Absence Makes the Heart Grow Stronger

IMG_3934Today, many physicians are still basking in the post Thanksgiving holiday bliss, enjoying their families and some rest. Plenty are still working, though, staffing the hospitals and clinics, holding the pager so patients with emergencies can still get help.

I am off today and I am so very grateful for those who are working, who make time off for me possible.

So in the spirit of absenteeism I thought I would share a juicy little tidbit…

Did you know that you are less likely to die if you are admitted to a hospital for a heart attack or congestive heart failure when the big national cardiology conferences are being held, when most of the top/senior cardiologists are away?

I had touched on this before, but here is the actual article from JAMA: 

Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings

Why?

Patients are less likely to have a heart catheterization during that time. So maybe less intervention? Then there is the possibility that younger doctors are more skillful than their seniors (I like this possibility less the older I get).

It is sobering to consider that there may be other conditions that this holds true for, that as physicians, sometimes we do more with less.

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74 thoughts on “Absence Makes the Heart Grow Stronger

  1. Wow…Victo, this is an eye-opener! Never read that article. My Dad died instantly of a heart attack! Best way for him to go. A friend went through the heart procedure route up to open-heart surgery & dialysis. It was grueling and a compromised life! Not sure how I’d like to go! Don’t think it’s my choice in the end! Just living a healthy life, holding and hoping! Chryssa

    Liked by 1 person

  2. I remember when you raised this last time. I did a bit of research then as well. Then there are the patients who get really upset if you don’t do anything because they don’t need anything but they want a pill or a prescription or a referral. So basically you guys lose either way. Maybe you’d be better off as a chicken farmer.

    Liked by 1 person

  3. Great post. I’m on the bottom of the rung, but a whole lot of the problems my clients have come about from too much medical intervention. Some of it comes from the patients themselves pressuring for quick solutions, some of it is the nightmare that is insurance bureaucracy, and some of it is from doctors that just want to fix the problem and move on.

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  4. I have been the beneficiary of “younger minds” in the medical field a couple of times when the older minds could not find anything wrong. I am a firm believer that my youngest child would not have been born had it not been for a young doctor sitting going over lab results and thick medical histories on Thanksgiving night. That’s when I got the call…about 10 pm on Thanksgiving night, 1989. The doctor’s theory was that my repeated miscarriages were due to a low progesterone level in the first trimester. Administering the progesterone allowed my pregnancy to develop and mature and now that daughter is 25! And last March, when all older doctors were stumped about the growth in my abdomen and thinking it was liver damage or kidney failure, it took one young doctor (another woman) to keep exploring and questioning and testing until she found the answer.

    I really believe that younger doctors SOMETIMES either keep plugging away at a medical problem until they find the right diagnosis. This might be because they have more time to spend on patients or it could also be that they are closer to what they’ve learned or read or heard (they remember it better because they learned of it more recently). They might have more open minds because they haven’t seen “cases like this” a bazillion times.

    Liked by 2 people

      • I am always a little suspicious that procedures might not be necessary, especially when money is involved. I have enough problems with our cat specialist – our cats are well past their sell-buy date so don’t need unnecessary tests for treatments that we are unable to give feral animals.

        Liked by 1 person

  5. I am beginning to believe less is usually better. Iatrogenic injuries are the scourge of healthcare. Don’t worry though, we have a pill for that. I swear, if I could convince nurses there are non- pharmaceutical interventions for pain, I would be thrilled.

    Liked by 1 person

  6. Goodness,
    Why do your posts always bring a particular song to mind that I hadn’t thought about in years? Perhaps it’s just me yes? Maybe you are projecting unknowingly? At any rate, at the risk of looking foolish again. . .here you are.

    Liked by 2 people

  7. Although no expert, as I grow older I have been acquiring more and more experience of friends and acquaintances who are aging themselves, and therefore prone to almost every potentially fatal malady one can think of. Based on anecdotal evidence from this population, I do believe that often (although of course not always) less is more, and that perhaps wiser medical heads are coming round to that position in many more instances. The trick, I suppose, is to know when to leave well enough alone and to be less aggressive in medical intervention — and when not to. A conundrum.

    Liked by 1 person

  8. Fascinating… Maybe cardiologists need to have more conferences, etc…

    I’m also very grateful for those who work on public holidays, so I try to return the favour. I was going to volunteer to work this Christmas (at the pharmacy) since I wouldn’t be doing anything during the day, but someone else beat me to it!

    Liked by 1 person

  9. In the UK the evidence is that patients are more likely to die when admitted over the weekend when there are less doctors present. Junior doctors here have overwhelmingly voted for strike action in protest at what they perceive as unfair contracts introduced by the Secretary of State for Health, Jeremy Hunt. Discussions are ongoing to try to avoid the industrial action taking place. Hopefully a resolution can be reached avoiding a strike. Kevin

    Liked by 1 person

  10. One would have to check the methodology thoroughly, but my null hypothesis is that seniority may have an adverse effect…
    In the hospital my daughter did her residency, all residents feared the “recommended” syndrome. A “recommended” patient, was either a celebrity, a politician, or a relative of the hospital top brass. Recommended patients always suffered complications, were visited in excess by the brass, (too many cooks in the kitchen leaves no-one to wash the dishes) and had a higher – apparent – mortality rate. She was tempted to, but never did a tally.

    Liked by 1 person

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