Transcript Cardiologist and Primary Care Physician Report

Effect of Media / Advertising on Physician
Treatment Choices–
Cardiologist and Primary Care Physician Report
Findings from the
June 2013 CardioSurve and PCP studies
Objectives And Methodology
This research was designed to:
 Develop an understanding from U.S. Cardiologists and Primary Care
Physicians about the impact of media and advertising on patient treatment
decisions
 For the cardiologist research, email invites were sent to CardioSurve panelists
– current, active Fellows of the ACC. A total of 150 physicians completed the
survey for an overall response rate of 33%.
 For the PCP study, email invites were sent to 1,900 PCP Research Now panel
members. A total of 253 physicians completed the survey for an overall
response rate of 13%.
 Each survey was in the field from June 12 – July 12, 2013
Key Findings
•
For both Cardiologists and primary care physicians (PCPs), clinical guidelines and scientific evidence
have the strongest influence on patient treatment. Patient preference is an influencer for about half of
physicians. PCPs are significantly more likely to consider cost of treatment when prescribing a
treatment regimen. Information from non-scientific sources such as public media have little/no direct
influence.
•
Almost all physicians (99% cardiologists and 98% PCPs) have responded to a patient inquiry regarding
pharmacologic treatments covered in the media. Approximately 1 out of 5 patients are asking
physicians about drug treatments which have received negative coverage in the news. PCPs are more
likely than cardiologists to field questions about DTC pharmaceutical company ads. Significantly
fewer patients are asking clinicians about treatments involving lawsuits or personal injury claims they
have seen advertised.
•
Media coverage and advertisements have some influence on clinician prescribing behavior when
approached through the patient. Cardiologists and PCPs are more likely to possibly change a patient
treatment based on negative coverage in the news compared to other media such as lawsuits, DTC
advertising, or positive news coverage. Negative media coverage is also more likely to lead to
increased communication between the physician and the patient as well as place more pressure on the
justification of the prescribing/treatment regimen. Other media coverage, particularly lawsuits/personal
injury claims have less of an influence on the patient/physician dynamic.
•
Overall, PCPs are more likely than cardiologists to consider patient preferences in response to news
coverage or advertising. The more common patient scenarios for considering it are when the possibility
or risk of adverse events is low.
Key Findings, ctd.
•
Cardiologists are less likely than PCPs to say that they have performed defensive medicine practices
solely to minimize the risk of a lawsuit. The top three practices are consistent among clinicians:
ordering imaging, ordering lab tests, or making patient referrals.
•
The level of complexity in a disease state does make a difference in clinician likelihood to honor a
patient’s request for a change in their treatment program. Given a patient with a CHADS2 score of 1,
clinicians are generally more likely to consider honoring a patient’s request; about three-fifths of
cardiologists (63%) and PCPs (57%) are willing to consider the patient’s request to discontinue/change
treatment based on what the patient has seen advertised. However, if the patient has a CHADS2 score
of > 2, clinicians are significantly less likely to honor the request. Three fifths of cardiologists (58%) and
almost half of family physicians (47%) say they would oppose the patient’s request.
•
For the majority of cardiologists and PCPs the top factor that would lead them to change their clinical
opinion is if the patient suffers an adverse event. However, one-quarter of cardiologists and 30% of
PCPs would consider changing their opinion if the patient mentions “legal liability” or is “litigious”.
Strongest Decision Influencers for Patient Treatment
•
For both cardiologists and primary care physicians (PCPs), clinical guidelines and scientific evidence have the
strongest influence on patient treatment. Patient preference is an influencer for about half of physicians. PCPs
are significantly more likely to consider cost of treatment when prescribing a treatment regimen. Information from
non-scientific sources such as public media have little/no influence.
