No abstract

I do not wholly agree with the authors' explanations regarding the organization of healthcare service structures. Adult cardiologists as well as pediatric cardiologists can acquire an additional qualification for treating adults with congenital heart defects if they are suitably qualified and have gone through the required advanced training. For pediatric cardiologists this scenario means that no seamless transfer of adult patients with congenital heart defects to cardiologists treating adults is required but that the qualified pediatric cardiologist treating the patient so far can continue to look after the patient. From my own experience as an accordingly qualified, hence authorized, doctor, however, I have to say that this option is not all that easily put into practice. Adult patients with congenital heart defects presenting in my outpatient clinic for a cardiological examination still require a referral from a specialist in pediatric and adolescent medicine in private practice. Referrals from general practitioners and specialists in internal medicine are not accepted by the National Association of Statutory Health Insurance Physicians. Specialists in pediatric and adolescent medicine, however, are restricted to looking after children and adolescents, respectively-so how is this possible? My own conclusion: the possibility that pediatric cardiologists can develop into cardiologists treating adults with congenital heart defects does not seem all that popular.