Is Perfusion a “Dead Language” ?

Editor’s Note:

I got this letter from a soon-to-be-enrolled perfusion student.

He has legitimate concerns and asks for feedback from perfusionists currently in the field.

Help him out ?

Hello Frank,

First and foremost I wanted to let you know that I have been a huge fan of your site since I discovered it about 6 months ago. I find your site the most satisfying at night when I read through new stories and informative bits while laying in bed, an “adult bedtime story”, if you will. Before I get into the sole purpose of my letter, I would like to give you a brief introduction of myself.

I went to school at Arizona State University (B.S. Biology) and  worked as a Bartender at P.F. Chang’s. In school, my goal was to become a healthcare professional of some sort, but couldn’t quite put my finger on which avenue I would pursue. One night a couple came into the restaurant and starting talking to me over some drinks about my aspirations in healthcare.

After a great conversation, I had learned that the couple were healthcare professionals themselves. One an Anesthesiologist for a cardiac team and the other a Nurse Practitioner specializing in cardiology. They insisted that I come shadow them to see if anything would catch my eye. That is when I met the chief perfusionist and the rest was history.

Immediately  I was drawn to the profession and starting following the perfusionist on a regular basis. I then applied to Midwestern University’s perfusion program and was accepted. I start class at the end of August (2012).

Since my acceptance, I have been exploring all opportunities that the perfusion occupation has to offer. I have found it both exciting and intriguing.

However, lately I have stumbled upon some discouraging information from doctors, students and journal articles. I wanted to express my concern to people like you and others on circuit surfers, so that hopefully I can get some good insight and feedback from people who live the dream I hope to one day soon, share. The dream that I will be a part of a specialized realm in which the primary objective is to hold one’s life literally at my fingertips and that my sole responsibility will be to care for this patient as if it were me lying on the operating table.

I have heard that the amount of CABG and other invasive procedures have declined in the last 5 years as much as 40% in some cities. Furthermore,  the use of extracorpreal technology is diminishing proportionately. It seems that practice is shifting toward percutaneous coronary intervention and other non-invasive procedures.

I don’t want to go to P.A. school, I want to be a “Circuit Surfer”!

My obvious concern here is that there will not be enough work for new graduates, leaving us with tremendous debts to repay. Other healthcare professionals have warned me to not get into the field for this very reason and have tried to steer me in another direction, such as P.A. school.

I don’t want to go to P.A. school, I want to be a “Circuit Surfer”! I was wondering if I could please have an honest opinion from people who are much wiser than I am in the field. I would like strong advice from everyone before I invest my every bit of existence into what seems to be a wonderful and rewarding career. Thank you to all for your time and consideration!!!

-Ryan Dysart

P.S. please feel free to share this on circuit surfers, I am not sure how to post but I would be glad to contribute many more posts to your site in the future. I have also attached some cool pictures for your site, one of them is a mini circuit I was able to observe during one of my shadowing experiences 🙂

25 thoughts on “Is Perfusion a “Dead Language” ?

  1. Nice letter Ryan,

    First of all- congrats on getting into a program.

    You brought up some good points in your letter- a lot of things every generation of perfusion grads worries about. I heard it when I graduated in 1990.

    I don’t know the future or what to tell you, but the profession is rich in terms of developing essential skills, and has a pretty wide scope of practice.

    It seems our attrition rate matches our influx (more or less) and the market has it’s high’s and lows.

    Ya gotta go with your gut- and it sounds like you have a lot of passion.

    Good luck bro 🙂 !!!

    1. I can echo what many have already said. I had one of my instructors tell me he didn’t think there would be a perfusion career in 10 years. That was in 1993. My job has changed quite a bit in the last 19 years, but everytime some new therapy, stent, or Cath lab procedure, or off-pump, robot case comes along, they have never been the “Golden Bullet” they were expected to be.
      My advice to all present and future perfusionists is to never say no to learning, supporting, keeping or taking over any kind of therapy, support or procedure. Even if it means re-inserting yourself back into the world of ECMO, cell saving and autotransfusion.
      The group of perfusionists I am associated with never says no to any opportunity, and do our best to be as “irreplaceable” as is possible. We try to maintain a good relationship with the surgeons, anesthesia staff, and also the pre, Peri, and post operative nursing staff. Think about what kind of “Value added services”, you can add to increase your value to the hospital.

      1. As a recent graduate of MWU, I can happily say that all of my colleagues that were looking for jobs got jobs. The vast majority of us before we graduated. At our hospital our caseload is higher than ever. Yes, you may have to move to some random city, but if you are halfway competent you will be able to find a job. It is a wonderful field and I echo Mr. Grist, the future of perfusion is bright.

