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Cardiologist Writes to His Congressman Regarding Medicare Cuts – The Impact

Posted Dec 11 2009 2:20pm
Recently I have posted a couple of times about the impact the proposed cuts in Cardiology will have if they go through.  One of my clients was kind enough to send me a copy of his letter to his representative in Congress.  Not too long ago I did a short presentation for doctors at his hospital on imagesocial networking and you can go to the QIK widget, click menu and see who’s talking here and he helped the hospital enroll in the Siemens program last year on trying to win an MRI. 

Is Your Cardiologist Now Going to be Your Hospitalist? Many Will Close Offices If Reductions Are Made

CMS plans cuts to Medicare Cardiology Provider Fees Close to 40%

Perhaps if all get involved here and write and support Cardiology and wave off the proposed budget cuts, we could make a difference.  He spells out his own impact as well as expanding on how cardiology will be impacted throughout the US.  BD
This is the email I received from Dr. “Mike” with his preface on the letter to his person in Congress.
“I am embarrassed and humbled as I send this letter to you. It is a letter I sent to my congresswoman regarding the budget cuts solely directed to cardiologists come January 1st. It is self-explanatory. I am literally scared about my survival as well as the impact these changes will have on my patients and for healthcare in general.
In the next few days there will be a vote in Congress about this and the possibility of freezing the pay cuts to Cardiology. Though I don't know if you agree with me or if you even care I would deeply appreciate your help. If you can send a letter or even copy my letter and send it to your representative or to other cardiologists you know it will make a difference. Time is of the essence.”

The Letter below:
Dear Honorable Ms Richardson:
We met a few weeks ago at the Long Beach Community Hospital Condit dinner at the Hyatt Hotel.
I was impressed by your kindness and sincerity and I thank you for giving me your email address.
Long Beach has amongst the best heart specialists and programs in southern California.  We have developed a reputation however we are about to lose all this if current budget cuts go into effect by CMS (Medicare).
Outside of Health Care Reform which is being debated or the slated 21% pay cut coming for all physicians as per CMS on January 1st, there is an additional 20% being cut to one medical specialty and no other..........Cardiology. What adds to the significance and scariness of this is that whatever Medicare does all other insurance companies follow with similar cuts.
In an effort to try to entice more medical students to go into primary care they are increasing payments to primary care physicians and making up for this by taking it away from Cardiology. I can give you one reason why there are less primary care physicians nowadays.  It is because the gender demographics of medical students has changed and now roughly 50% of the medical students are women. 
They are electing to work in less time-demanding specialties (like Dermatology, non-interventional radiology, etc) so that they do not need to take call and thus compromise their desire to have children and a family. I can understand this but it is not because of the pay. In fact primary care physicians in some ways get paid more as they jump right into the workforce after residency whereas the rest of us who spend an extra 3-4 years specializing have to defer our income.
With the anticipated 21% pay cut for all physicians and the additional 20% cut for cardiologists this results in a roughly 40%  overall pay cut to cardiologists. The average cardiologist has at least a 60% overhead. This translates into zero income. To reduce our income by 100% is fiscally irresponsible let alone insane. We are still expected to work 11-14 hours per day including weekend work, receive calls any time of the day or night and respond to emergencies.  We are interrupted at every sacred moment of our lives. 
We go thru hell trying to balance seeing patients in the office during the day, running to several hospitals to see patients during the day and night, squeeze in performing surgeries (stents, pacemakers, etc) and be available at any time every day and night.  The demands are incredible and perhaps more so than any other medical specialty................and all this now for free! 
We live in constant fear that a simple error in judgment (whether it be because of lack of sleep or dealing with the stresses of simultaneous emergencies, etc) or a miscommunication will result in serious consequences for patients let alone to us and our families. We are aware there are attorneys and medical boards, confidentiality organizations, etc hovering over us to catch us off guard. We don't need these additional stressors. We are nowadays seeing more and more patients in the hospital who have no insurance and we are taking care of them for free (pro bono).
Cardiology perhaps more than any other specialty has made great strides in healthcare.  Cardiology has raised the prestige of the United States in the world of medicine. People rich and famous all over the world want their advanced cardiology care in the United States. Now that cardiologists will be reduced in effect to slaves the prestige of Cardiology in this country will dissipate and there will no longer be money or incentive to create new innovations and better care.
To compound this there is an expected shortfall of 15,000 cardiologists in this country in the next 10-15 years. Do you think any medical student will want to be a cardiologist when they have to work for free?
Rep Charlie Gonzalez (D-Tex) is introducing legislation to do away with these singular cuts to Cardiology. We would deeply appreciate if you can take the lead and help co-sponsor this bill. The government has lots to lose by allowing these cuts to take place yet will have much to save by not making these cuts. Remember that cardiologists have not had a raise in over 10 years yet our expenses grow. In lieu of raises please do not cut us any further.
Finally, these cuts to healthcare will come with serious repercussions. I know I will need to lay off 2 employees and other physicians will be doing the same. However more than just this, the adverse effect on physicians will spill over to other healthcare workers (nurses, technicians, administrators, etc). 
We will all be forced to cut back and there will be less discretionary income. The health care industry does its share and usually much more than its share in spending and supporting the local economies (stores, vendors, other professionals, philanthropic institutions, etc). With many businesses marginally holding on, cutting back on healthcare will result in our inability to continue to financially support these businesses and thus further compromise their ability to stay afloat. The quickest way to turn a bad recession into an all-out depression is proceeding with the current budget cuts. Mark my word on this.
Thank you so much for your understanding and help
My best wishes to you,
E. Mike Vasilomanolakis M.D.
Assistant Clinical Professor
Western University of Health Sciences
Director, Cardiac Services and
Heart Catheterization Laboratory
Community Hospital of Long Beach
1760 Termino Avenue    Suite 314
Long Beach,  California  90804
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