Larry S. Dean, MD, provides insight on the randomized SURTAVI trial, which was presented in a late-breaking session at the ACC scientific session. At two years, intermediate-risk patients with severe symptomatic aortic stenosis had similar rates of all-cause mortality or disabling stroke whether they underwent TAVR or SAVR. Dean says the results confirm findings from the PARTNER IIA trial, which showed that TAVR can be effective in lower risk patients.

ACC President Mary Norine Walsh, MD, discusses the origins of “nocturnists,” a term used for internal medicine physicians who are hospitalists, work only at night and cover cardiology patients. Walsh’s practice employs nocturnists and believes they are well-trained and effectively serve patients while reducing the burden of night call on cardiologists.

With the implementation of the MACRA legislation and the Merit-based Incentive Payment System (MIPS), Peter Tilkemeier, MD, says many physicians are dealing with the administrative burdens of medicine. He recommends cardiologists submit data to qualified clinical data registries to gain insight into how their practices are performing and meet a quality requirement for MACRA and MIPS. 

On March 10, the ACC and other medical societies updated the terminology used in the appropriate use criteria (AUC) for coronary revascularization in patients with stable ischemic heart disease. Gregory Dehmer, MD, notes the old methodology used “appropriate,” “uncertain” and “inappropriate,” whereas the new methodology uses “appropriate,” “may be appropriate” and “rarely appropriate.” Dehmer says the new terminology is a better fit for how cardiologists practice and discusses other changes in the updated AUC.

Today, 1.5 million to 2 million adults in the United States have congenital heart disease, which is more than the number of children with the condition. Disty Pearson, PA-C, discusses new congenital heart disease guidelines and accreditation programs for appropriate care. Although there is a lack of adult congenital heart disease cardiologists, she says physician assistants and nurse practitioners can help care for these patients, many of whom have comorbidities and neurocognitive issues.

Burnout among cardiologists is very real, with nearly half of cardiologists suffering from it, according to Charles Chambers, MD. Still, it is difficult to recognize even though it can lead to job dissatisfaction and severe issues such as alcoholism and suicide. Chambers suggests physicians take time off, exercise, stay in shape and maintain a work-life balance to help decrease the risk of burnout.  

Cardiologists are facing rapid changes in reimbursement due to new payment models, but James C. Blankenship, MD, MHCM, says physicians should focus on providing the best quality of care for patients. He recommends physicians take care of everyone in their practice or group, as well. These days, physicians must also understand the balance between the traditional fee-for-service model and new payment models, such as the Merit-based Incentive Payment System.

Cardiologists are facing rapid changes in reimbursement due to new payment models, but James C. Blankenship, MD, MHCM, says physicians should focus on providing the best quality of care for patients. He recommends physicians take care of everyone in their practice or group, as well. These days, physicians must also understand the balance between the traditional fee-for-service model and alternative payment models such as the Merit-based Incentive Payment System.