Physician Certification and Implantable Cardioverter-Defibrillators—Reply
- Jeptha P. Curtis, MD jeptha.curtis@yale.eduDepartment of Internal MedicineYale University School of MedicineNew Haven, Connecticut;
- Jeffrey Luebbert, MDDepartment of Internal MedicineThomas Jefferson University School of MedicinePhiladelphia, Pennsylvania;
- Harlan M. Krumholz, MD, SMDepartment of Internal MedicineYale University School of Medicine
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- CARDIAC ELECTROPHYSIOLOGY
- CERTIFICATION
- DATA INTERPRETATION, STATISTICAL
- DEFIBRILLATORS, IMPLANTABLE
- ELECTROPHYSIOLOGIC TECHNIQUES, CARDIAC
- ELECTROPHYSIOLOGY
- INTRAOPERATIVE COMPLICATIONS
- OUTCOME ASSESSMENT (HEALTH CARE)
- QUALITY OF HEALTH CARE
In Reply: Drs Ghali and Schreiber observe that, compared with electrophysiologists, the absolute differences in outcomes among implants performed by thoracic surgeons were larger compared with those of other nonelectrophysiologist physician categories. We agree that focusing on thoracic surgeon implants may serve as a good starting point for efforts to improve the outcomes associated with nonelectrophysiologist implants. However, our study reflects average performance for the entire group, and it is likely that there are thoracic surgeons who achieve excellent outcomes. Furthermore, a narrow focus on thoracic surgeons misses the broader question raised by our study: given the available evidence, what purpose is served by the majority of nonelectrophysiologist implants? In the absence of significant barriers to access, our findings support that these devices should be implanted by the physicians who have undergone the most rigorous training.
We understand the concerns of Dr Lick and colleagues that the characteristics of patients …
