Cardiologists - Enemies or Humans?

[Dodgy Ticker]

Hi folks

After 2.5 years of seeing and being checked by a seemingly vast array of Cardios, I am at my wits-end with them as a community.

My standard comment to Cardio nurses (which they utterly love) is that if you ask 4 cardios for advice and recommendations, you'll get 9.5 different answers to the same question!

I am now TOTALLY convinced that the average cardio is as tied to the central logic of cardiovascular study and practice as a cat is to following the thin yellow line in the middle of the road. They just can't do it.

At first I was somewhat forgiving, thinking to myself that "well, they're JUST humans, after all....".

Well under any other circumstance that would work. But when dealing with someone's life expectancy - that just ain't good enough.

Having had a plethora of health problems since my Infective Endocarditis 2.5 years ago change the course of my life, I have had a large exposure to a broad range of medical specialists from Rhumatologists to Cardios, and the one thing that rams home is that they're ALL - as a race or species - so completely blinkered, that they are ALMOST useless.

To explain, or give an example...

I went to A&E and was admitted after having broken my femur. the agony was astonishing, but I was transferred to the cardio ward as they knew me and had my full patient record. A Cardio comes ot see me to find out what's going-on, and I swear - I could have been talking Mongolian!! If it wasn't a cardiovascular problem, it went in one ear, and out of the other. The same with the Rhumatoligists, Dermatologists, Pediatricians, etc. In each and every case, these folks were just so focused and centred on their area of specialisation, that they simply didn't see anything else!

And I have had the same problem across 4 different hospitals.

I AM NOW GETTING FED UP!!!

But the cardios seem to be the worst.

I have now see about 10 different cardios in 2.5 years, and each and every one of them gives me a definitive statement of what my INR should be, AND THEY'RE ALL DIFFERENT !!

Is this just me...?????

 

[LondonAndy]

I see that you are in France, so have all these Cardiologists been in French hospitals? I may not be a particularly inquisitive patient, but here in the UK I think the 2 or 3 Cardiologists I have seen over the last 7 years or so (mostly at London specialist heart hospitals) have been pretty consistent in their advice/treatment of me. I would certainly agree that it is important to find the right specialist for your situation, and of course sometimes we mere patients don't know exactly what type to seek out. I think our two biggest issues in the UK (in normal times, ignoring pandemics) are:

1. Delays in getting a diagnosis. I am quite convinced that some of the heart failure I have is down to the months it took to end up getting the right test done (an ultrasound/echo), leaving me with severe aortic stenosis during that time.
2. Lack of centralised, accessible patient records, which also contributes to poor communication

Once you get your diagnosis you are "in the system", and everything happens. And when I go and see a new doctor/Cardiologist/Diabetes nurse or whatever I take a file of my medical records with me, in case they haven't got something.

 

[pellicle]

this is indeed one of the issues with specialists : they specialise. I see this in a number of areas not just medicine.

It is becoming a bit of a tower of babel and I think that in some cases they just don't want to get better at what they do because what they are doing is good enough and nobody really questions them.

So it comes down to the personality of the individual as to what standard (above that set by their own peers in registration and ongoing registration to practice.

I think two words in the vocabulary are important, they practice and they give opinions. I often wondered when they'll get better and discuss evidence based solutions.

Happily my own situation has been relatively straight forward (well, except the infection).

Can you not go over to England for some treatment?

 

[Paleowoman]

I have had a large exposure to a broad range of medical specialists from Rhumatologists to Cardios, and the one thing that rams home is that they're ALL - as a race or species - so completely blinkered, that they are ALMOST useless.

That’s because they’re all such specialists they’ve forgotten everything else. A very good GP I had once posted this short sketch "the best 'medical' quote from comedian Kenneth Williams ever”:



If you’re lucky you will find a good specialist who is good at most other medical fields too. I am under four specialists but my endocrinologist happens to be an exceptional generalist too so I will invariably discuss my other problems with him too.

 

[d333gs]

Hi folks

After 2.5 years of seeing and being checked by a seemingly vast array of Cardios, I am at my wits-end with them as a community.

My standard comment to Cardio nurses (which they utterly love) is that if you ask 4 cardios for advice and recommendations, you'll get 9.5 different answers to the same question!

I am now TOTALLY convinced that the average cardio is as tied to the central logic of cardiovascular study and practice as a cat is to following the thin yellow line in the middle of the road. They just can't do it.

At first I was somewhat forgiving, thinking to myself that "well, they're JUST humans, after all....".

Well under any other circumstance that would work. But when dealing with someone's life expectancy - that just ain't good enough.

