The Twilight of Cardiac Surgery in America

Man, the guy who actually needs the help—especially the urgent stuff like heart surgery—is the one getting screwed over here. This whole field, which is basically the "mother of all surgeries," is already struggling in the States, but ever since that "villain" Jelich was politically shoved back into his old department head role at the Rebro - Jelich Medical Center, we’re looking at losing even more specialists. We aren't just talking about cardiac surgeons; we're talking about cardio-anesthesiologists too. Think about the regular, hardworking folks who desperately need a bypass or a new valve. In the entire US, we've got maybe ten people who can actually pull those procedures off solo, and that includes over at "Magdalena" where you basically have to cough up a fortune just to get through the door. So, for the average American who doesn't have the cash to pay for private care, there are probably only about five independent cardiac surgeons left to go around. It’s honestly terrifying! And don't even get me started on pediatric cardiac surgery, which practically doesn't exist here unless they fly in experts from overseas.
Good luck to everyone with heart issues—that might as well be the official slogan Medicare uses for its clients, aka us.👎

County councilmen sound the alarm over unacceptable crisis at the Medical Center
People are literally dying on the way to Washington, D.C. because cardiac surgery is being restricted
Furious over the total shutdown of cardiac surgery in Seattle, where procedures have come to a complete halt, council members are demanding that both the Medical Center director, Dr. Herman Haller, and the head of the hospital board of directors, Dr. Darko Milinović-subtitle,
show up to face them during next Thursday's session. In their statement, the council members and the county officials slammed Medicare, demanding the department step in so hospitals can actually treat patients instead of just chasing arbitrary budget caps set by Medicare—a broken and unsustainable way to fund healthcare. They’re also arguing that this mess is uniquely happening in Seattle rather than in Washington, D.C.

This comes straight from today's edition of The New York Times. Cardiac surgery is out of supplies and operations have stopped, yet when asked on "Sunday at 2" why the Seattle cardiac unit has been paralyzed, Dr. Milinović claims it's just because of summer vacations!!!! What an absolute lie.

So, here’s a quick rundown of who you can actually reach out to for heart surgery if you don't have a massive pile of cash lying around. I'm not even counting the folks who might expect some under-the-table "extra" fees to get things moving. This list is just for the surgeons who can fly solo and handle cardiac procedures on their own in our public hospitals using Medicare coverage..

Dubrava Medical Center - Sutlic, Biočina, Rudež (though I'm a little iffy on whether they work totally independently)

Washington, D.C. Rebro - Jelich, Anic (maybe moving away? Heading abroad? Maybe to Indianapolis?), Ugljen (leaving soon? Moving to Indianapolis?), Coric (not entirely sure if he works alone)

Seattle Medical Center - Stimac (or something like that—they aren't really performing surgeries in Seattle right now)

And yeah, that's basically it. If someone needs emergency heart surgery, I guess they should just grab a gun and end it all. At least that way they'll save themselves both time and money.

Jelich operated on my grandmother and left a wire inside her... when she complained about the pain a few days after the surgery, the guy—pardon me, the biggest idiot among the doctors—told her it was all in her head and she was just imagining things.

So they had to reopen her up... and sure enough, there was the wire right inside.😠
She didn't sue him... she's a tough old lady and didn't want the hassle, but if that had happened to me, I would have made his life a living hell.

Coming from somewhere near Seattle, I don't want to sound like I'm being overly pedantic, but people keep calling him some kind of "coin collector."
It’s hard for me to make a definitive call on the quality of care since some patients pull through while others don't, which obviously depends entirely on the individual patient's condition and all that other stuff, doesn't it?