Clinical guidelines /
Clinical guidelines/scientific
evidence
scientific evidence
92%
82%
Past experience with
Past experience
with ent/drug
treatment/drug
treatm
Side-effects of
Side effects
of treatment
treatm
ent
Co-m orbid
Co-morbid
conditions
conditions
Articles in scientific
Articles in scientific
journals
journals
68%
78%
63%
75%
61%
70%
55%
39%
55%
CostCost
of of
treatm
ent
treatment
73%
47%
52%
Patient
Patientpreference
preference
44%
49%
Disease
com
plexity
Disease
complexity
43%
Ease
Easeof
of use
use
51%
Risk
Risk
algorithm/risk
calculator
algorithm /calculator
Colleague
Colleague
recommendation
recom
m endation
26%
30%
30%
15%
Liability
Liability
Inform ation from
Information
from public media
public m edia
Cardiologists
16%
28%
PCPs
1%
5%
Q: Which of the following most influence your decision on a treatment regimen for your patients?
(CardioSurve - n=150, PCPs - n=253)
Average % of Patients Asking About Treatments Seen In…
•
•
Almost all physicians (99% cardiologists and 98% PCPs) have responded to a patient inquiry regarding
pharmacologic treatments covered in the media. Approximately 1 out of 5 patients are asking physicians about drug
treatments which have received negative coverage in the news. PCPs are more likely than cardiologists to field
questions about DTC pharmaceutical company ads.
One-in-ten patients are asking physicians about treatments involving lawsuits or personal injury claims they have
seen advertised.
Negative coverage about
19%
Negative
in
in coverage
the news
news
Advertised by
Advertisements
by
pharm a
pany
pharmaceuticalcom
company
Positive
21%
% of MDs asked about
drug treatments:
98% PCP
99% Cardiologist
15%
22%
12%
Cardiologists
Positive coverage about in coverage
the news
in
news
Concerning
Concerning
a lawsuit
lawsuit
or legal /
claim
personal injury claim
18%
PCPs
11%
13%
Q: What percent of your patients ask you about pharmacologic treatments that…
(CardioSurve - n=144, PCPs - n=253)
Frequency of Changing Treatment Based on Media/Ads
•
Media coverage and advertisements have some influence on clinician prescribing behavior. Cardiologists and PCPs
are more likely to possibly change a patient treatment based on negative coverage in the news compared to other
media such as lawsuit, DTC advertising, or positive news coverage.
All of
the time
Often
Some of
the time
Negative coverage
in the news
1%
3%
3%
Positive coverage
in the news
0%
3%
2%
8%
Lawsuit / Personal Injury
Legal Claim Ad
1%
2%
3%
0%
12%
12%
1%
6%
26%
26%
36%
Pharmaceutical
company ad
45%
49%
42%
55%
55%
37%
Never
25%
Depends on
condition
Not
sure
22%
19%
22%
19%
24%
26%
16%
7%
56%
59%
4%
4%
3%
2%
9%
3%
Cardiologists
PCPs
Cardiologists
PCPs
Cardiologists
15%
14%
19%
3%
4%
1%
PCPs
Cardiologists
PCPs
Q: How often have you changed a patient prescription/treatment based on information the patient receives from:
(CardioSurve - n=144, PCPs - n=253)
Impact on Communication Based on Media/Ads
•
•
Negative media coverage is more likely to lead to increased communication between clinician and patient. Although
not as strong, positive media coverage does have an impact as well.
PCPs are also more likely to have an increase in patient conversations based on pharmaceutical ads.
Negative coverage
in the news
Positive coverage
in the news
Pharmaceutical
company ad
Lawsuit / Personal Injury
Legal Claim Ad
37%
55%
Yes
71%
60%
62%
72%
54%
39%
No
24%
21%
Not
sure
6%
8%
Cardiologists
41%
49%
PCPs
6%
Cardiologists
51%
38%
29%
29%
12%
9%
PCPs
Cardiologists
13%
PCPs
8%
9%
Cardiologists
PCPs
Q: Have any of the following increased communication between you and the patient
(CardioSurve - n=144, PCPs - n=253)
Pressure to Justify Treatment Based on Media/Ads
•
•
Not surprisingly negative media coverage is more likely to place pressure on the cardiologist and PCP to justify their
prescriptions/treatment to the patient.