Having had a plethora of health problems since my Infective Endocarditis 2.5 years ago change the course of my life, I have had a large exposure to a broad range of medical specialists from Rhumatologists to Cardios, and the one thing that rams home is that they're ALL - as a race or species - so completely blinkered, that they are ALMOST useless.

To explain, or give an example...

I went to A&E and was admitted after having broken my femur. the agony was astonishing, but I was transferred to the cardio ward as they knew me and had my full patient record. A Cardio comes ot see me to find out what's going-on, and I swear - I could have been talking Mongolian!! If it wasn't a cardiovascular problem, it went in one ear, and out of the other. The same with the Rhumatoligists, Dermatologists, Pediatricians, etc. In each and every case, these folks were just so focused and centred on their area of specialisation, that they simply didn't see anything else!

And I have had the same problem across 4 different hospitals.

I AM NOW GETTING FED UP!!!

But the cardios seem to be the worst.

I have now see about 10 different cardios in 2.5 years, and each and every one of them gives me a definitive statement of what my INR should be, AND THEY'RE ALL DIFFERENT !!

Is this just me...?????

I am in France too , 1hr out of Marseille

 

[slipkid]

Hi folks

After 2.5 years of seeing and being checked by a seemingly vast array of Cardios, I am at my wits-end with them as a community.

My standard comment to Cardio nurses (which they utterly love) is that if you ask 4 cardios for advice and recommendations, you'll get 9.5 different answers to the same question!

I am now TOTALLY convinced that the average cardio is as tied to the central logic of cardiovascular study and practice as a cat is to following the thin yellow line in the middle of the road. They just can't do it.

At first I was somewhat forgiving, thinking to myself that "well, they're JUST humans, after all....".

Well under any other circumstance that would work. But when dealing with someone's life expectancy - that just ain't good enough.

Having had a plethora of health problems since my Infective Endocarditis 2.5 years ago change the course of my life, I have had a large exposure to a broad range of medical specialists from Rhumatologists to Cardios, and the one thing that rams home is that they're ALL - as a race or species - so completely blinkered, that they are ALMOST useless.

To explain, or give an example...

I went to A&E and was admitted after having broken my femur. the agony was astonishing, but I was transferred to the cardio ward as they knew me and had my full patient record. A Cardio comes ot see me to find out what's going-on, and I swear - I could have been talking Mongolian!! If it wasn't a cardiovascular problem, it went in one ear, and out of the other. The same with the Rhumatoligists, Dermatologists, Pediatricians, etc. In each and every case, these folks were just so focused and centred on their area of specialisation, that they simply didn't see anything else!

And I have had the same problem across 4 different hospitals.

I AM NOW GETTING FED UP!!!

But the cardios seem to be the worst.

I have now see about 10 different cardios in 2.5 years, and each and every one of them gives me a definitive statement of what my INR should be, AND THEY'RE ALL DIFFERENT !!

Is this just me...?????

My experience with cardiologists - and Drs in general - pretty much mirrors yours, so no it is not just you. I'm on my 2nd cardiologist now and he is even worse than the first one. Would love to switch again but I've seen nothing to convince me they do not all suck in some way or another.

An I've already been through the three different INR answers like you as well (1 from the surgeon - he was correct, one from his assistant - he was wrong, and one from my cardio practice at the time - who not only were wrong (and the assistant in their office in charge of my INR had never even heard of my On-x heart valve and to make it worse did not even know how to properly manager warfarin doses and took offense when I had no choice but to question him - total idiot!!!!).

 

[AZ Don]

Doctors are just people and some will be better at their job than others. The trick is to find the good ones.

I always look online for highly rated Dr's. In the US, we have Find a Castle Connolly Top Doctor which identifies the top 10% in their field based on peer reviews, a local magazine maintains a list of local top doctors and then there is also HealthGrades.com which provides patient reviews. Perhaps you have some similar resources in France? I see that at least Google Reviews is available.

Due to insurance changes, I've had 4 Cardiologists in 8 years and a 2nd opinion with a fifth (who confirmed what my Cardiologist was saying). I've used the above to find them so I don't think it's luck that they were all very good. Lot's of others thought they were very good before I did. But still I've had issues with specialization. My highly skilled cancer surgeon ordered a follow-up scan that uncovered my aortic aneurysm. When I asked her later why she didn't tell me about it, she said "I didn't think anything of it". Probably because it was out of her specialty. Fortunately for me I requested, read, and followed up on the test report.

 

[d333gs]

As I mentioned in another post I have been to two cardios: One thought I had a torn aortic valve and the other a bicuspid from birth.

