REPLY
What Influences the Frequency of Angiography ... Cardiologists?
Jack V. Tu, MD, PhD;
C. David Naylor, MD, DPhil; and
Edward L. Hannan, PhD
1 August 1997 | Volume 127 Issue 3 | Page 245
IN RESPONSE:
We are grateful to Drs. Page and Bell for their interest in our study. We agree with them that coronary anatomy is not the only consideration in the management of patients with ischemic heart disease and that the number of cardiologists is probably an important determinant of rates of coronary angiography. On the basis of data from various unpublished and published sources [1, 2], we estimate that New York State has approximately two to three times as many cardiologists per capita as Ontario does. However, we caution that directly comparable data based on identical definitions of a cardiologist are currently not available. Further studies of physician supply and the practice styles of cardiologists in the two regions would provide further insight into the differences in rates of coronary angiography and CABG surgery in Ontario and New York State.
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Author and Article Information
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University of Toronto; Toronto Ontario M4N 3M5, Canada
State University of New York Albany, NY 12144
1. Ayanian JZ, Hauptman PJ, Guadagnoli E, Antman EM, Pashos CL, McNeil BJ. Knowledge and practices of generalist and specialist physicians regarding drug therapy for acute myocardial infarction. N Engl J Med. 1994; 331:1136-42.
2. Canadian Medical Directory. Don Mills, ON: Southam Information and Technology Group; 1995.
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