If you were to receive a communication from the Executive Committee about a practice issue of yours that it feels could have clinical repercussions, or to justify your complication rate, how would you address the members when meeting with them?

"Cardiac patients are never good candidates for anything, really, so a morbidity or mortality rate considered inappropriate in other specialties is a reality that we in cardiovascular medicine must live with as a natural part of its less forgiving survival rate. If their concern were over such a complication rate, prior to my meeting I would research the literature about the most recent data for a basis of comparison. My specialty allows for some latitude, but if in researching this I discover a serious problem that justifies their concern, I would report that I am cognizant of it and am examining my patient cases to identify any problem areas so that I could learn and remodel my protocols. If I found that I could defend what I'm doing from my research, I would make my case but tell them I would abide by their decision on this."