To a lesser extent, lawsuit / personal injury legal claim ads also have led to the same need for clinicians to justify
their prescriptions/treatment plans.
Negative coverage
in the news
Positive coverage
in the news
Lawsuit / Personal Injury
Legal Claim Ad
34%
41%
Yes
68%
30%
Not
sure
2%
Cardiologists
36%
50%
53%
69%
62%
No
44%
Pharmaceutical
company ad
54%
52%
60%
45%
43%
25%
6%
5%
5%
4%
5%
4%
5%
PCPs
Cardiologists
PCPs
Cardiologists
PCPs
Cardiologists
PCPs
Q: Have you ever experienced any pressure to justify your prescriptions/treatment based on the following?
(CardioSurve - n=144, PCPs - n=253)
When To Consider Patient Preference Influenced by Media
•
Overall, PCPs are more likely than cardiologists to consider patient preferences in response to news
coverage or advertising. The more common patient scenarios for considering patient preference are when
the possibility or risk of adverse events is low.
Possibility of serious
Possibility of serious
adverse event(s) is low
37%
of adverse
events
RiskRisk
of adverse
event(s)
is low
37%
adverse events is low
57%
is low
55%
Nostatements/guidelines
specific clinical
No specific clinical
35%
statem ents/guidelines
30%
Treatm ent concern
Treatment concern based on
news on
coverage/ads
based
news
coverage/ads
22%
40%
17%
Liability
risk
low
Liability
risk
is is
low
Chronic
condition
Chronic
condition
Other
Other
Do not
consider
Do not consider
patient
preference
patient
preference
influenced by media
influenced by m edia
Not
Notsure
sure
39%
8%
23%
9%
6%
22%
Cardiologists
8%
8%
PCPs
3%
Q: When are you more likely to consider patient preferences in response to news coverage or advertising?
(CardioSurve - n=143, PCPs - n=253)
“I View Every Patient as a Potential Lawsuit”
•
Although the majority of clinicians disagree with the statement, still for nearly 1 out of 4 cardiologists (23%) and
nearly 2 out of 5 PCPs (37%) there is some sentiment that these clinicians view every patient as a potential lawsuit.
6%
6%
Total Agree
23%
Total Agree
37%
17%
31%
14%
18%
21%
Total Disagree
56%
23%
Total Disagree
40%
38%
17%
Not sure
7%
3%
Cardiologists
PCPs
Strongly disagree
Somewhat disagree
Neutral
Somewhat agree
Strongly agree
Q: Please indicate your level of agreement with the following statement: “I view every patient as a potential
lawsuit.” (CardioSurve - n=141, PCPs - n=253)
Defensive Medicine Practices Performed to Avoid Lawsuit
•
Although more PCPs than cardiologists are indicating that they have performed defensive medicine practices
solely to minimize the risk of a lawsuit, the top three practices are consistent: ordering imaging, ordering lab
tests, or making patient referrals.
45%
Ordered
imaging
Ordered
im
aging
70%
44%
Orderedlab
labtests
tests
Ordered
67%
31%
Referred
patients
Referred
patients
68%
31%
Followed
clinical
guidelines
Followed
clinical
guidelines
44%
18%
Changed / Discontinued
Changed
/ Discontinued medication
m edication
49%
12%
Prescribed
Prescribed
m medication
edication
Suggested
interventional
procedure
Suggested
interventional
procedure
Other
Other
None
None
36%
7%
21%
Cardiologists
6%
2%
30%
PCPs
12%
Q: Which of the following defensive medicine practices have you performed solely to minimize the risk of a
lawsuit: (CardioSurve - n=141, PCPs - n=253)
Patient Scenario
In the following case scenario, which of the following perspectives most
closely resembles your own view?
A patient with Atrial Fibrillation and a CHADS2 score of 1 makes a request
to be taken off of a novel oral anticoagulant based on what they have seen
advertised.
Dr. Smith is in favor of considering his patient’s request to discontinue or
change treatment since these are relatively new pharmacologic
approaches to treating the disease and there is no current antidote.
