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Heart Institute of Wisconsin
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"We are in the business of saving lives,
we practice state-of-the-art cardiovascular medicine in a caring practice setting." - Dr. Shammo
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A Team Effort

After seven years in independent practice in Milwaukee, Dr. Shammo admits that the path he has chosen is not an easy one. Maintaining a viable practice in an age of rising practice costs and declining reimbursements is difficult for any physician, let alone an independent practitioner.
But Dr. Shammo considers it the price of freedom and self-satisfaction and emphasizes that he is far from alone in his efforts. “It is very much a team effort and the patient bears significant responsibility. It is ultimately the patient’s life, the patient’s body. Spouses and children also play an important role. And we partner with other physicians to ensure continuity of care. The primary care physician, cardiovascular specialists, diabetes specialists, dietitians and exercise physiologists all play a part. It is definitely not a one-man job.”
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Dr. Shammo is committed to doing his part to keep health care costs in check. His emphasis on prevention is part of that. So is a willingness to go the extra mile to help the indigent, uninsured and underinsured. Ultimately, he says, the hours of staff time spent on the phone and on paperwork to ensure that patients receive maximum benefits is preferable to the costs of ignoring their plight. “It is more cost effective in the long run to help on this end because, otherwise, they will end up getting sick and costing the health care system even more.”
“In the final analysis, medicine and cardiology will always be personal interactions between a doctor and a patient. The lifelong doctor-patient relationship, the trust that develops, the evidence-based treatments, timely interventions and appropriate utilization of health care resources will still be the most important factors in the perception of the quality of the care patients receive.”
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Caring for Life

Dr. Shammo’s interventional practice remains strong, keeping him and his small staff very busy. He typically sees new and established patients in his Milwaukee clinic and satellite clinic in Watertown. In most cases, it is the start of a long-term relationship.
“The vast majority of patients I intervene on become our cardiac patients for life. We believe in continuity of care, rather than episodic care where you have a procedure, and then you do not see the cardiologist again until you have another problem. We understand that heart disease does not go away. We are not going away either. We are here in the community to provide longitudinal care for these patients. They know they can call on us for cardiac health.”
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Shammo describes his small, friendly practice as a “counterrevolution,” a more personal alternative to larger group practices. While he respects his colleagues in group practice, Shammo believes there is still a place for what he calls the “personal touch” in cardiology.
“We may like the glitzy ads about magical cures and machines that can do miracles, but most patients are just looking for comfort, reassurance, support and someone who cares. If you practice state-of-the-art cardiovascular medicine in a warm and caring practice setting, your product can be superb and your business can also be highly successful.”
Shammo says warmth and caring environment are not only good for the body but also vital for the psychological well-being of cardiac patients, many of whom are scared of the future. Dr. Shammo and his staff offer them hope and treat them with respect. ” We want them to feel assured that we will work hard to improve their quality of life. We hope that it will be a quality, long life. But, if their life expectancy is short we are committed to making sure their suffering is minimal and that they are treated with respect and dignity.”
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Prevention vs. Intervention

Board certification for the subspecialty of interventional cardiology was introduced in 1999. Physicians who have completed their three-year cardiology fellowship must take additional training in cardiac interventions such as stent placement, angioplasty, pacemaker placement, etc.
Although he is skilled in these techniques, Dr. Shammo says he prefers not to have to use them at all.
“I think that what distinguishes my practice is our great emphasis on prevention,” he explains. “Even though I am busy interventionalist, in my mind the best practice will always be prevention, rather than intervention.” On that note, Dr. Shammo aggressively battles heart disease risk factors such as high cholesterol and high blood pressure with his patients and has been proactive in initiating cardiac rehabilitation programs that stress the importance of exercise and weight loss with the aim of giving patients not only longer, but better lives. And the message is timely. As baby boomers age, Shammo suggests that continued treatment of the symptoms of heart disease alone will not be practical, cost effective or even medically prudent.
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Successful prevention hinges on another important factor. “We also pride ourselves on early detection,” emphasizes Shammo. “We believe that early detection of heart disease, just like early detection of cancer, is paramount to changing the prognosis and outcome for many of our patients. We work very hard in that regard.”
The evolution of cardiology as a specialty, as well as the emerging technologies that support it, is helping to make Shammo’s mission easier. New imaging capabilities, including high-end CT angiography, MRI and intravascular ultrasound, enable cardiologist to evaluate both the anatomy and the function of the heart like never before.
“Thanks to these kinds of technologies, we can now diagnose heart disease before any damage is done. In our office, we perform echocardiograms  as well as nuclear stress testing procedures which help us to clearly understand the anatomy and physiology of the heart.”
Dr. Shammo predicts noninvasive diagnostic procedures will eventually replace invasive testing as the modality of choice for the diagnosis of heart disease, allowing for early, intense preventive efforts. As researchers map the human genome, identify new risk factors for heart disease such as inflammation and devise methods for repairing damaged tissue with stem cells, Dr. Shammo is hopeful that reversal may one day be a real possibility.
“Early evidence suggests that intensive therapy, in some patients, there is hope that the process can be slowed, halted or even slightly reversed. Complete reversal is still not here, but it may come.”
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