The Exchange

Commentary and Observations from
the Medical Front Lines

Daniel Thibodeau, MHP, PA-C

Daniel Thibodeau, MHP, PA-C

  • Associate Professor
  • Physician Assistant Program
  • Eastern Virginia Medical School
  • Norfolk, Virginia
  • Physician Assistant
  • Cardiovascular Specialists, Inc.
  • Suffolk, Virginia
New and First Ever Chest Pain Guidelines Released

New and First Ever Chest Pain Guidelines Released

There's exciting news in the world of cardiovascular medicine! A multi-joint medical society (2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR) has published the "Guideline for the Evaluation and Diagnosis of Chest Pain." The announcement was released on October 28, 2021—shedding new light to directly address the needs of evaluation and treatment of patients who present with chest pain.

Based on countless studies, data, and input from numerous medical societies, the guideline will help all pra... Continue Reading

Filed under: Cardiometabolic

Wearable Technology Is Helpful, But Not Perfect

Wearable Technology Is Helpful, But Not Perfect

We have all seen this scenario before: A patient comes in and tells you that they've seen a concerning reading on their smartphone or smartwatch regarding so... Continue Reading

Filed under: Miscellaneous

Innovation in a Post-Pandemic World: What We Have Taught Ourselves

Innovation in a Post-Pandemic World: What We Have Taught Ourselves

So much has changed since January of this year. By now, most states are working to get back to some sense of normalcy while hospitals and healthcare systems... Continue Reading

Filed under: Health Policy and Trends, Miscellaneous, Practice Management/Career

Get Your Patients With Heart Failure to Rehab!

Get Your Patients With Heart Failure to Rehab!

Treatment for heart failure (HF) is established, but always growing. The profiles of patients who get HF vary, but one thing that is consistent is that the d... Continue Reading

Filed under: Cardiometabolic

The PA Profession Wants to Change Its Name

The PA Profession Wants to Change Its Name

In May 2021, on a vote of 198 for and 68 against, the American Academy of Physician Assistants (AAPA) House of Delegates (HOD) passed a resolution to change... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

Kidney Function and Hypertension in Heart Failure: They Go Hand in Hand

Kidney Function and Hypertension in Heart Failure: They Go Hand in Hand

We all have been educated numerous times about the need to control hypertension in all patients with that diagnosis. This is particularly in patients with he... Continue Reading

Filed under: Cardiometabolic

Sacubitril/Valsartan and Heart Failure: Improvement of Health Status

Sacubitril/Valsartan and Heart Failure: Improvement of Health Status

For the last few years, we have seen a number of continuing education sessions and articles related to advances in the treatment of heart failure (HF). One o... Continue Reading

Filed under: Cardiometabolic

Major Stroke Prevention: A New Use for a Well-Known Medication

Major Stroke Prevention: A New Use for a Well-Known Medication

Strokes can have a devastating impact on the long-term survival and function of our patients. Therapies to treat them have been well established, and there h... Continue Reading

Filed under: Cardiometabolic

It’s Time to Talk About Vaccinations

It’s Time to Talk About Vaccinations

As we make our way through the immunization phase of the COVID pandemic, I cannot help but think about the many Americans who have not received their vaccine... Continue Reading

Filed under: Preventive Medicine, Public Health

Out of the Woods? Considerations and Follow-up for When COVID Goes Away

Out of the Woods? Considerations and Follow-up for When COVID Goes Away

As we approach the 1-year mark of COVID becoming globally prominent, we are, unfortunately, also getting into the next surge of cases. At some point, this de... Continue Reading

Filed under: Cardiometabolic, Infectious Diseases, Public Health

Sports Physicals in a Post-COVID World

Sports Physicals in a Post-COVID World

Athletes want to compete and give their best to their sport at every age. COVID has changed this in ways that no one was prepared to imagine. Now that we may... Continue Reading

How COVID-19 is Impacting the PA and NP Professions

How COVID-19 is Impacting the PA and NP Professions

Have you or one of your colleagues had an impactful change to your career or current job because of COVID-19? Apparently, it is happening to more than we kno... Continue Reading

Filed under: Practice Management/Career

Brain Natriuretic Peptide in Clinical Trials: Why This Matters for Practitioners

Brain Natriuretic Peptide in Clinical Trials: Why This Matters for Practitioners

As we look to improve the treatment and quality of life of our patients with heart failure, we often use relevant labs to help us determine the extent of the... Continue Reading

Filed under: Cardiometabolic

The Cardiovascular Impact of COVID-19

The Cardiovascular Impact of COVID-19

On Wednesday, March 18th, the American College of Cardiology held a we... Continue Reading

Filed under: Cardiometabolic, Infectious Diseases

COVID-19 and the Curve

COVID-19 and the Curve

As of the writing of this post, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been confirm... Continue Reading

Filed under: Health Policy and Trends, Infectious Diseases, Public Health

New Cholesterol Drug Soon to Make It to the United States

New Cholesterol Drug Soon to Make It to the United States

Normally, when a new drug hits the United States market you will see a small market spike of curiosity. As we continually seek ways to improve the health and... Continue Reading

