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Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
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Appropriate Use Criteria: Questions for the Task Force Chair

Appropriate Use Criteria: Questions for the Task Force Chair | Heart and Vascular Health | Scoop.it
Seth Bilazarian corners Manesh Patel on the challenges that the AUC for coronary revascularization present to the practicing cardiologist.
Seth Bilazarian, MD's insight:

I had the good fortune to sit down with Dr. Mahesh Patel who Is chairman of the appropriate use criteria for the American College of Cardiology and American Heart Association Task force on appropriate use and got his take on the inappropriate use of the word "inappropriate" and communicating the new "rarely appropriate" with payers and the patient's.

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Radiation Safety in Heart Imaging Tests

Radiation Safety in Heart Imaging Tests | Heart and Vascular Health | Scoop.it

My comment: Useful information for patients undergoing cardiac testing.  The 10 questions are excessive.  Patients should be sure they understand the answers to questions 1,2 4 & 9.

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Recent public concern regarding radiation exposure in a cardiac test provides an important opportunity for all patients to discuss with their doctors the benefits and risk of testing. Within the medical community, there is controversy regarding the projected cancer risk resulting from radiation exposure during cardiac testing, such as a nuclear scan or catheterization. Research experts studying the projected cancer risk agree that there is a very low risk of cancer following radiation exposure during medical testing for certain procedures including a nuclear scan or catheterization.

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Clinicians Remain Reluctant to Allow Negative Findings to Influence Practice

Clinicians Remain Reluctant to Allow Negative Findings to Influence Practice | Heart and Vascular Health | Scoop.it

My comment: The American physician - patient interaction is complex. It is apparent to me that many in policy positions don't understand simple aspects of care that will have huge implications as the ACA is adopted and ACOs become more prevalent.

It is MUCH harder and more time consuming for a physician to counsel a patient NOT to have a procedure than it is to persuade a patient to have a procedure.  Many pundits have estimated there will be a glut of physicians as procedures are ratcheted down with greater adoption of appropriate use guideleines and evidence based medicine.  Unfortunately this will not be the case.  American patients generally are suspicious when physicians counsel against evaluation or treatment.  And this is occurring in the current fee for service environment.  We are in for a significant transitional storm for the next several years as physicians become incentivized (in ACOs) to limit care.

This JAMA essay speaks about physician adoption of new guidelines, but says litle about patients willingness to limit care.

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Handling inappropriate care appropriately in cardiology

Handling inappropriate care appropriately in cardiology | Heart and Vascular Health | Scoop.it

What do you do when your patient seeks inappropriate care—based on appropriate use and Choosing Wisely guidelines as well as your clinical judgment—from another cardiologist?  How do you then reconcile the situation with the patient?

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