For this Fall 2011 issue of The Cardiologist, I would like to update you on some of the educational, legislative and political issues and initiatives that our Chapter has been engaged in over the last few months. 

From an educational standpoint, the 83^rd Annual Scientific Session of The New York Cardiological Society and the 21^st Annual Meeting of the New York State Chapter were held in Rochester on Saturday September 24^th and was a great success. We heard excellent lectures on the evolution of device-based management of heart failure and management of lipid disorders focusing on recent studies on HDL. A special lecture was given by Dr.William Zoghbi, incoming President of the ACC, on advances in cardiac imaging. Dr. Zoghbi also chaired a special lunchtime seminar for fellows on future opportunities in cardiology—there are still many exciting opportunities in academic and private practice cardiology to be had, around the state and throughout the nation. Attendees were also updated on regulatory requirements, now being introduced for hospital practice by the State of New York and the Centers for Medicare and Medicaid Services, which will soon make their appearance on our doorstep. There will be increasing emphasis placed on documenting the justification and quality of what we do as physicians. Great thanks are due to John Bisognano, our upstate Governor; Nancy C. Weiner, our executive director; and Sharon Diego for organizing the meeting.

The ACC Legislative Conference was held in Washington D.C. September 11-13^th, and highlighted the challenges we face today and in the coming years. The national debate has given increasing credence to the idea that current payment methods are “broken” causing overuse of medical resources and expanding the budget deficit. Potential savings for new payment modes, such as accountable care organizations, are off in the future and physicians have been reluctant to participate. Unfortunately, Congress feels that budgetary savings are needed now. MedPAC, the Medicare Payment Advisory Commission, has recommended that the Medicare Sustainable Growth Rate be fixed by asking physicians to repay $300 Billion over 10 years. This would be accomplished by freezing primary care reimbursements at current levels and cutting reimbursements for all specialists by 5.9% per year for three years and then holding it constant for seven years. The graph below, formulated by the AMA, projects the disparity between historic and projected physician office costs (blue line) vs. reimbursement for primary care (green and grey lines) and specialists (green and red lines). If enacted, cuts of this magnitude will make office practice untenable within the next ten years.

At the ACC Legislative conference, physician representatives from the New York State Chapter met with our Senators and about half of our Congressmen to impress upon them how disastrous this plan would be for patient access to care and for medical practices throughout New York State. Partly as a result of our efforts, the entire New York State Congressional delegation signed a letter to HHS Secretary Sebelius protesting the MedPAC plan.

One thing is very clear—New York State  physicians and cardiologists must get more involved in the political process. Less than a dozen, out of the 3,000 cardiologists in New York State took time from their practice to join us in Washington. As is attributed to Thomas Jefferson: Democracy is government by those who show up. Write/call/email/Tweet your Congressman, contribute to ACC-PAC, get involved, or as Jack Lewin, the ACC Executive Director says, if we are not at the table, we will be on the menu.   

Andrew VanTosh, MD, FACC

Andrew.vantosh@chsli.org

Bylaw Revisions Approved

The membership of the New York State Chapter has voted to approve the proposed bylaw changes. The proposed changes focus upon voting privileges for Cardiac Care Associate members, the c hange in the term of office of Councilors and the Secretary-Treasurer from two (2) years to three (3) years and the change of the term “Affiliate-in-Training” to “Fellow-in-Training”. The changes are effective immediately.

Cardiology 2011:

Imaging, VADs, Prevention & the Future

The 83rd Annual Scientific Session of The New York Cardiological Society and the 21st Annual Meeting of the New York State Chapter of the American College of Cardiology, Cardiology 2011: Imaging, VADs, Prevention & the Future was held in Rochester on Saturday, September 24, 2011. The attendees were welcomed by John Bisognano, MD, PhD, President of The New York Cardiological Society and Andrew VanTosh, MD, President of the New York State Chapter. Speakers included Charles J. Lowenstein, MD; Mark Slaughter, MD; Mary Therriault, RN, MS; Raymond R. Townsend, MD and William A. Zoghbi, MD.  

A luncheon panel discussion entitled, The Changing Job Market: How to Navigate the New Landscape, included William A. Zoghbi, MD; J.D. Filippone, MD; and M. James Doling, MD. The entire program was extremely well received.

Additionally, the winners of the 2011 Young Investigators' Award Competition presented posters of their winning research. For additional information, please visit

http://ny-acc.org/young.php 

Legislative Conference

Members of the New York State Chapter of the American College of Cardiology joined 366 attendees from 47 states, Puerto Rico and Washington, D.C. at the 2011 Legislative Conference hosted by the American College of Cardiology. This year’s conference saw a 31 percent increase in CCA attendance and a 56 percent increase in FIT attendance over 2010. Two hundred and thirty-three Congressional meetings were scheduled on the last day of the conference, of which an impressive 106 were with the actual member of Congress and not his or her staff.

We thank those members who participated in this worthwhile program and encourage all New York State Chapter members to attend this annual event.

2011 Young Investigators' Awards Presented

Congratulations to Carlos L. Alviar, MD, St. Luke’s-Roosevelt Hospital Center and Mount Sinai Hospital, New York City; Andrew Brenyo, MD, University of Rochester Medical Center, Rochester; Usman Baber, MD, MS, Mount Sinai Medical Center, New York City; and Parag Goyal, MD, New York Presbyterian-Weill Cornell Medical Center, New York City on their selection as the 2011 winners of the Young Investigators' Competition sponsored by the New York State Chapter of the American College of Cardiology. Poster presentations of their research appeared at the September 24^th, 2011 Annual Scientific Session of The New York Cardiological Society/ New York State Chapter, Cardiology 2011: Imaging, VADs, Prevention & the Future.

