Cardiology Morphs into Cardiovascular Medicine

I have a special interest in the scope of practice of the various medical specialties. I have written previous notes about the commonality between radiology and pathology/lab medicine and the possibility of a merger between these two specialties. The New York Times recently featured an article (New Tests, New Future For Doctors; available for a fee) indicating that gastroenterologists have become too dependent on colonoscopy as a mainstay of their practice and will suffer economically as this procedure is supplanted by less invasive medical imaging procedures that accomplish the same or similar results.

In a previous note, I also commented about how medical students are now being trained on portable ultrasound devices so such devices will become a more commonplace diagnostic tool in standard medical practice. Technology giveth and taketh away. In these days of rapid advances in technology, the various specialty groups need to be scanning the horizon for opportunities and threats to their livelihood and attempt to redefine their scope of practice as required.

Cardiology is a good case case in point, now in the process of redefining itself as cardiovascular medicine. A Google search for the term "cardiovascular medicine" yielded 1,330,000 hits. It's a simple story. The cardiologists developed the skill of passing catheters into the coronary arteries to both visualize the arteries and perform angioplasties. As stents were perfected, they trained themselves to insert these prosthetic devices into the coronary arteries. The interventional cardiologists then expanded their scope of practice to other major arteries in the body including the carotid arteries, the renal arteries, the aorta, and the femoral arteries, all of which can be affected by atherosclerosis.

Cardiologist (oops; cardiovascular medicine specialists) now have the strategic advantage of controlling access to their hospital-based "cath labs" to fend off competitive assaults on their practice by other specialists such as vascular surgeons and interventional radiologists. Better yet, many cardiologists have built their own standalone cardiovascular clinics and hospitals where they can control the professional committee structure. I am not sure what the next chapter in this story will be but I am certain that there WILL be a next chapter.