- Joined
- Jul 21, 2004
- Messages
- 141
- Reaction score
- 0
What's the Real Deal? Is it really gonna die? What have you heard from Attendings (Cardiologists and CT Surgeons)?
Cardio - Thoracic Surgery...
- Thread starter DocM
- Start date
- Joined
- Nov 1, 2004
- Messages
- 6
- Reaction score
- 0
do fields every really die? i mean, can we name a single field in medicine that has actually died?
i have rotated at stanford, an excellent cardiac surgery program, and i don't think that any of the attendings or trainees are just going to quit what they are doing.
the heart is an important organ. there will always be hearts that require surgical interventions.
i have rotated at stanford, an excellent cardiac surgery program, and i don't think that any of the attendings or trainees are just going to quit what they are doing.
the heart is an important organ. there will always be hearts that require surgical interventions.
- Joined
- Jul 22, 2004
- Messages
- 21
- Reaction score
- 0
DocM said:
AGAIN the same questions. A couple of months ago i asked one of the moderators here to create a subforum for CT surgery for this exact reason, ie so that there will be a place where info about CT will be organiozed and that questions about dying CT will not pop up every now and then.....but i got a negative answer from the moderator.
Here is a good thread to start.
http://forums.studentdoctor.net/showpost.php?p=1667601&postcount=1
my opinion is that in 10-15 years CTS and Interventional Cardiology will meld in to ONE speciality. Some years ago Vascular surgery was under attack. They got their lesson and we now see in big centers OR's with C-arms and the vascular surgery speciality meding in with vascular interventional radiology. And its easy for a CTS to push a catheter, but i dont think that a cardiologist will ever learn to operate. Thus I think that CTS will benefit from this kind of evolution.
- Joined
- May 2, 2001
- Messages
- 1,616
- Reaction score
- 192
CardiacSurgeon said:
Completely different political dynamics @ work when you compare this situation to Vascular Surgery's reinvention. As things have developed, CTVS has become alarmingly dependent on the cardiologist to sustain a practice (Vascular Surgery does not have the same imbalanced relationship with its refering MD's). Unfortunately, I don't really see a way to do an end-run around that relationship de novo in 2004+ which will limit momentum on progress on global cardiac mangement & Surgeon-performed coronary stentings.
I agree with your sentiments that in the ideal world you'd have the efficiency of one Physician directing both the Medical & Surgical treatment for CAD and cardiopathology, it just doesn't seem like you can put the genie back in the bottle with the money and politics involved
- Joined
- Jul 22, 2004
- Messages
- 21
- Reaction score
- 0
droliver said:
i beg to differ from your opinion and point of view. There is not such a big difference between VS and CTS as you might think. I really believe and i will not stop yelling it everywhere i can that predicting the demise of our speciality is something completely wrong and unrealistic. I can understand the frustration that hangs over the US but in the EU things are a LOT different. I agree with you that these are rough times, but in every speciality ( VS a couple of years ago, GS a lot of years ago with the GI guys and ERCP's ) there are rough times and yet i do not know a single speciality that became extinct. One that follows things in CTS closely can see the change in CTS month by month.
Let me say this once again because sadly i see people that have the will and the potencial to serve a great speciality like CTS being driven away from it for wrong and unrealistic reasons that CTS has a LOT to offer for a LOT of patients.
And if i may risk a prodiction myself, as i see the match stats and the decline in CTS applicants, i believe that in the following years in the HEART FAILURE TREATMENT ERA and with the baby boomers retiring ( all those predicting the extinction of CTS have not realized that from the CTS big bang era till now no (or better a very very small number) cts surgeons have retired (cooley and debakey, both legends pionners in cts are still operating at age 83 and 91 respectively) ) there will actually be a shortage of CTS surgeons in the US in the years to come. (this is actually from an STS report not entirely my prediction.)
