As healthcare financing becomes more of a political issue as we approach the 2012 presidential elections, cardiologists and specialists such as interventionalists (including electrophysiologists) have to "Get with the Guidelines." The ACC/AHA/HRS have published scientific statements for almost every test and procedure. These guidelines drive quality and, in particular, focused areas including pneumonia, myocardial infarction, and congestive heart failure. Performance in these areas will also have an effect on physician reimbursement.

Other areas of medicine, especially expensive therapies like stents and implantable defibrillators, will be areas of heightened attention. Following the guidelines for your practice and enhancing your medical documentation can be helpful as we move forward toward universal health care. My advice to you is to make every effort to document your rationale for prescribing a particular test or therapy.

As always, all the best and happy documenting!

Todd J. Cohen, MD, FACC, FHRS is the Emeritus Editor-in-Chief of EP Lab Digest, author of Practical Electrophysiology, and author of the recently published Johns Hopkins Health Book entitled "A Patient's Guide to Heart Rhythm Problems."