the Young Scientist Program, and the Early Career Section to help establish the Missouri CV Scholars Program. The program pairs inner city students from disadvantaged backgrounds with Early Career Cardiologists for an immersive summer-long research experience, giving these students a wholly unique opportunity which hopefully sparks an interest in them to pursue a future career as a cardiovascular clinician or CV Team member.
- What were your greatest challenges on that you faced during your term, and how did you overcome them?
One of the challenges was emerging from the COVID pandemic. In the preceding two years before I assumed the role of Governor in 2022, our Chapter’s operational cadence had been largely disrupted. Although we continued to hold our Annual Meetings in a virtual format, we were all distracted by what was going on in our own communities and practices and really didn’t really focus on much else. We began accumulating vacancies on our Council and had outdated bylaws which made filling those vacancies somewhat challenging. Even our Chapter Newsletters and member communications had essentially all but vanished.
Upon becoming Governor, I met with our wonderful Chapter Executive, Beth Quick-Andrews, and we agreed that we needed a reset. This included a much-needed update to our Bylaws, putting out a call to members to volunteer and fill Council vacancies, and laying out a roadmap for enhancing member engagement and communications, including revamping our website and restarting — and ultimately reimaging — communications with our members going forward.
- Do you have any advice for early or mid-career faculty and CV team members that are seeking to be more engaged with the state chapter? And what would be the benefits of engaging with the Missouri ACC?
There are many ways to engage with the state chapter, and I hope that those that haven’t yet avail themselves of the opportunities — no matter where they are in their careers. I think it’s especially important for early career members, as it helps them build a strong network that will open doors for future career opportunities and collaborations. For those wishing to one day engage with the ACC at a national level in terms of committee or leadership roles, state chapter engagement and participation is the best way to showcase your talents and abilities and to build your resume in support of those positions.
- What are your future hopes for the Missouri ACC chapter?
The ACC is working to become the home of all cardiovascular team members. Going forward, I’d like to see more CV team members such as CV sonographers, cath and EP lab staff, and pharmacists, become engaged and help build educational and other career development programs that meet their needs. I also hope state chapter members continue to support and engage in advocacy efforts, both at the state level as well as nationally though activities such as the annual ACC Legislative Conference and support for the HeartPAC.
- How do you plan to stay engaged with the ACC moving forward?
I’ll be serving on the ACC’s Digital Transformation Committee for the next three years, as well as continue my term on the Medicare Contractor Advisory Committee. I’ll also remain involved in our chapter’s Scientific Sessions Planning Committee and Missouri ACC Foundation’s Early Career Grant Review Committee. Finally, I plan to continue advocacy on behalf of members and patients via the ACC Legislative Conferences and HeartPAC.
Interview with Dr. Toniya Singh: Vision for the Missouri ACC Chapter
- Congratulations on your new term. Can you tell us about your career journey?
Thank you—it’s truly an honor to step into this role. I’ve had the privilege of practicing as a clinical cardiologist for over two decades. My training—including residency, chief residency, and fellowship in cardiovascular disease—was completed at St. Louis University. Since joining St. Louis Heart and Vascular in 2003, I’ve remained with the same practice, which has given me a deep appreciation for how clinicians think, collaborate, and grow together.
Becoming involved with the ACC has been one of the most meaningful parts of my career. I was drawn to the strong sense of community and the opportunity to engage with diverse perspectives beyond the walls of my own practice. Through the ACC, I’ve gained new leadership skills, navigated complex challenges, and broadened my understanding of our field in ways I hadn’t anticipated. It’s been a truly rewarding and fascinating journey. - What are your primary goals and vision for the Missouri ACC chapter during your term as governor?
My vision for the Missouri ACC chapter is to make it as inclusive, engaging, and connected as possible. The education, relationships, and professional growth I’ve experienced through the ACC have been invaluable, and I want every Missouri chapter member to have access to those same opportunities.
My focus is two-fold:
• First, to increase awareness of the many ways members can get involved with the ACC.
• Second, to foster a warm, welcoming community where Missouri’s cardiologists and cardiovascular team members feel a true sense of belonging.
I believe the MO ACC can serve as a hub where members with shared clinical and non-clinical interests can connect, collaborate, and grow together. Building that sense of community is especially important to me—because it is one of the most effective ways we can combat burnout and support each other in this challenging field.
