Adventures in Cardiology: What SDM Means to Patients

Shannon Brownlee, MSActing Director, New America Foundation

Health Policy ProgramInstructor, The Dartmouth Institute for Health

Policy and Clinical Practice

brownlee@newamerica.net

Happy Cardiology News

REDDING, CALIFORNIA

Senate Finance Committee: “Midei may have implanted 585 stents which were medically unnecessary”

H. Vernon Anderson et al Circulation 2005;112;2786-2791

Relationship Between Procedure Indications and Outcomes of Percutaneous Coronary Interventions by American College of Cardiology/American Heart Association Task Force Guidelines

Cardiologists’ Use of PCI for Stable Coronary Artery Disease

“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.”

“[The patient] is not going to get out of the cath lab without a stent.”

Grace A. Lin, et al ARCH INTERN MED/VOL 167 (NO. 15), AUG 13/27, 2007

Well Bob, it looks like a paper cut, but just to be sure, let’s do lots of catheterizations.

•Only 31% had activity limiting chest pain •Cardiologists’ perception of the patient’s angina was often greater than the patient’s

MB Rothberg Ann Intern Med. 2010 Sep 7;153(5):307-1

“Guidelines must be living documents; they must continue to evolve to meet the needs of interventional cardiologists faced with increasingly complex patients . . .”Circulation 2005;112;2754-2755

H. Vernon Anderson et al Circulation 2005;112;2786-2791

Relationship Between Procedure Indications and Outcomes of Percutaneous Coronary Interventions by American College of Cardiology/American Heart Association Task Force Guidelines

MARILDA

HEALTH CARE

Busting Budgets

$8,600 – 14,300

$7,800 – 8,600

$7,200 – 7,800

$6,600 – 7,200

$5,280 – 6,600

Not populated

THANK YOU!!

Source: Dartmouth Atlas