Cardiologists are doctors that specialize in diagnosing, treating, and preventing conditions of the cardiovascular system including the heart and the body's blood vessels.
Currently, there are close to 40,000 cardiologists working in the United States.
Cardiologists are required to complete medical school and earn a Doctor of Medicine (M.D.) degree. Cardiology is a specialty medicine, so doctors who want to become cardiologists are required to complete a 2 to 3-year residency program in internal medicine that prepares doctors to deal with a wide range of medical conditions.
After completing a residency program, doctors who want to become cardiologists must complete up to five years of a fellowship program in cardiology or interventional cardiology.
Cardiologists must have a medical license to practice medicine. Medical licenses are controlled by individual states, so the requirements will vary in each state. A medical license allows doctors to practice any type of medicine in a state but does not show any specific qualifications in a field of medicine.
Cardiologists demonstrate their skill level by becoming board certified through the American Board of Internal Medicine (ABIM). The ABIM will also certify doctors specifically as cardiologists or in a subspecialty of cardiology after a doctor has become board certified in internal medicine. To gain certification, doctors must meet certain requirements and to take an extensive exam. Board certified cardiologists will be required to maintain their certification through professional development and eventually through retaking the exam.
Where Cardiologists Work
Cardiologists typically work in group or private practices that work through hospitals. Some cardiologists work directly for hospitals. Cardiologists can also work in clinical settings or in universities.
How Cardiologists Help People
Cardiologists diagnose, treat, and prevent diseases of the heart, arteries, and veins. Patients are often referred to cardiologists to look into risk factors for heart disease like hypertension, obesity, smoking, or a personal or family history of heart disease. Cardiologists are not primary care physicians, and patients are usually referred to them by their family doctors or see them in hospital settings after experiencing symptoms.
Cardiologists will perform a variety of diagnostic tests on patients like listening to their heart or taking EKG tests, x-rays, stress tests, and blood samples. Electrocardiograms (EKG or ECG) are the most common tests done on patients with suspected heart problems. These tests use an electrode attached to the skin around the chest to monitor the heart's electrical activity.
Another common diagnostic test interventional cardiologists will perform is called a catheterization procedure. Catheterization is a procedure where a catheter is inserted into a patient's femoral artery into the heart to look at the rate of blood flow to and from the heart by inserting a special dye into the veins. This specialized procedure can also detect blockages in the blood vessels of the heart. If blockages are detected, the cardiologist may elect to place a stent into the blocked blood vessel to open it up for normal blood flow to return.
Cardiologists will decide if a patient's condition can be managed with lifestyle changes or medications, or if patients require surgery. If patients need surgery, they will be referred to a cardiovascular surgeon, a cardiologist with special training in interventional surgery.
Cardiologists can work in a number of subspecialties that focus on specific conditions. Non-invasive cardiologists will perform basic diagnostic tests and help patients with lifestyle changes, interventional cardiologists may perform sent placements and valve repairs for patients, non-interventional cardiologists may perform minor operations like locating blocked arteries, and electrophysiology cardiologists may insert pacemakers, defibrillators, and other devices in the patient.
Other doctors, like cardiothoracic surgeons, are qualified to perform complex cardiac surgery such as bi-pass surgery on patients, but they are not considered cardiologists because they do not treat the overall condition of the patient; they focus on the specific surgical needs of the heart.
Part of a cardiologist's duty is to communicate with the patient's primary care physician and other members of the patient's medical team about treatment plans and test results.
Other duties of a cardiologist include:
- Ordering and interpreting diagnostic tests
- Prescribing medications
- Coordinating treatment plans
- Offering proactive care to reduce the risk of heart disease
- Offering postoperative care to cardiac patients after surgery
The average salary for a cardiologist in 2015 was $348,087.
Medical Negligence and Cardiologists
Cardiologists both diagnose and treat patients with life-threatening conditions, so the risk of malpractice is high. The Doctor's Insurance Company completed a survey of over 400 cardiology malpractice claims from 2007 to 2013 to study the most common malpractice claims against cardiologists. They were:
Misdiagnosis, failure to make a diagnosis, delayed diagnosis (25% of all claims)
Diagnosis errors were the most common malpractice claim against cardiologists. Specifically, failure to diagnose myocardial infarction (heart attack) was the most common claim in this group. Many claims involved patients being diagnosed and treated for ischemic heart disease, coronary artery disease or a buildup of plaque in the arteries, which resulted in a delayed diagnosis of myocardial infarction. The study also found that cardiologists often overlook non-cardiac conditions that look similar to cardiac conditions like pulmonary embolism, aortic dissection, and cancer.
Misdiagnosis of a heart condition can lead to the improper use of coronary stents. Coronary stents are used to help keep blocked blood vessels open to allow the blood to flow more easily, but they come with many complications. Though studies have shown that procedure is only valuable to patients who truly need stents, many patients unnecessarily undergo the procedure with detrimental results. A study by Stony Brook University School of Medicine found that over 200,000 cardiac stent procedures a year, or one-third of all yearly cardiac stent procedures, are unnecessary.
In 2010, Briggs Bedigian, one of our founding attorneys, represented over a dozen patients of St. Joseph Hospital after they were sent letters detailing potential mishandling of their cardiac stents. Over 600 patients of a single cardiac surgeon were informed that their cardiac stent procedures were potentially unnecessary and may have put them at greater risk. Risks associated with unnecessary cardiac stents include blood clots, perforated arteries, and internal bleeding among other problems.
Improper performance of a treatment procedure, including surgery (23%)
Cardiothoracic surgeons often perform high-risk procedures and treatments on their patients, which lead to a larger amount of malpractice cases. Sometimes even the best cardiovascular surgeon will face surgical complications, but all doctors must provide their patients with the standard of care and act as any other reasonable doctor would in their position.
Common complications include retroperitoneal bleeding, vascular complications, arterial laceration during pacemaker implantation, neurological damage, and node damage during ablation.
Improper management of treatment (14%)
This category includes a wide range of treatments including communicating with other members of the patient's care team, failing to follow up with test results, failing to follow protocols, failing to take adequate records, among other processes.
Improper medication management (6%)
Medications prescribed by cardiologists are meant to target specific cardio and vascular conditions, but they often come with high risks for adverse side effects. Patients should only be prescribed anticoagulants and antiarrhythmic drugs when absolutely necessary, and their conditions should be closely monitored while taking these drugs.
Experienced Medical Malpractice Attorneys
Cardiovascular disease is one of the leading causes of death in the United States, and many Americans will be treated by a cardiologist, interventional cardiologist or cardiac surgeon at some point. Though these doctors work in a high-risk, complex field of medicine where complications can occur, they must treat patients within an established standard of care. Deviating from this standard can result in a malpractice case.
If you or a loved one has suffered an injury under the treatment of a cardiologist, call Gilman & Bedigian today to schedule a free consultation and to learn more about your legal options.