2010 has seen the potential stalemate for President Obama's health care initiative with Republican Scott Brown elected to replace Ted Kennedy's seat in the Senate in the state of Massachusetts. The Republicans have cornered enough votes to filibuster the Democratic healthcare vote. This has placed the current Obama health care initiative in limbo.

What does that mean to us in the field of electrophysiology?

Many questions remain unanswered. Health care reform is still a priority for the Obama Administration. Changes are likely to evolve over the next year and perhaps some compromised bill may occur as a bipartisan effort. Electrophysiology programs will need to be mean and lean. That means they will need to practice good medicine but be careful of the costs of their disposable products as well as their capital budgets.

The cost of implants also needs to be considered. There is a wide variety of prices amongst the different vendors as well as different tiers of products. There are low-end pacemakers as well as high-end pacemakers with all the bells and whistles. The same goes for implantable defibrillators and their biventricular counterparts.

In summary, electrophysiologists need to be ahead of the game. They must think, be light on their feet, and plan for the future. They need to work hard to contain the costs of their procedures. This type of ahead of the curve thinking will hopefully be rewarded with a successful practice, program, and/or laboratory.

Todd J. Cohen, MD is the Emeritus Editor In-Chief of EP Lab Digest. He serves as Director of Electrophysiology, Director of the Pacemaker-Arrhythmia Center, and Director of Advanced EP Technology and Innovations at Winthrop University Hospital in Mineola, New York. He is also an Associate Professor of Medicine at the State University of New York in Stony Brook. Look for his new blog next month on the Journal of Invasive Cardiology website (www.invasivecardiology.com).