Dr. Jones opposes his patient’s request to discontinue or change treatment
as he/she is at an increased risk of stroke and Dr. Jones believes the
benefit/risk ratio favors the new anticoagulant.
If the patient in this case scenario has a CHADS2 score of > 2, how would
this impact your perspective?
Patient Scenario - Overall
•
•
Given a patient with a CHADS2 score of 1, clinicians are generally more likely to consider a patient’s request; about
three-fifths of cardiologists (63%) and PCPs (57%) are willing to consider the patient’s request to discontinue/change
treatment based on what the patient has seen advertised.
However, if the patient has a CHADS2 score of > 2, clinicians are significantly less likely to honor the request. Three
fifths of cardiologists (58%) and almost half of family physicians (47%) say they would oppose the patient’s request.
Scenario: Patient has
CHADS2 score of > 2
Scenario: Patient has
CHADS2 score of 1
31%
Consider
Patient
Request
39%
63%
57%
58%
47%
Oppose
Patient
Request
19%
Neither
5%
Unsure
Consider
Patient
Request
Oppose
Patient
Request
29%
3%
9%
6%
Neither
13%
7%
6%
7%
Unsure
Cardiologists
PCPs
Cardiologists
PCPs
Q: In the following scenario, which of the following perspectives most closely resembles your own view?
Q: Now if the patient in this case scenario has a CHADS2 score of > 2, how would this impact your perspective?
(CardioSurve - n=68, PCPs - n=129)
Patient Scenario 1: CHADS2 Score of 1
•
•
Given a patient with a CHADS2 score of 1, more than half of cardiologists (61%) and nearly half of PCPs (49%) are
willing to consider the patient’s request to discontinue/change treatment based on what the patient has seen
advertised.
However, if the patient has a CHADS2 score of > 2, then more than 2 out of 3 cardiologists (71%) and more than
half of PCPs (59%) are opposed to the patient request.
Original Scenario: Patient has
CHADS2 score of 1
Strongly
13%
27%
Total Consider
Patient Request To
Change Treatment
61%
Adjusted Scenario: Patient has
CHADS2 score of > 2
22%
27%
Consider
Patient
Request
59%
Oppose
Patient
Request
49%
36%
Somewhat
34%
11%
71%
7%
Total Oppose
Patient Request To
Change Treatment
28%
Somewhat
18%
34%
28%
Strongly
10%
4%
6%
5%
7%
Cardiologists
PCPs
Cardiologists
14%
PCPs
Q: In the following scenario, which of the following perspectives most closely resembles your own view?
Q: Now if the patient in this case scenario has a CHADS2 score of > 2, how would this impact your perspective?
(CardioSurve - n=68, PCPs - n=129)
Patient Scenario 2: CHADS2 Score of > 2
•
•
Given a patient with a CHADS2 score of > 2, less than 2 out of 5 cardiologists (39%) are willing to consider the
patient’s request to discontinue/change treatment based on what the patient has seen advertised. However, slightly
more than half of PCPs (53%) are still willing to consider the request.
If the patient has a CHADS2 score of 1, then roughly 2 out of 3 cardiologists (69%) and PCPs (65%) are willing to
consider the patient request.
Original Scenario: Patient has
CHADS2 score of > 2
Total Consider
Patient Request To
Change Treatment
39%
Strongly
15%
14%
Somewhat
25%
Adjusted Scenario: Patient has
CHADS2 score of 1
53%
38%
69%
65%
Consider
Patient
Request
24%
Oppose
Patient
Request
4%
Total Oppose
Patient Request To
Change Treatment
45%
Somewhat
7%
27%
27%
10%
21%
11%
9%
5%
Cardiologists
PCPs
Cardiologists
Strongly
18%
36%
11%
PCPs
Q: In the following scenario, which of the following perspectives most closely resembles your own view?
Q: Now if the patient in this case scenario has a CHADS2 score of 1, how would this impact your perspective?
