Jackpot

Want to earn lots of money for your cardiology department? Just place an online "heart risk" assessment on your hospital's website and label 37.4% of the respondents "at risk:"

Since going live in late January, 7,072 people had completed the HeartAware assessment through early May, and 2,645 have been labeled "at risk."

"There's an awful lot of people who develop a bad event from heart disease on a yearly basis, not to mention the 8 or 9 million folks walking around with some form of blocked arteries and abnormal functions," said Dr. Vince Bufalino, medical director of cardiovascular services at Edward Heart Hospital.

"But when you look at the random public you wouldn't predict [these HeartAware at-risk numbers] up front," said Bufalino.

More than half of the at-risk test takers (1,597) accepted Edward's offer for follow-up services.

Wow. Think of all that testing, office visits and the like. Who knew?

Well someone did. Because with the stroke of a little logo change and voilà - another hospital in Maryland or Ohio or anywhere else you please can have the same assessment.

This is a program started by the HeartAware organization, a program of the National Heart Association. So who is the National Heart Association?

Well, I'm not sure. I'm not sure it's a real organization, but rather a front.

What I can tell you is that HeartAware is a product of Byrne Healthcare who labels this program as a "strategic marketing program for healthcare providers that identifies undiagnosed and at-risk individuals in their community that have disease and mobilizes them into their hospital or clinic." So it seems to me that the National Heart Association is really a marketing firm, and has nothing to do with heart health, other than to do marketing for hospital systems.

More impressive, they also have a whole line similar risk assessment tools for orthopedics, diabetes, stroke, sleep disorders, lung disease and cancer!

Now there certainly is nothing wrong with people being empowered with performing their tests online and seeing how their "risk bars" turn from "healthy green" to "threateningly red." But when Congress wants to look for ways to trim costs, maybe they should look at the fact that over 1/3rd of on-line people are found "at-risk" and a remarkably high number are undergoing testing that is likely to be of very low yield, moderate cost, has a real and significant false-positive rate to every test done that might incur more costs and more testing, and some of which might be quite invasive and carry significant risks.

But it's all about awareness, right?

Well, now you're aware that the so-called National Heart Association does not exist and maybe this prevention thing promoted by our President and government organizations to save costs in health care might just be doing the opposite.

-Wes

EKG's and ADHD: Common Sense Prevails

I'm so glad 'dem der pediatricians set us here cardiologists straight.

Dang, I had no idear there was so many of 'dem der corrections to the original announcement about the need for EKG's before administering ADHD drugs.

Nice to know some common sense could prevail...

-Wes

More Fear-Based Medical Marketing

I'm not sure it gets better than this:

Scanning the heart's arteries for calcium deposits accurately predicts the overall death risk for American adults, a new study suggests.

"So far, this is the best predictor we have of who will have a problem and who will not," said study co-researcher Dr. Matthew Budoff, associate professor of medicine at the Harbor-UCLA Medical Center.

He and his colleagues reported the finding in the July 1 issue of the Journal of the American College of Cardiology.

A calcium scan looks for calcification, a hardening of the arteries caused by high blood fats and calcium deposits that can eventually block blood vessels, causing heart attacks, strokes and other major problems.

I can hear it now:

"Hey Marge, hey lookie here in the Washington Post! I wanna get one of dem der fancy schmancy CT scanner gizmos to find out if I'm gonna DIE sooner than you are! Let's take $600 bucks for that fancy schmancy thing-a-ma-bob out of our retirement fund. It'd be WORTH IT!"

Sometime later, in the doctor's office...

Doctor: "Well, Mr. Jones, I see my this fancy schmancy CT scan that you'd got some calcium in your coronaries. Hmmmm. And you calcium score is 210, just like Tim Russert! So, guess what?"

Mr. Jones: "What?"

Doctor: "Well Mr. Jones, you're at increased risk of DYING!"

Mr. Jones: "Uh, what do you mean, Doctor?"

