After reading various posts in the radiology and surgery forums, I perceive a generalized hatred towards cardiologists. Pardon my ignorance, but why is this? Is it real or a product of my imagination??
Cardiology Haters???
- Thread starter HMSBeagle
- Start date
- Joined
- Feb 6, 2008
- Messages
- 86
- Reaction score
- 0
We hate them becasue, we as doctors are scientists and we follow our brains while they follow their hearts.....
- Joined
- Apr 24, 2006
- Messages
- 7,984
- Reaction score
- 49
I am going to ignore the above post.
I think hate is a strong word. There are turf wars involving diagnostics and what not between cardiologists and radiologists and surgeons (CT in particular). Cardiologists are now a gateway for CT guys and they are also running a lot of the diagnostics that radiologists normally do in addition to competition with some of the Interventional guys. If I misstated this I am sure someone will correct me, but that is the gist I get.
I think hate is a strong word. There are turf wars involving diagnostics and what not between cardiologists and radiologists and surgeons (CT in particular). Cardiologists are now a gateway for CT guys and they are also running a lot of the diagnostics that radiologists normally do in addition to competition with some of the Interventional guys. If I misstated this I am sure someone will correct me, but that is the gist I get.
- Joined
- Jun 28, 2007
- Messages
- 1,958
- Reaction score
- 10
Cardiologists have a slight negative reputation in the medicine world, across many fields, for different reasons. From my different rotations I've heard reasons put forth ranging from Cards guys being "snobby", "money hungry", "self centered", "full of themselves", etc. Some small part of this is certainly jealousy for cardiology's salary and respect in the medical field, however.
Specifically, for radiology and surgery, as stated above, there's a lot of turf wars going on. Vascular and IR guys decry some Cardiologist approach to "drive by stenting", stenting everything they can to make a buck, even if it's not medically indicated. A big sticking point is that Cardiologists basically control the patient referals. For example, 72 year old guy sees his cardiologist after his MI. He starts developing claudication, cardiologist tells him he has PVD. Instead of referring him to a Vascular Surgeon or Vascular Interventional Radiologist who may be more qualified with peripheral interventions, the Cardiologist decides he's going to do the procedure himself and pocket the cash (or refer to somebody in his group.)*
Also, surgeons in particular like to attack "procedural" medicine specialties like Interventional Cards as being "surgery lite", implying the people who go into them wanted to be surgeons but couldn't "hang with the big boys".
*Note some Cardiologists are apparently specialty trained for this and has expertise that match the other two specialties, but most don't.
Personally, in my interactions with Cardiologists I see both sides of the coin. One cardiologist put on one of the most childish, petty displays I've ever seen from any doctor to a nonexistant but perceived insult from his resident. On the other hand, I've seen some who are amazing: their patients love them, they're great educators, and absolutely fantastic doctors. So, it's hard to generalize. I think it suffers a bit as a field because it's a "prestige" field out of the less prestigious Internal Medicine, and it can attract people who are only interested in it BECAUSE of it's prestige who end up miserable and making everyone else miserable, but most guys who go into it for the love of the field are ok by me.
Specifically, for radiology and surgery, as stated above, there's a lot of turf wars going on. Vascular and IR guys decry some Cardiologist approach to "drive by stenting", stenting everything they can to make a buck, even if it's not medically indicated. A big sticking point is that Cardiologists basically control the patient referals. For example, 72 year old guy sees his cardiologist after his MI. He starts developing claudication, cardiologist tells him he has PVD. Instead of referring him to a Vascular Surgeon or Vascular Interventional Radiologist who may be more qualified with peripheral interventions, the Cardiologist decides he's going to do the procedure himself and pocket the cash (or refer to somebody in his group.)*
Also, surgeons in particular like to attack "procedural" medicine specialties like Interventional Cards as being "surgery lite", implying the people who go into them wanted to be surgeons but couldn't "hang with the big boys".
*Note some Cardiologists are apparently specialty trained for this and has expertise that match the other two specialties, but most don't.
Personally, in my interactions with Cardiologists I see both sides of the coin. One cardiologist put on one of the most childish, petty displays I've ever seen from any doctor to a nonexistant but perceived insult from his resident. On the other hand, I've seen some who are amazing: their patients love them, they're great educators, and absolutely fantastic doctors. So, it's hard to generalize. I think it suffers a bit as a field because it's a "prestige" field out of the less prestigious Internal Medicine, and it can attract people who are only interested in it BECAUSE of it's prestige who end up miserable and making everyone else miserable, but most guys who go into it for the love of the field are ok by me.
- Joined
- Aug 25, 2006
- Messages
- 59
- Reaction score
- 0
Cards Rocks!.... hehe...