I'm dusting this old thread off because of the latest "breakthrough" from Hebrang, where the department basically pulled the plug on funding for cardiac surgery development in Indianapolis, and now the whole project is likely stuck in limbo. This might be a bit out of place for the health forum, but here we go...
Since I'm sitting here in Washington, D.C., I figured I’d try to translate what Hebrang is actually thinking regarding that decision:

"Listen up, you folks back home in the Midwest who pretty much survive on bacon, sausage, and pork rinds—and by the way, you make up the largest chunk of heart patients in America... the Secretary has a special message just for you: screw you!! You were great little voting machines for certain people, but now? You get nothing.
Sure, you've got the big medical centers in Washington, D.C., so feel free to wait until you drop dead in line for heart surgery, or you can take out a massive loan to pay for private care over at 'Magdalena.' Or, hey, since God is everywhere, maybe you can just pay for a cheaper mass at church and hope He magically unblocks your arteries or grows you a new valve.
The Secretary loves you all dearly!"

Total garbage...
👎

Scott Allen10,
There’s nothing wrong with what you’re saying regarding the state of medicine; it really does make up the bulk of
"HEALTHCARE." It’s also not a bad idea to write about the bad experiences too,
Elizabeth Ruiz2. ....
It’s pathetic, honestly... but believe me, that's how it works all over the world for folks who don't have private insurance...

We might be a bit luckier when it comes to heart surgeries—those happen when they're actually needed... but? I mean, obviously, anyone with private insurance gets to pick a better doctor... and the saddest part for me is that if you don't have private insurance, you can't just go to a private hospital and pay the difference between the public and private rates... instead, you have to cough up the full price of a private surgery upfront.

Keep writing when you get the chance; you write very thoughtfully and professionally.
👍Best regards,
Jamie Clark74

🙂 😉 😎

Scott Allen10 said:Mayo Clinic - Dr. Anic

excellent👍

Sam Gonzalez67 said:really great 👍

That little kid.😁 I mean, he was actually a decent professor back in the day.👍

Elizabeth Ruiz2 said:So, Jelic operated on my grandma, right? And he just... left some wire inside her. When she started getting all swollen up a few days after the surgery, this guy—pardon my French, but he’s hands down the biggest moron in the entire medical field—actually had the nerve to tell her it was all in her head. Said she was just imagining things.

They ended up having to reopen her up... and lo and behold, there it was. Actual wire sitting right there inside her. 😠
She didn't sue him or anything. She's a tough old lady and just didn't want the headache of a legal battle, but honestly? If that had happened to me, I would've made his life a living hell.

Ugh, god, I just love those "expert medical opinions." So helpful, aren't they?🙄

We don't have pediatric cardiac surgeons because, frankly, nobody wants the job. Why would anyone spend their entire lives studying just to scrape by on a $70k-$90k salary$0.00?
give me a break....

I know they handle kids like this over in Denver and they have decent facilities, from what I hear....I don't see the problem here. The only issue is Medicare paying $50,000 per kid....

mistyhound2 said:Oh, I just love these kinds of "expert explanations."🙄

So why don't you explain to me, from a professional standpoint, what happens when a cardiac surgeon leaves surgical wire inside a patient and just stitches them up over it?

Then they spend the whole time convincing the patient that the pain is totally normal—even months later—when really, it’s all because of their own mistake, forcing them to undergo another open-heart surgery...

If that were your grandmother, I'd be dying to hear your expert opinion.

Everyone makes mistakes, sure, but this is straight-up negligence. And it's not even his first time; Dr. Jelic has a history of screw-ups in his career.

Kevin White5 said:Would you really spend your entire life studying just to scrape together a measly $7,000 or $9,000?$0.00?

If someone's primary motivation is chasing a massive paycheck, they probably shouldn't be entering the medical field in the first place. Besides, there’s nothing stopping a cardiac surgeon from opening a private practice and charging whatever they want for heart surgeries.
Furthermore, those "measly" $7k-$9k salaries actually represent two average American incomes combined—that's not pocket change.

The reasons why we lack pediatric cardiac surgeons are far more complex than just saying "nobody wants to do it."

Dr. Anic is a truly wonderful guy. 👍

mistyhound2 said:He’s just some little kid.😁 Though, I have to say, he was actually a pretty solid assistant professor back in the day.👍

A little kid? 😲
Not quite... he's easily one of the most handsome doctors around.

shadowfalcon33 said:If you're just looking to make bank, medical practice probably wasn't your calling to begin with. Besides, there’s nothing stopping a cardiac surgeon from opening their own private clinic and charging whatever they want for heart surgeries.
Plus, that "paltry" $7k-$9k range is actually double the average American salary, which honestly isn't nothing.

