{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/cardiologists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Cardiologists",
    "soc_code": "29-1212",
    "category": "Healthcare",
    "us_employment": 17290,
    "median_annual_wage": 496010
  },
  "verdict": "SAFE",
  "risk_resistance": 85,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 14,
    "embodiment": 16,
    "liability_shield": 20,
    "trust_premium": 17,
    "judgment_accountability": 18
  },
  "reasoning": {
    "task_resistance": "At 14 rather than 18, the diagnostic reading layer — rhythm strips, EF quantification, calcium scores, carotid Dopplers — is genuinely being taken over by algorithms and is a measurable share of a non-invasive cardiologist's billable day, but femoral and radial access, wire manipulation through a tortuous RCA, device interrogation with a patient who has both AF and CKD stage 4, and the actual conversation about whether a 84-year-old gets TAVR are not tasks a model can complete.",
    "embodiment": "16 reflects that the interventional and EP work happens in a cath lab with fluoroscopy, sterile drapes, and a patient whose blood pressure can drop in seconds — sheath insertion, lead placement in the coronary sinus, pericardiocentesis — while acknowledging a meaningful fraction of cardiology is clinic-based echo review and med titration that happens at a desk, which is what keeps this off 19.",
    "liability_shield": "20 is the ceiling and correctly so: every stent, every anticoagulation decision, every stress test read carries a state medical licence plus ABIM cardiovascular disease board certification, hospital credentialing and privileging specific to each procedure, and personal named exposure in malpractice suits where missed dissection or delayed cath are among the highest-payout claim categories in medicine.",
    "trust_premium": "17 because heart failure and post-MI patients are in a decades-long relationship with one named cardiologist who knows their baseline creatinine, their tolerance for beta blockade, and their family's wishes — but the score isn't 20 because a large volume of cardiology is consult-driven and episodic, read for another physician or performed on a patient you meet once in the ED.",
    "judgment_accountability": "18 fits calls that guidelines explicitly leave open: whether ambiguous chest pain with a troponin of 0.06 goes to cath, whether to escalate to LVAD or shift to palliative, whether to stop the DOAC before surgery in a patient with a mechanical valve — decisions made with incomplete data, under time pressure, where either choice can kill the patient and the cardiologist owns the outcome."
  },
  "rationale": "AI already matches or beats cardiologists on narrow read tasks — ECG rhythm classification, echo ejection-fraction measurement, coronary calcium scoring on CT — and those reads are a real slice of the workday, especially for non-invasive practices. But the core of the job is physically inseparable from the patient: auscultation and volume-status exams, catheterizations and stent placement, pacemaker and ICD implants, stress test supervision, and titrating heart failure regimens in patients with kidney disease and five other prescribers. Every diagnosis, prescription, and procedure requires a licensed physician's signature and carries personal malpractice exposure, and patients with a life-threatening chronic condition pay specifically for a named human who will take the call at 2am.",
  "outlook": "By 2035 AI will handle most first-pass imaging and ECG reads and compress demand for purely non-invasive diagnostic cardiology, while procedural, advanced heart failure, and continuity-of-care roles stay short-staffed as the population ages.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "task_resistance",
        "change": "As FDA-cleared autonomous ECG/echo/CT-calcium interpretation absorbs the routine read tier (e.g. Cleerly, Us2.ai, Anumana already reimbursed under CMS NTAP/CPT codes), the residual workday concentrates on structural intervention, EP ablation, advanced heart failure and transplant listing, and multi-comorbidity titration — the tier no model closes. Task-mix shift, no new law needed.",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "embodiment",
        "change": "Continued shift of volume toward structural/interventional work — TAVR, mitral TEER, LAA occlusion, CTO PCI, leadless pacing — as non-invasive reads are automated. Robotic PCI (CorPath GRX) has not displaced the operator and its vendor exited the market, which is itself evidence the manual ceiling is high.",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "trust_premium",
        "change": "If ACC/AHA appropriate-use criteria or hospital credentialing require a named attending cardiologist of record be disclosed to the patient for any AI-assisted diagnostic pathway — analogous to radiology's push against unattributed autonomous reads — the human name becomes a purchased feature rather than an implicit one.",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "If CMS or the Joint Commission require documented physician override rationale for AI-generated risk scores and treatment recommendations (as several state AI-in-utilization-review laws already require for payer-side denials, e.g. California SB 1120), the cardiologist formally owns the ambiguity call on the record.",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "Liability shield is already 20 and cannot rise; state medical practice acts plus malpractice exposure are the binding constraint and there is no headroom above them. Overall score is near the register ceiling — the realistic gains are a few points of task-mix concentration, not a structural change in exposure."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2021,
        "emp": 18610,
        "wage": 239200
      },
      {
        "y": 2022,
        "emp": 16870,
        "wage": 239200
      },
      {
        "y": 2023,
        "emp": 15190,
        "wage": 239200
      },
      {
        "y": 2024,
        "emp": 18020,
        "wage": 239200
      },
      {
        "y": 2025,
        "emp": 17290,
        "wage": 496010
      }
    ],
    "from": 2021,
    "to": 2025,
    "change_pct": -7.1,
    "comparable_from": 2021,
    "spans_soc_revision": false
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}