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As risk-sharing agreements become more common, hospitals and physicians are focusing on teamwork and attention to metrics.  

Are enough resources available to treat the growing population of adults with congenital heart disease?   

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a Republican majority in the Senate and House as well as a Republican president, the Affordable Care Act hasn’t been repealed—despite multiple attempts.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.

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.

While the WannaCry cyberattack against hospitals, clinics and device makers was largely unsuccessful, future hacks might be used to imperil patients. Experts worry the U.S system is still too vulnerable and health IT departments are under-resourced.  

Physician burnout has been called a “silent epidemic” that not only overwhelms physicians but can impact the care they deliver to patients. A number of programs are starting to confront the problem head on—giving doctors hope that someone is listening.

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.

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.

Cardiology fellow Haider Warraich, MD, hopes his book about death will change how we live.

Recent medical group compensation and productivity data surveys fielded by AMGA suggest trends for practices to watch.

When implementing new technologies, success sometimes hinges on how quickly and efficiently we collect, analyze and react to data.

Questions have swirled around the value of percutaneous coronary intervention (PCI) for patients whose quality of life has suffered from chronic total occlusion (CTO). Inevitably, another issue has arisen: which cath labs and operators should be undertaking these difficult and costly procedures?

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