Cardiology > GI?

[JudoKing01]

So I seem to hear/see a lot of people talking about how GI docs like to "pretend" they are surgeons, but how come I don't see anyone talking like that about cardiologists? I mean they have their own little OR in that cath lab, they scrub, they do procedures that are surgery-esque. Is it because they actually do scrub etc? Or am I just ignorant to the making-fun-ofs since I like cardiology?

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[bigfrank]

"people" are probably just jealous of the GI's. It's a tough fellowship to get.

 

[JudoKing01]

Yeah, don't get me wrong, I love GI and have a lot of respect for the docs. I was just wondering why so many people made fun of them for what seems like an unfounded reason. I guess jealousy could be it. But then again, it's coming from surgeons, so maybe they're just afraid the GIs will take some of their business.

 

[Fantasy Sports]

Yeah, don't get me wrong, I love GI and have a lot of respect for the docs. I was just wondering why so many people made fun of them for what seems like an unfounded reason. I guess jealousy could be it. But then again, it's coming from surgeons, so maybe they're just afraid the GIs will take some of their business.

I think it's because it is one of the most obvious fields where people are in it for the money (not so much as derm or gas though)

Back when they thought there was a GI surplus and salaries were dropping, you couldn't get a IM to apply GI. Now that the salaries and demand are high, there are suddenly a ton of applicants. Also, almost no one is really interested in the anatomy of the GI tract... you're dealing with poop.

So basically, its like derm. Very few people are interested in the field, and if the field paid the average for a subspecialty, it wouldn't be popular at all.

 

[14022]

I think it's because it is one of the most obvious fields where people are in it for the money (not so much as derm or gas though)

Back when they thought there was a GI surplus and salaries were dropping, you couldn't get a IM to apply GI. Now that the salaries and demand are high, there are suddenly a ton of applicants. Also, almost no one is really interested in the anatomy of the GI tract... you're dealing with poop.

So basically, its like derm. Very few people are interested in the field, and if the field paid the average for a subspecialty, it wouldn't be popular at all.

Derm doesn't pay that well. The average is around $200,000 I believe which is far less than several other specialties. I think most people go into it for the lifestyle mostly.

 

[MD2b06]

Derm doesn't pay that well. The average is around $200,000 I believe which is far less than several other specialties. I think most people go into it for the lifestyle mostly.

It's hard to make a lot of $$$$ when you work only 6 hrs/ day, 4 days/wk, and 2 of those 6 hrs are reserved for "lunch." Obviously, an exaggeration, but you get the point. The traditional derm stuff may not pay all that well, but cosmetic dermatology surely does. All cash based. No insurance hassles, no call, great hours, relatively short residency (4years). All these are why DERM is one of the most competitive specialties to match into.

 

[14022]

It's hard to make a lot of $$$$ when you work only 6 hrs/ day, 4 days/wk, and 2 of those 6 hrs are reserved for "lunch." Obviously, an exaggeration, but you get the point. The traditional derm stuff may not pay all that well, but cosmetic dermatology surely does. All cash based. No insurance hassles, no call, great hours, relatively short residency (4years). All these are why DERM is one of the most competitive specialties to match into.

Agreed. All I am saying is that people tend to confuse lifestyle specialties with salary specialties. People tend to talk about how much money dermatologists and ophthalmologists make when in reality, it is the lifestyle of these specialties that make it competitive. A cardiologist or GI doc will double the salary of both of these specialties.

 

[Mumpu]

Invasive cardiologists are becoming surgeons. Cardiothoracic surgery is on a vent with three pressors maxed.

If you really want lifestyle with no competition do psych or path (haven't yet decided which is worse -- no patients or psych patients). Not the best money but they'll take just about anyone.

 

[june015b]

So I seem to hear/see a lot of people talking about how GI docs like to "pretend" they are surgeons, but how come I don't see anyone talking like that about cardiologists? I mean they have their own little OR in that cath lab, they scrub, they do procedures that are surgery-esque. Is it because they actually do scrub etc? Or am I just ignorant to the making-fun-ofs since I like cardiology?

The whole field is growing and changing very fast. Remember GI also includes hepatology, transplantation (pancreas, liver, small bowel), nutrition, ID in Liver/GI, immunology (i.e., treat IBD with chemo/modulator like infliximab, etc.), proctology, etc. Interventional GI is only one part of of many GI's.

