First Word: Less Money, More Character?
If you turn to the back of this month’s issue, there are two articles in our News & Views section that speak to the state of cardiovascular medicine and its practitioners. The first, “More patients seen, but less reimbursement,” details the results of a survey that indicate a rise in the number of patient visits with a concomitant decrease in overall profits. That’s not really surprising, given the challenges handed to cardiovascular practices in the last several years.

What is surprising, though, is the high level of satisfaction of practices that have integrated with hospitals in an effort to stave off financial insolvency. A source associated with the survey sees a silver lining in this. If cardiologists are happy, they’ll work longer. This is promising given several scenarios: The increased demand on cardiovascular services by an aging population, and the increasing rate of retiring cardiologists.

The second news items reports on the slowing down of hospital executive salaries, some drops being quite considerable, while executive retention moves in the opposite direction: up. One interpretation offered for this trend speaks to the character of hospital executives: They want to remain at the helm during these tough times. They willingly accept the challenge to maintain and even improve patient care. They are charged with cutting costs, but they also want to continue to find innovative ways to add or expand service lines.

Controlling costs is the name of the game across the hospital enterprise, cardiology department and cardiology practice. Our cover story this month addresses practical ways to control costs in the cath lab. We’ve rounded up five cardiovascular professionals who serve in the trenches and have logged many years of experience. Their practical wisdom is refreshing and enlightening. One of the overriding messages of this roundtable discussion is that no area of cardiovascular medicine gets overlooked in terms of ways to save money. Devices, drugs, protocols, techniques and technologies are all put under the microscope, given to committees to review and brought into countless meetings until their value and ROI are completely understood. It’s a must read!

And finally, the debate surrounding industry support is heating up and we’re featuring two articles on the topic. In one, the American College of Cardiology defends these relationships, but also outlines the steps it has taken to make them more transparent. In the other, cardiologists on both sides of the issue present their arguments. Points are very valid on both sides. Is innovation stifled when industry support is taken away? Are patients better served by cutting off industry support? Those are two of the questions raised by our sources. Whether there will be a wholesale elimination of industry support remains to be seen. But the momentum for transparency seems to be unstoppable at this point and where it will take cardiovascular medicine is anyone’s guess.