The cardiovascular community as a whole naturally tends to lapse into an egocentric, self-centered world view in which the issues we face are the “important issues,” “the “most significant” concepts and constructs being those that affect us. We talk to cardiovascular medicine colleagues, lament our not-too-dissimilar problems and perceive the subspecialties in cardiology as vastly different from each other, the imager and the interventionist having nothing in common save a tax ID number and perhaps distaste for the sustainable growth rate.

In reality, we are but a small and homogenous cog in a very large wheel. Of the 850,000 physicians licensed in the U.S, we are but 25,000. Likewise, of the almost 1 billion ambulatory visits patients made to physician offices last year, the majority were not to cardiologists or even specialists but to primary care physicians. Similarly, in spite of what we sense when on call in the emergency rooms of our nation’s hospitals, only 7 percent of the visits were for chest pain.

If we pause, step back, and cogitate the issues of the day from the vantage of the entire physician body politic, what mutation of our prevailing attitudes would we perceive?

For example, from such a station, what would we determine to be the most important issue surrounding the electronic health record? I would venture not structured reporting or PINNACLE Registry extraction, but interoperability, for through it workflow is enhanced, care improves and true cost saving occurs.

Similarly, what would we opine as to the best strategy for our nations payment reform? Would a defense of imaging recompense or an increase in evaluation and management valuation be more likely?

Likewise, in considering the maintenance of certification conundrum, are the current requirements so onerous to our colleagues with a single board certification in family or internal medicine as to foment, in their ranks, revolt? From that larger vantage, how would we reconcile the self-inflicted wound of multiple board examinations (many of which are self-serving) and our entreaty that those board certifications really do make us better-qualified physicians when juxtaposed to our protestations that the continued demonstration of proficiency costs too much and really doesn’t matter?

Professionalism – that requirement of those privileged to be granted membership in one of the learned professions – demands we take the broader view. Anything less demeans us and those upon whose shoulders we stand.

< Back to Listings