It's true that the interventional GI endoscopists nowdays do some of what the surgeons did 5-10 years ago. Many of them now function as endoscopic/transmural surgeons in some sense. The filed is expanding rapidly. There are also many newly developed or developing procedures like endoscopic bariatric surgery ($$ nutrition), partial esophagectomy for cancer using endoscopic cutting and suturing devices, transluminal and extra-luminal procedures including EUS-guided LN biopsy-staging of cancer, implanting radioactive seed for pancreatic cancer, andendoscopic anti-reflux surgery (Endo-cinch type procedures or the Stretta RFA). Magnifying endoscopes, chromoscopes, small bowel scopes, endoscopic cutting/suturing devices are already available commercially. GI's also treat IBD with immunomodulator/Chemo like "infliximab" (bills like a procedure $$). A good thing about GI is you can tailor your lifestyle based on your interest. If you don't like to do endoscope, you don't have to. You can be specialized in other areas like pancrea, liver, transplant, or nutrition. If you like eveything, you can do them all.

 

[JudoKing01]

There are also many newly developed or developing procedures like endoscopic bariatric surgery ($$ nutrition), partial esophagectomy for cancer using endoscopic cutting and suturing devices...

Whaaaa? Really?

 

[14022]

Whaaaa? Really?

I predict the general and colorectal surgeons will soon dive into this up and coming enterprise, much like many colorectal surgeons who do colonoscopies. Surgeons manage to push their way into many of the minimally invasive procedures, like vascular surgeons who take peripheral artery angiograms/angioplasty/stents away from the interventional radiologists. F the surgeons. I thought they liked to cut and tie, and now they like threading catheters and scopes. Something tells me their just in it for the money!

 

[hans19]

Something tells me their just in it for the money!

OR they?




The same can be said about interventional cardiologists, who are stenting and not uncommonly butching renal arteries, AAA and thoracic stenting. These procedures have been the in the domain of Interventional radiology and more recently vascular surgery.

Furthermore, cardiologists want a piece of cardiac CT but don't care to read the lungs or the rest of the mediastinum. There is software being marketed that deletes the lungs and mediastinum from the acquired images, even though the patient has received just as much radiation as a full chest CT. Who cares if there was a cancer sitting in the lung images?!?

Greed lies on both sides of the medical - surgical divide.

 

[JudoKing01]

You know, I don't really know anything about interventional radiology.

 

[psuketu]

OR they?




The same can be said about interventional cardiologists, who are stenting and not uncommonly butching renal arteries, AAA and thoracic stenting. These procedures have been the in the domain of Interventional radiology and more recently vascular surgery.

Furthermore, cardiologists want a piece of cardiac CT but don't care to read the lungs or the rest of the mediastinum. There is software being marketed that deletes the lungs and mediastinum from the acquired images, even though the patient has received just as much radiation as a full chest CT. Who cares if there was a cancer sitting in the lung images?!?

Greed lies on both sides of the medical - surgical divide.

I constantly hear this argument, but does anyone actually know how often the cardiac imaging actually notes a significant finding outside the heart in these patients? Have there been any studies done? For that matter have there been any studies comparing the effectiveness of each of the groups (radiologists vs cardiologists) at interpreting the cardiac imaging (false positives, negatives, efficiency)? It seems to me at this point all I hear is the two groups yelling back an forth at each other without data to back up their positions.

 

[Hysty]

I constantly hear this argument, but does anyone actually know how often the cardiac imaging actually notes a significant finding outside the heart in these patients? Have there been any studies done? For that matter have there been any studies comparing the effectiveness of each of the groups (radiologists vs cardiologists) at interpreting the cardiac imaging (false positives, negatives, efficiency)? It seems to me at this point all I hear is the two groups yelling back an forth at each other without data to back up their positions.

false positives, negatives , efficiency..yukkkkkkkkk!...

 

[june015b]

OR they?




The same can be said about interventional cardiologists, who are stenting and not uncommonly butching renal arteries, AAA and thoracic stenting. These procedures have been the in the domain of Interventional radiology and more recently vascular surgery.

Furthermore, cardiologists want a piece of cardiac CT but don't care to read the lungs or the rest of the mediastinum. There is software being marketed that deletes the lungs and mediastinum from the acquired images, even though the patient has received just as much radiation as a full chest CT. Who cares if there was a cancer sitting in the lung images?!?

Greed lies on both sides of the medical - surgical divide.

There are enough works for everybody including rads. Share the love and fun~ Neuro already reads their share of MRI and CT of head and SC. Card wants to do their CT of Heart. GI is already getting a piece of CT of alimentary. It would be nice to open up oupatient CT/MRI centers for Card and GI. Some are already planning to do so.