Puneet Gandotra, MD: Challenges Faced by Interventional Cardiologists

FEBRUARY 03, 2018
Matt Hoffman
Puneet Gandotra, MD, the director of the Cardiac Catheterization Lab at Southside Hospital spoke with MD Magazine about the fears and challenges that interventional cardiologists have and face every day just doing their jobs. Gandotra explained how they worry about their health from long-term exposure to things like lead and radiation, and how days and shifts have increased in length, adding to the chances of developing burnout while reimbursements for these clinicians have decreased.

Puneet Gandotra, MD, the director of the Cardiac Catheterization Lab at Southside Hospital:
So I think to look at what the challenges are that are faced by interventional cardiologists in general, I think we worry about our own health. 

Even though it is a great field, we're working and wearing lead on a daily basis. I can be in lead on and off for a whole day—up to 6 to 7 to 8 hours. We're talking about 15 to 20 pounds, maybe more, of weight that we're carrying on our shoulders and necks and backs. So physical debilitation is a big concern.

Radiation is a big concern. We work in radiation all day. Interventional cardiologists are at a high risk for having cataracts because of the radiation to the eyes. Interventional cardiologists are at a high risk for having tumors in the left side of their head because we work with the radiation that directly effects the left side of our heads. So those are the biggest concerns that we have—at least a few of the concerns that we have.

I think, in general, we always look at and think about and consider, with the amount of work that we put in and the effort that we put in, reimbursement continues to go lower. It's the same amount of reimbursement if I wake up at 2 o'clock in the morning and drive at 90 miles per hour to come and treat somebody's heart attack, versus me being able to see 3 to 4 patients in the office—it's the same reimbursement.

That, to me, is a big deal. Every time I get into that car half sleeping and driving at that speed, I'm putting myself and my family's life, our future, in jeopardy. And yet, the reimbursement continues to go lower. Every time you notice or see that there are changes in Medicare reimbursement, interventional cardiology continues to get lower and lower. We put in a lot of time, a lot of effort, and that's one of the concerns that we have from a physical standpoint. Those are some of the things that we talk about.

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