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Cancer doctors get hit because the Administration believes specialists order too many MRIs and CT scans. Certain kinds of diagnostic imaging lose 24% under new assumptions that machines are in use 90% of the time, up from 50%. There isn't a radiologist in America running an MRI 10.8 hours out of 12, unless he's lining up patients on a conveyor belt. But claiming scanners are used far more often than they really are lets the Administration "score" spending cuts.

And this change is applied to all expensive equipment, not just MRIs and CTs, so payments for antitumor radiation therapy will fall by up to 44%. The American Society for Radiation Oncology says it "will have a devastating effect on cancer patients' access to care."

One priority of the Baucus bill is to require the executive branch to wreak this kind of devastation every year, not just when a Democrat is President. It directs the Secretary of Health and Human Services to search out "potentially misvalued" RVUs, meaning those "for which there has been the fastest growth" or "that have experienced substantial changes in practice expenses." In other words, any specialty that grows too much must be targeted.

It's important to understand that these are "cuts" that don't actually cut any spending; the RVUs merely redistribute it from one medical bucket to another. In this case, Team Obama is sending a message to the medical community about its political priorities. The fee schedule is designed to avoid wild year-over-year payment swings, but HHS justified its decision with a flimsy survey whose data it won't release and whose results can't be replicated. Dr. Lewin told us that both HHS Secretary Kathleen Sebelius and budget director Peter Orszag refuse to meet with him to discuss the topic.

We have nothing against primary care physicians, and clearly the country could use more of them. But then, it could probably use a lot more doctors, including specialists, as the boomers age and the prevalence of obesity, diabetes and other chronic diseases rises. The increase in specialists has tracked advances over 50 years in medical science and technology. Democrats look at these advancements and see only the costs, not the benefits.

***

Markets are supposed to determine the composition of the workforce, not a command medical economy run out of Washington. It is perfectly insane to support one type of doctor by punishing others on a flawed theory about cost-control. The press passes all this off as routine when it bothers to notice, but we suspect our media colleagues would show more interest if Messrs. Obama and Baucus were deciding how much journalists should be paid and what they should cover.

If Democrats are going to stomp on specialists, they should at least be open about it. Then again, all Americans might take a different view of health-care "reform" if they understood that it means snuffing out the best medicine.


ACCPR letter to Governor Fortuño

Dear ACC members:
 
In view of the CMS threatening actions made in July 2009  to make a significant reduction in reimbursement next 2010, the ACC  has develop an onslaught attack trying to withdraw this menacing change. All the states have engaged in direct contact, letters, meetings and reunions with senators and legislators and soon even personally in Capitol Hill now in september. In view of our limited voting access in Capitol Hill we decided to make this letter informing our Governor of the present status and the reasons why this changes should be avoided. We urgently request his help in this matter. The impact to our island will be worst than in any other state of the nation in view our already reduced reimbursement condition. Please read this letter carefully which is short and self explanatory. Any doubts or comments please contact us.
 
Jose R. Rivera Del Rio MD, F.A.C.P., F.A.C.C.
President and Governor
ACC PR Chapter

Download Documents in PDF format:
cartafortuno.pdf LegislativeUpdate.pdf


PUERTO RICO DOES IT AGAIN!!

SMALL CHAPTERS HERO AWARD On January 30, 2009 Puerto Rico ACC Chapter obtain for the first time the HERO (Heroic Efforts to create Results and Opportunities) Award for the Small Chapter category. The Chapter Awards Program is a recognition and celebration of the good work done last year (2008) by the American College of Cardiology Chapters.

Puerto Rico Chapter was recognized for its consecutive well attended (>60% ACC members) and well received meetings not only for the members of the ACC but also for the patients. The communitarian symposium has covered for the last 10 years the needs of the patients to obtain information related to cardiovascular conditions and their management. Also our chapter has reached the private schools and the Boys Scouts with cardiovascular teaching topics. The annual conventions has always brought the best lecturers been the latest example the January meeting where ten renowned Masters of the ACC (MACC) assisted and lectured about the past, present and future of cardiology.