(CardioSurve - n=71, PCPs - n=124)
What Would Change Your Treatment Opinion of this Afib Patient?
•
•
For the majority of cardiologists and PCPs the top factor that would lead them to change their opinion is if the
patient suffers an adverse event.
However, nearly 1 out of 4 Cardiologists and 1 out of 3 PCPs would consider changing their opinion if the
patient mentions “legal liability” or is “litigious”.
Patient
71%
Patient Suffers
Suffers
AdverseEvents
Events
Adverse
77%
27%
Patient Mentions
Patient Mentions
“Legal Liability”
"Legal Liability"
Patient
33%
25%
Patient Is
Is
“Litigious”
"Litigious"
Other
Other
30%
9%
6%
Cardiologists
18%
None
None
PCPs
9%
Q: Which of the following, if any, would change your opinion on how to treat this patient with Afib?
(CardioSurve - n=139, PCPs - n=253)
How Is Clinician-Patient Dynamic Is Affected By Public Communication?
Cardiologist Perspective
•
•
•
•
•
•
•
•
•
•
•
•
•
“It is important to offer a balanced opinion and factual information. The patients are given a "spin" by the press and we (the cardiology experts)
give them the true picture. That is why they come to us for care."
"Consumer advertising and news coverage are affecting the clinician patient dynamic. The clinician must be prepared to respond and provide
adequate reasoning to support his viewpoint."
"Fear of Litigation adds enormous cost and in many cases exposes patient to unneeded procedures. Negative news coverage has denied
many of my patients simple therapies such as statins that can potentially make a big difference in their outcomes."
"How much consumer advertising, news and lawsuit propaganda affects patients decisions vary from patient to patient. I try to keep my
recommendations the same and let the patient make an informed decision. The patient should have a more decisive role and the physician be
an advisor."
"News coverage of half-baked research is confusing to the public, and again creates an environment that leads to mistrust of scientific research
in general."
"I end up having to spend a lot of time deprogramming patients!"
"I have found that by keeping current in the literature and in current treatment paradigms / options, I usually am well "ahead of the curve" in
whatever the patient may see or hear through popular lay media."
"I have these discussions often. I explain that there are risks of taking the medication and risks of not taking medication. I review the published
studies and relative risks of all options. Patients generally agree with therapy when provided the information this way."
"If public communication increases my patient's awareness of their treatment and leads to a discussion that helps them understand their
condition, I'm all for it. Unfortunately, much of the information is publicly presented in a ‘scare tactic’ mode which creates unnecessary panic in
patients."
"It has heightened the need to spend time with patient's to educate them on their condition and the available options for treatment."
"It is a complicated issue. The best action is to have an honest conversation with the patient about treatment options and explain what the ads
message mean. Unfortunately in the current environment there is no time to have these discussions."
"It is imperative to have a detailed discussion with the patient about risk/benefit ratios and treatment options. It is only through these
discussions that you can understand the patient's perspective. You cannot force patients to come to your opinion - you can have the discussion
but in the end, it is their (now informed) decision."
"Negative press and lawsuits always advertise the negative aspects of treatments rather than bringing any attention to the benefits. It becomes
an uphill battle for providers to convince PTs of efficacy. We are still fighting this battle on statins many decades later , despite the deluge of
data in our high risk PTs."
Q: Please provide any additional thoughts you may have on how the clinician-patient dynamic is being
affected by public communication (direct to consumer advertising, news coverage, lawsuit solicitation, etc.).
(CardioSurve - n=56, PCPs - n=139)
How Is Clinician-Patient Dynamic Is Affected By Public Communication?
Primary Care Physician Perspective
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
"Doctors are wasting health care dollars protecting themselves from lawsuits, even when it is not in the best interest of the patient.“
“I do not like direct to consumer advertising. Patients come in demanding a new drug that often is not appropriate or demand to stop one
based on liability attorney ads”
"I feel most patients come to me with fear about what they hear on TV. This adds complexity to the visits, since most of the time these
potential risks have been thought about in the initial decision to treat.“
"I find that some patients put more credence in lawsuit solicitation and the news than in professional medical advice, especially those under 60,
yet they are quick to find fault if there are adverse effects from the treatment they have pushed to have.“
"Misinformation in the news makes it difficult to convince patients that a therapy is good.“
"More time-consuming for us to discuss. Lots of times the med they want is not appropriate for them or too expensive.“
"Most of my patients realize they are not doctors, so when they bring up something they saw on TV or read in the paper it is to get my opinion.
