Certification and Competency in Interventional Cardiology

Abstract

Physician competence is perhaps the most essential part of the many complex components involved in providing optimal heath care. The patient’s trust that their physicians have the appropriate training, fund of knowledge, clinical decision-making, and technical skills to deliver their healthcare services in a caring manner, with the ultimate goal of providing the safest and most efficacious clinical results, is fundamental to the patient–doctor relationship. Healthcare systems and payers also expect optimal care delivered in an efficient and cost-sensitive manner. The only groups with the knowledge and background required to define and evaluate physician competence on a sustained basis are the physicians themselves. The United States has historically been a leader in training clinicians and setting quality standards for healthcare delivery. This has been especially evident in the field of interventional cardiology, a relatively young subspecialty with a history of robust evolution and expansion since the early days of Andreas Gruentzig’s pioneering first coronary balloon angioplasty in 1977. During the past 35 years, the field has rapidly and relentlessly expanded. We are a field that started with a rather simple balloon-based revascularization concept only applicable to a limited number of carefully chosen patients. We have now evolved into an expansive subspecialty treating a wide range of both stable and acutely ill patients presenting with a broad spectrum of not only increasingly complex coronary artery disease, but also other cardiovascular conditions. Notably, during the past decade, further expansion into the areas of peripheral vascular and structural heart disease has occurred.1 This has been accompanied by the proliferation of a voluminous amount of scientific information facilitating our interventional community’s maturation. We have assumed a leadership position in the practice of evidence-based clinical medicine. However, the ever-emerging advances in our field have inevitably led us to another critical challenge in the optimal …