cardiologists out of work?

[coldfeet]

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I'm wondering if anyone has any thoughts on something that's been tugging at my mind for a couple years...seems that a lot of CT surgeons have been looking for other ways to keep food on the table lately, and I've wondered if cardiologists would have the same thing happen to them, for the following reasons:

1) Cardiac CT almost entirely replacing diagnostic caths in the next decade
2) Statins dramatically reducing the incidence of advanced atherosclerosis in the next decade
3) Better imaging/predictive techniques able to pick out unstable plaques--which is a wonderful thing for patients and for the healthcare system--but would mean less interventional caths
4) Even better plaque reducing wonder drugs in the next two decades?

 

[spyyder]

I am not at all "in the know" of the field of cards, but here are my thoughts, take them for what they are:

1) Cardiac CT almost entirely replacing diagnostic caths in the next decade

Good news for Nuclear Cards maybe or those planning on going into this? Perhaps even better reason for Rads to specialize in Nuclear? I would be interested in seeing documentation suggeting this.

2) Statins dramatically reducing the incidence of advanced atherosclerosis in the next decade

While reducing incidence, prevalence will remain high with increased aging population. Wouldn't this really depend on cost. Will it be cheaper to do an interventional procedure. What will insurance cover in the future

3) Better imaging/predictive techniques able to pick out unstable plaques--which is a wonderful thing for patients and for the healthcare system--but would mean less interventional caths

Wouldn't this result in more interventional procedures and less surgical?

4) Even better plaque reducing wonder drugs in the next two decades?

We have always had drugs at our disposal, they are nothing but preventative measures. This is certainly not gonna put a cards out of a job. Someones gotta decide whether you need them in the first place.

I think these things are of more concern to CT surgeons than to cardiologists. As long as cards can keep patients out of the OR, then they are doing their job well. Other things to be considered might be obesity problems on the rise in the US, younger populations suffering heart problems, and the fact that most cards patients seek out help when simple procedures are no longer an option.

 

[hans19]

I'm wondering if anyone has any thoughts on something that's been tugging at my mind for a couple years...seems that a lot of CT surgeons have been looking for other ways to keep food on the table lately, and I've wondered if cardiologists would have the same thing happen to them, for the following reasons:

1) Cardiac CT almost entirely replacing diagnostic caths in the next decade
2) Statins dramatically reducing the incidence of advanced atherosclerosis in the next decade
3) Better imaging/predictive techniques able to pick out unstable plaques--which is a wonderful thing for patients and for the healthcare system--but would mean less interventional caths
4) Even better plaque reducing wonder drugs in the next two decades?

Have you ever heard of:

1) Noncompliant patients

and

2) Obesity ('Obeastitty' in County hospitals)

I think there would sooner be world peace than an entire population of people that exercises, eats reasonably and takes their meds.

3) You think wonderdrugs fall out of the sky? Wonderdrugs are frigging expensive. Even if you had patients that were compliant patients that actually WANTED to take these meds, not everyone will be able to afford them.

Cardiologists out of work?!? You have got to be kidding me!!! Cardiologists are some of the most aggressive-minded people in medicine. Cardiology is one of the most promising fields in medicine.

 

[PaxInterna]

I'm wondering if anyone has any thoughts on something that's been tugging at my mind for a couple years...seems that a lot of CT surgeons have been looking for other ways to keep food on the table lately, and I've wondered if cardiologists would have the same thing happen to them, for the following reasons:

1) Cardiac CT almost entirely replacing diagnostic caths in the next decade
2) Statins dramatically reducing the incidence of advanced atherosclerosis in the next decade
3) Better imaging/predictive techniques able to pick out unstable plaques--which is a wonderful thing for patients and for the healthcare system--but would mean less interventional caths
4) Even better plaque reducing wonder drugs in the next two decades?

One word: Diabetes!

 

[skypilot]

While reducing incidence, prevalence will remain high with increased aging population. Wouldn't this really depend on cost. Will it be cheaper to do an interventional procedure. What will insurance cover in the future.

Heart Disease and Cancer cause most mortality in the U.S. So nobody in either field is going to go hungry.

 

[leviathan]

Have you ever heard of:

1) Noncompliant patients

Contemporary studies show a 50% non-adherence rate for following medication and/or other treatment/prevention plans.

