I’ve recently seen in medical journals an advertisement that features an image of a clot within a stent and this headline in all capital letters: “Low Levels of Platelet Inhibition May Have Significant Consequences.” The final two words, “Significant Consequences,” are in a very large font, and the entire ad has an ominous black background. Below the image is a bulleted list of “factors that may impact platelet inhibition”: genetic variation, concomitant medications, pre-existing conditions, and patient noncompliance. Each bullet point ends with numbered footnotes, with references appearing at the… Continue Reading

At a recent committee meeting, my hospital’s administration announced new quality measures and targets. Striving for top performance, the board of the hospital system set the bar extraordinarily high. The bonuses of senior management are tied to achieving the targets, so the announcement had everyone’s attention. One target that caught my interest was for achieving a door-to-balloon time of less than 90 minutes in STEMI patients. As an interventional cardiologist who helped to organize the national D2B Alliance for Quality, I have spent some time thinking about door-to-balloon times. The… Continue Reading

CardioExchange welcomes this guest post, reprinted with permission, from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem in Evanston, Illinois, and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes. It is no surprise that hospitals are acquiring cardiology and primary care groups in droves lately, as described in this article from Becker’s Hospital Review. It seems that, for now, there is a signficant financial incentive for hospitals to do so, but doctors, and especially cardiologists, should read the tea… Continue Reading