On March 10, the ACC and other medical societies updated the terminology used in the appropriate use criteria (AUC) for coronary revascularization in patients with stable ischemic heart disease. Gregory Dehmer, MD, notes the old methodology used “appropriate,” “uncertain” and “inappropriate,” whereas the new methodology uses “appropriate,” “may be appropriate” and “rarely appropriate.” Dehmer says the new terminology is a better fit for how cardiologists practice and discusses other changes in the updated AUC.

Today, 1.5 million to 2 million adults in the United States have congenital heart disease, which is more than the number of children with the condition. Disty Pearson, PA-C, discusses new congenital heart disease guidelines and accreditation programs for appropriate care. Although there is a lack of adult congenital heart disease cardiologists, she says physician assistants and nurse practitioners can help care for these patients, many of whom have comorbidities and neurocognitive issues.

Burnout among cardiologists is very real, with nearly half of cardiologists suffering from it, according to Charles Chambers, MD. Still, it is difficult to recognize even though it can lead to job dissatisfaction and severe issues such as alcoholism and suicide. Chambers suggests physicians take time off, exercise, stay in shape and maintain a work-life balance to help decrease the risk of burnout.  

Cardiologists are facing rapid changes in reimbursement due to new payment models, but James C. Blankenship, MD, MHCM, says physicians should focus on providing the best quality of care for patients. He recommends physicians take care of everyone in their practice or group, as well. These days, physicians must also understand the balance between the traditional fee-for-service model and new payment models, such as the Merit-based Incentive Payment System.

Cardiologists are facing rapid changes in reimbursement due to new payment models, but James C. Blankenship, MD, MHCM, says physicians should focus on providing the best quality of care for patients. He recommends physicians take care of everyone in their practice or group, as well. These days, physicians must also understand the balance between the traditional fee-for-service model and alternative payment models such as the Merit-based Incentive Payment System.

Andrea Baer, director of patient advocacy, discusses how Mended Hearts and Mended Little Hearts provide peer support to heart disease patients, families and caregivers. Participants benefit from receiving advice and feedback from people who have gone through similar experiences. Case studies from Mended Hearts have shown peer-to-peer support helps reduce readmissions and improve adherence to medications and treatment plans.

ACC Vice President C. Michael Valentine, MD, sees teams of physicians and administrators as key to managing the changing healthcare industry. Partnerships help them tackle legislative, administrative and financial changes. And while some clinicians complain about MACRA, Valentine says, the legislation aligns government and physicians in switching from volume- to value-based care. ACC has created a MACRA task force and website to inform cardiologists and patients.