Today Bloomberg published an article highlighting overuse of stenting procedures, and deaths linked to stenting. While we cannot comment on specific patients or cases, we do not condone any situation where patients are put at risk for personal gain. However, as I said in the article, it is important to remember that the majority of physicians are doing the right thing for their patients, and cardiologists who’ve been accused of fraud or are serving prison time are outliers who don’t represent the overwhelming majority.

The College and its partner cardiovascular societies are committed to continuing to support patient-centered decision making through appropriate use criteria (AUC), which provide guidance for when and how often medical procedures should be performed, evidence-based clinical practice guidelines that assist health care providers in clinical decision making, and point-of-care tools to help ensure appropriate, evidence-based care is given to patients.

The ACC currently has several tools in place to assist with decision-making about percutaneous coronary intervention (PCI) procedures including AUC for coronary revascularization and clinical practice guidelines for PCI and coronary artery bypass graft (CABG) surgery.

It is important to remember that PCI procedures are life-saving in appropriate situations. As mentioned in the Bloomberg article, the study published in the Journal of the American Medical Association using data from the CathPCI Registry showed that for non-acute indications, 12 percent were classified as “inappropriate” from July 1, 2009 to September 30, 2010, at 1,091 U.S. hospitals. While this data tells us there is still room for improvement, the data and terminology has often been misunderstood, and consequently the ACC recently updated its technology for describing the levels of appropriateness of care.

In addition, the ACC’s ongoing advocacy efforts on Capitol Hill continue to urge Congress to develop and test new payment models that reward appropriate, evidence-based cardiovascular care. Unfortunately, our system for paying for medical care is one that often rewards quantity. We will continue to advocate at both the state and national level for the development of overarching payment reforms that reward appropriate, evidence-based care.

The ACC has long emphasized patient-centered care and shared decision making, where the patient is educated about their options and is an active participant in the decision-making process.

As I said in a recent President’s Page in JACC along with Ted A. Bass, MD, FSCAI, FACC, “As a profession, our duty is to do the right thing for the right patient at the right time. There has never been a more important time to be involved in professional organizations like the ACC and SCAI. We know what the solution is, and we are well on the way to getting there.”

Let us rise to the occasion and continue to be good stewards of care to ensure our patients receive high quality and effective cardiovascular care.

[youtuber youtube='http://www.youtube.com/watch?v=bRbYW4QkOoc']

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