Community Cardiologist

Cardiologist in the community - aka “The real world”

[Community Cardiologist @calicardio]

I m here to dispel some myths about reimbursement in medicine especially in cardiology for medical students and trainees. Also evidence based medicine from perspective of a community cardiologist 🎭🫀💉💊🩺💰💵💸💔

[Community Cardiologist @calicardio]

“Still living in the world of the meta-analysis” is not how evidence evolves: the post below essentially dismisses the latest RCTs because it conflicts with prior pooled data. Science moves forward with new, larger RCTs — especially negative ones.
#cardiotwitter #ACC

[Ibrahim H. Tanboga, MD, PhD @ihtanboga]

I’m still living in the world of the meta-analysis published just last week😁before IVUS-CHIP and OPTIMAL. Keep using IVUS!

[Community Cardiologist @calicardio]

Academia never quite calls it ‘standard’… but sure promotes it like one:
IVUS for LM/CHIP. Watchman. CTO interventions .

Then ACC 2026 Scientific Session drops data that’s… less convincing.

Maybe enthusiasm got ahead of evidence.

#CardioTwitter #ACC2026 #EBM #MedTwitter

[Community Cardiologist @calicardio]

If a drug failed non-inferiority and showed worse outcomes, we’d abandon it.

But when it’s a procedure, academics debate!

CLOSURE-AF is a reality check for LAAO.
Indication creep has consequences.

[Community Cardiologist @calicardio]

LAAO morphed into a lifestyle procedure.

CLOSURE-AF reminds us:
It’s not benign. It’s not equivalent. And it’s not for everyone.

Time to recalibrate.

[Community Cardiologist @calicardio]

This is refreshing!
A Sham ‘ablation’ procedure could be done and proven effective with this data!
A new device could have been approved!
‘Thought leaders’ would be promoting it online and offline.
Would have received class II B recommendations from societies!#sarcasm

[Jason Andrade @DrJasonAndrade]

@RashadKhaziSyed @drpaari @narrowQRS @MarkMarieb We’ve shown that 44% of untreated PVCs spontaneously resolve at 3-64 months.

https://t.co/eqrw1dFCv3

[Sanjay Kaul @kaulcsmc]

1/
Does the evidence support Class IA guideline recommendation for catheter ablation for AF HFrEF?

2019 guidelines: Class IIb, LOE B (to potentially lower mortality and reduce HHF)

Any new data to justify upgrading to Class IA?

https://t.co/AH2OljoXRo

[Community Cardiologist @calicardio]

Permanent Pacemaker placement reimbursement in year 2000 was $697. It is $588 in 2023. Adjusted for inflation it is $332!
That’s ‘Revenue’ for the practice. When you account for overhead, take home for physician would be less than $200!
#CardioTwitter
#MedTwitter
#reimbursement

[Bradley Knight @DrBradleyKnight]

Major Declines in Physician Reimbursement in Electrophysiology https://t.co/vGJujQpeVR

[Community Cardiologist @calicardio]

🤷🏽‍♂️Academics!

[Ash Paul @pash22]

In Plain Sight: The Need for a Dedicated Cardiovascular Infectious Disease Subspecialty https://t.co/YiiMSAs1hV via @lstrnad5 et al. Do we need yet another subspecialty? @gushamilton @DavidLBrownMD @mmamas1973

[Community Cardiologist @calicardio]

#Cardiology
#MedTwitter
#cardiotwitter

[Community Cardiologist @calicardio]

I asked ChatGPT to create a picture of workspace for different specialties. And of course for Hospital CEO and insurance company's CEO.
The one for GI is hilarious. I don't what is in that box in the corner. 😅
1/n

[Community Cardiologist @calicardio]

Insurance company's CEO