That being said, I do have a problem with a very high number of procedures (stents and pacemakers, defibrillators, etc) that take place as prophalactic prevention. In other words, they are performed with no certainty whatsoever that they are either necessary or beneficial... but they do pay a lot to perform.
And my BIGGEST pet peave is in regard to cholesterol inhibitors and cholesterol chealators. Please, for God's sake, do a little research into the connection (or lack thereof) between cholesterol levels and heart disease and STOP THE MADNESS! 😱
That being said, I do have a problem with a very high number of procedures (stents and pacemakers, defibrillators, etc) that take place as prophalactic prevention. In other words, they are performed with no certainty whatsoever that they are either necessary or beneficial... but they do pay a lot to perform.
And my BIGGEST pet peave is in regard to cholesterol inhibitors and cholesterol chealators. Please, for God's sake, do a little research into the connection (or lack thereof) between cholesterol levels and heart disease and STOP THE MADNESS! 😱
- Joined
- Feb 16, 2008
- Messages
- 16
- Reaction score
- 0
N
njbmd
One of the things that you quickly realize when you actually begin to work as a physician is that every specialty becomes important to the care of your patients. I have never heard any of my colleagues from residency, through fellowship and especially any of my surgery professors "hate" any other specialty or practitioner for that matter.
There is a fair amount of just "growing up" that takes place when you start caring for patients. One usually learns the difference between good natured "ribbing" that people will often take part in versus "hating". Cardiologists are no more "hated" than any other specialty.
There is a fair amount of just "growing up" that takes place when you start caring for patients. One usually learns the difference between good natured "ribbing" that people will often take part in versus "hating". Cardiologists are no more "hated" than any other specialty.
- Joined
- Apr 24, 2006
- Messages
- 7,984
- Reaction score
- 49
I can def. see how some cards guys are considered arrogant. In fact, all the ones we know are pretty full of themselves, but they are still damn good doctors and their patients love them. One guy is like a textbook, and even shadowing him as a premed he forced me to apply knowledge throughout the day, and gave me a real hands on approach. He was a D.O. boarded in internal medicine, pulmonology, and cardiology, with his practice covering both cards and pulm patients. I don't hate him from the money aspect because he works harder than 90% of the doctors out there (also lived in a tiny house for about 15 years just saving up cash).
Lets face it, cards is a sexy field. It has a lot of money in it. Watch t.v. and you see half a dozen ads for heart meds. Hell, they are advertising stents now which I find ridiculous. While all fields get the drug reps coming by, it is like overdrive with cards. I shadowed there for a couple of days and the drug rep girls were even flirting with me, trying to plant the seed later on. I had like 15 pens, hats, and other crap by the end. Every day was a big lunch. The cardiologist guys generally never bought lunch. They had pretty expensive stuff purchased by drug reps every day. (2 of them brought sandwiches because they refused to eat on principle, which I respect)
Lets face it, cards is a sexy field. It has a lot of money in it. Watch t.v. and you see half a dozen ads for heart meds. Hell, they are advertising stents now which I find ridiculous. While all fields get the drug reps coming by, it is like overdrive with cards. I shadowed there for a couple of days and the drug rep girls were even flirting with me, trying to plant the seed later on. I had like 15 pens, hats, and other crap by the end. Every day was a big lunch. The cardiologist guys generally never bought lunch. They had pretty expensive stuff purchased by drug reps every day. (2 of them brought sandwiches because they refused to eat on principle, which I respect)
- Joined
- Feb 6, 2008
- Messages
- 86
- Reaction score
- 0
Must have been them DO's.😆
- Joined
- Apr 9, 2007
- Messages
- 991
- Reaction score
- 100
🙂 You can bet that I'll have no pharma pens, post-its etc. used by me- by staff when practically feasible, when I'm someday running, or am part of an ED team.
This is from a post in another forum. "Oh yes Cardiology. The most hated medical specialty by all other specialties. Maybe they should learn to stop stealing other field's work."
See what I mean? Even the word hate was used. wtf?
See what I mean? Even the word hate was used. wtf?
I've seen it before. It's resentment because cardiology is in maybe the best referral position of any specialty in medicine. So if there's a lucrative procedure that's reasonably close to cardiology, they can just do it themselves instead of having to refer it out to whoever used to do it.
Naturally not all of them do this but the perception that cardiologists want to steal your endarterectomy while happily leaving you with your diabetic feet is out there. There is also a great deal of controversy regarding the degree to which some cardiologist interventions are necessary and when they're just being used as revenue generators (see: stent controversy). Unsurprisingly there is resentment (sometimes justified, sometimes not).
- Joined
- Jun 28, 2007
- Messages
- 1,958
- Reaction score
- 10
Someday I'm going to release my masterpiece chart that shows which medical specialties hate which others and why.