Doctor: "You heard me: you're at increased risk of DYING with all that calcium in those coronaries - you know - BAM! Just like Tim Russert."

Mr. Jones: "Any idea when, Doctor?"

(Silence)

Mr Jones: "Doctor, did you hear me? When will I die? I mean, won't we all die sometime?"

Doctor: "Heck, Mr. Jones, I don't know! But I can assure you that based on this fine article here in the prestigious Journal of the American College of Cardiology (you know, the same one that's also promoting their new Cardiovascular Imaging journal) that you're gonna die of SOMETHING sooner than some of the other people who don't have that evil calcium in their arteries."

Mr. Jones: "Gosh. So what should I DO about it, Doctor?"

Doctor: "Well, you know, since we're proposing that it's a RISK FACTOR for DYING, you should do the usual stuff: eat right, take tons of statin drugs, don't smoke, take your aspirin, lose weight, eat a low trans fat, high antioxidant, super-radical-consuming diet, do yoga, take mega vitamins, face East, say a few 'Hail Mary's..."

Mr. Jones: "Uh, but I was already doing that stuff..."

Doctor: "Have you had your CRP level and genes tested yet?"

Mr. Jones: "How would that help?"

Doctor: "Well, Mr. Jones, it might mean your risk of DEATH is EVEN GREATER!"

Mr. Jones: "But what can I do about it if it's positive also?"

Doctor: "Well, you know, the usual stuff... like I said... eat right, take tons of..."

Mr. Jones: "That's okay, Doctor. I've had enough. Thanks for all of your help. Hope that $300 bucks comes in handy. Don't mind me: I'll keep doing what I've been doing and get started preparing my Bucket List. Oh, but one more thing..."

Doctor: "What's that Mr. Jones?"

Mr. Jones: "You wouldn't happen to work with General Electric like those two guys who wrote that article you quoted, would you?"

-Wes

McCardiac Arrest

McDonald's answer to Hardee's Monster Burger in Australia:

Some of the fast-food chains sell super-sized Quarter Pounders, which contain about 220g of fat and 11,500kJ each, on request.

The "double pounder" is the equivalent of more than three days' worth of fat for a grown man - or almost five Pizza Hut deep-pan Hawaiian pizzas or 45 Tim Tams.

"Have it Your Way" takes on new meaning. And for $0.99 more, they'll throw in a defibrillator, too.

-Wes

ADDENDUM: In this related article, it seems the Australian Medical Association wants to take McDonalds $330,000 for use of their heart-healthy logo, but then turns around and claims to the media "Sheesh. These things are really BAD for you!"

Looks like they got their hand caught in the cookie jar, just like our AMA across the pond...

Feeling Guilty

I lied today.

I feel guilty.

But it was good.

I feel a bit like Robin Hood: stealing from the wealthy and giving to the poor.

So in order to clear my consciousness, I'll confess to my transgression...

... I am not authorized to practice medicine in the state of California, yet clicked on a webscreen button intended only for California physicians.

It seems California doctors are special, at least in the eyes of Kaiser Permanente, when it comes to making helpful suggestions about managing heart disease.

We have designed our website to help everyone in our communities have the healthiest heart possible. Our clinical experts understand the critical role that individual clinicians play in helping their patients lead heart-healthy lives. We want to provide a resource to California practitioners in their efforts to help their California patients make healthy heart choices about their lives. If you are a California clinician, we hope that the Kaiser Permanente tools and resources we are offering on our website will be useful for you in your practice. Over time, we are planning to add more resources as we develop them. This information is not intended to provide medical advice or services to any individual.

But you know what? Their recommendations aren't bad. Their flow charts and data seem sound, and they might just help doctors of the front lines of health care around the world remember a simple approach to evidence-based management of common cardiovascular ailments.

But there's just one catch...

... if you don't practice medicine in California, you'll have to lie to use them.

-Wes