Providers

The Monthly Pulse – Providers (Dec. 2022)

The Monthly Pulse

Industry News

A Spirited Debate: Annular Root Enlargement vs. Total Root Replacement

The Story

Cardiothoracic surgeons tend to be divided when it comes to methods for treating aortic valve disease. Recently, experts in aortic surgery presented a webinar to discuss deciding factors for each approach. In particular, a primary concern in treating aortic valve disease is avoiding a patient-prosthetic mismatch.

What You Should Know

Surgeons agree that using larger prosthetic valves can help prevent patient-prosthetic mismatch, an issue which could be addressed by using larger valves during aortic root enlargement. Yet, to treat patients with a smaller aortic annulus, some surgeons argue that aortic root replacement should be the preferred option. While the debate continues, surgeons must continue to weigh risks and the patient’s wishes to make the best recommendations in each scenario.

Generation X: Reaching the Minds of Residents and Fellows

The Story

As aging cardiothoracic surgeons near retirement, a new generation of residents and fellows in cardiothoracic surgery is emerging. To adapt to the preferred learning styles of Millennials and Generation X, gamified learning systems have been introduced in both graduate and undergraduate medical education. One solution, Anki, appears to be especially promising.

What You Should Know

Anki is electronic flashcard software that leverages spaced repetition and retrieval practice to help students in medical education. There are several potential applications for Anki and similar technology in cardiothoracic surgery. For instance, gamification has been shown to help trainees memorize clinical practice guidelines. They can even compare their progress to that of other students, helping to identify knowledge gaps or areas that may need improvement.

Imaging Tools Underscore How CAD Looks Different in Women

The Story

Identifying the factors that lead to coronary artery disease (CAD) calls for a sophisticated approach. CAD goes beyond vessel obstruction, particularly for women. For this reason, tools like advanced imaging should be deployed to get a full picture of the abnormalities that could be at play.

What You Should Know

According to a study in Denmark with more than 11,000 patients referred for coronary angiography, nearly two-thirds of women patients showed no obstructive disease to explain symptoms, versus just nearly a third of males. The findings not only illustrate how CAD may look different in women, but also emphasize the need for a multidisciplinary approach. Experts agree that an understanding of microvascular disease is needed to better treat both women and men. Bringing experts together from cardiology, radiology and more may help facilitate this.

Leadership Reflections

Economic Outlook
I had the privilege of hearing Dr. Marci Rossell speak last month at the Staffing Industry Analysts Healthcare Staffing Summit conference. Her outstanding keynote address, Economic Turbulence and the Healthcare Workforce: What’s Next? provided past, present, and future economic insights within the healthcare industry.

Here are some key takeaways:

The healthcare worker shortage is exacerbated by baby boomers retiring, millennials taking time off to start families, and fewer young people to enter the workforce. (Every year, there are 300,000 fewer young people turning 18 than a decade ago.)
Pre-COVID workers valued schedule flexibility by 8% of their salary, (meaning they were willing to accept 8% less pay for a role with flexibility). COVID technology adaptations have likely increased this. Post-COVID workers attracted to remote work are leaving high touch healthcare roles that cannot be remote.
Financially stricken healthcare organizations are facing: 1) severe wage pressure from below with no ability to alleviate, 2) inflation at the retail level of healthcare not keeping up with general inflation (6% vs. 8%), and 3) margin compression leading to bankruptcy or selling out to merger/acquisition.
While we’re experiencing the highest inflation we’ve seen in 40 years, we have not yet met the definition of a recession, and circumstances look more like late 1990-2000 vs. 2008-2009. Marci is anticipating the Federal Reserve will begin to lower rates in the second half of 2023, so there is hope of movement toward recovery in the next 12 to 18 months.

We recognize the significant challenges healthcare organizations are facing and are committed to partnering in sustainable ways. If you would like to hear more about this talk, please feel free to reach out - I would love to share more of what I learned and brainstorm ways you and your teams can creatively navigate this turbulent financial season.