- Joined
- Apr 25, 2006
- Messages
- 94
- Reaction score
- 1
Extra points if you can superimpose this on a map ala Master of Orion or Axis and Allies👍
- Joined
- Sep 17, 2006
- Messages
- 211
- Reaction score
- 2
The US has lots of heart disease, Cards is in a good position for referrals, and subsequently likes to takes over procedures others may have developed. This is pretty much the case anywhere. I don't know if other specialties hate them, but Cards sure does like to lobby hard against others.
- Joined
- May 7, 2006
- Messages
- 670
- Reaction score
- 0
Anyone else notice that cards also is really popular among their classmates who don't want to do surgery?
- Joined
- Jun 18, 2005
- Messages
- 910
- Reaction score
- 5
Yes D Wade, it sure is 😀
Isn't it such a beautiful specialty?
Plus for all us "studs," cards gives us a chance to start fixing hearts instead of breaking them all the time!! hahaha... (drumroll)...haha...yeah....um, ok.
Isn't it such a beautiful specialty?
Plus for all us "studs," cards gives us a chance to start fixing hearts instead of breaking them all the time!! hahaha... (drumroll)...haha...yeah....um, ok.
- Joined
- Feb 18, 2002
- Messages
- 685
- Reaction score
- 3
It's all about money and ego. As technology advances surgical solutions to medical problems will be replaced by medical and catheter based interventions. This is especially pronounced in cardiology.
Many vascular surgeons border on hating cardiologist, especially the cardiologists that stent the carotids, femorals, popliteals, renals, etc. And now that endovascular AAA repair is proving to be superior to open AAA repair more of the vascular surgeons' business will be fleeing as I see interventional cardiology running with EVAR just like they did with stenting. Then it will get really contentious.
I also see coronary stenting to continue to play an increasing role in CAD. Despite the marginal, at best, improvement in outcome with CABG versus stents, I think patients will continue choosing stents. I know I would personally choose stenting multi-vessel disease over CABG if I had to face that decision today. Lastly, while CABG won't change much at all over the next ten years, stenting will continue to be revolutionized by R&D into the field that will yield better results.
Many vascular surgeons border on hating cardiologist, especially the cardiologists that stent the carotids, femorals, popliteals, renals, etc. And now that endovascular AAA repair is proving to be superior to open AAA repair more of the vascular surgeons' business will be fleeing as I see interventional cardiology running with EVAR just like they did with stenting. Then it will get really contentious.
I also see coronary stenting to continue to play an increasing role in CAD. Despite the marginal, at best, improvement in outcome with CABG versus stents, I think patients will continue choosing stents. I know I would personally choose stenting multi-vessel disease over CABG if I had to face that decision today. Lastly, while CABG won't change much at all over the next ten years, stenting will continue to be revolutionized by R&D into the field that will yield better results.
- Joined
- Jun 26, 2004
- Messages
- 187
- Reaction score
- 1
From the Radiology side, some are seen as money-hungry. They took nuclear scans from Radiology years ago. Angiography(caths) were also created by Radiologists. Now they are pushing hard to take cardiac MRI and cardiac CTA. Radiologists spend years creating new modalities and techniques. They become mainstream and get reimbursed well then everyone comes looking to take their bite.
Here is a good example of money before patient. Imaging companies have created software for CT scanners that will remove all information regarding structures other than the heart. So the cardiologist can own the scanner and then read the study themself. At first, it doesn't sound too bad, just the issue of self-referral comes to mind. But, another problem is the patient receives the same dose of radiation and could therefore have the chest evaluated as well. Until this new software was available they would have to share the studies with Radiology and have Radiologists read the chest portion for them. Now why would they want to go and change that for, $$$.
There is no doubt that Cardiologists are essential and appreciated, but sometimes some of them chase the dollar, as evidenced from my post and others above.
Here is a good example of money before patient. Imaging companies have created software for CT scanners that will remove all information regarding structures other than the heart. So the cardiologist can own the scanner and then read the study themself. At first, it doesn't sound too bad, just the issue of self-referral comes to mind. But, another problem is the patient receives the same dose of radiation and could therefore have the chest evaluated as well. Until this new software was available they would have to share the studies with Radiology and have Radiologists read the chest portion for them. Now why would they want to go and change that for, $$$.
There is no doubt that Cardiologists are essential and appreciated, but sometimes some of them chase the dollar, as evidenced from my post and others above.
- Joined
- May 7, 2006
- Messages
- 670
- Reaction score
- 0
It is a really cool field, and I see the appeal regardless of reimbursement. But there are plenty of other extraordinarily beautiful fields in medicine and none of those are as popular pre-Step 1.