Cooperation and coordination between American College of Cardiology physicians and cardiovascular teams are reaping benefits for New York State patients, in a study released recently. For patients suffering heart attacks, the faster they reach the hospital door and undergo balloon opening of the artery, the better the results.

A study published on August 22 in Circulation reports that median door-to-balloon (D2B) times for heart attack patients undergoing percutaneous coronary intervention following an acute myocardial infarction have declined from 94 minutes in 2005 to 64 minutes in 2010. The improvements represent a more than 30 percent decline in D2B times. The percent of patients with D2B times less than 90 minutes increased from 44.2 percent to 91.4 percent from 2005 to 2010, as did the percent of patients with D2B times less than 75 minutes (23.3 percent to 70.4 percent). The study employs the Centers for Medicare and Medicaid Services data from Jan.1, 2005, to Sept. 30, 2010.

The paper notes the important role that ACC’s D2B Alliance has had on improving times by promoting the integration of proven strategies into practice. The D2B Alliance was launched in 2006 to provide clinicians, administrators, other health care professionals, hospitals and other partners with key evidence-based strategies and support tools to not only reduce D2B times to meet the guideline-recommended time of 90 minutes or less, but to also sustain these gains over time. Since its creation, more than 1,000 hospitals have enrolled in the D2B Alliance. In New York State, thirty-seven hospitals participated in the D2B Alliance.

For information about the D2B Alliance and additional quality improvement programs that help hospitals demonstrate performance, visit CardioSource.org/QualityPrograms. The level of care demonstrated by the D2B study’s findings shows that registry participation combined with dedication to programs like D2B and Mission: Lifeline lead to substantial improvements in the quality of care delivered. By measuring patient care in an appropriate and actionable way, registries bring to light the invaluable improvements being made by physicians and clinical care teams. Learn more about the ACC's suite of hospital and practice-based registries at http://www.ncdr.com/webncdr/common/

U.S. Department of Health and Human Services Secretary (HHS) Secretary Kathleen Sebelius has approved the Secretary's Advisory Committee for Heritable Disorders in Newborns and Children recommendation to add a screening for critical congenital heart defects to the recommended universal screening panel. This means that all children born in the U.S. will be screened for congenital heart defects within the first 48 hours of life using pulse oximetry. 

Mended Hearts

Mended Hearts is a national non-profit organization dedicated to providing patient-to-patient support to heart patients and their caregivers. It is comprised of nearly 18,000 members in 300 community-based chapters and satellites across the United States and partners with over 450 hospitals and cardiac care facilities. Mended Hearts volunteers perform more than 200,000 visits to heart patients in person, online and by phone. Recently, the American College of Cardiology and Mended Hearts have established a formal alignment. The New York State Chapter has been in contact with local Mended Hearts Chapters to determine how they may work together and to establish a mutually beneficial relationship.

Suggested ways in which Mended Hearts members could assist the New York State Chapter include, but are not limited to, the following: provide patient-to-patient support or caregiver-to-care giver support to patients diagnosed with heart disease and their families; participate in ACC chapter annual meetings or educational conferences as attendees, speakers, planners or panelists providing patient, parent or caregiver perspectives; and assist with Hospital-to-Home gaps/barriers to reduce re-admissions by providing insight on patient experience or through hospital-based Mended Hearts visiting programs which engage patients in their own recovery

Suggested ways in which the New York State Chapter could assist local Mended Hearts Chapters include, but are not limited, to the following: provide speakers at Mended Hearts meetings; serve as medical advisors or guides to local chapters; refer patients or families to Mended Hearts for patient-to-patient support and encouragement; provide introductions and referral to hospitals where no Mended Hearts visiting program currently exists; author articles in local newsletters or the Mended Hearts  web site; participate in pilot programs sponsored by grants to support the ACC/MH relationship; and assist Mended Hearts chapters in  raising awareness of services within the medical community and community at large.

If you are interested in becoming involved in the Mended Hearts program, please contact

Larry Feldman by email at Larryf@rochester.rr.com or by telephone at 585.544.1565 or Joe Quigliano by email at jquagliano@comcast.net or by telephone at 845.226.1739 or the New York State Chapter office at nweiner@nycms.org or 212.686.0228

Upcoming Meeting

REIMBURSEMENT & CODING SEMINAR FOR CARDIOLOGY

Thursday, November 17, 2011

LaGuardia Airport

LaGuardia Plaza Hotel

East Elmhurst, New York

15^th Annual

New York Cardiac Center Lecture

PERCUTANEOUS MANAGEMENT OF VALVULAR HEART DISEASE

Martin B. Leon, MD

Tuesday, December 13, 2011

SUNY-HSC Stony Brook

Stony Brook, New York

12^th Annual    (co-sponsor)

NEW FRONTIERS IN HEART FAILURE THERAPY

INTEGRATING DEVICES & PHARMACOLOGY

Saturday, January 2, 2012

Jumeirah Essex House

New York City

The Thirty-Ninth Annual

Arvilla Berger Lecture

UNDERSTANDING THE INHERITED BASIS

FOR MYOCARDIAL INFARCTION RISK

Sekar Kathiresan, MD

Tuesday, March 20, 2012

University of Rochester Medical Center

Rochester, New York

ACC.12

Saturday, March 24 – Tuesday, March 27, 2012

Chicago, Illinois

Up-to-date meeting information appears on the

New York State Chapter website www.ny-acc.org