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COMPEL Member Bruce L Feldman, MD – Stress Tests Miss 86%
Only 5% of the population will have a heart attack this year – but that’s one in 20! 90% of heart attacks are preventable, yet 37% of the people who have a heart attack this year are repeaters – they are already being “managed” for coronary artery disease. According to the American College of Cardiology, only 55% of American cardiologists meet the minimum standard of care for the people who have already had a stent or heart attack. No wonder there are so many repeaters.
These numbers are frankly scary. Anyone near or in middle age might be worried if they are being managed by a traditional medical practice. The focus of current healthcare practices, especially in cardiac conditions, is fix it when it occurs. That’s a good idea?
Stress tests are a great example. Regular and nuclear exercise stress tests (the treadmill with or without radioactive “stuff”) measure failure to deliver oxygen in coronary blood vessels by a couple of different mechanisms. It identifies what’s called obstructive coronary artery disease – that means >70% narrowing of the artery with cholesterol plaques. That sounds good, and continues to be the standard of care for early evaluation, except for one thing. 86% of heart attacks occur in people WITHOUT “obstructive” disease (anyone with <70% narrowing)! Below 70% narrowing of the artery, no stress test can identify any abnormality. Yet, this remains the standard evaluation method for coronary artery disease.
I have been involved in all different forms of healthcare delivery. After 20 years of trying to change the way healthcare was delivered from within the system, I decided to try an alternative approach. I left the usual practice model when it became clear that delivering care the way I felt was important for the patient was no longer feasible. I developed a practice designed to be more personal and proactive for those who understood the importance of their health and were willing to do more than talk about it. I knew the point of focus for me would start with vascular protection and prevention – do everything to prevent heart attacks and stroke, and the incidence of cancer, hypertension, diabetes, and inflammatory diseases drop between 50 and 85%. That wouldn’t be bad, right?
Fortunately, I have two advantages over the standard practice. First, I already had a prevention program that had been tested over a 12 year period as providing the 90%+ event avoidance we were looking for (the Bale-Doneen method). Second, in 2001, I became aware of a cardiac testing technology that identified those early, low level plaques that were missed by standard stress tests (Multifunction Cardiogram potentially misses up to 5%, not 86%). I knew that this would become a cornerstone in my evaluation process. Add these distinctive benefits to a model that allows patients to be evaluated where and when is convenient for them, with the time and attention someone important craves, and I created My Personal Doc.
For the last 4 years I have been evaluating patients from all walks of life, but mostly C-suite executives and professionals with very busy lives and very little time or patience for the usual healthcare experience. They have undergone my comprehensive evaluations, and I’m happy to report at least 3 people have had their lives saved by these evaluations. Each of them had been under usual care, but none of them had been found to have cardiac issues. My evaluation revealed a different story, therapy was initiated and they are now safe to live their lives without worry. Numerous others have had their lives changed in dramatically positive ways.
COMPEL Members are offered a 50% discount.
Bruce L Feldman, MD
My Personal Doc
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