Start Here: CardiAdvocate.com
Note: this content been moved to the the article: What is CardioAdvocate?
For Patients:
Be Your Own Advocate
We believe now more than ever before it is imperative for patients to be their own advocate. We have observed that patients feel this way too. How do we know this? Because patients are telling us. It’s becoming a common “Chief Complaint” in the cardiometabolic clinic.
Doctor: “Why are you here?”
Patient: “I want to be my own advocate.”
With a few swipes of the fingers, the push towards full transparency and complete access to their medical records, EHRs now provide patients with more detailed information about their personal health status than ever before. But despite this information being literally right at their fingertips, a significant gap exists between information and action.
Patients invariably do not understand the information they are receiving. Most patients do not possess the training, nor do they have the time to look up the meaning to every piece of data they are bombarded with. Even if they do, it is very difficult for them to appreciate the clinical significance. Many simply put it aside and wait for a provider or nurse to explain it. Others become confused, anxious or look to “Dr. Interwebs” to help them interpret.
For the Clinician:
Be an Advocate for Your Patient
As preventive cardiometabolic consultants we understand how challenging it can be for the average provider to find cardiometabolic specialists in their community. When they do, they are often booked for months. While the Cardiometabolic specialty field is growing, there are simply not enough to meet the growing demand.
As a result patients become frustrated. Their PCP’s, doing the best they can, often feel the brunt of this frustration. This then leads to “provider burnout,” a growing epidemic in medicine, driving more and more providers to quit the field of medicine altogether. Believe it or not, most providers went into medicine to make a difference. No, that’s not a sappy cliche. It’s true. Yes, medicine can be a rewarding career and provide financial stability, but most of us didn’t go into medicine to get “rich.” For a growing number of us, when the added administrative work and stress encountered in the office does not seem to be rewarded with better care for our patients, it can create a sense of futility and apathy. We’re all human.
We believe providers feel better when they are delivering great care and their patients are pleased with this care. This is why we wish to provide not only you, but your patients with the resources of a cardiometabolic specialist. We aim to build an army of such specialists. But it begins with you.
Our Pledge:
CardioAdvocate.com Advocates For You
We advocate for better care, involving the patient and their care team in a way that we can change the way medicine is delivered. The patient, as the captain of their team, should have easy access to “tip of the spear” medical information that is publicly available, but digested and explained by cardiometabolic specialists and experts, directing them towards established treatment pathways and facilitating well informed expert-level discussions with their care team members.
Flying Under the Radar
Why do these cases go undertreated?
When it comes to cardiometabolic diseases, no single medical discipline “owns'' it. Unfortunately, in many healthcare systems and communities nobody WANTS to own it. So nobody does.
It might come as a surprise, but even specialists such as cardiologists frequently ARE NOT comfortable addressing and treating cardiometabolic diseases. Some groups are lucky and one of their partners may have a keen interest in prevention, lipids or cardiometabolic diseases, but many, if not most, do not.
The cardiometabolic patient, therefore goes undetected and/or undertreated.
A checklist of targeted recommendations based on published guidelines
- Review your medical records
- “My Chart” and others EHR tools have made this much easier
- CMS has continually pushed for EHR “transparency”, allowing patients full access to their records and results
- But they forgot to give patients the instruction manual and a medical degree
- See our list of Cardiometabolic Diseases
- Use our CardiAdvocate Calculator to search for additional cardiometabolic diseases you may not be unaware of
- Visit our “stories” which highlight unique aspects of certain cardiometabolic “phenotypes” or patterns within particular diseases or syndromes
- These pages will be updated and modified as new information becomes available and additional authors contribute
- Check back regularly as the site will periodically change content
- Use our CardiAwareness Tool page to locate:
- Cardiometabolic specialists in your area
- Cardiometabolic advocacy groups, foundations, medical groups
Going into detail on the evidence behind the recommendations and history of treatment for this phenotype.
Let’s face it, there are many gaps in care and an overall lack of continuity when it comes to the cardiometabolic patient. As medicine becomes more specialized, various camps and silos are forged. In many ways this can be a good thing. For instance, it allows very specialized medical scientists and clinicians to come together at scientific meetings, publish their work in very specific journals and really push innovation and scientific discovery related to that very specific field. But it can leave the overall care of the patient fragmented.
But if a cardiometabolic specialist wants to get the latest information at a scientific meeting, they often need to go to the SCCT meeting to hear about Calcium Scores (Annual Scientific Meetings - Society of Cardiovascular Computed Tomography), the NLA meeting to hear about lipids (Scientific Sessions - Home | National Lipid Association Online), the ADA meeting to hear about diabetes 84th Scientific Sessions | American Diabetes Association, The Obesity Society Meeting to learn about obesity (ObesityWeek® - The Obesity Society) and so on.
The word "cardiometabolic” certainly sounds like something in the wheelhouse of a “cardiologist" and many patients are under the impression that ALL cardiologists are particularly knowledgeable about cardiometabolic diseases. Unfortunately, that is not always the case. Cardiologists receive training in “Cardiovascular Medicine” and are particularly well versed in entities like coronary artery disease, heart failure, valvular disease and heart rhythm disorders. Obviously there are sub and sub-sub specialists within this very broad field. Most general cardiologists have knowledge of the more popular guidelines (usually ACC/AHA) and therapies for cardiometabolic ailments like hypertension and hypercholesterolemia, but they are not often experts. They are also not likely to address obesity, diabetes, prediabetes, fatty liver disease, chronic kidney disease and so on.
Using lipids as an example, they will typically prescribe lipid lowering therapies (particularly statins and sometimes ezetimibe). But like many other providers, they have been just as guilty of undertreating lipids in high risk patients and invariably missing the “atherogenic triad” patient, for instance. Few cardiologists understand what non-HDL-C is. Even fewer have heard of or ever ordered an Apo B level, though that’s changing with the help of people like you, armed with material from the likes of Dr. Tom Dayspring (Thomas Dayspring (@Drlipid) / X) and Dr. Peter Attia (The Peter Attia Drive Podcast) - two experts who have greatly popularized awareness of lipids and ApoB in particular. Most cardiologists know they need to hone in on LDL-C, but rarely do they know when not to, such as when TG are significantly elevated, or when LDL-C is really low. Without that knowledge and awareness, they will miss the “atherogenic triad” every time. They just don’t understand. It’s not entirely their fault however, because there is no formal training on lipids in medical school, residency and sadly, cardiology fellowship. While endocrinologists do receive formal training on lipids, not all of them care to specialize in this or make it much of their practice.
Evidence Based Guidance:
We aim to continually update these “stories” and topics with the best available evidence and expert guidance. We seek to inform on all levels of evidence and will make efforts to appropriately weigh the level and quality of evidence.
Misinformation will not be propagated on this site.
Room for Improvement:
This site is not perfect. We are not perfect. We are constantly evolving. This site is designed to be updated and improved upon.
We have busy day jobs and may have missed something or made a mistake. Please let us know.
Please provide feedback:
- What do you like?
- What don’t you like?
- Did we make a factual error or mistake?
- What else would you like to see?
Please contact us if interested in becoming a CardiAwarness.com Advocate by contributing as an author.
Disclaimer:
The information on this site is provided as a resource to facilitate communication with those seeking care and those delivering care. It is in no way intended as individual medical advice. Please consult with your doctor and care team for all medical decision making.