Choosing a cardiologist

BY KATHLEEN KERR | kathleen.kerr@newsday.com

May 20, 2008

While academic credentials, experience and availability in an emergency should top the list of cardiologist qualifications, heart patients should also consider convenience and whether the doctor's office is easily accessible.

Dr. Martin Handler -- a Great Neck cardiologist who is a senior attending physician at Roslyn's St. Francis Hospital -- says cardiac patients should keep easy office access in mind.

Some cardiac patients are weak, Handler explains, and others have breathing problems. For them, walking a long way to a doctor's office might not be smart, and even a small number of steps could pose problems.

"Do you have to climb stairs?" Handler asks. "That's not a great thing."

Handler also says patients should determine whether it's easy to get an appointment with a cardiologist when a problem arises and whether there's a substitute cardiologist on call 24 hours a day.

"If you have chest pain, you don't want to have to wait three weeks for an appointment," Handler says. He also says patients should check medical credentials, and make sure doctors listen to them.

"It's availability, affability and ability," Handler says.

Dr. Sandeep Jauhar, director of the heart-failure program at Long Island Jewish Medical Center in New Hyde Park, says a doctor who doesn't listen carefully to a patient's symptoms might have problems making an accurate diagnosis.

"On your first visit, you want to make sure that he's listening to you, is allowing you to complete your sentences," Jauhar says.

And patients should feel free, he continues, to ask cardiologists to explain any tests they might order and what makes them necessary. Questions about the frequency of tests are appropriate too, Jauhar says.

"In cardiology, because the treatment regimens are often quite complicated and because patient input is often critical, you want a doctor who's going to solicit your input and your partnership in treating your disease," Jauhar says.

At Stony Brook University Medical Center Dr. David Brown, chief of cardiology, advises patients to seek cardiologists affiliated with teaching centers or universities.

"They frequently have more access to newer technology and more expensive technology that's not available in smaller community hospitals," Brown says. He noted some medical centers use advanced equipment like surgical robots that do less invasive surgery -- offering patients alternatives to traditional surgery and, in some cases, a speedier recovery.

Initially, Jauhar says, some patients see general cardiologists, who later refer them to specialists in certain aspects of heart care. For example, patients with coronary artery disease might be referred to an interventional cardiologist who can implant stents, while those with certain heart-rhythm problems might see a cardiac electrophysiologist.

Brown agrees with Jauhar that sub-specialists are often called for, to handle more complicated cases, but that some people don't need specialized cardiac care: "I think a general cardiologist is fine for people who have mild symptoms."