Dr. Tim Johnson: The Quest for Quality

When you are diagnosed with heart failure, something that happens to 400,000 Americans every year, you want to believe you will get the best treatment possible. But all too often that assumption might cost you your life.

Unfortunately, there are significant differences between the quality of care you can receive, depending on where you go for treatment and the expertise of the health care professionals you put your trust in.

For heart failure, it is especially crucial that you get the best quality care possible. Heart failure, which affects nearly five million people in this country, is actually a chronic condition that can result from many different underlying diseases. It often occurs after the heart muscles have been weakened by a heart attack or an infection, reducing the heart’s ability to pump blood.

Because this form of heart disease affects so many people, it is important that you know how to get the best treatments available, in case it ever touches your life or the life of someone you love.

Differences in Care Documented Two important studies released this week reinforce the theory that patients can receive vastly different levels of care. One study looked at the difference between treatments at a major teaching hospital and a local non-teaching hospital for elderly patients who had suffered an acute heart attack. Disturbingly, those who were treated at the teaching hospital were more likely to walk out of that facility alive — and were more likely to still be around and kicking two years later.

Why is that so? After all, teaching hospitals are often overburdened, located in poor urban areas, and staffed with inexperienced interns fresh from medical school. Despite these factors, teaching hospitals were also found to be more likely to use the most up-to-date treatment methods proven to help heart patients, such as aspirin, ACE inhibitors, and beta-blockers.

Unfortunately, these lifesaving drugs are not being used as extensively as they should be. The second study shows that a specific kind of beta-blocker called carvedilol (Coreg) used on patients with severe heart failure cut their chance of dying by a third. In fact, the treatment was so effective the study was actually halted early to make sure that the medication was given to all the patients in the trial. Researchers predict this drug could save as many as 50,000 lives a year.

Previously, doctors were unsure whether this beta-blocker medicine was safe for patients with severe heart failure. In light of these new results, I believe doctors will re-evaluate their practice and consider using this beta-blocker on all appropriate patients with chronic heart failure. Patients should talk to their doctors as soon as possible to make sure they are getting every possible edge in fighting this disease. Finally, if you are ever in doubt of the cardiac care you are receiving, you may want to consider transferring to an expert cardiologist at a major medical center.

Because it’s your life on the line, you should demand the best care doctors can provide — and accept nothing less.

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