Earlier this week a study came out that examined what influences care decisions by cardiologists. It found that nearly 25 percent said that malpractice concerns play a role (in the hypothetical situations asked about). According to a MedPage Today article on the study:

About 17% of respondents said patient expectations frequently or sometimes affected the decision to order a test, increasing to 29% for expectations of referring physicians. ... About 27% of respondents said they would order a cardiac catheterization if they knew a colleague would order the test in the same situation, and almost 24% said they would order cardiac catheterization solely because of malpractice concerns.

Let's ask our readers... how often do malpractice concerns influence your care decisions? Frequently? Never? Or somewhere in between? Leave more in the comments section by clicking on the "comments" button in the bottom right of this post.

 

A question posed recently by ACC SVP of Advocacy Jim Fasules, MD, FACC, that I'm passing along to our cardiologist readers: For those of you in private practice, did your practice integrate with a hospital in 2009, or do you have plans in the next couple of years?

 

I'm heading down tomorrow to Orlando for AHA's 2009 Scientific Sessions. Are you joining?

Cardiovascular Business magazine yesterday came out with an interesting article on the rule: "CMS cuts could make hospitalists out of cardiologists." I was interviewed for the article, which says: "This lack of practice sustainability will lead cardiologists, according to Lewin, to become 'employees of hospitals, causing the closure of individual and group cardiology practices.'" What do you think?

I talked a little bit earlier this week about comparative effectiveness research (CER) and the role of cost effectiveness in this research. At ACC's Medical Directors' Institute, a variety of views on the topic were given. Tell me what you think below (and check out what others have said in previous posts on the topic).

 

Earlier this week, I pointed out an editorial in the WSJ about the "War on Specialists." The article makes some great points about what's going on currently in the health care world, but I think it's important to remember that the ACC is supportive of President Obama's efforts. So for today's Friday Poll, I ask The Lewin Report readers: Is President Obama waging a war on specialists?

 

Former ACC Presidents Jim Dove, M.D., M.A.C.C., and Doug Weaver, M.D., M.A.C.C., and I recently co-authored a piece for Cardiovascular Business magazine on a hot topic in health care reform: accountable care organizations (ACOs). We write:

The problem, however, is that outside already established integrated systems, government regulations have made it difficult or even illegal for practices and hospitals to coordinate care and quality. Since most of the care is delivered by small groups of physicians that are not connected, the challenge is to allow trials of ACOs that are not legal large partnerships or entities.

This is complicated, and the ACC believes clinicians, patients and payors should have input about the design and function of this new structure. The ACC, for example, believes an ACO should reward providers for reducing unnecessary and discretionary services but not denying necessary care. ACO members also should not be at risk for costs they can’t control.

For today's Friday Poll, I want to know what you think about ACOs and their role in delivery system reform.

As I'm sure you know, the Senate Finance Committee on Tuesday began a markup of its health care reform legislation ("America's Healthy Future Act of 2009"). The ACC likes some pieces of the bill (like its attempts to expand coverage to every American and strengthen Medicare) but isn't so fond of other provisions (including its one-year fix to the SGRrrr rather than a permanent fix, as included in the House bill) -- see ACC's full comments on the proposal for more.

But now I turn to my readers: What do you think of the bill? Do you think it should pass as is? Undergo major revisions? Die? As always, leave your full comments in the comment section below.

ACC Board of Trustees' Work Force Taskforce Chair George Rodgers recently blogged on The Lewin Report about an impending cardiologist work force shortage and what we could do to stop it. I want to know what you think -- what will be the effects of a shortage?

 

Beginning on Sunday, ACC members from all across the country will be arriving in Washington, D.C., for ACC's 2009 Legislative Conference. These members will be on the front line of educating Congress during this crucial time about the need to stop the proposed payment cuts and for health care reform. I'll have coverage of the conference here, with posts covering some of the sessions, videos where available, and entries from members attending the conference. Also, you can follow ACC's advocacy Twitter account, @Cardiology, for more coverage. If you're attending Leg Conference, share why in the comments on this post.