Cardiac Studies to Do In Your Office Rather Than Sending Them Out
Good for the patient - good to increase your reimbursement.
In this article, we are going to talk about two cardiac diagnostic studies that can be done in your office, simply and easily for the benefit of the patient, and, for your income. These two pieces of equipment are the EKG (Electrocardiograph) and the Holtor Monitor. Let’s talk about the EKG.
In these days of obesity, hyperlipidemia, hypertension, diabetes and illegal drug usage, it is imperative that an EKG be considered in your practice.
Family physicians often see patients who complain of chest pain. The differential diagnosis can include anterior chest wall disease, coronary artery disease, hypertensive cardio vascular disease, gastro intestinal disease that can mimic significant cardiac disease and other problems causing chest pain. In our office, if you are 35 years-of -age and have never had an EKG, we perform this service.
In the hypertensive patient, it is imperative that an EKG be done to detect left ventricular hypertrophy. In the patient with a poor familial cardiac history, it is important to look for ST and T wave changes of significance. In the cardiac arrhythmia patient it is vital to know whether the irregularity is ventricular or supra ventricular in origin. The EKG in your office will be, probably, the first step in diagnosis and treatment. Cocaine and other illegal drugs are notorious for inducing cardiomyopathies and sudden death. You need to be on top of this with the use of EKG studies in your office.
The purchase of the latest, advanced feature EKG that will automatically read the graph and give you a diagnosis, can be purchased for less than $2,000. These machines will tell the testing person if the leads are reversed, or if there is insufficient lead-skin contact.
The supplier of the instrument can provide instruction to two of your clinical medical assistants on how to successfully operate the machine and give you an excellent graph to view. It doesn’t take a PH.D or a certified EKG Technician to operate the machine. The reimbursement goes to you and not some other organization. We need to keep our testing in house.
Another excellent cardiac related piece of equipment that can be an excellent addition to your reimbursement income and at the same time, give you and your patient excellent information. This piece of equipment is the Holtor Monitor.
How often have you seen a patient who complains of cardiac arrhythmia, but on repeated consultation, it is undetectable – and how about the patient who says he or she has intermittent chest pain but his T waves look good on EKG and you don’t see much S-T segment change. This is an ideal candidate because you can monitor that heart for 24 hours and pick up ST-T wave segment depression that you could not find on the EKG that records electrical cardio activity at a single instant of time, and not on 24-hour surveillance.
The Holtor Monitor will also tell you about series of Tachycardia. How many instances and duration. This can be helpful in determining if you wish to employ a beta-blocker. If the patient turns up with significant ST segment depression and T wave abnormalities you now that they should be send for a treadmill cardiac stress test or an Adenosine Sestamibi study.
The Holtor Monitor can also tell you when they are having the most extra beats. Is it during the night when we see much psychiatric unrest in the subconscious mind that is transferred to the electrical system of the heart? The other scenario is a night clear of extra-abnormal beats but daytime activity loaded with abnormal beats.
Does the patient really have heart failure or valvular disease? You can answer the question by doing an Echocardiogram in your office as we do. This will give you the answer you need. In another article, we will cover Echo Cardiography that you can do in your office AND 24 hour blood pressure monitoring which you also can do in your office.
In summary, we have reviewed the advantage to your patient and to your income in doing needed studies on your patient with the use of the EKG & the Holtor Monitor. Why let someone else do these studies & collect the fee? If you want to be a good businessman, and at the same time help your patient, do these things in house.