1. Leveraging Your Clinical Leadership Franklin W. Maddux, MD FACP Saturday, March 21, 2009 RPA Annual Meeting

9. Current State What Nephrology Practice Looks Like Now

10. RPA 2007 Benchmarking Survey

11. RPA 2007 Benchmarking Survey

12. RPA 2007 Benchmarking Survey

13. RPA 2007 Benchmarking Survey

14. Nephrology SERVICES Clinic, Dialysis Unit, Hospital and … Beyond… RPA 2007 Benchmarking Survey 19% Vein Mapping 49% Hepatitis Vaccination 66% Pneumovax 77% Flu Vaccination 78% ESA Administration 81% Dialysis Education 14% Vascular Doppler 24% Renal U/S 38% Iron Administration 40% Research

17. Patient Demand in a A World of Chronic Illness USRDS, 2008 Atlas In U.S. adults, chronic kidney disease (CKD) is more prevalent than either congestive heart failure or diabetes, and the prevalence of CKD appears to have grown over a period of approximately fifteen years.

18. USRDS CKD Patient Breakdown USRDS, 2008 Atlas

19. Prevalence of GFR <60 ml/min/1.73m 2 NHANES participants age 20 & older

23. Future State How Physician Leadership Must Transform the Practice of Nephrology

24. The Goddess Durga and The Practice of Nephrology A representation of the Hindu goddess depicted with multiple arms

25. The Future Nephrologist The nephrologist will need eight arms instead of two. Six of these eight arms will be from members of the clinical care team that supports a structured care approach for patients with kidney disease.

30. Rely on Authority Value Accountability Minimize Risk Accept Risks Avoid Conflict Use Conflict Make rules Break rules Tell The Vision Sell the Vision Implement Plan Details Set Direction & Vision Instruct Mentor Reorganize Reinvent Address daily issues Have a vision for the future Supervise Subordinates Nurture Followers Do things right Do the right things Managers Leaders