Friday, May 8, 2009


Swam in the outdoor 25 meter pool at Life Time Fitness because I had a 7 am meeting at the hospital. Water temp was good, and I had my own (7 foot) lane.

400 swim , 200 kick, 400 pull
Main set: "Double up" 4 x through--50/100/200 on 1:00 base per 50
First round went :42, 1:25, 2:50 (nice and easy),
Second round :38, 1:18, 2:40,
Third round :37, 1:15, 2:35,
Fourth round :36, 1:15, 2:30 (my fastest 200m free in practice)
100 easy

We met with hospital administrators from St. David's (our primary hospital in Round Rock) and Scott and White (a competing health care system with its own insurance plan and a closed medical staff). For over a year the Scott and White facility has been performing coronary interventions without an on site cardiac surgery program. Most of these have been elective daytime cases since the hospital does not provide 24/7 coverage. Consequently, STEMIs are diverted to St. David's at which point we are called in on nights, holidays, and weekends to perform emergent interventions (caths and stents) on their patients. After discharge, however, the patients are then obligated to follow up with a Scott and White physician locally or in Temple. Until recently the standard of care was to perform these procedures only at facilities with a cardiac surgery program; the American College of Cardiology is reconsidering this ostensibly because of the need to offer PCI (percutaneous coronary intervention--ie stents) to STEMI patients in rural areas served only by community hospitals.  Interestingly, one of the leaders in this movement is in fact a Scott and White cardiologist. 

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