They still consider me the expert on their health and I think this is the way this relationship is supposed to be.”
“Public communication is favorable in that patients are more informed, more likely to express concerns previously left unasked, unfavorable in
that trivial matters are exaggerated in media.”
"Public communication causes patients to stop the medications abruptly without physician awareness, leading to worsening of diseases."
"Public communication has made patients more interested in better understanding the risks and benefits of their medical treatment and
interventions. I feel this promotes a healthy level of discussion in most cases, however, some patients are unable to understand that many of
the media hype about certain medical therapies is simply not supported by strong clinical evidence. This can be problematic and interfere with
appropriate medical management."
"Some of the information being conveyed gives a distorted view of risks of certain medications and can make patients reluctant to take such
medications even when they would benefit from them."
"It is very difficult to insure compliance under the best of circumstances but when a patient is bombarded constantly with conflicting
reports/information by the media it makes it even more difficult."
"The lawyers are slowly ruining medicine for those of us who are really trying to help patients."
"We live in a litigious society and until we reform our malpractice laws we will continue to have expensive defensive medical issues.“
“Unfortunately, lawsuit solicitations give the public the impression that if they have the stated "problem" that they WILL be entitled to
compensation. They ,of course, do not understand that the alluded "problems" can be the result of etiologies other than what has been
indicated by the advertisement.”
Q: Please provide any additional thoughts you may have on how the clinician-patient dynamic is being
affected by public communication (direct to consumer advertising, news coverage, lawsuit solicitation, etc.).
(CardioSurve - n=56, PCPs - n=139)
Final Thoughts
•
While cardiologists and PCPs are consistent in their approach relying primarily on the
latest clinical guidelines, scientific evidence, and education to guide their judgment in
patient prescriptions and treatment decisions, the role of patient preference is
significant in prescribing behavior (“patient multiplier”). This presents some
unique challenges in care and treatment.
•
Patients are empowered; they have more access to information and are more likely to
question their treatment regimen. Almost all PCPs and cardiologists are having to deal
directly with the influence of the media and advertising in the clinical realm. Although
PCPs appear to be more on the “front lines” of this issue fielding questions from a bit
larger patient group, cardiologists are not immune to the impact that media coverage
and advertising are having on their patients.
•
Media coverage and advertisements have some influence on clinicians’ prescribing
behavior, particularly negative news coverage. Clinicians generally try to honor
patient requests/preferences, particularly when the risk is low or the disease state
less complex.
•
While physicians are less likely to honor a patients request for a more complex disease
state, a notable percentage are willing to change their prescribing treatment. Further
investigation is needed to better understand this dynamic.
Final Thoughts, ctd.
•
Clinicians face an uphill battle in remaining abreast of media coverage as well as having
accurate information from credible sources to discuss and present to patients regarding
treatment options. Clearly there is an opportunity to support the medical community
in these areas. Those clinicians who appear to be in a better position are those who
anticipate these conversations with their patients and plan for them by closely monitoring
the latest reports, findings, etc. that are “making headlines” and then responding to
patient inquiries with guidelines and evidenced-based patient education materials.
•
Legal claims are less important to the prescribing dynamic unless the patient suffers an
adverse event or is seen as litigious; response to negative media coverage should
take priority.