Filed under: Cardiometabolic, Preventive Medicine

Connecting with our Patients: What Matters Most

Connecting with our Patients: What Matters Most

We all have busy clinical days, but it is still important to make a personal connection with our patients. I think it is fair to say that one of the main rea... Continue Reading

Filed under: NPs & PAs, Practice Management/Career

The Continued Study of an Old Drug: Aspirin

The Continued Study of an Old Drug: Aspirin

It started out by taking extract from the willow tree and using it as a medicinal agent well over 150 years ago. Today, this extract, now transformed into ac... Continue Reading

Filed under: Cardiometabolic, Miscellaneous

Do Physician Assistants and Nurse Practitioners Know What They Bill?

Do Physician Assistants and Nurse Practitioners Know What They Bill?

As a practicing clinician, do you know what you bill for? Do you know how much is asked for in the bills that are sent to your patients? The truth of the mat... Continue Reading

Filed under: Health Policy and Trends, NPs & PAs, Practice Management/Career

The Real Risks of Vaping: All Clinicians Must Ask the Right Questions and Warn Patients

The Real Risks of Vaping: All Clinicians Must Ask the Right Questions and Warn Patients

Most of us have seen the recent news regarding the alarming rise of respiratory-related illnesses and deaths due to e-cigarettes, or vaping. For those not aw... Continue Reading

Filed under: Health Policy and Trends, Substance Abuse

New Statement Related to Hospitalized Heart Failure Patients

New Statement Related to Hospitalized Heart Failure Patients

The American College of Cardiology has issued a new Expert Consensus Decision Pathway for the management of patients with heart failure. This newly released... Continue Reading

Filed under: Cardiometabolic, Health Policy and Trends, NPs & PAs

Palliative Care for Heart Failure: An Early Discussion Would Benefit Patients

Palliative Care for Heart Failure: An Early Discussion Would Benefit Patients

As clinicians, we care for patients over the course of a lifetime and often face the reality of patients who are challenged with end-of-life (EOL) decision m... Continue Reading

Filed under: Cardiometabolic

No Difference in Outcomes and Treatment No Matter the Etiology—Analysis from PARADIGM-HF Trial

No Difference in Outcomes and Treatment No Matter the Etiology—Analysis from PARADIGM-HF Trial

Heart failure (HF) is a complicated disease state with multiple, staged therapies. Over the last couple of years, addition of a sacubitril/valsartan combinat... Continue Reading

Filed under: Cardiometabolic

CHAMPS HF - We All Can do Better!

CHAMPS HF - We All Can do Better!

Many of us manage patients with heart failure with a reduced ejection fraction, or HFrEF. The management of this patient population is complex, and most pati... Continue Reading

Filed under: Cardiometabolic, Preventive Medicine

Consider Deprescribing in Our Older Adults

Consider Deprescribing in Our Older Adults

We all have patients in our practices who are older and on numerous medications. They are stabilizing their problems but are faced with the reality of nearin... Continue Reading

Filed under: Health Policy and Trends, Preventive Medicine, Public Health

Measles Outbreak – A Public Health Concern

Measles Outbreak – A Public Health Concern

The modern world was turned upside down in 1997 when researcher Andrew Wakefield suggested there was a direct correlation between the MMR (measles/mumps/rube... Continue Reading

Filed under: Infectious Diseases, Preventive Medicine, Public Health

Cardiovascular Health Promotion—A Must Read for PAs and NPs

Cardiovascular Health Promotion—A Must Read for PAs and NPs

PAs and NPs are encouraged to read a recent issue of the Journal of the American College of Cardiology on cardiovascular health and promotion. This... Continue Reading

Filed under: Cardiometabolic, Preventive Medicine

Caution: Population Is Having More Heart Attacks at a Younger Age

Caution: Population Is Having More Heart Attacks at a Younger Age

This March, the American College of Cardiology will meet in New Orleans for their annual scientific assembly, and one major discussion will be the growing pe... Continue Reading

Filed under: Cardiometabolic

Patient Autonomy: Keeping Our Patients’ Self-Determination Preserved

Patient Autonomy: Keeping Our Patients’ Self-Determination Preserved

If you’ve practiced in medicine for at least 20 years, you may remember the case of Terri Schiavo, a woman in her 20s who was in a coma for more than a dec... Continue Reading

Filed under: Health Policy and Trends, Public Health

Transcatheter Aortic Valve Replacement: What's In It for Your Patient?

Transcatheter Aortic Valve Replacement: What's In It for Your Patient?

Over the last few years more and more development and technology has been devoted to transcatheter aortic valve replacement, or TAVR. This procedure, develop... Continue Reading

States' Involvement With Medicaid Expansion

States' Involvement With Medicaid Expansion

For a little over 50 years, Medicaid has provided healthcare as a stopgap to millions of people. With passage of the Affordable Care Act (ACA), few states ut... Continue Reading

Filed under: Health Policy and Trends, Public Health

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