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Our "I need a" series is a helpful guide to finding the care you need when you don't know where to start. Today, we're learning how to find a heart surgeon.
If you're considering having heart surgery to address a health concern like coronary artery disease (CAD) or heart valve disease, choosing your surgeon is a big decision. So, before you start your search, let's answer some helpful questions.
What Does a Heart Surgeon Do?
Most surgeons focus on certain areas of the body or treating specific diseases. Heart surgeons—also known as cardiac surgeons—focus on treating heart disease. These can range from minimally invasive surgical procedures to major surgeries like a heart transplant. Conditions that may require heart surgery include:
- Coronary artery disease (CAD)
- Heart valve disease
- Heart failure
- Congenital heart disease
- Aortic disease
Terms to Know
Heart surgery is a complex field with many subspecialties and overlapping names. For example, heart surgery falls into a broader category called cardiothoracic surgery, which treats conditions affecting organs in the chest but focuses on the heart. Heart surgeons may also specialize further based on what types of procedures they perform or conditions they treat, and some surgeons highlight the type of surgery they perform.
While the sheer number of names and categories can be confusing, it’s helpful to know some of these common terms, to help refine your search. These include:
- Cardiac surgeon — a more technical term for “heart surgeon”
- Cardiothoracic surgeon (aka CT surgeon) — typically interchangeable with cardiac surgeon, but reflects the surgeon’s training in both heart care and lung and chest disease
- Transplant surgeon — a cardiac surgeon who performs heart transplantation
- Congenital heart surgeon — a heart surgeon that has specialized in treating heart defects that are present from birth, in either children or adults.
- Pediatric heart surgeon — typically an interchangeable term with “congenital heart surgeon”
- Robotic heart surgeon — a term that denotes the surgeon has experience using robotic surgical tools. When it comes to heart surgeries, these are most commonly used for valve-related procedures.
A Word About Interventional Cardiologists
Some heart conditions can be treated without surgery using interventional or transcather procedures, where the heart is accessed through a large blood vessel in the leg, arm, or chest. While the number of conditions that can be effectively treated continues to grow, surgery is still the best option in many cases. Surgeons and interventional cardiologists may also work together during hybrid surgery, which combines elements of both strategies.
Talk to your cardiologist to see if surgery or a transcatheter procedure is right for you. If both types of procedure can treat your condition, you may want to make appointments with both specialists to discuss your options.
What Credentials Should I Look For?
It can be hard to find a surgeon by looking at credentials alone, but it's a helpful place to start. Knowing that a surgeon has completed additional training or has been certified by a professional board is a good sign that they have the expertise you are looking for.
- Residency — All heart surgeons will have completed a residency program, meaning that after medical school, they trained for years under the supervision of seasoned physicians.
- Some heart surgeons complete a general surgery residency, then follow it with a cardiothoracic fellowship to become specialists in heart surgery. For many years, this was the traditional training pathway.
- More and more institutions are offering dedicated cardiothoracic residency programs, so future heart surgeons can begin their specialization earlier. This is becoming a more common training pathway.
- Fellowship — Fellowship is additional, focused training after residency. A fellowship-trained heart surgeon has completed a specialized training program under the supervision of an experienced surgeon.
- Board Certification — This voluntary process demonstrates that a surgeon has met rigorous standards set by their peers through a governing organization, or board. These boards are recognized by the American Board of Medical Specialties and the American Medical Association. Heart surgeons are board certified by the American Board of Thoracic Surgery (ABTS), with a subspecialty certification for congenital cardiac surgery.
- Professional Societies and Organizations — Membership in groups like the American Association for Thoracic Surgery and the Society of Thoracic Surgery indicates that a heart surgeon is active in their specialty's clinical and research communities.
The American College of Surgeons (ACS) offers a helpful Find a Surgeon tool that lets you search by the heart surgery subspecialty. The ACS is the world's largest organization of surgeons, and their comprehensive member database of board-certified surgeons is a great place to start looking.
🚩 Fellowships are a great way to know that a surgeon has taken the time to learn to perform a specific type of surgery by experienced experts.
A Word About Top Doctor Awards
When searching for a doctor of any kind, you'll probably come across advertisements for sites boasting Top Doctor lists, or you may find these awards mentioned in a surgeon's profile. While many of these awards are legitimate and are based on peer-nominated candidates and vetted feedback, not all lists are created equal. Some are essentially lists intended to promote only the doctors who have paid for the privilege.
🚩 If you use a Top Doctor list in your search, make sure that's only part of your criteria.
What Else is Important to Look For?
Because the heart plays such a vital minute-to-minute role, any heart surgery poses challenges that require significant preparation and support. For example, many heart procedures require the use of a cardiopulmonary bypass machine to take over for the heart and lungs and supply oxygen to the body while the heart is repaired; these machines are operated by specialists called perfusionists. It takes an entire team of specialists working with the heart surgeon to ensure a safe and effective outcome. To know that you’ll have the help of a comprehensive team, you might want to focus on specialized programs and multispecialty medical centers.
A comprehensive support team includes anesthesiologists, perfusionists, transplant cardiologists, imaging specialists, nurses, physical therapists, occupational therapists, and more. No matter what surgeon you choose, make sure to ask about what support you will have during and after your surgery.
