Currently in medical care in the United States, there are four main primary care specialties: family medicine, internal medicine, pediatrics, and geriatrics. Internal medicine is primary care for adults, pediatrics is primary care for children and infants, and geriatrics is primary care for seniors. Family medicine, the broadest specialty, is primary care for all ages.
A family medicine physician is a medical ‘home base’ for patients. They treat all ages, all sexes, all organs, and all diseases. They can see every member of the family, from birth through old age. This allows family medicine doctors to develop long-term relationships with their patients and to understand how their patients’ role in the family affects their health. They can provide check-ups, immunizations, screening services, gynecological exams and obstetric care, routine health care, and health counseling. When more specialized care is needed, a family medicine doctor can refer their patients to appropriate specialists. They can become educators and advocates for their patients in the sometimes overwhelming health care system.
As health care changes in this country, family medicine is a growing specialty for families and individuals who are seeking more personalized health care and a more personal relationship with their physician.
What is Interventional Cardiology?
Interventional cardiology is the treatment of heart disease without surgery, through the use of catheters. Primarily this is via a procedure called cardiac catheterization, where a long, thin, flexible tube, called a catheter, is threaded through a vein or artery up towards the heart. The catheter can be used to inject dye for x-rays, open narrowed artery walls, widen heart valves, place stents, or perform other tests and procedures.
Cardiology is a large specialty, and covers many diseases and disorders of the heart as well as several different kinds of treatments. What makes interventional cardiologists special is their ability to use minimally invasive procedures to treat heart disease. Interventional cardiologists may treat coronary artery disease and peripheral artery disease, where blood vessels become narrowed or blocked. They also may repair or replace damaged heart valves.
During a cardiac catheterization, the interventional cardiologist inserts the catheter into a blood vessel through a small incision in the groin or arm. It is then threaded to the blocked artery or into the heart, where tiny tools can be passed through the tube. These tools are used to perform percutaneous coronary interventions, or procedures done to the heart and arteries via catheter. Procedures may include:
Angioplasty, or opening of blocked arteries, often via the inflation of a balloon
Atherectomy, the physical cutting away of plaque buildup
Stenting, the placement of metal springs to hold artery walls open
Heart valve repair or replacement
Closure of holes in the heart
That these procedures can be performed without the pain and recovery time of traditional surgery is truly amazing.
What is Cardiology?
Cardiology is the study of the heart and blood vessels, and a cardiologist makes sure they are functioning well. Patients see cardiologists for many issues affecting the circulatory system, including:
Hypertension, or high blood pressure
Heart attack prevention and treatment
Congestive Heart Failure, where the heart cannot pump enough blood to meet the needs of the body
Heart transplant evaluation and care after surgery
Peripheral vascular disease, where arteries in the limbs narrow and reduce blood flow
Aneurysm, or a swelling in the blood vessels
Coronary Artery Disease, where the blood vessels delivering oxygen and nutrients to the heart become blocked
After performing a physical exam, a cardiologist may order a number of imaging tests in order to get a better understanding of what disease or complication might be causing problems in the heart and blood vessels. Some of these might include:
An electrocardiogram, which checks the heart’s electrical activity
X-rays to see tissues more clearly
Cardiac catheterization, where a small tube is directed into the heart to test pressure, oxygen levels, and blood flow
Although some cardiologists provide primary care, cardiologists more typically work as consultants to primary care physicians when a heart issue comes up. Cardiologists do not perform surgery, but they can perform “interventional” procedures, such as balloon angioplasty (where a balloon is used to stretch open narrowed veins) or stent placement to keep blood flowing.
Geriatrics is the subspecialty of internal medicine that provides primary care to older adults. Physical health tends to decline with age, and geriatricians work to manage such age-related concerns as chronic illness, frailty, multiple medications, and declining mental health to keep seniors as active and independent as possible.
Some of the most common concerns seen by a geriatrician include:
Mobility issues, including the need for canes and walkers, as well as preventing falls
Osteoporosis, a weakening of the bones, which affects as many as a quarter of all men and half of all women over fifty
Loss of hearing or vision
Incontinence, or the inability to control one’s bladder
Memory loss, including dementia and Alzheimer’s disease
A geriatrician may also provide their patients with comprehensive care that includes checking on their social health. Seniors are at increased risk for poverty, loneliness, abuse, and injuries in the home. As part of their health care, a geriatrician may inquire about family support, living conditions, or the ability of a patient to perform daily self-care tasks.
In some cases, a geriatrician may serve as an advisor to other physicians on a specific case or condition. However, most of the time geriatrics is a primary care specialty, and geriatricians provide routine health care to the older patients they work with.
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