Who is interpreting nuclear cardiology studies in the United States, and what are the requirements for privileges? A national survey of institutional policies from 80 major medical centers

Abstract

Background

This survey was conducted to determine the guidelines used by major medical centers in the United States for obtaining hospital privileges to interpret nuclear cardiology studies. The American College of Cardiology (ACC) and the American Society of Nuclear Cardiology (ASNC) have established guidelines to help maintain an adequate level of proficiency in the practice of nuclear cardiology. These guidelines were published only recently, and many hospitals have adopted different processes to obtain these privileges. It is likely that a marked difference among institutions exists.

Methods and Results

The survey was conducted predominantly by mailings with additional telephone communications if more information was needed. Chiefs of cardiovascular medicine sections were contacted to provide information concerning the policy of granting nuclear cardiology privileges at his or her institution. The responses were tabulated in four categories and the responders were asked to comment on whether they agreed or disagreed with their own university's policy. Of 80 responses (68%) from 121 institutions, cardiologists were involved in reading these studies in 62 (78%) and radiologists were the sole interpreters in 18 (22%). ACC or ASNC guidelines were strictly followed at 48 sites (60%). Eight (10%) and 6 (8%) of these institutions mandated a minimum requirement of, respectively, 12 and 6 months of additional training in nuclear cardiology. Ten (13%) of the cardiologists surveyed disagreed with their own institution's policies, primarily noting that the ACC and ASNC guidelines were more appropriate.

Conclusion

The recently established ACC/ASNC guidelines clearly have had an impact on the practice of attaining privileges in nuclear cardiology and are the most commonly quoted criteria used by institutions in the United States to assess competence in nuclear cardiology.