The Cycle of Cardiac Care and the Uninformed Patient

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Presentation given at the Foundation's Jan. 26, 2011 Research and Policy Forum by Shannon Brownlee, MS, acting director of the New America Health Policy Program and nationally known writer and essayist.

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  • Awesome slides. I usually have patients wonder about EKGs. I usually send them to this site which is geared towards pateints. It talks about all cardiac procedures: risks, whay a test is done, expectations.. etc. http://www.myheartprocedure.com
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  • 88% of patients believed that PCI reduced the risk of MI and death
  • Breaking budgets. Health care threatens to crowd out spending on many other things we value, like educating our children, traveling, starting new businesses, improving the nation’s infrastructure.
  • The Cycle of Cardiac Care and the Uninformed Patient

    1. 1. Adventures in Cardiology: What SDM Means to Patients <br />Shannon Brownlee, MS<br />Acting Director, New America Foundation Health Policy Program<br />Instructor, The Dartmouth Institute for Health Policy and Clinical Practice<br />brownlee@newamerica.net <br />
    2. 2. Happy Cardiology News<br />
    3. 3. REDDING, CALIFORNIA<br />
    4. 4.
    5. 5.
    6. 6. Senate Finance Committee: “Midei may have implanted 585 stents which were medically unnecessary”<br />
    7. 7. Relationship Between Procedure Indications and Outcomes of Percutaneous Coronary Interventions by American College of Cardiology/American Heart Association Task Force Guidelines<br />H. Vernon Anderson et al Circulation 2005;112;2786-2791<br />
    8. 8. Cardiologists’ Use of PCI for Stable Coronary Artery Disease<br />“Yes, medical therapy is as effective as PCI, but when I see a lesion, the bottom line is that the oculostenotic reflex always wins out.”<br />“[The patient] is not going to get out of the cath lab without a stent.”<br />Grace A. Lin, et al ARCH INTERN MED/VOL 167 (NO. 15), AUG 13/27, 2007<br />
    9. 9. Well Bob, it looks like a paper cut, but just to be sure, let’s do lots of catheterizations. <br />
    10. 10. <ul><li>Only 31% had activity limiting chest pain
    11. 11. Cardiologists’ perception of the patient’s angina was often greater than the patient’s</li></ul>MB Rothberg Ann Intern Med. 2010 Sep 7;153(5):307-1<br />
    12. 12. “Guidelines must be living documents; they must continue to evolve to meet the needs of interventional cardiologists faced with increasingly complex patients . . .”<br />Circulation 2005;112;2754-2755<br />
    13. 13. Relationship Between Procedure Indications and Outcomes of Percutaneous Coronary Interventions by American College of Cardiology/American Heart Association Task Force Guidelines<br />H. Vernon Anderson et al Circulation 2005;112;2786-2791<br />
    14. 14. MARILDA<br />
    15. 15.
    16. 16.
    17. 17.
    18. 18.
    19. 19. Busting Budgets<br />HEALTH CARE<br />
    20. 20. THANK YOU!!<br />$8,600 – 14,300<br />$7,800 – 8,600<br />$7,200 – 7,800<br />$6,600 – 7,200<br />$5,280 – 6,600<br />Not populated<br />Source: Dartmouth Atlas<br />

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