 

[medgator]

Heart Disease and Cancer cause most mortality in the U.S. So nobody in either field is going to go hungry.

Very true.... oncologists and cardiologists will have lots of business for a long time to come, especially with the aging baby boomer generation that is surviving longer. Interestingly, as we have become better at treating the heart (and associated conditions like hyperlipidemia and Diabetes), all-cause cancer mortality actually rose to the #1 spot last year.

 

[DrHeartMD]

cardiology is a fear driven profession...i.e. someone gets chest pain, they get referred to a cardiologist...someone has any ekg abnormality, they get referred to a cardiologist...so on and so forth...most other fields are so afraid of a cardiac related death, that virtually every patient ends up with a cards consult prior to surgery or if they sneezed too hard...this may not be great for the cost of healthcare (which sux for patients and many people involved), but will always generate a population of patients that will feed the cardiologist...sort of sad in so many ways, but this fact is true, and thus i HIGHLY doubt that cardiologists will ever end up in the gutter...

 

[DrHeartMD]

cardiology is a fear driven profession...i.e. someone gets chest pain, they get referred to a cardiologist...someone has any ekg abnormality, they get referred to a cardiologist...so on and so forth...most other fields are so afraid of a cardiac related death, that virtually every patient ends up with a cards consult prior to surgery or if they sneezed too hard...this may not be great for the cost of healthcare (which sux for patients and many people involved), but will always generate a population of patients that will feed the cardiologist...sort of sad in so many ways, but this fact is true, and thus i HIGHLY doubt that cardiologists will ever end up in the gutter...

 

[lateness]

therre will be competition among cardiologists more and more but still i dont ever see any of them going hungry

 

[coldfeet]

Has everyone heard about the new crestor trial?

I think that in 20 years, we'll be doing fewer caths than we do now, even with a greater number of people with cardiac risk factors.

 

[mysophobe]

The new crestor trial is great, but using 4 times the recommended dose is not going to work for everyone. People with crappy livers are not going to be able to go that route. Plus, it isn't a cure, it's just helpful. Cath numbers might go down, but I don't think this will be a major factor in that.

 

[tibor75]

The only thing that will cut down on the amount of caths are the new drug eluting stents which cut down dramatically on restentosis. back in the day, maybe about 10-20% of all caths were on restenosis of previously placed stents.

Statins won't impact that much on the incidence of CAD. simply put, not enough people care about preventive medicine - they don't visit their doctors, they don't care about their health, they get fat and get diabetes. Only when they first get chest pain, will they care. and then, it's too late.

 

[gwen]

that's pretty funny...seriously, do you not see med clinic/uninsured patients??? not that all uninsured patients are noncompliant...but duuuuude, statins aren't going to do anything when you have your 500 lb patient chomping down three burgers in one bite. at our hospital, we use "columbus units" meaning 1 columbus unit = 100 lbs. those units keep rising. not having enough patients is the last thing on a cardiologists mind.

...................................................
1) Cardiac CT almost entirely replacing diagnostic caths in the next decade
2) Statins dramatically reducing the incidence of advanced atherosclerosis in the next decade
3) Better imaging/predictive techniques able to pick out unstable plaques--which is a wonderful thing for patients and for the healthcare system--but would mean less interventional caths
4) Even better plaque reducing wonder drugs in the next two decades?

 

[tibor75]

that's pretty funny...seriously, do you not see med clinic/uninsured patients??? not that all uninsured patients are noncompliant...but duuuuude, statins aren't going to do anything when you have your 500 lb patient chomping down three burgers in one bite. at our hospital, we use "columbus units" meaning 1 columbus unit = 100 lbs. those units keep rising. not having enough patients is the last thing on a cardiologists mind.

...................................................
1) Cardiac CT almost entirely replacing diagnostic caths in the next decade
2) Statins dramatically reducing the incidence of advanced atherosclerosis in the next decade
3) Better imaging/predictive techniques able to pick out unstable plaques--which is a wonderful thing for patients and for the healthcare system--but would mean less interventional caths
4) Even better plaque reducing wonder drugs in the next two decades?

heh heh...columbus units.. I used the same term when I was at OSU for med school...

 

[hans19]

heh heh...columbus units.. I used the same term when I was at OSU for med school...

Everything is bigger in Texas.
Come to Dallas-- where 1 Parkland unit = 200 lbs.