Phothograph: Left to right: John Harold, MD (Elected President of the Board of Governors) Andy Baldwin, MD (US Navy Lieutenant, Undersea Medical Officer0 Jos R. Rivera del Ro MD (President and Governor PR ACC Chapter) Eurencia G. Olmo (Chief Executive Administrator PR ACC Chapter) Jane Schauer (President Board of Governors)


FINAL Program : Download Here in Acrobat PDF format


English Cover: Download Here in Acrobat PDF format
English Back: Download Here in Acrobat PDF format
Spanish Cover : Download Here in Acrobat PDF format
Spanish Back : Download Here in Acrobat PDF format

Anuncio Congreso (spanish): Download Here in Acrobat PDF format


Puerto Rico 20th ACC Convention

The 20th annual convention of ACC PR chapter celebrated in January 23-25, 2009 was an outstanding event. The presence of 10 Masters of the American College of Cardiology (MACC) at the same time together in a chapter was an event that we will share the rest of our lives. The MACC were directed by our own and first MACC, Dr. Mario Garcia Palmieri. The topics discussed, the friendly atmosphere, and the local Puerto Rican amenities made the convention a great success.

The convention had 253 attendees of which 155 were physicians and of the ACC members 53% assisted. The invited guests displayed their knowledge in a way only a MACC can do. Timely topics, review of the past history and glimpse of the near future was heard throughout the lectures. Review of cholesterol management, epidemiological cardiovascular history of PR, management of chronic angina pectoris, PTCA/STENT present status, antiplatelet therapy, quality in cardiovascular medicine, surgical repair of the MV assisted by echocardiography, etiologies of SAM, health reform, wide pulse pressure predictive value, EKG clues, RV dysplasia and acute dissection of the LM were among some of the topics presented.

During the amenities the MACC show us that age was not an important factor. Dr. Leonard Dreifus (85 y/o) and his lovely wife danced with us “Plena” , “Merengue”  and even Limbo! Their energy might explain why the thirst for knowledge doesn’t wane with age. One of his topics was “The next 50 years” and he said he would be there to see it!
As always the Fellows in Training (FIT) presented very interesting clinical cases and discussed the related cardiovascular information related to it. Also four satellites symposia were presented related to cardiovascular and diabetic topics.

Concomitant with the ACC Convention the Cardiac Care Associates (CCA) had their 3rd Annual Convention with two invited guests and our local lecturers. The assistance was also impressive (89% of the OSCAR registered island CCA’s) and the attendees reported excellent lectures and interesting and very productive workshops.
The Puerto Rico Chapter already started the coordination of its 21st Annual Convention which will be  as always, another  event to plan in your annual agenda.  This time will be again in May as before in the Ritz Carlton Hotel.

Until then,
 
José R. Rivera Del Río, MD, F.A.C.P., F.A.C.C.
President and Governor
ACC Puerto Rico Chapter


Click here for a Photo Gallery of the Event


FIRST CARDIOVASCULAR CARE ASSISTANCE (CCA) SYMPOSIUM IN PUERTO RICO

Last 5th of April 2008 we had the opportunity to start our CCA educational symposium for the first time in the island of Puerto Rico. It was celebrated in Mayaguez, PR with an assistance of 108 participants. Of these 92% were females. There were 9 invited speakers among them PhD nurses, cardiologists, our first PR MACC (Dr. Mario Garc’a Palmieri) and even the University of Puerto Rico Mayaguez (CAAM) campus dean. The topics ranged from nursing management, PR medical history, pharmacology to psychological and religious assistance. The event took place from 8:00 AM to 4:00 PM. People from 10 different institutions came to the symposium and many of the participants came from other 4 nearby towns.

The symposium was evaluated as excellent by 95% of the participants and 5% as a good activity. They considered that this type of activity is greatly needed in these areas, should be done more frequently and include a wider variety of topics. Significant recommendations obtained from this meeting included: distribute the conference in writing mode, more promotion, and increase the duration.

