Fear Is No Reason to Dismiss a Proven Therapy

"Getting Pumped" [May 31] disparaged a clinically proven and overwhelmingly successful medical treatment for heart disease. The utterly imbalanced manner in which Enhanced External Counterpulsation (EECP) was discussed is cause for grave concern; it likely dissuaded seriously ill patients from exploring it as a treatment option and enjoying its significant documented benefits.

By attempting to answer the question "Why does this therapy earn disdain from cardiologists?" the article offered an opportunity to shatter some widely held myths about heart disease and celebrate a noninvasive, safe and effective treatment that has not only improved the lives of millions of heart disease sufferers around the world but is also supported by a tremendous volume of clinical research and is covered by Medicare and private insurers. The writer could have used science to easily refute every possible answer from cardiologists and concluded, simply, that while EECP has garnered disdain, it has not legitimately earned it. There is no clinical basis for discrediting the treatment. Instead, though, the factually incorrect and fear-based claims of an invasive cardiologist who does not accept scientific truth went virtually unchallenged. What a disservice to readers.

Debra Braverman, MD

Founder and Medical Director,

VitalHeart EECP Clinics

University of Pennsylvania

School of Medicine

Philadelphia

You Can't Just Phone In Good Medicine

TelaDoc founder Michael Gorton's comment in "Dialing for Doctors" [The System, May 24] that the telephone medical consultation provider must be careful in "some" states to establish a physician-patient relationship through a physical examination is inaccurate. All states consider a physical exam, which is crucial for correct diagnosis and treatment, as foundational to meeting the accepted standard of care.

Telephone consultations have a place in the practice of medicine, but only when they're used to supplement, and not circumvent, the physician-patient relationship established by a physical examination.

James N. Thompson, MD

President/CEO

Federation of State Medical Boards

Dallas

Emergency Room Observations

I was an ER boarder ["Holdover in the ER," My Time, May 31] at age 69 after having been in a traffic accident. I sustained multiple injuries, including six broken bones. After numerous X-rays and other tests, I was placed on a gurney in the cast room for the night until a bed was available on a temporary unit for observation. I never could figure out who was observing me, either in the ER or the new unit, since staffing was minimal. I happen to be a retired RN myself, and I know how things are supposed to be, and our hospitals these days cannot, or do not, measure up.

Carolyn J. Mattaino

Alexandria