When the cardiologists were at their conference, the sickest heart patients at teaching hospitals died less often
Medicare, 2002 to 2011: during the two national cardiology meetings, high-risk heart failure patients at teaching hospitals had 30-day mortality of 17.5 percent against 24.8 percent. Cardiac arrest, 59.1 against 69.4.
Reasonable evidence with real limitations. how we score evidence
Caveat on this rating: An observational comparison of meeting and nonmeeting dates in Medicare data, not a trial, and the authors say plainly that they cannot establish the mechanism. It cannot say who was actually in the building. The result is confined to high-risk heart failure and cardiac arrest patients at major teaching hospitals; there was no difference for low-risk patients anywhere or for any patient at nonteaching hospitals, and the high-risk heart attack group had the same mortality with fewer stents. It is one study. It is evidence that a particular intensity of care may not help the sickest, not evidence that hospitals or cardiologists are dangerous.
Every year thousands of cardiologists leave for the American Heart Association and American College of Cardiology annual meetings. Four researchers asked what happens to the heart patients admitted while they are away.
Significant findings
They took every Medicare admission for heart attack, heart failure or cardiac arrest from 2002 through 2011 that fell on a meeting date, and compared it with admissions on "identical nonmeeting days in the 3 weeks before and after". That is 19,282 heart failure admissions on meeting days against 114,591 around them, 1,564 cardiac arrests against 9,580, and 8,570 heart attacks against 57,471.
In major teaching hospitals the high-risk patients did better when the specialists were gone. Adjusted 30-day mortality for high-risk heart failure was 17.5 percent on meeting days and 24.8 percent otherwise. For cardiac arrest, 59.1 percent against 69.4 percent. The confidence intervals do not overlap.
The heart attack result is the clue. Among high-risk heart attack patients at teaching hospitals, mortality was the same on meeting days and off (39.2 versus 38.5 percent), but fewer got a stent: 20.8 percent had a percutaneous coronary intervention during meetings against 28.2 percent otherwise. Fewer procedures, same survival. The authors read that as "potential overuse of PCI in this population".
The effect had edges that make sense. "No mortality or utilization differences existed for low-risk patients in teaching hospitals or high- or low-risk patients in nonteaching hospitals." Cardiac deaths did not move during the oncology, gastroenterology or orthopaedics meetings.
What this does not show
The authors gave three explanations and said their data could not tell them apart: the cardiologists who stay home may differ from the ones who go; less intensive care during meetings may, for the sickest, avoid procedures whose harms outweigh their benefits; or fewer elective procedures may free attention for the high-risk patients who remain. Their stated principal limitation was "an inability to establish the mechanism". It is observational, Medicare only, and one study, though the authors note it echoes reports of falling mortality during physician strikes in Israel and elsewhere. It does not say cardiologists kill people. The same paper found no effect at non-teaching hospitals and none for low-risk patients, which is most patients. What it says is that for a small, very sick group, doing less was at least not worse.
Worth asking
Before a procedure: what happens if we wait, and who would be doing this on a day the senior people were away?
Source
Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings — Jena AB, Prasad V, Goldman DP, Romley J (2015)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1001/jamainternmed.2014.6781
DOI: 10.1001/jamainternmed.2014.6781
How this was scored
- Study design
- Cohort study
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- Yes
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 29, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "moderate evidence". Reasonable evidence with real limitations. It scores 67 out of 100 on our published rubric. One caveat travels with that badge: An observational comparison of meeting and nonmeeting dates in Medicare data, not a trial, and the authors say plainly that they cannot establish the mechanism. It cannot say who was actually in the building. The result is confined to high-risk heart failure and cardiac arrest patients at major teaching hospitals; there was no difference for low-risk patients anywhere or for any patient at nonteaching hospitals, and the high-risk heart attack group had the same mortality with fewer stents. It is one study. It is evidence that a particular intensity of care may not help the sickest, not evidence that hospitals or cardiologists are dangerous. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings — Jena AB, Prasad V, Goldman DP, Romley J (2015). Published in: Top-tier peer-reviewed journal. DOI: 10.1001/jamainternmed.2014.6781. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cohort study. Funding: Independently funded. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.