How technology is bringing cardiology, cardiac surgery together

New technological developments in the cardiology field have increased collaboration to improve patient care, according to one cardiac surgeon. 

Frank Fazzalari, MD, who is the chief of cardiothoracic surgery at Troy (Mich.) Beaumont Hospital, recently connected with Becker's on the state of the cardiac surgical and cardiology fields. 

Note: Responses were lightly edited for clarity and length.

Question: What are the biggest challenges facing the cardiology and/or cardiac surgery field?

Dr. Frank Fazzalari: A lot of cardiac surgeons now are hospital-affiliated, with the majority of them probably as part of a hospital-employed medical group. That has happened over the past 15 years or so, which has led to there being very little purely private practice cardiac surgical groups left in the country. I think that's a little different in cardiology, but my guess is over time that they may experience the same sort of pressures as we have. I think that's one of the pressures that have caused cardiac surgeons now to be mostly somewhat financially affiliated with health systems.  

The other pressure, I think that's more toward cardiology specifically, is the advent of freestanding cath labs. That's a new thing that's come up where groups or entities or cardiologists are able to have their own cath labs outside the hospital. So that gives them even more market power over hospital systems, which is a change in the market dynamics. That is a negative pressure on hospitals because they are potentially losing some of that revenue. The same things are happening in surgical subspecialties like general surgery and gastroenterology; a lot of those have been shifted out of the main hospital and into privately owned surgery centers. This is just kind of another example of that in the cardiology space. Obviously, that's a negative for the hospitals that lose out on that revenue and those patients. 

Q: What is one positive trend you have seen in the industry?

FF: Advancements in technology, such as transcatheter aortic valve replacement, have further incentivized cardiologists and cardiac surgeons to work more closely together, which is a positive for patient care. Before TAVR, in the past the two specialties were relatively siloed, and now we're working much closer together. I think that's another benefit for patients because you know our goal is to take care of the patients. There's a lot more collegiality and working a lot better collaboratively with structural heart cardiologists, and I think it all came about through TAVR.  

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