Economic Tourniquet Escapes EP, Tightens Elsewhere

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C.P. Kaiser, Editor

Cardiovascular care, like other areas of medicine, is feeling the pinch of the economic tourniquet applied to stop the hemorrhaging of dollars and the potential closure of life-saving services. Interestingly, the pulse of electrophysiology is anything but flatlined, and vendors and CFOs are all a-flutter at the staggering growth of EP—estimated to be between 12 and 15 percent annually.

Several factors contribute to EP’s meteoric rise: the aging population and a better understanding of arrhythmias in general, but the advanced technologies in the field have allowed improved visualization of heart structures—especially intraoperatively; greater pinpoint ablative precision for increased accuracy and reduced recurrence; and expert dedicated physicians who are driving both the pace and quality of EP services.

In our cover story, some of the leading-edge luminaries discuss the EP “toys” that help their labs function at an optimal level, make money and improve outcomes.

Now to the bad news. Nuclear cardiology, while not exactly dead, has its share of challenges. Volumes are down to a whisper at some hospitals compared to the giddy cacophony of years past. And even with the right numbers, revenues are not as bullish as they could be for a whole host of reasons, including increased expenses and competition, newly bundled codes and the government’s scrutiny of advanced imaging utilization.

But Cardiovascular Business is not in the business of spreading doom and gloom, which is why we offer two features in this issue that shed light (albeit, from the radioactive spectrum) on ways to improve nuclear cardiology practice and quality.

An important aspect of specialist care is the daily interaction with primary-care docs in the hospital setting. Unfortunately, this pillar of collegiality is slowly eroding as the use of hospitalists increases. The Back Page column poses the provocative notion that this erosion leads to reduced referrals, and takes us to task for blindly blaming the economy for our woes without looking behind the scenes. This article should open eyes and start a constructive dialogue that will help hospitals and practices recoup lost revenues.

And finally, two items in our News & Views section are worth noting. One deals with “lean” thinking—similar to the Six Sigma program—which helps eliminate wasteful processes. Be forewarned, however, that this avenue is not for the faint of heart. It takes an organization-wide commitment and long-term fortitude. The second article posits the importance of marketing in times of economic stress and illustrates examples throughout modern history of companies that not only survived but also prospered because they continued to spend money on branding and marketing during precarious financial times.

I hope—and know—you will enjoy this issue of Cardiovascular Business and I welcome your comments.