Clinical Trials
The field of cardiac surgery is constantly evolving, with new approaches and devices being developed and tested to improve outcomes and quality of life. Clinical trials offer the latest experimental treatments driven by cutting-edge research, such as new implantable devices and robotic surgery. If you’re interested in participating in clinical trials, make sure to include academic medical centers in your search, as clinical research is an important part of what they do.
So I Found Some Surgeons I Feel Comfortable With… Now What?
It's time to start making appointments. Reach out to your top choices for what's called a surgical consultation, or consult. Skilled surgeons are in high demand, so keep in mind that sometimes it can take some time to get scheduled. When making the appointment, their care team will ask about what you're looking for, so be ready to explain what your needs are. But don't worry: you don't need to know exactly what surgery to ask for; the surgeon will be able to explain your options when you meet them.
🚩 While some conditions may require urgent attention, be wary of any surgeon who immediately pushes you to schedule a procedure. An ethical doctor will make sure that you have all the information you need to make an informed decision.
During My Consultation, What Should I Ask?
In a word: everything. This meeting is your chance to learn about your surgical options, but it's also your opportunity to learn about the surgeon: their approach, their demeanor, their experience, and their understanding of your condition. Bring notes if you're concerned about remembering complex medical terms. Here are some helpful questions to consider:
- About the Surgeon
- How many heart surgeries have you performed? How many do you perform each year?
- Based on the procedure you would recommend for me, how many times have you performed that specific surgery?
- Do you only perform heart surgery?
- Are you fellowship-trained? Do you have any board certifications or additional qualifications?
- Who is part of your care team? What specialists do you work with?
- What professional societies do you belong to?
- Are you involved in clinical trials that I might be able to participate in?
- About Your Procedure
- Am I a candidate for heart surgery?
- Is a transcatheter procedure a viable alternative?
- Are nonsurgical treatments like medications a good option for me?
- What will my procedure involve?
- What are my risks? What complications have you seen?
- Will I need to stay in the hospital? If so, for how long?
- What will I feel after my surgery?
- How long after the surgery will I start to feel better?
- How much scarring will there be?
- Is a minimally invasive or robotic approach an option for me?
- What support will I need during recovery and beyond?
- How much will this procedure help me?
🚩 No question is silly or useless if it helps you feel more confident about the procedure. Be wary of any surgeon that won’t take the time to answer your questions.
Do They Take My Insurance?
Money might not seem important when your health is at stake, but surgery can be expensive. Avoiding another stressful element can help you focus on your health. Nothing is more frustrating than finding a surgeon who's a great fit, only to learn that your insurance won't cover the procedure.
Most heart surgeries are covered by insurance, but not all insurance companies have the same eligibility requirements. And some insurance requires that you work with an in-network surgeon and hospital. So verify that the surgeon you're considering accepts your insurance, even if their website states they do. And contact your insurance company to confirm your eligibility. Some insurance plans also require a referral, so talk to your primary doctor about what you'll need.
Should I Get a Second Opinion?
Absolutely. Even if you think a surgeon is perfect for you, a second opinion can make you feel more confident about your decision. It can also help you become better educated about the procedure and your options. Second opinions can often be done with telehealth appointments, so they may not be as challenging to schedule.
🚩 Be wary of any surgeon that discourages you from getting a second opinion. An ethical surgeon will encourage you to get all the information you can and to consider every option.
Word of Mouth
Do you know anyone who has had the surgery performed by the surgeon you're considering? It can be helpful to get feedback from someone who has been through the procedure and recovery process. Keep in mind that everyone's health circumstances are unique, so their experience won't be the same as yours. But speaking with others can help you feel better informed about the real-world results and can give you some insight into how the surgeon and their team treat their patients.
🚩 Word of mouth can also be a great way to find a surgeon you might not have considered, especially if someone you know had a positive experience working with them. But make sure to then research the surgeon for yourself.
What Other Factors Should I Consider?
The decision to have surgery is about you and your health, so you should consider what's important to you. If you've reduced your options to a few surgeons who have convinced you they will provide the best care possible, practical considerations may help you make the final decision. These include:
- Do you want a doctor that can perform a surgery at a hospital closer to home? Or is it worth it to travel for your procedure?
- Do you want to work with a surgeon that has a relationship with your cardiologist, to make it easier to coordinate your care?
- Is finding an in-network surgeon a priority because of your health insurance?
- How urgent is your health issue? If you had to wait to schedule your surgery for an opening on a surgeon's calendar, is it worth the wait?
- Am I able to pay for a procedure out of pocket if my insurance doesn't cover it?
Once you have settled on a surgeon who can perform the procedure you need, where you want it, and when you want it, it's time to focus on getting ready for your procedure. That means following all instructions your surgical team gives you.
Heart surgery can be a life-saving operation, and it can dramatically improve your quality of life. Choosing the right surgeon can help feel like your best self.
Finding a Heart Surgeon at Columbia
If you would like to learn more about your surgical options, get a second opinion, or find out if working with the Heart Surgery team at Columbia is right for you, we’d love to hear from you. Call (212) 305-2633 or use our appointment request form.