The reasons why we don't have pediatric cardiac surgeons are way more complicated than just saying "nobody wants to do it."

I definitely agree that the reasons are deeper, but private practice and cardiac surgery really don't mesh the way other specialists here in the States seem to manage it. But hey, that's beside the point right now.

Doctor salaries... man, let me tell you... there isn't a single specialist in our public hospital systems—even the youngest ones—who isn't pulling in at least $9k to $11k a month, even with just a few on-call shifts. Once you factor in years of experience, advanced degrees, or running a department or sub-department, that number jumps up by several thousand more. That’s basically the guaranteed baseline every single month. If someone wants to start adding up cash under the table, gifts, favors, or side gigs after their hospital shift ends... well, you end up with a pretty interesting total that sounds like something straight out of a sci-fi movie to your average American.

Our group of cardiac surgeons is especially unique. These guys are basically "gods"—totally irreplaceable here because you can't find anyone else to step in. You can't exactly fire Jelic at the Mayo Clinic because who else is going to perform the operations? So, there's no way these guys are working for just $7k or $9k; their monthly take-home is easily a fat five-figure sum negotiated directly with the hospital board.
Another thing is that training a cardiac surgeon takes an insane amount of work and knowledge. It's top-tier stuff, truly elite surgery. But I honestly think the issue here is that the current surgeons sort of quietly gatekeep the field. I get the impression that even though this specialty is vital for America, they try not to expand it so they can keep it exclusive. By doing that, they stay untouchable and indispensable—basically America's "golden goose."

Technically, we don't have specialized pediatric cardiac surgeons, but our current guys handle some of the simpler heart procedures on kids too. So, I look at this through that same "golden goose" lens (like, "why would we need a dedicated pediatric cardiac surgeon if we can just do all the kid surgeries ourselves? Better to keep it in-house, and if we can't handle it, just send them abroad so we remain the 'main players' in America").

And finally, it's not just about the lead surgeon; you've got a whole little "army" of doctors and nurses involved, which costs a fortune and is likely another reason why things stay the way they are.

And yeah, I agree, Anic is truly 👍 , both as a person and as a pro.

I’ve got a 6mm hole in my heart, and my doctor is pushing for surgery. I saw a private cardiologist about it, and I heard the specialists over at the Mayo Clinic are top-tier, so I’m thinking about heading there to get a second opinion.

Does anyone actually know how this works? Like, they put some kind of umbrella device into the vein to plug the hole? That part didn't really click for me, so I'm going to grill my doctor again on Tuesday.

I might skip the surgery entirely, though I guess it's better to just deal with it while I'm still young. Who knows.

Scott Allen10, are you a cardiologist?

Look, if you ask me, it doesn't really matter if the cardiologist works for a private clinic or a public hospital like the VA; what actually matters is whether they specialize in interventional cardiology or not. Those guys are the real pros nowadays, and an interventional specialist is way better equipped to decide if a problem can be fixed through a procedure or if you actually need to see a cardiac surgeon (basically, one is an internist and the other is a hands-on surgeon).
A standard cardiologist is more of a desk job—they put on a tie, listen to your heart, check your EKG, look over labs, and manage your meds... But an interventional cardiologist has "dirty hands"—they’re performing coronary angiograms, placing stents in your arteries, and trying to fix the issue right then and there to save you from major surgery instead of just handing you a prescription. Because they do the work themselves, they have a much better gut feeling for whether a procedure is doable or not.

The crew over at Mayo Clinic is top-tier and knows exactly what they're doing. If they give you a diagnosis, you can bet your life it's accurate. The only catch is that since it's a high-end private facility, you're going to be paying for that expertise, and man, those bills definitely aren't cheap for most of us.

