Terrible doctor and office staff. Coumadin person is not even a nurse who gives advice based on a hunch. My mother saw this md 3 times for same issue. I needed to ask this doctor if an echo should be done. She had not had one in 4 years. After edema ascites and jvd he agreed and asked my opinion of which diuretic she should take. Inadequate care which in my opinion is dangerous. My mother had to switch Mds after her echo which I had to hound the md for 2 weeks . He had his Coumadin person tell me its ok. Far from ok...we are not looking at a second cardiac surgery. Office staff unprofessional. If you need anything sent, reports etc, you need to pick up yourself as after multiple requests never send reports to referring doctors. Absolutely horrendous care.