        1. Hi Allen,

          I have been accepted to MWU’s(glendale) perfusion program and will be starting in the fall. I have a question for you. How did you and your colleagues land jobs before graduation and also while on rotations? And how well did the school prepare you for the “real world” of perfusion?

  2. Ryan- There may be some issues with a reduction in CPB due to percutaneous procedures.

    But, the use of the heart/lung machine in patient resuscitation and destination support will become a priority in the next five years. The question is, will perfusion play a significant role in this process or will we leave it to the RNs and RTs.

    The choice is ours!

    Good luck and don’t be discouraged. I think the future is bright for perfusionists.

    Gary Grist RN CCP
    Kansas City, Mo.

  3. Excellent letter,

    I think our profession is just like cardiac surgery, redefining itself and its role in medicine. Cardiac surgery and perfusion are in a downward pattern, yet time is on our side since the most rapid growing segment in world population is age 85 and older.

    All of the interventional therapies treat lesions at specific anatomic sites, not the disease itself.

    Adult surgery will sustain – so will we.

    My thoughts.
    Steve

  4. Hey Ryan,
    I am actually in the process of applying to Midwestern University for the Perfusion program and I have heard the same things you mentioned in your letter. It worries me and this is how I’ve run into your letter. I have been a Resp Therapist for the past 5 years and hope to get into the program on my first try. I am very excited and can’t wait to start this new chapter of my life.
    I wish you the best and to hope we all get the jobs we want in the future.

    1. BG if you would like, you could email me to talk about school. It is rldysart@gmail.com. I saw a bunch of new applicants these past few months, if I dont speak with you, good luck on your application process! Thank you to everyone else who has posted their comments about my post. I have found my experience to be both amazing and exciting. I have to admit though, school is much harder than i thought.

  5. You are VERY bright to post such a question! Most would-be perfusionists have stars in their eyes when they finally realize what they want to do, and don’t want to hear anything untoward. You’ve done your homework, but nobody on here seems to want to confirm it for you. You obviously already know the answer, and want confirmation.

    I would never attend perfusion school in today’s environment, nor recommend it for my kids. And I’m not alone. I’m the silent majority. But this is a small community, I may have to apply for a job to some of those same companies. So people stay quiet.

    Many of us are still paid very well, and tight with our admin and physicians. I believe this will be very hard place to reach for your class, given the new paradigm of SC and others. Except for the few that estabish themselves well in peds, the prospects are mediocre. Unless say 750 people retire in the next three years. In a nutshell: the number of cases has halved, and the number of perfusionists have doubled in 20 years. The existing cases are the sickest of the sick. Will we be allowed to operate on them in the coming years if they are “lost causes” determined by ACA? Who knows.

    If you do go to school, volunteer and watch every peds case, and do a paper or presentation on peds. Most peds places want people with experience, so that’s a slim chance for a new grad too, but the one pidgeonhole you’ll never have to worry. Peds is probably the only truly secure job areas, with a good lifestyle in perfusion for a new grad.

    This is a commentary not on perfusion as an avocation, but on the prospects of a career. I’ve had such a rewarding life doing this, and very happy with my choice. But that choice was made in a different era. The dawn of the hollow fiber era, before PCI, when the cardiac surgeon was God, not the Cardiologist’s lapdog. When there were countless manufacturers, R&D on devices, and yes, steak dinners and pole dancing.

    The advancements made in those years, the stuff that makes modern adult perfusion so easy and safe. Those days are gone. It’s doesn’t matter how much you love love love love perfusion, if you can’t get a job, you are done.

    There is way to much disinformation put out there by the very people having pecuniary interests in a fresh crop of frantic-for-cases students every year, or those whose jobs depend on training perfusionists. Their job or business depends on cheap labor, or students. You’re fuel for the engine that is their business. I’m generally anti-union, but if anyone needs a Airline pilot type union, it’s the guys at SC and related businesses. They put in so much overtime it’s ridiculous.

    A hospital based guy like me, a company will comes in… “We can save you 10-25% $$$ off your perfusion costs”. How asks the hospital administrator? Oh market efficiencies. Nope, they move in and take it right out of your pocket. You need to re-apply for your job, Guess what, you need one less person, and you now also make 40% less, I’m keeping half of that pay cut. Got a problem with that? Fresh new grads ready to replace you any time.

    CT surgeon residency slots are going unfilled for some time now, some have even been closed. PCI and stents have devistated my surgeons. Surgeons have to do twice as many cases for 2/3 of the money. Residents are smart and avoiding CT surgery. And there’s a lot of old surgeons out there. As they start to retire, who will replace them? Nobody, because the existing docs will be thrilled to get the cases. Less surgeons require even less perfusionists.