One way to do this is by expanding our programming beyond the Annual Scientific Session. Offering events shaped by member interests at various times of the year and in new locations across the state—including areas we haven’t traditionally reached—can help broaden participation and strengthen statewide connections. - What initiatives will the Missouri ACC chapter focus on to enhance continuing education and professional development?
We have several exciting initiatives underway to enrich continuing education and professional development across Missouri.
In addition to our Annual Scientific Session, we are now participating in a four-state virtual cath conference in collaboration with Illinois, Kansas, and Oklahoma. This case-based series will rotate quarterly among the states, providing opportunities for our members to engage with interesting cases while also showcasing Missouri’s own talent.
We are also launching an in-person imaging conference, led by two passionate Missouri cardiologists. The plan is for this conference to rotate through different cities, with local imaging experts at the helm—fostering learning and collaboration across regions.
A key focus is also on expanding our Women in Cardiology (WIC) gatherings. Women in our field are often underrepresented or siloed, and we want to create intentional spaces for connection, mentorship, and shared learning statewide.
For our Fellows in Training (FITs), we remain committed to providing exposure to the business side of cardiology—a crucial area often missing from formal training. Drawing from my experience chairing the CV Management Council, we plan to launch a dedicated series on contract negotiation, reimbursement models, and practice management to help prepare the next generation to thrive.
Additionally, we are partnering with our CV Team Lead to ensure cardiovascular team members are engaged across all chapter initiatives, working together to develop content that is meaningful and valuable to them. - Are there any specific patient advocacy efforts you plan to pursue at the state or national level?
Advocacy is a critical part of our mission, and I strongly encourage everyone to become a member of HeartPAC (Political Action Committee) and consider contributing. HeartPAC plays an essential role in representing the voice of cardiology on Capitol Hill, advocating for policies that impact both our patients and our profession.
Another powerful way to engage is by attending the ACC Legislative Conference, held each fall in Washington, D.C. This event offers the chance to meet directly with your state representatives and discuss key issues affecting Missouri and the cardiovascular community.
A major advocacy focus right now is addressing reimbursement cuts, including the recent 2.8% Medicare reduction—a cut we are actively working to reverse. It is also critical to maintain Medicaid access, especially amid federal policy changes that could affect coverage.
Here in Missouri, our legislators have already made significant strides toward prior authorization reform, an important step in reducing administrative burden and improving patient care. Another issue gaining momentum is the effort to address restrictive covenants; a current bill in the Missouri Senate proposes ending restrictive covenants for not-for-profit healthcare organizations.
I look forward to continuing to partner with our state medical associations and other stakeholders to advance these advocacy efforts and ensure we are supporting both our patients and our colleagues.
- What advice would you give early- and mid-career cardiologists and CV team members who want to engage more with the Missouri ACC? What are the benefits of getting involved?
If you’re interested in getting more involved, I encourage you to reach out to me directly. Anastasia Ambruster, our CV Team Lead on the Chapter Council, is also a wonderful resource.
There are many ways to engage—whether by joining the Chapter Council, serving on the planning committee for the Annual Scientific Session, participating in local events, or contributing to our Missouri ACC Newsletter and Communications Committee, which is always looking for fresh ideas and new voices.
For our Fellows in Training (FITs), we offer 2-3 travel grants each year, supported by the ACC, to attend the Legislative Conference in Washington, D.C.—a great way to build connections, learn about advocacy, and help shape the future of cardiology.
No matter where you are in your career, there is a place for you here. We would love to have your voice, your ideas, and your energy at the table. The relationships and knowledge you gain through participation will often give back more than you ever expect. - What do you see as the biggest challenges and opportunities for the Missouri ACC in the coming years? How can we address them?
One of the biggest challenges facing cardiology today is the changing landscape of private practice models—including consolidation, private equity involvement, and the continued shift toward employment-based structures. Helping our members understand these dynamics and how they impact career choices, compensation, and practice stability is a critical priority.
At the same time, one of our greatest opportunities is to strengthen member engagement and make the ACC feel like a true professional home for even more of us. Being part of a community like the ACC provides not only education and leadership development but also a network of colleagues you can rely on for support, advice, and camaraderie.
Whether you’re celebrating a success or facing a challenge, having a trusted professional community makes all the difference. In today’s fast-paced, often isolating world, that sense of connection and shared purpose is more valuable than ever.
