- Jeffrey A Leppo: Cardiology Division, Berkshire Faculty Services, 777 North Street, Pittsfield, MA 01201, USA. jleppo@bhs1.org
Although cardiovascular mortality is decreasing over the last two decades, the cost of such care is escalating at a pace that is not sustainable for Medicare. Over this same time period, cardiac imaging has grown at an extremely rapid rate and is a leading contributor to this escalation in expense. It is now incumbent on both profession medical societies and individual physicians to demonstrate that cardiovascular care and the imaging growth lead to better patient outcomes and that the level of competent performance in these areas is documented. The development of physician certification and laboratory accreditation are key components to this effort and need to be supported and updated in a timely manner. The recent introduction of appropriateness criteria for patient imaging and treatment, especially in concert with the more established national clinical guidelines, appears to offer the best mechanism to deal with all the clinical and economic factors that we will need to address to continue our efforts to improve cardiovascular healthcare. Physicians can best serve their patients by practicing best standards of practice as well as being advocates for high-quality medical care in the setting of responsible healthcare funding.