Saturday, June 28, 2008


I spend the larger part of last week ( Tuesday-Friday ) in Bangkok, attending and helping to moderate the 4th Asian Interventional Cardiovascular Therapeutics. This is basically a meeting organised by interventionist to teach interventional cardiology to interventionist and maybe also paramedics. It is costly, and funded by industry, who in many ways are forced ( arm-twisted ) to support and sponsor, because their big clients demands it of them. I dare say that this three day meeting in Bangkok would have cost about USD1.5 - 2.0 million. Cases done at institutions like hospitals in Bangkok and China, are transmitted across the city and the ocean, to the Central Convention Center ( where we are gathered ). The attendance was relatively poor and consisted of interventionist from across Asia and many paramedics. Cases done are discussed in a hurry and lectures are basically regurgitations from American and European meeting. Imagine if in Asia, 10 such courses are held a year. What is the cost to the industry, USD 15-20 million. I have always asked the many friends, who invite me and whom I meet often at these meetings, what is the relevance of these meetings and how do live demo interventional cardiovascular courses ever end, or dont they. We must not forget, that the six-figure money that we obtain from device sponsors will eventually have to go back to cost of products ( there is no free lunch ). When Dr A Gruentzig first discovered coronary intervention, he held interventional courses, as a means of disseminating the techniques and his experience quickly to the people who wish to learn. I for one benefitted from these courses in 1988. Twenty years later, and after 31 years of angioplasty, when millions of angioplasties are done worldwide, and millions of coronary stents are implanted world wide, is there still a need for live demo courses. Anyone who wish to learn and do angioplasties, could easily join an active center, and be proctered for 6 months ar a year and become good at it. What is most worrying are those who join a live demo course for 3 days and then return home, thinking that he or she is an expert and start to try out on real patients. Well this is not a popular song to sign, but it has always been my stand. I think that many dislike me for it, but because, I am senior ( read old ) enough, I still get invited. I have concluded that the aims of live demo courses in the year 2,ooo is not so much for teaching, but for rubbing shoulders and also for industry to show case their new products for the region and also to give their key doctors a paid vocation. Let us face it, the academic content is minimal and the commaradie is maximal. For all the "you scratch my back-I scratch yours next time ", the cost of devices goes up and ultimately, the consumer pays for it. Is it worth it, you decide. As for me, if there is any cardiologist out there who wish to learn angioplasty to help patients, please do contact me and I will help you get into a proper teaching center, so that you can be properly trained, at no extra cost and harm to patients.

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