Hi All,

Our Physiotherapy practice is seeking to start outpatient cardiac rehab services for patients under EPC/Drs referral. I am rather concerned about doing this and would welcome any advice on:

1. If this is a good idea for a small private practice (2 PTs) with a small gym to be considering
2. Risk stratification and assessment procedures
3. Emergency protocols and equipment

I have talked to an experienced contact I have in this area who was very cautious and advised that the benefits to the practice are not necessarily worth the risks.

At the moment, the other PT and myself have agreed that it might be doable if we have strong assessment and stratification procedures- probably taking post CABG pts and no heart failure, unstable angina etc. I am not sure about my skill level in doing this (even though I am an Ex Phys as well as PT) because of my colleague's comments (such as that it took their team a year to develop stringent protocols).

My physio partner is really pushing for this to go ahead as they want to be able to offer this service to Drs and community as there isn't much in our area. They also think that my colleague is overcautious and trying to scare us off his business area. So far I have been trying to stop this going ahead (my PT partner has also never done anything like this before). Am I being reasonable or is that too cautious? Can cardiac rehab be carried out safely and well in the community? Is there any further training that we can do?

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