CardioExchange Archive

I call myself a “preventive cardiologist,” but what makes me different from other cardiologists? Many academic centers categorize cardiovascular prevention as a distinct field within cardiology that merits its own label, sub-department, and leadership. Outside the university, however, the distinction may seem, well, academic. But not to me.

Although I’ve been in practice for only 1 year, I have on many occasions found myself defending against statements such as “Every cardiologist practices prevention” and “We all do a lipid panel on our patients.” Some even say, “I order a CRP on every single patient” (not all patients need that test, in my opinion). And, of course, a lot of cardiologists use the word “preventive” to make themselves more marketable.

So how do I justify my title? Well, cardiovascular prevention doesn’t just mean interpreting a lipid panel, ordering C-reactive protein tests, or prescribing statins. It’s much more than individual patient care — as a field, it is closely linked to population science.

During my formal education, I spent 2 years earning a master’s degree in cardiovascular epidemiology. After my required years as a clinical cardiology fellow, I spent 2 more doing research in cardiovascular prevention and working with patients in the prevention clinic. I continue to be active in cardiovascular-prevention research and closely follow the related medical literature.

My patients receive ongoing lifestyle education, including smoking-cessation counseling and exercise-physiology information. I also incorporate evidence-based findings from the field of cardiovascular imaging into my risk-stratification efforts. In short, I bring the science of cardiovascular prevention as a specific medical and epidemiologic discipline into my daily care of patients.

But that’s my point of view as a prevention specialist. Do you think that all cardiologists practice prevention by default? Should any cardiologist be allowed to proclaim himself or herself a prevention specialist? Or should we regulate who gets to use that title?