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Practice Management


People with HIV and risk factors for heart disease and stroke are less likely to receive prescriptions for statins and aspirin than those without HIV, according to a study in the Journal of the American Heart Association.

During the Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, Michael J. Rinaldi, MD, showed a survey of 92 health systems in which 52 percent reported an average negative margin on TAVR procedures. In an hour-long session, Rinaldi and other experts agreed shortening hospital stays and reducing the number of days spent in the intensive care unit (ICU) are key aspects in making TAVR more profitable for hospitals.

Interventional cardiologists are exposed to chronic low-dose radiation, which can lead to adverse health conditions. At a Nov. 1 presentation at the Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium in Denver, Wieneke Vlastra, MD, reported a 20 percent decrease in radiation exposure for operators when a lead-free disposable pad was placed on the patient.

William Oetgen, MD, MBA, has been elected chairman of the MedStar Health Board of Directors, the American College of Cardiology (ACC) announced in a release today. He will serve a two-year term.

When Robert Hromas, MD, MS, began working at University of Florida Health seven years ago, he heard a gripe that is likely echoed in academic medical centers across the country.


Recent Headlines

What’s one improvement that could further improve length and quality of life for children with congenital heart disease as they age?

Due to advances in medical, surgical and transcatheter therapies, there are now more adults living with congenital heart disease (CHD) than children. Development of accessible integrated transition pathways from pediatric healthcare systems to specialized adult CHD centers will be essential to improve cardiac health, longevity and quality of life for children as they age. There are numerous potential barriers, such as inadequate self-understanding of the nature of their heart disease, separation from parental support, insurability concerns and lack of knowledge of available support resources, that can have a negative impact on the health of young adults living with CHD. Organized planning and access to centers with specialization in the management of adult CHD can prevent long periods of being lost to follow up and potentially irreversible decline in quality of life.

How do you handle stress and protect yourself/your team from burnout?

As president of a community hospital in suburban Boston, and a practicing vascular medicine specialist myself, I am terribly worried about the deterioration in the morale of my physician colleagues. They feel devalued, overwhelmed by administrative burden and are permanently tethered to computer screens. This is particularly evident among the primary care physician workforce. My hospital employs over 270 physicians representing many specialties. I am focused and committed to restore joy to the professional lives of my medical staff. I am looking at creative ways to make interacting with our electronic health record easier. I am investigating novel compensation plans that promote behaviors that align physicians and our health system. I am regularly interacting with my medical staff, listening to issues and evaluating solutions. Most important, I am discussing the challenges facing U.S. physicians on a regular basis with colleagues around the country, hopeful that successful pilots elsewhere would be applicable to my colleagues.

Do you encourage today’s young people to pursue careers in healthcare? Why or why not?

To my grandchildren, I would say…

Are you insecure? Healthcare is recession proof and unlikely to be outsourced offshore.

Are you financially worried? Healthcare jobs pay well, in some cases outrageously well.

Are you adventurous? Healthcare is needed in exotic settings where few are bold enough to go.

Are you innovative? Healthcare begs for innovation, from basic science research to global health policy.

Are you good with your hands? The best place for skilled hands is on the handle of a scalpel.

Are you intellectual? Daily your mind will be challenged by strange symptoms and insoluble problems.

If you could have an immediate fix to one healthcare problem, which problem would you choose, and why? 

It would have to be providing basic universal healthcare for all. There is no other way to address healthcare in the U.S. short of this, as evidenced by the political reality in Washington D.C. Even with a Republican majority in the Senate and House as well as a Republican president, the Affordable Care Act hasn’t been repealed—despite multiple attempts. People want access to adequate healthcare. We, as a country, should move forward to modernize our healthcare delivery system and fix the current patchwork of programs. Very little of the current system represents the modern reality. Providing adequate healthcare for citizens is the only way to move the country forward on this issue. Anything else is a political excuse.

Education, screening program nearly eradicates inappropriate catheterization

A one-month education and screening program at a rural tertiary medical center reduced inappropriate cardiac catheterization referrals by primary care physicians (PCPs) from 17 percent to zero percent.

Early discharge for low-risk pulmonary embolism patients linked to fewer complications, lower costs

Patients with low-risk pulmonary embolism (LRPE) who were discharged from the hospital within two days had better clinical outcomes and resulted in cost savings when compared to those with longer stays, according to a study in PLOS One.

Collaborative initiative to address gaps in healthcare information

The American Medical Association (AMA) has announced a collaborative initiative to improve the organization and sharing of healthcare information.

10 health systems seeking cardiology administrators

Cardiology administrators have important work ahead of them as practices look to flourish financially and remain compliant during a transition to merit-based payment models.

JAMA: Cardiac procedures among the 10 most unnecessary, overused treatments of 2016

Overtreatment, overtesting and overdiagnosis were the themes of a JAMA: Internal Medicine review this month that explored 10 of the riskiest instances of medical overuse in 2016.

Do the right thing—and save money—by addressing burnout

Nobody wakes up hoping for a bad day. Nobody walks into work hoping things go wrong. Similarly, cardiologists don’t expect to experience burnout but many do. A fair share grow to hate their jobs, with cynicism and apathy overtaking a belief in doing good, depression deepens and debilitation and exhaustion become the norm.