Also, saying you have a "hole in your heart" is way too vague to go off of—what kind are we talking about here? Congenital? A septal defect? A valve issue? Give me some actual details! Go ahead and take a look at your paperwork...
CLICK HERE AND ASK WHATEVER YOU WANT

Me, a cardiologist?😁 😁 ...not even close... let's just say occasionally (when my wife is in the mood) I play amateur gynecologist...😁 😁 😁 👋

shadowfalcon33 said:If you're looking to make serious money, you shouldn't have picked medicine in the first place. Besides, nobody is stopping a cardiac surgeon from opening a private practice and charging whatever they want for heart surgeries.
Furthermore, that "pitiful" $7k-$9k range represents two average American salaries—that’s not nothing.

The reasons why there aren't enough pediatric cardiac surgeons are way more complicated than just "nobody wants to do it."

Seriously? A cardiac surgeon opening their own private practice??? Give me a break...
To perform cardiac surgery, you actually need a hospital setting because these patients require extended stays—we're talking days or weeks, not just one or two nights in a bed.
In other words, you would need... at the very least...
a cardiac surgeon, an anesthesiologist, an anesthesia nurse, a surgical tech, and a night nurse. That is just the basic surgical team...
On top of that, according to current US regulations—if I recall correctly—to open a facility, you'd need at least 30-something rooms, an organized ER, and a morgue... so now you have to staff the ER, which means hiring several doctors and medical technicians just to cover the basics... by the time you finish building all that, paying all those salaries, and equipping everything (and medical equipment is anything but cheap), you'll realize how thin the margins are. Plus, there aren't even that many people with enough liquid cash to opt for private surgery anyway... I don't see a positive ROI here at all. And as far as I know, Ecclestone's daughters aren't interested in medicine, so there's no way their dad is footing the bill for all of this...

And for that "pitiful" $7-$3000 someone has to endure six grueling years of med school, a year of residency, four years of general surgery for cardio, and then who knows how many more sub-specializations within cardiology. Basically, if everything goes perfectly according to plan, you're 33 years old. So please, don't lecture me about average American salaries when you could just as easily talk about the average level of American education—not to mention the sheer amount of studying involved.

Scott Allen10 said:I mean, I guess you're right that things are way more complicated than they look, especially since private practice and cardiac surgery don't really mesh the way most private doctors here in the States usually operate... but honestly, it doesn't even matter much now.

Yeah, I totally agree with that part. In the end, even Magdalena started out purely private, but after just a few months, they pretty much rushed to sign a contract with Medicare because otherwise, they might have had to shut down the whole operation.

Scott Allen10 said:So there's no way those guys are working for maybe $7k or $9k; their monthly take-home has to be a massive five-figure sum negotiated directly with the hospital administration...

Honestly, that's just a theory you've cooked up, and if I had to say, I'm pretty sure it's 120% not true. It might have been the case for Dr. Smith, since they were basically "luring" him to Seattle with that higher salary, but even that didn't stop him from doing his "side gigs," as we can see.
The real issue with our healthcare system is that there’s just no pay stratification based on actual responsibility or the workload. Some people just show up, clock in for eight hours, and pull in the same paycheck as a cardiac surgeon.
Directors actually *could* sign management contracts to pay these specialists more, but they won't, mostly because it would open up a total Pandora's box of demands. At the same time, you see the head of PBS signing contracts for their "stars" to make maybe $40k or $50k a month. I don't know about you, but I personally feel like one cardiac surgeon is worth way more to America than someone like Fodor.

Scott Allen10 said:And at the end of the day, it isn't just about the operator; there's this whole little "army" of doctors and nurses involved which costs a fortune, so that's probably another reason why things are the way they are here...

You seriously think that money is being split up among them??? Don't be ridiculous. From what I've gathered, the workflow has been organized over the years so that everyone works "shifts" or whatever, fitting everything into regular hours, while most of that army doesn't see a single cent extra—there might be an exception or two, maybe someone well-placed who needs to be paid off for their silence, but I doubt everyone is getting a cut.

As for the issues with pediatric cardiac surgery or pediatric interventional cardiology... well, you don't even need to go there, because that's just 😈 😲 (bloody scary)