The Inner Workings of the NFL Combine

This post was authored by Dermot M. Phelan, MD, PhD, member of the ACC’s Sports and Exercise Cardiology Section and director of the Sports Cardiology Center at the Cleveland Clinic.

After a calamitous opener at Ohio Stadium, the Buckeye Nation (including this adopted son of Ohio) rejoiced last Monday night after Ohio State secured the National Championship through the calculations of Urban Meyer, the powerful arm of Cardale Jones and the dancing feet of Ezekiel Elliott. Throughout the country, college athletes went to bed overjoyed, devastated or indifferent but with one eye firmly fixed on Lucas Oil Stadium in Indianapolis. Here, the National Football League (NFL) Scouting Combine will take place within a short few weeks. By invite only, college athletes will have the opportunity to showcase their skills, strength and pace in the hopes of improving their draft status, salary and career prospects. Over the years, this has become a media extravaganza. Who can resist the spectacle of the 40-yard dash and the 225-lbs bench press (14 players have done more than 40 reps!)? Continue reading

Advocacy: An Individual Right and a Professional Responsibility

This post was authored by Richard Chazal, MD, FACC, vice president of the ACC.

While the ACC has long been known for dissemination of education to cardiovascular specialists, quality improvement and advocacy have also become crucial cornerstones of the College’s mission over the last several decades. In fact, these objectives are literally written in stone in our Heart House lobby in Washington, DC.

In a recent Journal of the American College of Cardiology (JACC) editorial, strong opinion was voiced about physician responsibility and the use of advocacy. What is the proper role to be played by physicians and by the ACC in regard to these efforts? How best do we maintain the primacy of care for patients, but also respect the needs of members? And what of our obligations beyond those to the individual patient: obligations to society or our obligations to improve systems of care? Continue reading

The New Online Professional Home For the Entire CV Care Team Has Arrived

This post was authored by Kim Eagle, MD, MACC, editor-in-chief of

As the editor-in-chief for the new, I am pleased to announce today’s launch of the ACC’s new and improved website. Nearly two years ago, the ACC embarked on the redesign of, with the goal of leveraging new technologies to ensure cardiovascular professionals and their patients have the tools and resources to communicate easily and effectively in today’s increasingly digital world. What you see today is the culmination of this journey. I congratulate the ACC staff and the many member leaders who played a role in this impressive undertaking.

The return to the original web address symbolizes an overall streamlined approach to the College’s new online home. Centering on the key attributes of anytime and anywhere, focused and personalized, and trusted and in-depth, the new website furthers the ACC’s key missions of science, quality patient care, lifelong learning and member education. Key highlights include mobile optimization, personalization options, streamlined navigation and improved search performance – all of which make the website easier to use whether in the office, at home or on the go. Continue reading

The ABIM MOC Debate Continues

Last week two perspectives were published in the New England Journal of Medicine discussing the ongoing controversy of the American Board of Internal Medicine’s (ABIM’s) Maintenance of Certification (MOC) process. (For those who need a refresher, you can view all of the previous blog posts on MOC here.)

The first perspective, by Mira B. Irons, MD, and Lois M. Nora, MD, JD, MBA, representatives of the American Board of Medical Specialties (ABMS), details the background of MOC and how the recently approved 2015 ABMS standards for MOC were developed. They note that the standards were modified after a comprehensive two-year review. They emphasize that “high standards of specialty certification are important to health care, and we hope our medical-community partners will work with us to continue to evolve our certification systems to ensure that the standards they set continue to be highly valued in the future.” Continue reading

PINNACLE Registry Wraps Up Successful Year of Research

This post was authored by William J. Oetgen, MD, MBA, FACC, executive vice president of Science, Education, & Quality of the ACC.

I recently had the opportunity, along with other members of the ACC staff, to serve on the research team for a project that analyzed data from the PINNACLE Registry India database. The database now includes well over 100,000 patient records collected from Indian hospital outpatient clinics. Using this database, Yashashwi  Pokharel, MD, MSCR, and a team of his colleagues recently submitted an abstract entitled “Guideline Recommended Medication Use Among Systolic Heart Failure (HF) Patients in India: Insights from the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) India Registry,” to the 66th Annual Conference of the Cardiological Society of India. The abstract was selected for a prestigious oral presentation at the conference this past December, which was delivered by Prafulla Kerkar, MD, FACC, the Mumbai-based chair of the PINNACLE India research group. Not only does this study inform us on guideline-recommended medication use among patients in India, but it also marks the first time data from ACC’s outpatient registry in India have been presented at a conference outside of the U.S. Continue reading

A Good Reminder Not to Lose Sight of Patient Value When Looking at Costs of Care

This post was authored by William A. Zoghbi, MD, MACC, past president of the ACC, in response to the New York Times article on echocardiography charges.

