I just found out that the cardiologist I am using to place my coronary artery stent allows fellows to perform the procedures on certain cases. Do I have the right to demand that the doctor handles the procedure? I wouldn't have a concern if this was something simple, but it this is too critical to me. Thanks in advance.
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Cardiologist allowing fellow to do procedure?
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Last: 1 day ago by traxter
Yes, you can request that the attending cardiologist do the procedure from start to finish. Though if you are going to a teaching hospital, it's usually understood that residents and fellows will be involved in your care.
Just so you are aware, the attending is standing next to the fellow throughout the procedure. If this is an interventional cardiology fellow, he's likely already done hundred of diagnostic catheterizations through his cardiology fellowship of 3 years, and is now focusing on the interventional catheterizations.
Do you know if this is a complex stent they're placing? Or what makes you think the fellow can't handle it?
Just so you are aware, the attending is standing next to the fellow throughout the procedure. If this is an interventional cardiology fellow, he's likely already done hundred of diagnostic catheterizations through his cardiology fellowship of 3 years, and is now focusing on the interventional catheterizations.
Do you know if this is a complex stent they're placing? Or what makes you think the fellow can't handle it?
This is how fellows and others doing residency learn how to do them. My wife who is a retired OB saws the motto for her in med school was to see one, do one ,then teach one.
My experience is that you will have to be verbal and insistent. For my procedure, a friend who is a doctor and a friend whose son is a doctor, both recommended not using a fellow.
The first time, there was not a specific waiver form. I did not speak with the doctor ahead of time. I told the nurse that I didn't want a fellow assisting and she tried to talk me out of it. When I went into the procedure room, I told the surgical team that I didn't want a fellow and they didn't call the fellow.
The second time, there was a specific waiver form and I selected not to be treated by a fellow. The nurse didn't have any comment. When I went into the procedure room, I again told the surgical team no fellows. A few minutes later a fellow showed up and introduced himself as assisting/doing the procedure with my doctor. I told him I didn't want him and had signed the no consent waiver. He wanted to argue with me and I had to firmly tell him no a few times, until he left.
The first time, there was not a specific waiver form. I did not speak with the doctor ahead of time. I told the nurse that I didn't want a fellow assisting and she tried to talk me out of it. When I went into the procedure room, I told the surgical team that I didn't want a fellow and they didn't call the fellow.
The second time, there was a specific waiver form and I selected not to be treated by a fellow. The nurse didn't have any comment. When I went into the procedure room, I again told the surgical team no fellows. A few minutes later a fellow showed up and introduced himself as assisting/doing the procedure with my doctor. I told him I didn't want him and had signed the no consent waiver. He wanted to argue with me and I had to firmly tell him no a few times, until he left.
As others have said, you can request for a fellow to not be present for the procedure.
I get it, but just to be clear, the idea of "see one, do one, teach one" is just a saying. If it is an interventional fellow, then that means they have already gone through 3 years of Cardiology training and are already board certified for cardiac cath. They then are spending another 1-2 yrs of time dedicated solely to stenting procedures. This allows for them to get a lot of experience quickly. By the end of my interventional fellowship I had done well over 700 interventions. Meanwhile in practice, most are probably closer to 100 (and many much less) per year.
I would also point out that it's different everywhere and pretty individual too and you have no real way of knowing what your situation will be. There are plenty of fellows that are awful. But when I was a fellow there were several attendings that were awful in the lab and essentially dependent on the fellow to do the case. If someone would have taken their fellow away, it wouldn't have been good.
Just trying to stick up for the interventional training process. But it's your body and your decision. So go with whatever makes you most comfortable. I'm sure everything will go well. Best of luck.
I get it, but just to be clear, the idea of "see one, do one, teach one" is just a saying. If it is an interventional fellow, then that means they have already gone through 3 years of Cardiology training and are already board certified for cardiac cath. They then are spending another 1-2 yrs of time dedicated solely to stenting procedures. This allows for them to get a lot of experience quickly. By the end of my interventional fellowship I had done well over 700 interventions. Meanwhile in practice, most are probably closer to 100 (and many much less) per year.
I would also point out that it's different everywhere and pretty individual too and you have no real way of knowing what your situation will be. There are plenty of fellows that are awful. But when I was a fellow there were several attendings that were awful in the lab and essentially dependent on the fellow to do the case. If someone would have taken their fellow away, it wouldn't have been good.
Just trying to stick up for the interventional training process. But it's your body and your decision. So go with whatever makes you most comfortable. I'm sure everything will go well. Best of luck.
I have had 2 heart catheterization. First one done about 6 years ago with an older cardiologist and he went in from the groin area.
The second one was a couple of months ago by a much younger cardiologist and he used the wrist area and he inserted a stint for my descending aorta. Went very easy
The second one was a couple of months ago by a much younger cardiologist and he used the wrist area and he inserted a stint for my descending aorta. Went very easy
I really appreciate all the responses. I actually messaged the doctor's assistant via the patient portal and it sounds like they will be willing to honor my request. Don't get me wrong, I don't mind helping in the training of new folks and would be fine with it if this was a broken arm or something "simple". My luck isn't very good and with something like this, I just want to try and stack the odds in my favor. I am extremely comfortable with the physician I found.
Anyone know if they use simulators to train fellows/residents in doing heart procedures like stent placement? I know sims are used in other medical fields/procedures.
As far as interventional cardiology in general, they don't use simulators. There are some out there, but they really aren't that good or helpful.
The neurosurgeon I had doing my back had a resident. I 'almost' felt bad for the guy b/c my doctor never let him anywhere near a spinal
nerve. The resident was only there for prep, observation, and cleanup. He wasn't even allowed to close up the incision or put any sutures in.
nerve. The resident was only there for prep, observation, and cleanup. He wasn't even allowed to close up the incision or put any sutures in.
Probably was a general surgery resident, or another resident other than neurosurgery, rotating on the neurosurgical service. Or maybe 1st year neurosurgical resident. Surgeons, and most procedural specialties, take a lot of ownership in their procedures and don't want complications.
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