CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

December 23rd, 2010

James De Lemos: Looking Back at 2010 and Ahead to 2011

To celebrate the holiday season, CardioExchange asked several of our contributors to choose the 3 most important cardiology-related events of the past year and to make 3 predictions for 2011.

Looking back at 2010:

  • ACGME releases new work hour rules. Although these new guidelines are not specifically focused on cardiology training, they promise to impact all cardiologists in teaching facilities. The long-term impact of these changes will take years to fully understand, but are likely to continue the erosion of professionalism and competence among trainees.
  • Aldosterone antagonists continue their winning streak with EMPHASIS-HF. With this trial, indications for aldosterone antagonists have been extended to milder forms of heart failure due to LV systolic dysfunction. The consistency of benefit with regard to hard outcomes with this class of agents is remarkable and challenges clinicians to identify appropriate candidates for treatment.
  • The merging of cardiology practices with hospitals. Interestingly, relatively modest changes in reimbursement, rather than health care reform legislation, appears to be responsible for the incredible changes in the cardiology private practice landscape.

Predictions for 2011:

  • The end of the independent practitioner. The momentum towards marriages of practices with hospitals will continue and the last solo practitioner will close shop Dec 31 2011. Then, in 2012 the divorces will begin—this is America after all!
  • Increasing focus on the harm we cause with unnecessary radiation exposure. A cardiologist will be sued by a patient who develops a malignancy following multiple questionable cardiac procedures involving radiation.
  • Conflict of interest is taken up by the lay media and public. Increasing focus is placed on inherent conflicts of interest arising from fee-for-service medicine.

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