Letters to the Editor
Letter to the Editor
November 2020
I read with interest the group discussion regarding the role of community hospitals in the performance of patent foramen ovale (PFO) closure (Conversations in Cardiology: How Should Complex Procedures in Small Community Hospitals Be Managed?).1 I very much appreciated the fact that the Conversation was held at all, the thoughtful comments of Dr. Kern (who put himself in the shoes of the community hospital interventionalist), and especially the inclusion of Dr. Butman, as someone who actually comes from that world. This is a very relevant topic that is almost never addressed, yet has significant implications. Physicians working in community hospitals represent a true “silent majority” — who collectively care for more patients than those in large and/or academic medical centers (documented, for example, for valve surgeries), yet who are almost never represented on guideline-writing committees, editorial boards, society documents, etc.
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