The ACC Interventional Committee and SCAI recommend (which for many medical staff means “require”) that interventional cardiologists who perform angioplasty and stenting (PCI) perform at least 75 interventional procedures annually to qualify to perform PCI interventions on acute myocardial infarctions. Many hospitals do not enforce this, but those that do might be creating a perverse incentive to perform PCIs that are not necessary to reach this "magic" number!

A vigorous on-line conversation among many members is going on about whether this is now an obsolete number to require -- one that many highly qualified interventionalists may not reach. Consumer groups are also likely becoming curious that such “practice targets” could be promoting unnecessary procedures. In view of recent public scrutiny, the question is, should this number be revisited -- because better medication and sustained clinical benefits of PCI already provided to persons with coronary artery disease have created a reduced average number of per capita procedures in many areas? It seems obvious that the Interventional Committee and SCAI should revisit the issue. In terms of workforce consideration, maybe we need to think carefully about whether we are training too many interventionalists at this point?

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