Keeping pace with constant change

“In a business that’s constantly changing, there are always areas for improvement,” said Cathleen Biga, RN, MSN, a member of the Cardiovascular Business editorial advisory board. Cathie shared the sentiment with my colleague Daniel Allar, who was interviewing her about the upcoming American College of Cardiology Cardiovascular Summit that she co-directs and we’ll be attending. (Watch for conference coverage on 

I can’t think of a field that Cathie’s comment doesn’t fit to at least some degree, but healthcare might win the prize for constant change and ceaseless expectations for improvement. In fact, nearly every story in this issue of CVB examines changes that are unfolding in cardiovascular care or practice management.   

We start with a cover story that marvels at TAVR’s impact on patients with aortic stenosis and its transformative effect on the field of structural heart disease and considers whether similar potential will be realized with transcatheter mitral valve replacement and repair. Next, we explore the impact of ORBITA and whether cardiologists’ ideas about stable angina are shifting. And, on the healthcare delivery front, this issue’s feature on single-ventricle survivorship clinics highlights experimental models for patients with complex conditions whose care requires “more than just cardiology.” 

Also in this issue, we look at— 

  • How Commissioner Scott Gottlieb’s efforts at the FDA are shaping up to affect cardiovascular practice, particularly in digital health; 
  • How cardiology practices are throwing out old call coverage models in favor of new approaches that might reduce burnout and improve quality of life for physicians; 
  • How healthcare purchasing is evolving into a team enterprise; and 
  • How now might be the right time for cardiology to embrace the science of shared decision making. 

Constant change has long been the currency of medicine, and cardiovascular clinicians are accustomed to revising their protocols to reflect new data and guidelines. Is it more challenging to keep pace with shifting expectations around swings in healthcare policy, delivery models and practice management? Let me know how you’re adjusting, the adaptive strategies that work and don’t, and the changes you’d like us to cover.  

Kathy Boyd David, Editor