The PR ACC chapter has engaged in an active sponsorship effort to improve the education and training of its CCA, general nursing and pharmacologistÕs assistant in the island. After this first symposium the plans are to develop a yearly organized program which will cover the island from west to east. In the next months the full program will be announced.

Dr. Marcos Velazquez, FACC, Mrs. Ana Santana, RN, MSN (CCA President), and Mrs. Miriam Nieto, RN, PhD (CCA Secretary) should be congratulated for the excellent symposium they coordinated.

Jos R. Rivera Del R’o, MD, F.A.C.P., F.A.C.C.
President and Governor
Puerto Rico ACC Chapter


Click here to watch video


The first Puerto Rican MACC!!

Born in the town of Adjuntas, Puerto Rico (PR) Dr. Mario Ruben García Palmieri obtained his bachelor in science (Magna Cum Laude) in the University of Puerto Rico and his MD in the University of Maryland. At present, Dr. García is Distinguished and Emeritus Professor and Head of the Section of Cardiology of the University of Puerto Rico School of Medicine. He has trained more than 100 cardiologists in Puerto Rico. He is board certified in Internal Medicine and Cardiology.

Dr. García is a member of more than 20 professional societies including many with restricted admission such as the Alpha Omega Alpha, Association of University Cardiologists, and the Association of American Physicians. He has been a major lecturer in scientific programs in 33 countries, has been designated Honorary Member in 14 national cardiological societies, and has been decorated by the governments of the Dominican Republic, Venezuela and Spain.

Locally in Puerto Rico, Dr. García has presided many Societies such as: the Puerto Rican Society of Cardiology, the PR Medical Association, and the PR ACC chapter in 1957. He served as the Secretary of Health in 1966, and in many commissions and committees with the PR government. Actively he still participates in the ACC chapter executive committee. He has also contributed to the US government as member in NIH committees and United States Presidential commissions. Internationally he has presided over the International Society and Federation of Cardiology and on two occasions the Interamerican Society of Cardiology.

Dr. Garcia has published 178 medicine articles, 6 books, and more than 80 newspapers columns geared to orient the people concerning medical problems. He holds Fellowships in the Royal Society of Health, the American College of Chest Physicians, the European Society of Cardiology, and the American Heart Association. He was granted many honors which include the title of Master of the College of Physicians and the Honor and Gold Key Award for most distinguished alumnus in the University of Maryland. The University of Puerto Rico has established the Mario Garcia Palmieri endowed chair since 1996 and the main lecture of the Interamerican Congress of Cardiology held every two years bears his name. In 1989 the ACC bestowed him with the Distinguished Service Award.

Besides his professional endeavors Dr. García Palmieri has been an avid sponsor of master craftsmen in Puerto Rico. He assembles bonsais and has one of the most complete collections of photographs of cardiologists all over the world.

Dr. Garcia Palmieri is a man of many interests and talents: a gifted clinician, an articulated teacher, a productive clinical investigator, a supporter of educational activities for residents in cardiology, a supporter of Puerto Rican culture, an example of excellence in public service and above all a teacher of teachers. All these contributions in a life dedicated to serve his country, physicians, fellow workers and students are so outstanding that he constitutes a role model to us in our College.


ACCPR By Laws Now available online
BY LAWS (HTML) | BY LAWS (PDF)

 

GAP Lectures

The Puerto Rico Chapter of the ACC decided to start a series of lectures concerning the Guidelines Applied to Practice (GAP) for the management of the cardiovascular diseases developed by the ACC/AHA. These lectures will help us understand the rationale and procedures which will allow us optimize the management of our patients. The conferences will be offered in three major metro areas (San Juan, Ponce, and Mayaguez) in a monthly basis by ACC members. The power point presentations will be accessible in the PR ACC here for your review and discussion.


Arterial Hipertension


Heart Failure
Stable Angina


Acute Coronary Sindrome