The New York Times this week ran a feature article in its “Health” section on the variations in charges associated with echocardiography (The Odd Math of Medical Tests: One Scan, Two Prices, Both High). In addition to raising concerns about charges, the piece suggested not only an increase in the use of echocardiography, but also inappropriate use of the technology by physicians.

Discussions about variations in cost are important across the health care spectrum – charges for all health services, not just echocardiography, vary significantly from one institution to another in the US. However, as Dr. David Wiener of the American Society of Echocardiography (ASE) noted in the article, it’s important that these discussions take into account the multiple factors responsible for the variation, including our decentralized health care system, state regulations and the need to subsidize poorly reimbursed services. Furthermore, the actual charges have little to do with actual payment for services by private or governmental payers, as charges have become an index of overall health care costs and inflation for each institution over the years, and do not mirror actual payments – a mere fraction. Unfortunately, the uninsured in the US are burdened with negotiating these high charges to a more acceptable and realistic level, highlighting the need for reform and transparency in prices of rendered services.   Continue reading

A Viewpoint From the Front Lines of Heart Screenings

This post was authored by James Beckerman, MD, FACC, member of the ACC’s Sports and Exercise Cardiology Section.

For the past several years, I have had the honor of volunteering with Play Smart Youth Heart Screenings in Portland, OR, providing free blood pressure and electrocardiogram screenings for nearly 5,000 young people ages 12 through 18 in our cardiology clinics and in their schools. We have identified nearly 200 with hypertension, and approximately one out of every 100 children screened is diagnosed with a cardiac condition, including structural abnormalities like hypertrophic cardiomyopathy, coarctation of the aorta, and bicuspid aortic valves, as well as electrical anomalies like long QT syndrome and Wolff-Parkinson-White syndrome. Along with over 50 screening programs nationwide, from family-run foundations like Simon’s Fund and the Nick of Time Foundation to academic centers like Johns Hopkins, University of Washington and Stanford, we screen kids because we believe that there is value in identifying young people with cardiac conditions before they might become symptomatic or dangerous. We actively fundraise to support our efforts and provide our screenings for free. Continue reading

Congenital Heart Disease Research: An Expanding Frontier

This post was authored by Ami Bhatt, MD, FACC, member of the Adult Congenital and Pediatric Cardiology Section.

In 1949, the National Institutes of Health began funding research in congenital heart disease (CHD). Since then, not only has the field grown, but the patients have aged successfully, introducing new frontiers for CHD research. As the field of cardiology has advanced impressively in the past four decades, the field of CHD has steadily grown and research efforts are now abundant. In addition to single center and multicenter academic efforts, collaboration with patient advocacy organizations and privately funded foundations has helped move research and registries forward. However, the time for an increase in the advancement of scientific inquiry is beginning now. Continue reading

The Physical Exam in Fellowship

This post was authored by Akhil Narang, MD, a fellow-in-training at the University of Chicago.

Over lunch, Jafar Al-Sadir, MD, FACC, a master clinician and often described by trainees as a “human echo,” introduced us to his long time patient, Mr. Jones. For years, Mr. Jones has been driving more than an hour to join fellows-in-training (FITs) at the monthly Bedside Physical Exam Rounds. At each of these sessions, Al-Sadir carefully selects a patient with excellent physical exam findings and then spends the entire hour helping us hone our skills, appreciating pericardial knocks, describing jugular venous pulsations, or ensuring we all hear the posteriorly radiated murmur of mitral regurgitation due to a flail posterior leaflet. Continue reading

U.S. vs. Canada: The Emerging World of Sports Cardiology

This post was authored by John Vyselaar, MD, member of the ACC’s Sports and Exercise Cardiology Section.

Sports cardiology is an emerging area of cardiovascular care. It is an exciting time to be involved in this developing field. This is true not only in the U.S., but also internationally.

As a Canadian cardiologist and international member of the ACC, I have been surprised by how similar some aspects of medical practice can be regardless of jurisdiction, whereas others can be quite different. The clinical practice of medically treating patients seems pretty much the same everywhere. Certain things like access to medications or the units you use to measure your lab values (mg/dl vs. mmol/L) may differ slightly, but physicians everywhere still care about using the right anticoagulant or accurately determining a glomerular filtration rate. On the other hand, the practical and financial aspects of actually getting patient care done can vary widely. The impact of single vs. multi-payer insurance, socioeconomic factors, and litigation risk make some aspects of practicing medicine in Canada very different from the U.S. and other jurisdictions. Continue reading