The Centers for Disease Control and Prevention reports that about 610,000 people die of heart disease in the United States every year, accounting for a whopping 25 percent of all American deaths. As such, the CDC notes that “heart disease is the leading cause of death for both men and women.”
Contributing to these deaths is a wide array of heart-related diseases and conditions, from coronary artery disease and high blood pressure to congestive heart failure, arrhythmias and heart defects. The specialist doctor who can treat and help manage these conditions is a cardiologist, and if you have any heart-related conditions or diseases, it’s important to find a cardiologist you can work well with over the long term.
[See: The Facts on Heart Disease.]
There are several subspecialties within cardiology, and if you know the nature of your medical issue, that can help narrow your search for this specialist doctor, says Dr. James Blankenship, an interventional cardiologist and director of cardiology and cardiac catheterization laboratories at Geisinger in Danville, Pennsylvania. “If you know what [the problem] is, you want someone with expertise in that problem. If not, a general cardiologist is best.” He says if the problem you’re having has stumped other doctors, you might also consider going to a tertiary referral center — a hospital that specializes in cardiac care — where you can meet with several different specialists if need be.
Practically speaking, finding a doctor who accepts your health insurance is a smart place to start your search. Blankenship says you should also consider whether the doctor is convenient and accessible. “If you have to wait months for an appointment, you may have trouble getting subsequent timely appointments.”
Dr. Steven Nissen, chair of cardiac medicine at Cleveland Clinic, says that board certification is also an important component of finding a good cardiologist. “Believe it or not, there are actually significant numbers of people out there who are not board-certified,” but you can easily check this status by visiting the American Board of Internal Medicine’s website. Board certification signifies that the doctor has gone through a rigorous, three-year training and examination procedure after completing medical school. Doctors must continue their education to maintain board certification status.
Blankenship adds that cardiology society membership can also provide a clue about the quality of a particular doctor. “While membership is no guarantee, not being a FACC [a Fellow of the American College of Cardiology] should raise questions,” he says.
Beyond just the doctor, Nissen says you should consider the institution where the doctor works. “There’s still a mixed model of care delivery in this country,” he says, with some doctors in private practice, others in group practice and some employed by a large health care system. “There are people who work in a fee-for-service environment, where the more they do, the more they get paid,” he says. At the Cleveland Clinic, Nissen says the nearly 150 cardiologists in his department all earn a fixed salary, meaning there’s no financial incentive for them to perform additional procedures. “I personally think that taking financial incentive out of a care system is a better way. All other things being equal, having a physician who works as a salaried employee of a health care system rather than on a fee-for-service basis is something that helps a lot,” he says.
He says looking at hospital rankings, such as those offered by U.S. News, can also provide helpful information about the facility where a particular doctor practices. “If you have the ability to go to a physician at a highly-ranked hospital, you have the advantage of knowing that person is working in a system that has good outcomes and has a very good reputation with peers.”
[See: The 13 Best Diets for Your Heart.]
In preparing for your first visit with a new cardiologist, Nissen recommends making sure all of your medical records have been received by the new doctor. You should also come prepared with a list of all medications and the dose and frequency with which you take them. “There’s nothing more complicated than when a patient comes and you ask what medications they’re on and they say, ‘Well, I’m on a blood pressure pill and a cholesterol pill.’ Well, what dose and which drug?” He says some of the most organized patients make it easy by giving him a one-page summary of their health history and medications. This summary should include details about any procedures you’ve had, such as stent placement (a tube-shaped device placed in a coronary artery to help prop it open) or other surgeries. Include when the procedure happened, who performed it and which artery or part of the cardiovascular system was involved in the surgery.
In addition, Nissen says “we don’t want to repeat tests that you’ve already had,” so bring the results of any completed tests. “It saves cost and a lot of duplication of effort.” He says it’s important to remember that “the physician is no better than the information they’re provided with.”
Blankenship recommends bringing a list of questions and a notebook to take notes while meeting with the doctor. Bringing a loved one or close friend to help with this and serve as an advocate for you can also be helpful. After the visit, he suggests considering how you felt about the doctor and the visit. “Did the doctor spend time with you, speak in understandable language, answer your questions, listen to you and act courteously? Were you comfortable?” With regard to treatment options, did the doctor offer you more than one option and did he talk about the risks and benefits of any options you discussed? Did you feel included in the decision-making process?
Nissen says that while it can be helpful to talk to others about their experiences with a particular doctor, keep in mind that a good bedside manner doesn’t automatically translate to the doctor being current in his or her knowledge. Blankenship also notes that bedside manner isn’t the be-all-end-all of assessing a doctor. “When I was a young resident, an older and wiser physician told me that he would be less happy with a doctor who held his hand and compassionately told him he was dying and happier with a doctor with no bedside manner who had the skill to keep him from dying.”
[See: 17 Ways Heart Health Varies in Women and Men.]
So what makes a good cardiologist? Nissen says a top heart doctor will strike “the right balance between aggressiveness and knowing when you shouldn’t be aggressive. There was a period of time a number of years ago, for example, when too many stents were being put in and not as much attention was being paid to the more preventive aspects of care. I think you really want a doctor who’s very balanced,” he says. That’s not always so easy to ascertain, but it’s something to think about when considering how you want your doctor to treat your heart issue. “We tend to be very enthralled with technology in America, and technology can be wonderful, but it can also be overutilized. You want a doctor who reserves the technology for people who will benefit and doesn’t use it willy-nilly. Sometimes less is more.”
Blankenship says a good cardiologist will possess “the same qualities that make any physician great: empathy, courtesy, willingness to listen, wisdom, experience and professionalism.” And he underscores that “the ability to instill and convey hope to the patient — not unrealistic hope, but realistic hope” is also a hallmark of a good cardiologist.
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How to Find a Top Cardiologist originally appeared on usnews.com