 

[user 15848]

Nothing is what it used to be 30 years ago...., and Doctors, all of them, as they get older they become insensitive plus out the blues start believing they know everything; Stick to younger ones, the old one develop complex of demi gods; there are 12 in my family, including 2 sisters, so yes, i know them and their friends, and nope, once they reach 50, they know it all, and they dont want to know new things; As per checking valve, i got an On-X and have not seen a cardiologist since the Wuhan Virus arrived, and not planning to see one ; i do Self Test every 10 days and life goes on

 

[Chuck C]

As I mentioned in another post I have been to two cardios: One thought I had a torn aortic valve and the other a bicuspid from birth.

I'm beginning to wonder if something is up with the cardiology in France. I've only read threads started by two posters based in France- yours and Dodgy Ticker and both have had strange experiences with cardiologists. Have others had similar experiences in France?
Did they give you these opinions after an echocardiogram? Echos are not always conclusive for either torn valve or bicuspid. But, an MRI could resolve the question. If there is doubt, why haven't they ordered an MRI?
My first echo indicated possible bicuspid valve- inconclusive. An MRI was ordered which removed all doubt and concluded that I was bicuspid.

 

[pellicle]

Another issue
https://arstechnica.com/science/202...n-inconsistency-from-confusing-expert-advice/

 

[user 16827]

Another issue
https://arstechnica.com/science/202...n-inconsistency-from-confusing-expert-advice/

interesting read , having read it i can confirm i have a lot of noise inside my head : )

 

[Superman]

To an extent, I get that they are often noncommittal in responses and also want to bring up all possibilities. This sounds wishy-washy, but many times it’s just the reality. Without more detail it’s hard to definitively say what an issue is. Especially with just an EKG and a listen. An echo helps. But a CT or MRI really gives them the info they need. However, given the the state of healthcare here, I don’t want to pay for that when I feel fine. In other countries, scheduling and limited machines may be an issue where they save them for when they are needed.

Also, were you in the US, I’d suggest fear of litigation on the part of many doctors. So you give broad, non-specific answers and you can never be wrong.

 

[pellicle]

you can never be proven wrong in court.

I added my change

 

[tom in MO]

From your rant, I'd say like most human interactions, "it takes two to tango." Be careful you don't get flagged as the "difficult patient"...there's a great Seinfeld episode on that subject

My first cardiologist forgot to review my echo and thus forgot to tell me I needed surgery. My internist found out a few months later and told me to call my cardio. My cardio called me at work the same day before I could call him. We talked, I forgave him and got excellent service until he retired. Doctors are just as fallible at their job as you are. They have good days and bad days, good hours and bad hours. I had an orthopedist screw up a diagnosis of a wrist problem, then get it right when I asked for imaging and then tell me it couldn't be healed. I went to a specialist in wrists and got it fixed. I still go to that orthopedist since the early 1980s, he's cured a number of problems w/o surgery. Forgiveness is a virtue. Even Cleveland Clinic doctors have bad days.

 

[pellicle]

Be careful you don't get flagged as the "difficult patient"...there's a great Seinfeld episode on that subject

now I'm gonna have to look that one up ... can't remember it, but love Seinfeld
Thanks

 

[Chuck C]

now I'm gonna have to look that one up ... can't remember it, but love Seinfeld
Thanks

This Seinfeld episode involves a doctor patient relationship. It may or may not be the episode in question, but it is the best Seinfeld of all time.
Cosmo Kramer - The ASSMAN (Seinfeld

 

[tom in MO]

now I'm gonna have to look that one up ... can't remember it, but love Seinfeld
Thanks

Elaine is flagged as difficult by a doctor. When she tries to go to different doctors, they all react to her chart, because she's been flagged. She tries to see her chart to see what's in it but back in those days you couldn't. I believe it is "The Package" per Wiki: In this episode, Elaine cannot receive medical treatment for her rash because of a reputation for being a "difficult" patient, Kramer offers Jerry a method to get a refund on a stereo that is two years out of warranty, and George discovers that Sheila, a clerk at the photo store, is looking at his pictures.

 

[Chuck C]

now I'm gonna have to look that one up ... can't remember it, but love Seinfeld
Thanks

 

[Superman]

Elaine is flagged as difficult by a doctor. When she tries to go to different doctors, they all react to her chart, because she's been flagged. She tries to see her chart to see what's in it but back in those days you couldn't. I believe it is "The Package" per Wiki: In this episode, Elaine cannot receive medical treatment for her rash because of a reputation for being a "difficult" patient, Kramer offers Jerry a method to get a refund on a stereo that is two years out of warranty, and George discovers that Sheila, a clerk at the photo store, is looking at his pictures.

The only part that requires suspension of disbelief is that the other doctors actually read the file. Considering the number of times I have to repeat myself to the doctor after the nurse just put all those same notes in my file.