Dr. R. deGoma is a board-certified cardiologist, internist and clinical lipidologist. After practicing traditional clinical and non-invasive cardiology for over two decades, he decided in 2001 to push the boundaries of cardiac care to a higher level by stopping heart attacks before they happen instead of just treating them when they occur - an uncommon approach even now. It was a challenging journey because preventive cardiology was new and only a few had done it successfully.

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There are several milestones in his journey to prevention which is worth sharing to encourage other physicians to incorporate heart attack prevention in their practice.

 

•  2003: Developed a numerically goal-oriented clinical management system and proved that while others had failed, it was possible to close the wide treatment gap uncovered by the L-TAP study in 2001. In the L-TAP study, only 18% of patients with established coronary artery disease were treated to the recommended LDL-cholesterol goal of less than 100 mg/dL while 82% were either treated inadequately or not treated at all.

• 2006: Published his first performance data with 85% of his high-risk patients treated to goal. Heart attacks and the need for stents and heart bypass surgery started to decline. 

• 2006: Became among the first batch - a small group of physicians in the US, who became board-certified in Clinical Lipidology (Cholesterol Specialist). This specialty is important since optimal cholesterol management is the foundation of aggressive prevention in patients with silent coronary plaques who have yet to experience a heart attack and those who already had a heart attack, stent, and heart bypass.

• 2010: Cost savings. MEDICARE data showed that compared to the average cardiologists nationwide, Dr. R. deGoma saved MEDICARE $8,790 per beneficiary with a diagnosis of Coronary Artery Disease and $6,490 per beneficiary with a diagnosis of diabetes (a high-risk condition for heart attack). 

• 2016: Published his second performance data showing that after a decade, it is possible to not only maintain (89% reached LDL-cholesterol less than 100 mg/dL) but even improve treatment performance (51% were less than 70 mg/dL) - proving that turning off the faucet instead of just mopping the floor was achievable. 

•  Awarded Top Doc by New Jersey Monthly magazine in 2018, 2019, 2020, 2021, and 2022.

• 2022: During the COVID-19 pandemic that took the lives of more than 1 million Americans, Dr. R. deGoma embarked on a project to save lives by launching the Save Your Heart Campaign by shining a light on the over 600,000 largely preventable first heart attacks that victimize Americans every year. For most patients, the first time they become aware that they have a serious heart problem is when they are already having a heart attack. Both the patients and their physicians are totally unaware until that moment. Earlier coronary plaque detection by coronary calcium scoring test is the first step but MEDICARE and other insurance, are still refusing to cover this proven test endorsed by the American Heart Association and the American College of Cardiology. 

• 2022: Began the Heart Attack Prevention Channel on YouTube to educate patients and their healthcare providers that heart attacks are largely preventable and also to expose medical misinformation and disinformation surrounding heart attack prevention and cholesterol treatment.

• Spring 2023: Launch a Corporate Program. Employers, especially those self-insured, have a lot to gain financially by eliminating heart attacks (and strokes) among their vulnerable employees - those with undiagnosed and therefore untreated silent coronary plaques. In addition to premature death, disability, and increased healthcare cost, personal bankruptcy is not always appreciated as a complication of a premature heart attack. These threats are real and avoidable. Employers must demand coronary calcium scoring for their older adult employees at no extra cost. It is spending $100 to save $50,000 to $100,000 later for a heart attack and stents or heart bypass surgery that could have been avoided. In the last three decades, our health-care industry has transformed itself into a disease-care industry where the main focus is profit, not patients. Chronic diseases generate more revenues and in the current business model, there is no compelling reason to prevent most heart attacks and strokes. Employers can help begin to change that model by providing coverage for coronary calcium scoring which is like "mammography for the heart". This is NOT a yearly test - only once or twice in a lifetime in most cases.

• The COVID-19 pandemic killed over 1 million Americans causing the biggest drop in life expectancy in the US in 100 years. There is an epidemic in the US that is largely ignored - every year over 600,000 Americans fall victim to a largely preventable first heart attack. That's over 3 million Americans in 5 years. In 2015 the president of the American College of Cardiology - Dr. Kim Willams Sr. said: "It is time to turn off the faucet instead of just mopping the floor." The time is right.