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When Headlines Bash Doctors

While I know it grabs the eye, it really didn’t matter what the article was about. The headline says it all: Doctors are the problem, not the system, right?

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Outpatient Cardiology Services And An “Out” For Hospitals

It’s no surprise that hospitals are acquiring cardiology and primary care groups groups in droves lately. It seems there’s a signficant financial incentive to do so for now, but doctors (and especially cardiologists) should read the tea leaves ahead. From Becker’s Hospital Review:

While hospitals are limited to paying fair market value for practices, they can gain an edge over competing hospitals by offering longer employment contract terms or better electronic medical record systems and management services. If hospitals move forward with a transaction, Ms. Kaplan suggests they limit employment contracts to no more than two years if possible and rebase compensation annually based on productivity.

“In healthcare you shouldn’t assume anything is permanent,” says Ms. Kaplan. She cautions that the revenue increases that are currently available to hospitals through expanding outpatient cardiology services may not last forever, which is why she urges hospitals to limit employment contracts and other agreements to only a few years. Doing so will afford an “out” for the hospital if the service line goes from a money-maker to a money pit.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Cardiologists As “Heart Whisperers”

From the Dallas Morning News, a creative moniker if there ever was one, but it should probably be reserved for primary care specialists instead:

DALLAS — Heart attacks are the No. 1 cause of death and a major cause of disability in America. For nearly half of the casualties, the first symptom is the last. That’s how cardiovascular disease has earned the nickname “silent killer” — you never know when it will strike.

Doctors are trying to change that by treating heart disease as a progressive problem. They are becoming “heart whisperers,” seeking new tests to read the small stresses that can, unchecked, grow into big ones.

“By the time someone rolls in with a heart attack, his family will look at me bewildered, and the patient may say, ‘Doc, what happened?'” says Dr. Bruce Gordon of Heart Hospital Baylor Plano. “But it’s not what happened. It’s what’s been happening. The process has been going on for decades.”

It’s a process that can be accelerated by high cholesterol, high blood pressure, obesity, diabetes, tobacco use and secondhand smoke.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Is February Heart-Marketing Month?

Heart disease and February: What relationship could be more cozy? From the scary risks of shoveling snow (yep, you could die, so be sure to lift a little at a time), Mercedes-sponsored red dress parades and government-sponsored National Wear Red Day®, to tips for identifying heart attacks in women (men, you need a different month I guess), February has all the important stories to improve your awareness. Such a polite term “awareness.”

But I wonder, now that the Internet is upon us and people are seeing their insurance rates and co-pays skyrocket, if maybe we’re shooting ourselves in the foot with all this heart-month marketing hype. People are sick and tired of testing “just to be sure.” It’s starting to directly cost them a fortune, and people are frustrated at having to pay a fortune for healthcare, let alone heart care.

I know, I know — I should be at the forefront of working with patients to stomp out heart disease. And goodness, people DO need to be attuned to diet, exercise, and weight loss. But the reality is, if we’re giving you the 10 latest tips on how to detect a heart attack, we’re probably a bit too late.

That’s the problem with all these press releases: While there’s a need to raise “awareness” of heart health, there’s also a very real need for people to take us — heart disease professionals — seriously to help cut costs in healthcare here. The last thing our healthcare system needs is more frivolous testing. Yet this is exactly what all this marketing does for our healthcare system — and it helps those with the largest PR budgets most of all. Read more »

*This blog post was originally published at Dr. Wes*

The Eroding “Doctor” Label

It came as a Twitter “follow” from @coldfeet65, a self-proclaimed “Nurse Practitioner Hospitalist.” I had never heard this term before. Does it mean a nurse practitioner who cares for hospitalists? Or is it a hospitalist who is a nurse practitioner? Or maybe it’s a nurse practitioner who helps hospitalists? (Honestly, I think I know which one she means, but you get my point.)

Perhaps this is a prescient glimpse to healthcare of the future, where our more typical nurse and doctor labels are supplanted by more and more monikers that serve to confuse, rather than clarify, each of our roles in healthcare delivery. As specialists in cardiology, we’ve seen a similar trend with cardiology hospitalists. But we should be clear what this means to the patients and doctors going forward.

No doubt most people in America still expect to see a doctor when they come to the hospital. Increasingly, it appears that might not be the case. Your doctor might be a robot while a nurse (aka, nurse practitioner) will be the one providing the hands-on care in the inpatient setting. Is that a good thing? Honestly, I’m not sure.

No one argues that the costs in healthcare need to be cut. No doubt the central authority has deemed that doctor salaries will be a big part of that effort. Already, 20 states have cut physician Medicaid payments for fiscal year 2010 and, given the current economic pressure on our states both now and after they start feeling the financial impact of the “Affordable” Care Act in 2019, this trend is not likely to improve anytime soon. As a result, we are seeing that the world is full of “creative solutions” to our healthcare access crisis and the evolution to “nurse practitioner hospitalists” might be one of these. Read more »

*This blog post was originally published at Dr. Wes*

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