NBPAS Launches Alternative to MOC

   Today’s the day that The National Board of Physicians and Surgeons (NBPAS) officially launches. Briefly stated, it’s an alternative certification organization, set up by Dr. Paul Teirstein and a group of physicians, mostly cardiologists, who strongly objected to the Maintenance of Certification assessment track established by the American Board of Internal Medicine (ABIM).

You can read more about it in my post from last week, “Scalpel…Suture…Suction…Pencil?” and in Dr. Teirstein’s New England Journal of Medicine article, titled “Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients.

I’ll be following the progress of this initiative, but a few recent articles and developments bring up some interesting points. Continue reading

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Filed under ACC, Medical Education, Meetings & Conferences

Scalpel…Suture…Suction…Pencil?

  The buzz going around the medical community this week is Dr. Paul Teirstein’s article in today’s New England Journal of Medicine, titled “Boarded to Death — Why Maintenance of Certification Is Bad for Doctors and Patients,” in which he skewers the imposition of the Maintenance of Certification (MOC) requirement put into place a year ago by the American Board of Internal Medicine (ABIM).

The concept of the MOC was to ensure that physicians who had been certified in their specialty kept current with medical practice and the current guidelines. It’s not that concept that Dr. Teirstein objects to, but its heavy-handed implementation by, as he puts it, “people not directly involved in patient care who have lost contact with the realities of day-to-day clinical practice.” Ouch!

And Dr. Teirstein is not alone in his objections. An online petition he created has garnered almost 20,000 signatures. It asks the ABIM to recall the changes in MOC and institute a simple pathway consisting of  a recertification test every ten years; a corollary petition, pledging non-compliance (read “boycott”) has over 6,000 signers – a more difficult pledge since many physicians are employed by hospital systems that require the ABIM MOC. And this certification is a monopoly, but more on that later…. Continue reading

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Filed under ACC, Medical Education, Meetings & Conferences, SCAI, Web Site

New Treatment for Peripheral Artery Disease is Approved by the FDA

Dr. Charles Dotter in LIFE Magazine (1964)

Dr. Charles Dotter in LIFE Magazine (1964)

Who is that mad scientist in the 1964 issue of LIFE magazine? Oh, just the man who invented the concept of angioplasty; in fact he’s the man who actually coined the word “angioplasty!” And he’s the doctor who performed the first angioplasties in the leg, in order to save limbs from amputation without resorting to surgery.

Like many innovators, he had a crazy idea: to open blocked arteries from the inside out. No cutting, suturing, or stitching. Less trauma, lower morbidity, quicker recovery. His name was Charles Dotter and he was a radiologist in Portland, Oregon who, 51 years ago next week, performed an angioplasty on the blocked leg artery of an 82-year-old woman. Continue reading

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Filed under Back to the Future, Endovascular, Europe, FDA, History, Innovators, Peripheral Artery Disease (PAD), Video

Philips Buys Volcano: It’s About Money, Technology, and History

  Rumors and theories about an acquisition of Volcano Corporation (NASDAQ: VOLC) had been circulating for quite some time: months, years even. The company seemed an obvious choice: it has an advanced intravascular ultrasound (IVUS) technology that leads the market, with Boston Scientific coming in second; it has a fractional flow reserve (FFR) wire that splits the market with St. Jude Medical; and recently Volcano gained FDA approval for its Instant Wave-Free Ratio (iFR) physiologic measurement product, a faster, cheaper potential alternative to FFR. Continue reading

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Filed under ACC, Angiograms, Back to the Future, Business & Industry, Cardiac CT, Cost Effectiveness, FFR, Global Trends, History, Imaging, Intravascular Guidance, IVUS, OCT, Video

From Bench to Bedside to Bench Revisited: Supreme Court Justice Ginsburg Back in Action

  Almost two decades ago, interventional cardiology pioneer Dr. Spencer B. King III penned an article for Circulation titled, “Angioplasty From Bench to Bedside to Bench.” Dr. King’s article was a recounting of the history of the development of the angioplasty balloon catheter by his colleague at Emory University, Andreas Gruentzig.

This morning, the title of his article took on new meaning, as Supreme Court Justice Ruth Bader Ginsburg entered the courtroom and took her seat, engaging in several complex legal arguments concerning mortgage loan officers, Facebook threats, and more. Continue reading

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Filed under Celebrity Patients, History, Media Coverage, Stent

The Beginnings of Endovascular Abdominal Aortic Aneurysm Repair (EVAR)

Dr. Frank J. Veith

Today was day one of the 41st Annual Veith Symposium in New York City. Started by Dr. Frank J. Veith, a pioneer in the field of endovascular approaches to vascular surgery, this five-day event covers the entire field of minimally invasive approaches to clinical situations that just a couple decades ago were the exclusive purview of open surgery.

The whole field of endovascular repair and intervention has grown exponentially since the  first endovascular repair of an abdominal aortic aneurysm (EVAR) was performed by Dr. Juan Parodi in 1990, but it took quite some time to be accepted as a standard of care. Today the endovascular approach is the preferred procedure to repair an AAA and this is because of the advances in medical device design and manufacturing and the dedication of physicians to this less invasive non-surgical approach, physicians who will be attending this year’s Veith Symposium.
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Filed under Endovascular, History, Innovators, Meetings & Conferences, Peripheral Artery Disease (PAD), Video

Plavix and Aspirin After Stent: 8 Years Later – Is Longer Better?

plavix_and_stentNo one thought it would take quite so long to get this information, but in just a couple hours results from the Dual Antiplatelet Therapy (DAPT) Study will be presented at the American Heart Association Scientific Sessions 2014. The question to be answered: Is there a benefit to extending dual antiplatelet therapy (aspirin plus a thienopyridine, such as clopidogrel/Plavix, prasugrel/Effient, etc.) beyond one year after stenting?

This is a question asked back in 2006, during a special two-day FDA hearing, convened to discuss all known issues with drug-eluting stents and prompted by the “ESC firestorm” over the problems of increased incidence of late stent thrombosis in drug-eluting stents. (See “Problems Resurface with Drug-Eluting Stents” – September 9, 2006.) Continue reading

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Filed under Antiplatelet Medications, Bare Metal Stents, Clinical Trials / Studies, Drug-Eluting Stents, Global Trends, Meetings & Conferences, Optimal Medical Therapy, Stent Thrombosis