- Joined
- Jul 22, 2004
- Messages
- 21
- Reaction score
- 0
http://www.ctsnet.org/doc/9696
___________________________________________
A Critical Decision
By Denton A. Cooley, MD
When a student completes medical school and reflects on his or her future, that student must make a critical decision about whether to pursue a career as a primary care physician or a specialist. This decision may not necessarily be permanent, for career changes are often made later. But an early decision may be preferable in order to establish a clear direction and a workable plan for the future. In recalling my own decision to become a cardiothoracic surgeon, I feel that I made the perfect choice. The cardiothoracic specialty has offered me an abundance of rewards, not only economic incentives but also personal satisfactions, including an enjoyable professional life and the opportunity to alleviate human suffering.
Since the early history of mankind, the heart and its function have been equated with the mystery of life. Until the past century, surgeons were warned not to attempt to operate on this essential organ. Eventually, experience in cardiothoracic surgery, acquired largely on the battlefield, disproved the wisdom of this advice. The dawn of modern heart surgery, made possible by the advent of open heart techniques in the 1950s, was an exciting period in which many breakthroughs occurred within a few short years. Heart surgeons acquired a glamorous aura, especially during the early days of heart transplants and the artificial heart. Many young physicians were attracted to the cardiothoracic field and eventually became its leaders.
In the late 1970s, however, things began to change. With the advent of interventional cardiology techniques, numerous cardiac disorders became amenable to nonsurgical therapy. Myocardial revascularization began to be accomplished with balloon angioplasty and stenting. Implantation of pacemakers and implantable cardiac defibrillators became the province of cardiologists. Ventricular arrhythmias became treatable with catheter ablation. Likewise, bronchoscopy was increasingly performed by pulmonologists rather than surgeons. At the same time, the cost of cardiothoracic training began to increase while subsequent reimbursement was cut back. Applications to this specialty began to decrease. Today, there are fewer than 4000 cardiothoracic surgeons in the United States. Most of the operations that they perform are fairly routine?coronary artery bypasses and valve procedures for heart disease, pneumonectomies and lobectomies for lung cancer.
At first glance, it might seem that cardiothoracic surgery has little new ground to cover. However, a deeper look will show the tremendous clinical and research opportunities that await physicians entering this field. In the cardiac arena alone, we are already seeing minimally invasive valve and coronary artery operations; transmyocardial laser revascularization; left ventricular reduction and other surgical procedures for the treatment of dilated cardiomyopathy; stem cell therapy for chronic ischemic heart failure; and totally implantable assist devices, including partial and total artificial hearts. The use of robotic surgical equipment and telepresence surgery has only begun to be explored. In the future, cardiothoracic surgery may be revolutionized by developments in gene therapy, xenotransplantation, molecular biology, bioengineering, and nanotechnology. These breakthroughs will be supported by the steady advent of new diagnostic and treatment technology based on computers, radiology, magnetics, ultrasound, optics, and other methodologies. Therefore, much ground remains for cardiothoracic pioneers to cover, and many unsuspected breakthroughs no doubt lie ahead.
During the 20th century, the average life expectancy in Western nations was increased by almost 30 years because of advances in medicine, surgery, and public health. Long-time scourges including typhus, cholera, smallpox, polio, tuberculosis, and the contagious diseases of childhood were brought under control. Today, chronic, lifestyle-related conditions such as heart failure, stroke, cancer, and chronic obstructive pulmonary disease are the greatest challenges. The goal of 21st-century physicians is to increase not only the length of life but also the quality of life, particularly in the elderly. Cardiothoracic surgeons will play an important role in meeting this goal, especially as the Western population continues to age.
The future is full of opportunities for our specialty if we will recognize and seize them. I strongly encourage new medical school graduates to consider entering cardiothoracic surgery. Some may harbor concerns about the demanding lifestyle traditionally endured by most surgeons in this field. But the constant challenges and life-saving opportunities make this profession especially gratifying. Also, I have always found that cardiothoracic surgeons are afforded special respect. They are almost uniformly considered leaders or even elite among other surgical specialists. Heading a team of other specialists?skilled healthcare providers of many types?is satisfying and stimulating.
Never do I regret having chosen cardiothoracic surgery. Today, I would select it even more readily if given a chance to start over. Having enjoyed a long, satisfying career in this specialty, I look forward to helping the current generation take cardiothoracic surgery to new heights.
