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Faisal Shamshad, Published April 12 2013

Letter: Sequestration another threat to delivering high-quality care

Rising health care costs threaten our nation’s economy and future. Medicare is heading toward bankruptcy. But there is still one group of doctors who can give you a bargain.

When you have your big heart attack in the middle of the night, it is a specially trained heart doctor – the interventional cardiologist – who hops out of bed, races to the hospital, and threads the catheter into your heart to open up the blocked artery and stop the heart attack – often all within an hour of you arriving at the emergency room. These procedures save lives and cut in half your hospital stay, saving costs for you and your hospital.

Cardiologists have reduced the number of heart-stent procedures by one-third over the past five years by identifying and eliminating procedures that offer little or no benefit. This saves patients cost and inconvenience and saves Medicare more than $500 million per year, at the expense of cardiologists. In addition, Medicare payments for these vital heart-stenting procedures have steadily decreased over the past decade and suddenly dropped another 20 percent on Jan. 1. These cuts are part of Medicare’s attempts to limit overall expenses while increasing payments to primary-care physicians. But these cuts make it very hard to run a medical practice.

Now, with the “sequestration” of the federal budget, fees are being cut another 2 percent. In a survey of interventional cardiologists, more than half reported that they or their hospitals had cut staff or services to stay solvent, and more than half were planning to retire or reduce their practice over the next three years. If those trends play out as expected, it may be hard to find a doctor to treat your next heart attack.

So as the national debate over health care expenses rages on, remember that your local heart doctors have your heart in mind – 24/7. We’ll continue to do our fair share to contain costs and provide the best care possible. Every day, we give at the office – and in the hospital.


Shamshad is a Fargo MD and fellow of the Society for Cardiovascular Angiography and Interventions.