    Your a smart guy. Why would you roll the dice when there are better options out there? I’m sure I’ll get flamed, but ask yourself, what is the motivation of the people who are flaming, do they need a constant supply of new grads?

  6. Hi,
    Your letter prompted me as well. I too am a respiratory therapist and am ready to move on. Perfusionist caught my eye and this would go along well with my RT knowledge. Did you have to wait awhile to before getting accepted into school? I dislike the thought of returning to school, spending the money only to find no job upon graduation

  7. It is not easy to find a job as a new grad!! You have to apply to everything out there and be willing to move anywhere in order to establish yourself in your profession. Be prepared to wait 6 months or more to find a job. The field is changing but there will always be a need for cardiac surgery and perfusionists. We are the safety net for the cath lab. We tend to be doing open heart surgery on sicker and older patients with a higher risk or emergent cath lab patients. Just my 2 cents.

  8. Ryan,
    You’re not the first to ask this question and I’m certain you won’t be the last! It’s a good and important question that can’t be taken lightly and needs to be explored. It is something that I always try to discuss with people who are considering a perfusionist career.
    I started by training a while back, 1975, and on the first day of school the director, Charlie Reed, told us there probably wouldn’t be any jobs in a few years. In the mid 80’s angioplasty entered the picture and CABG was going away. In the 90’s stents came and this time for sure CABG would never be done again. Then, when we were still doing CABG’s, OPCAB came into the scene and at least bypass wouldn’t be needed anymore… Now we see the TAVR and again we all wonder what the future will hold. The field has certainly changed over the years but it has been a great ride and I really don’t see the end of the road coming up any time soon.
    On the other side of the coin we see a great increase in the use of VADs, ECLS, and other treatment modes requiring extracorporeal circulation. The field will change, of that there is no doubt, but there will always be a need for our skills, our knowledge base, and technical expertise. What we can’t do is just rest, we have to contribute to the field, to the team, looking for ways to improve what we do and how to help other disciplines with what we know.
    Will we just be sitting in the OR in the future — most likely not. Be open to new opportunities, don’t be afraid to get your hands dirty, never say, ‘we can’t do that’ or ‘it’s not my job’. Also always remember that one needs to make a decision somewhere in the career whether they want to be a ‘pump tech’ and just pump the case and go home or truly be a perfusionist (I’m sure that comment will upset some…).
    Feel free to contact me if you would like to discuss this in more depth.

    Craig

    1. I have stumbled upon this forum nearly 4 years late, i am currently looking into perfusion and am wondering has your viewpoint of the profession changed, should i stay clear of perfusion?

  9. Truth: After graduation.. competition is fierce for jobs. With more and more coronary occlusions being stented their is less need for centers hiring many perfusionists. When I graduated 3yrs ago their was about 100 students graduating nationwide each yr and about 40some jobs available and only half of them would consider a new grad.

    1. Stent data is starting to sink in- they aren’t the golden goose so to speak. Conventional bypass grafting is still a solid way to go- don’t ignore the sheer numbers of aging Americans just now entering that particular pipeline-

  10. I had work as a cvt and trust me theres is been a lot times when the angioplastys or vascular catheter wouldn’t be the best way to go .and sometimes is just a temporary fix.

  11. Do you think it is possible to be accepted into the Midwestern program with a GPA of 3.0. I was a pre-med Biology major.

  12. Hi, I’m seriously considering this profession. However I have few concerns, the first be employment after school. Really worried since it is relatively expensive, and I do not want to default on my student loans. Second, being the income and the relative outlook on heart surgery in the future. I’m worried of being stranded and caught in the middle somewhat like what pharmacy school is going thru right now…If I could have some more insight, it would be great appreciated. I have shadowed a perfusionist and really enjoyed what I saw, but even he was contracted by a company too work thru several different hospitals, it seems like the profession has passed the golden age, where before they were much better treated, but I’m not sure, and would like more insight if available.

    1. Hi Everyone, there still seems to be a great deal of interest regarding this topic and thread. I have missed a lot of opportunities to offer my experience ever since becoming a CCP in 2014. The reason is because I wasnt checking my old email address. I may write a follow up post soon, until then, if you have any questions, email me: Ryan.Dysart@gmail.com

      As a quick update: I love the profession: I have found a very great team to work with. I would consider some of them to be as close as family. The work is challenging, the work is rewarding, it is great pay, i feel very fulfilled.

      To do it over again, i would of applied to a state univeristy so i could of payed in-state tuition. Midwestern is a great program if you put your heart&soul into it but the tuition is at least 40k more than state universities (not including traveling for clinicals, rent etc.)

      New grads start around 90-120k. Average is around after a few years 130-160, depending on location. You can make in the upper 100s, lower 200k if you are a cheif, partner, or work a ton.

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