peds cardio

[dsherida]

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Does anyone know much about this surgical specialty? Like what the hours or pay and if it is hard to find a position after all the training? THanks

 

[hammertime]

Check out the book "Walk on Water" by Michael Ruhlman which centers around Dr. Mee, a top congenital heart surgeon at The Cleveland Clinic. It can give you some insight into the speciality plus it's a great book.

 

[indiamacbean]

I am in the middle of reading that book and love it. My girlfriend just finished and she loved it too despite finding surgery in general a little off-putting. From the book, it seems clear that like any super specialty the pay is good but there are many many other specialties if that is the primary consideration. It is also clear from the book that it is in many ways a field of a few superstars and a number of good surgeons who just aren't good enough to suceed at congenital surgery. The author discusses the correlation between case volume and competency and makes a rather convincing argument that what would be in the best interests of the kids needing this type of surgery are larger specialty centers focused primarly on this type of surgery rather than peds cardio surgeons shoved into other programs. In this way, the surgeons performing these surgeries are adept at them rather than seeing a congenital now and again while performing adult cardiac surgery the rest of the time. I don't know if this would ever be put into practice, but if so it would seem to really limit the number of peds cardio surgeons needed in the future. For training, I believe that the current "power" centers are Boston Children's, Michigan, Cleveland Clinic. Really just read the book. it's awesome

 

[droliver]

Originally posted by indiamacbean
The author discusses the correlation between case volume and competency and makes a rather convincing argument that what would be in the best interests of the kids needing this type of surgery are larger specialty centers focused primarly on this type of surgery rather than peds cardio surgeons shoved into other programs.

This sentiment, championed by the LEAPFROG group (a consortium of the larger industry payers into the 3rd party payer system) has been a political hand grenade for a number of years. There are in fact a # of morbid procedures that seem to have better outcomes at the higher volume centers. The implications of this suggestion are very controversial for the hospitals (and even the different subspecialty surgeons) who would be affected.

The conclusions of analysis of this type of data is criticized for selection bias in patient groups, the potential for inter-surgeon variation in morbidity/mortality affecting instituitional grades (which is not reflected in these studies), and the questionable accuracy of the collected data. Vascular surgeons, colo-rectal surgeons, and oncologists have all made variations on this argument to say that only they should be doing procede "x" rather then general surgeons

 

[Gator05]

Like to voice another point on this interesting topic:

the ability of a program to care for subspecialty patient must also take into account the entire team; if the nurses/RT/pharmacists are not used to caring for these types of patients, even the best physician-care will be doomed to increased M&M.