___________________________________________
A Critical Decision
By Denton A. Cooley, MD
When a student completes medical school and reflects on his or her future, that student must make a critical decision about whether to pursue a career as a primary care physician or a specialist. This decision may not necessarily be permanent, for career changes are often made later. But an early decision may be preferable in order to establish a clear direction and a workable plan for the future. In recalling my own decision to become a cardiothoracic surgeon, I feel that I made the perfect choice. The cardiothoracic specialty has offered me an abundance of rewards, not only economic incentives but also personal satisfactions, including an enjoyable professional life and the opportunity to alleviate human suffering.
Since the early history of mankind, the heart and its function have been equated with the mystery of life. Until the past century, surgeons were warned not to attempt to operate on this essential organ. Eventually, experience in cardiothoracic surgery, acquired largely on the battlefield, disproved the wisdom of this advice. The dawn of modern heart surgery, made possible by the advent of open heart techniques in the 1950s, was an exciting period in which many breakthroughs occurred within a few short years. Heart surgeons acquired a glamorous aura, especially during the early days of heart transplants and the artificial heart. Many young physicians were attracted to the cardiothoracic field and eventually became its leaders.
In the late 1970s, however, things began to change. With the advent of interventional cardiology techniques, numerous cardiac disorders became amenable to nonsurgical therapy. Myocardial revascularization began to be accomplished with balloon angioplasty and stenting. Implantation of pacemakers and implantable cardiac defibrillators became the province of cardiologists. Ventricular arrhythmias became treatable with catheter ablation. Likewise, bronchoscopy was increasingly performed by pulmonologists rather than surgeons. At the same time, the cost of cardiothoracic training began to increase while subsequent reimbursement was cut back. Applications to this specialty began to decrease. Today, there are fewer than 4000 cardiothoracic surgeons in the United States. Most of the operations that they perform are fairly routine?coronary artery bypasses and valve procedures for heart disease, pneumonectomies and lobectomies for lung cancer.
At first glance, it might seem that cardiothoracic surgery has little new ground to cover. However, a deeper look will show the tremendous clinical and research opportunities that await physicians entering this field. In the cardiac arena alone, we are already seeing minimally invasive valve and coronary artery operations; transmyocardial laser revascularization; left ventricular reduction and other surgical procedures for the treatment of dilated cardiomyopathy; stem cell therapy for chronic ischemic heart failure; and totally implantable assist devices, including partial and total artificial hearts. The use of robotic surgical equipment and telepresence surgery has only begun to be explored. In the future, cardiothoracic surgery may be revolutionized by developments in gene therapy, xenotransplantation, molecular biology, bioengineering, and nanotechnology. These breakthroughs will be supported by the steady advent of new diagnostic and treatment technology based on computers, radiology, magnetics, ultrasound, optics, and other methodologies. Therefore, much ground remains for cardiothoracic pioneers to cover, and many unsuspected breakthroughs no doubt lie ahead.
During the 20th century, the average life expectancy in Western nations was increased by almost 30 years because of advances in medicine, surgery, and public health. Long-time scourges including typhus, cholera, smallpox, polio, tuberculosis, and the contagious diseases of childhood were brought under control. Today, chronic, lifestyle-related conditions such as heart failure, stroke, cancer, and chronic obstructive pulmonary disease are the greatest challenges. The goal of 21st-century physicians is to increase not only the length of life but also the quality of life, particularly in the elderly. Cardiothoracic surgeons will play an important role in meeting this goal, especially as the Western population continues to age.
The future is full of opportunities for our specialty if we will recognize and seize them. I strongly encourage new medical school graduates to consider entering cardiothoracic surgery. Some may harbor concerns about the demanding lifestyle traditionally endured by most surgeons in this field. But the constant challenges and life-saving opportunities make this profession especially gratifying. Also, I have always found that cardiothoracic surgeons are afforded special respect. They are almost uniformly considered leaders or even elite among other surgical specialists. Heading a team of other specialists?skilled healthcare providers of many types?is satisfying and stimulating.
Never do I regret having chosen cardiothoracic surgery. Today, I would select it even more readily if given a chance to start over. Having enjoyed a long, satisfying career in this specialty, I look forward to helping the current generation take cardiothoracic surgery to new heights.
Similar threads