Appendix: Respondent Descriptors
Cardiologist Profile Information
Cardiologist Profile Information
Gender
Percent
20 patients or less
16
11%
87%
21 - 60 patients
63
42%
100%
61 - 100 patients
51
34%
More than 100 patients
20
13%
150
100%
Frequency
Percent
0% - 33%
18
12%
34% - 50%
44
29%
51% - 66%
52
35%
More than 66%
35
23%
150
100%
Frequency
Percent
Influencer
97
65%
Non-Influencer
48
32%
5
3%
150
100%
Percent
19
13%
Male
131
Total
150
Female
Number of years in Practice
Total
Frequency
Percent
10 years or less
30
20%
11 - 20 years
46
31%
More than 20 years
55
37%
NA
19
13%
150
100%
Total
Number of Patients Per Week
Frequency
Frequency
Percent of Medicare Patients
Total
Board Certification
Frequency
Percent
Electrophysiology
16
11%
General Cardiology
82
55%
Interventional Cardiology
35
23%
Other
4
3%
Surgeons
1
1%
12
8%
150
100%
Pediatric Cardiology
Total
Decision Making Influence at
Practice
Not sure / No answer
Total
Cardiologist Profile Information –
Patient Procedure Specific
Invasive Procedures Performed
Non-Invasive Procedures
Performed
CT Angiography
Freq
%
Cardiac Catheterization - Diagnostic
Freq
%
72
48%
50
33%
25
17%
Electrocardiography
121
81%
Holter Monitoring/Event Recorders
126
84%
Electrophysiology
21
14%
ICD Testing and Reprogramming
53
35%
ICD Implants
22
15%
Nuclear Cardiology
70
47%
Peripheral Vascular Intervention
25
17%
Pacemaker Testing and
Programming
77
51%
Permanent Pacemaker Implants
33
22%
Stress Echocardiography
88
59%
None of these
56
37%
115
77%
150
100%
Tilt Table Testing
48
32%
Transesophageal Echocardiography
74
49%
150
100%
Stress Tests
Total
Cardiac Catheterization - Interventional
Total
Procedures Performed In Office
Frequency
Percent
Echo Performed In-Office
98
65%
Nuclear Cardiology Performed InOffice
72
48%
CCTA Performed In-Office
10
7%
MR Performed In-Office
6
4%
PET Performed In-Office
6
4%
150
100%
Total
Cardiologist Profile Information – Practice Specific
Primary Work Setting
CV Practice
Frequency
Percent
77
51%
3
2%
Hospital
15
10%
Medical School
34
23%
Multi-Specialty Group
14
9%
Other
7
5%
Total
150
100%
HMO/Industry
Practice Size (# of
Cardiologists)
Practice Ownership Type
Frequency
Percent
Independently Owned
60
40%
Hospital Owned
52
35%
5
3%
26
17%
Other
9
6%
Total
150
100%
Frequency
Percent
Rural
18
12%
Government Owned
Medical School/University Owned
Location
Frequency
Percent
Large (26+)
27
18%
Suburban
54
36%
Medium (11-25)
36
24%
Urban
76
51%
Medium Small (5-10)
35
23%
NA
2
1%
Small (1-4)
48
32%
Total
150
100%
4
3%
150
100%
Frequency
Percent
East
46
31%
North
27
18%
South
49
33%
West
28
19%
Total
150
100%
NA
Total
Four Point Geocode
Primary Care Physician
Profile Information
Primary Care Physician Profile Information
Primary Work Setting
Office Practice
Frequency
Percent
196
77%
9
4%
15
6%
0% - 10%
37
15%
8
3%
11% - 20%
61
24%
17
7%
21% - 30%
52
21%
Other
8
3%
31% - 50%
62
25%
Total
253
100%
More than 50%
41
16%
253
100%
HMO/Industry
Hospital
Medical School
Multi-Specialty Group
Percent of Heart Disease Patients
Total
Location
Frequency
Percent
56
22%
132
52%
Urban
65
26%
Total
253
100%
Rural
Suburban
Four Point Geocode
Frequency
Percent
East
97
38%
North
53
21%
South
38
15%
West
65
26%
Total
253
100%
Area of Expertise
Family Practice
Frequency
Frequency
Percent
Percent
240
95%
8
3%
Other
10
4%
Total
253
100%
Internal Medicine