What Limits The Job Market For Cardiologists?

[Economist]

I've been hearing from everywhere that there are no jobs for Cardiologists. I'm struggling to understand why. I understand that in B.C. you can't have echo outside of hospitals and ECGs done in private clinic are not covered by MSP but can't you just open up a clinic and send the patients to nearest hospitals to get their echos and ECGs done? Do you have to be affiliated with the hospital to be able to order echos/ECG/cath? I'm just trying to understand what limits cardiologists from opening up their own clinic if they can't find jobs in the hospital. 

 

 

[ACHQ]

I've been hearing from everywhere that there are no jobs for Cardiologists. I'm struggling to understand why. I understand that in B.C. you can't have echo outside of hospitals and ECGs done in private clinic are not covered by MSP but can't you just open up a clinic and send the patients to nearest hospitals to get their echos and ECGs done? Do you have to be affiliated with the hospital to be able to order echos/ECG/cath? I'm just trying to understand what limits cardiologists from opening up their own clinic if they can't find jobs in the hospital. 

 

My understanding is people who are interested in Cardiology are not JUST interested in clinic work. Definitely a good chunk of their work. But I *believe* (and anyone interested or in Cardio please correct me) the interest is being able to mix up the practice by doing in-patient work (cardio ward and CCU), outpatient work (clinics), and hospital consultation (on patients not admitted under cardio). That along side reading echos (and doing caths and other work for the interventionalists) is probably what they want to do too. Cant do it without a hospital/resources.

 

This actually applies to the majority of IM subspecialities not just cardio

[futureGP]

I've been hearing from everywhere that there are no jobs for Cardiologists. I'm struggling to understand why. I understand that in B.C. you can't have echo outside of hospitals and ECGs done in private clinic are not covered by MSP but can't you just open up a clinic and send the patients to nearest hospitals to get their echos and ECGs done? Do you have to be affiliated with the hospital to be able to order echos/ECG/cath? I'm just trying to understand what limits cardiologists from opening up their own clinic if they can't find jobs in the hospital. 

Nothing limits them. Anyone could order a test to be done in the hospital even if you are not affiliated with the hospital. 

 

So theoretically, nothing stops a cardiologist from opening up a clinic and sending all the patients to the hospitals to get their echos/ecgs done. But why would you go through cardiology training to have someone else read the echos and ecgs for your patients. A general internist could do the same job.

 

Same thing applies to all other specialties. Nothing stops GI from opening up a clinic and see GI consults and when someone needs a scope, send them to the hospital for a scope. Nothing stops Nephro from opening up a clinic and when someone requires dialysis, send them to the hospital to start dialysis by a nephrologist who's got privileges.

 

But why would you do that. The whole point of doing GI fellowship is so you can learn how to scope. The whole point of nephrology fellowship is to provide dialysis. A competent general internist with extra interest in any of those fields can manage the patients.

 

It's all about desirability of jobs.

[ralk]

Besides the desirability of jobs, why would any primary care provider refer their patients to a Cardiologist without access to these hospital-based tests and interventions? Sure there's some additional expertise, but when patients get referred, what they generally need is access to those extra resources, not just a Cardiologist's opinion on their case.

[rmorelan]

Besides the desirability of jobs, why would any primary care provider refer their patients to a Cardiologist without access to these hospital-based tests and interventions? Sure there's some additional expertise, but when patients get referred, what they generally need is access to those extra resources, not just a Cardiologist's opinion on their case.

 

this is the problem - cardiologists cannot just open there door and get patients. They have to be referred to them. If they work shifts at the hospital covering the fall etc they get the consult cases from emerg which often do become their clients moving forward. If they are a part of a cardiology group that family doctors contact for services then they can get a share of the referrals that way. If they have a long history with a particular family doctor (or team) then they can get business that way. 

 

However if you just show up and start your practice why would anyone send anyone to you? If there is no wait time and current service is reasonable whey would they refer to you? If there is a long wait time then the current team probably is looking to hire someone - and you probably want to be that person they hire. You probably don't want to be out in the cold as it were unless you can somehow attract business in a way currently no one else can.  

[Economist]

So a private cardiologist can not order EKG/Echos/Cath then receive the results from the hospital and interpret it themselves unless you have an affiliation with them?

[rmorelan]

So a private cardiologist can not order EKG/Echos/Cath then receive the results from the hospital and interpret it themselves unless you have an affiliation with them?

 

yeah those would be read by a staff cardiologist at the hospital. You would just receive the report which of course you could act on. Cath in particular would be interpreted by the cardiologist actually doing the cath itself.