Patients having a heart attack are more likely to survive if they receive angioplasty within 90 minutes. Duke University led a group of hospitals in North Carolina to establish a two-year project that put EKGs in ambulances, gave emergency services personnel the authority to diagnose heart attacks, and tied local hospitals to larger centers. The goal was to get more people life-saving angioplasty sooner. Researchers reported good results last month at the annual meeting of the American Heart Association.

Johnston Memorial Hospital near Raleigh wants to protect its local monopoly even though it does not have an angioplasty unit:

"It will make us into more of a Band-Aid station," the clinical director of its ICU told the Raleigh News & Observer. The paper notes that part of the reason for the controversy is that heart patients are "lucrative."

Bonus note: One of the more notable aspects of the project is the ability of emergency personnel in the field to make diagnoses. This goes back to the issue of licensing and is another example of how restrictive scope of practice rules hurt patient care.