Clinical Cardiologists : Do they exist Anymore?

Abstract

The specialty of Cardiology perhaps owes its origin most to the invention of the ECG machine. The ECG machine became the symbol of the Cardiology oriented physician. The art o clinical diagnosis and management of cardiovascular problems refined to a point that physicians with special training and experience in Cardiology felt obliged to branch off the mainstream of Medicine. Thus was born the Cardiologist.The Clinical Cardiologist and the Invasive Cardiologist. Technology knew no bounds and soon a whole array of non-invasive techniques, eminently typified by Echocardiography, came into existence. The knowledge exp1osio and necessary expertise required tee new breed of Cardiologists to be either Non-invasive Cardiologist or Invasive Carctiologists.Was the Clinical Cardiologist doomed to extinction when technology entered the world of Cardiology? Has his function been taken over by the General Physician who knows the clinical problem and would rather send the patient straight for an invasive or non-invasive work-up? Is there any need for this intermediate category of physicians between the general physician and the super-sub-specialjs? Is it that the functions of a clinical cardiologist have been split up between the genera1physjcjn and the &iper-subSpecia1ists?

Looking at the scene in Pakistan, there is no question in my mind that there is still a lot of need for the so-called Clinical Cardiologist, be he involved in 100% cardiology care or be he an Internist-Cardiologist. At the stage Medicine and Cardiology are in Pakistan, this middle group has still a role to play both because the cost-effectiveness of high technology is still beyond our reach and also because there just aren ‘t enough high technology centers and trained super-sub-specialist However, we must keep our eye on the direction that Cardiology has taken all over the world. It is only a matter of time before the inevitable happens here too.